Question when adjusting medications on maintenance

slbbw

I'm not quite to maintenance, but I find this board to be super helpful and since i am only 6 pounds away here I am. I have been on wellbutrin for the past 6 months. I have successfully managed my depression with diet and exercise in the past. For a variety of reasons I plan to work with my doctor to discontinue the wellbutrin. I have recently lost 34 lbs and I am super close to my goal weight. In that time I have also learned some great habits and I have a decent routine going to help me continue successfully.

So the question. Does anyone have tips on how I should adjust my intake/ exercise to adjust for my change in meds. My Dr is not particularly good with weight stuff, so I do not think he will be a good resource. My current strategy is mindfulness with hunger cues. Maintain current exercise habits and drop calories by 100 per day just to buffer in case there is a change in metabolism. Does this seem reasonable. I am about 6lbs away from the top of my declared maintenance range (135-145) and I really want to be careful not to gain.

My calculated NEAT based on 4 months of tracking is about 1800. I have been keeping at 1600-1700 + exercise and losing about 1 pound a week. I am planning a diet break in July at my 6 month mark, or whenever I hit my goal weight. 5'5" and 151 currently in that is helpful.

mbaker566

You really shouldn't have to change anything. just maintain your deficit.

endermako

slbbw wrote: »

I'm not quite to maintenance, but I find this board to be super helpful and since i am only 6 pounds away here I am. I have been on wellbutrin for the past 6 months. I have successfully managed my depression with diet and exercise in the past. For a variety of reasons I plan to work with my doctor to discontinue the wellbutrin. I have recently lost 34 lbs and I am super close to my goal weight. In that time I have also learned some great habits and I have a decent routine going to help me continue successfully.

So the question. Does anyone have tips on how I should adjust my intake/ exercise to adjust for my change in meds. My Dr is not particularly good with weight stuff, so I do not think he will be a good resource. My current strategy is mindfulness with hunger cues. Maintain current exercise habits and drop calories by 100 per day just to buffer in case there is a change in metabolism. Does this seem reasonable. I am about 6lbs away from the top of my declared maintenance range (135-145) and I really want to be careful not to gain.

My calculated NEAT based on 4 months of tracking is about 1800. I have been keeping at 1600-1700 + exercise and losing about 1 pound a week. I am planning a diet break in July at my 6 month mark, or whenever I hit my goal weight. 5'5" and 151 currently in that is helpful.

Wellbutrin for a lot of people (including myself) can suppress your appetite. You may feel hungrier when weaning yourself off of it. Just maintain your calorie deficit and you should be fine.

lorrpb

Congrats on your many successes! Keep your current eating and exercise routine. Do not change anything for 4 weeks, then reassess at that time. If you change too many things at the same time, you won't know what's causing what. I suggest that you log diligently during this time of change, just to keeps tabs and make sure you don't accidentally go over.

slbbw

Thanks for the advice. I am probably trying to change too much at once. I'll hold with my calories for a bit and see where I am in a month.

Keto_Vampire

Wellbutrin/bupropion is not weight based (at least for adults); good news is bupropion does not have significant withdrawal symptoms (lacks any significant binding affinities for serotonin receptor subtypes unlike SSRIs). Not to say that you should discontinue cold turkey. Coordinate a plan with your MD on tapering you down if you must; be aware you might lose some of the appetite suppressing effects & there can be some potential rebound weight gain (few pounds usually, not a monstrous amount).

Adults are typically dosed around 300mg/day (XL most common dose form). Tapering strategies could have you move down to 150mg XL or using SR dose forms (twice daily dosing vs. once daily for XL products) with 200mg, 150mg, and 100mg. *SR can be dosed once daily if needed/insomnia from using second dose late in the day (i.e. 200mg SR once in morning)

If needed, MD can even get you down to using regular release 75mg (lowest strength). NOTE: NOT recommended to cut any of these products per manufacturer package inserts (gray area with the regular release practice versus manufacturer package info, generally psychiatrists are ok with cutting regular release wellbutrin). Seizure risk from cutting/dose dumping/crushing this drug more so for the SR and XL version (no liquid version available)

slbbw

Keto_Vampire wrote: »

Wellbutrin/bupropion is not weight based (at least for adults); good news is bupropion does not have significant withdrawal symptoms (lacks any significant binding affinities for serotonin receptor subtypes unlike SSRIs). Not to say that you should discontinue cold turkey. Coordinate a plan with your MD on tapering you down if you must; be aware you might lose some of the appetite suppressing effects & there can be some potential rebound weight gain (few pounds usually, not a monstrous amount).

Adults are typically dosed around 300mg/day (XL most common dose form). Tapering strategies could have you move down to 150mg XL or using SR dose forms (twice daily dosing vs. once daily for XL products) with 200mg, 150mg, and 100mg. *SR can be dosed once daily if needed/insomnia from using second dose late in the day (i.e. 200mg SR once in morning)

If needed, MD can even get you down to using regular release 75mg (lowest strength). NOTE: NOT recommended to cut any of these products per manufacturer package inserts (gray area with the regular release practice versus manufacturer package info, generally psychiatrists are ok with cutting regular release wellbutrin). Seizure risk from cutting/dose dumping/crushing this drug more so for the SR and XL version (no liquid version available)

Thanks for the info. My MD did actually suggest cutting which is clearly counter indicated above. I was only on 150mg to start. I will have to discuss this with him and see where to go. The rebound weight gain is annoying to hear. I have noticed a slight increase in appetite, but have been able to stay under my calorie goals so far. next week will really be the test I am sure.