Gyn patient started on welbutrin 150 mg sr but developed new onset anxiety. can this med be stopped abruptly or must it be tapered? best alternative?

Yes: In this situation I would stop it abruptly. you can start the patient on lexapro (escitalopram) to bridge over. usually if they are doing well on SSRI you should tapper off the medication. But yes in his case I would stop it abruptly and if patient relapses into depression I would start Lexapro (escitalopram)

Despite extended…: release formulation, best to taper off Wellbutrin (bupropion) SR to avoid withdrawal symptoms, especially if pt has abruptly stopped using alcohol, seizure med(s), or sedative. Doing so might trigger seizures. Suggest change to non-SR and taper dose.

New Onset Anxiety: Hi, I would suggest that you might have a psychiatric consultation for the patient to further assess the patient's psychiatric status and determine if there's both depression and anxiety involved. The consultation could also indicate if the patient is perhaps on the right medication and dosage may need to be altered, and/or add another medication and/or discontinue Wellbutrin (bupropion).

Stop immediately: Unlike SSRIs, bupropion and its long acting versions can be stopped abruptly without negative consequences. What's more, given that it works on different neurotransmitter systems than SSSRIs it can induce anxiety or, in the case of individuals with PTSD, anger.

Taper: It is best to taper this medication. Talk to your prescribing physician to get a good discontinuation schedule.

Yes: Wellbutrin (bupropion) would be more likely to contribute to anxiety compared to other anti-depressants (i.e. ssris, snris, mirtazapine). Wellbutrin (bupropion) SR 150 could likely be stopped without taper (I generally start and stop from wellbutrin (bupropion) xl 150mg daily). it could be tapered to 100mg daily if you want to go conservatively.