Deprescribing
A long-time patient came in with a prescription to taper off Wellbutrin XL after more than ten years on the medication. Her doctor had prescribed a reduction of 50mg a week from 300mg until stopping completely, but recommended splitting the 300mg XL tablets. Because the manufacturer advises against splitting these tablets, I contacted the doctor suggesting an alternative tapering schedule based on a reliable source.
The doctor acknowledged my message but advised sticking with the original plan. The patient, uneasy about breaking the tablets, asked for my help. I then implemented a taper schedule recommended in a peer-reviewed journal and by a trusted clinical tool. I counseled her on the possible symptoms of discontinuation syndrome and advised when to seek medical attention. I informed her doctor of the adjusted plan.
We monitored her progress weekly during the taper. She experienced some expected discontinuation symptoms but managed them well with the guidance I provided. Ultimately, she completed the taper successfully. She expressed her gratitude for the support and clarity throughout the process.
Because of a pharmacist, something important happened.
