Campbejo: Tapering off multiple meds

[Campbejo]

Hi, I am interested in tapering off my meds...AD's, BP, Statin. My doses are as follows:

Wellbutrin XL 150mg 1x daily
Zoloft 50mg 1x daily  
Atorvostatin 10mg 1x daily
Bystolic 10mg 1x daily

I was also taking Belviq 10mg but am out and will not refill.

I have been on this particular regimen for appx a year.

Would appreciate any suggestions.

Thanks

[Altostrata]

Welcome, Campbejo.

 

That looks to be quite the cocktail. Sometimes drugs interact and cause a lot of problems. Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and copy and paste the results in this topic.

 

I'm not very familiar with Belviq, but I see it's a serotonergic. How long have you been taking it? Generally, all serotonergics need to be tapered. You may wish to get your prescription refilled so you can go off it more gradually rather than quitting it cold turkey.

 

Belviq could have been interacting with Wellbutrin and Zoloft in a way that could cause agitation, sweating, anger, rage, etc.

 

At what point and for what reason was the Bystolic added?

 

This is your topic for tracking your progress off drugs. Please follow this topic so you can see responses to your questions.
 

[KarenB]

Hello Campbejo and welcome to s/a,

 

To keep things simple it's a good idea to taper one drug at a time.  Otherwise it can get tricky figuring out which drug to adjust if you run into problems.  You could have a read of Which Drug to Taper First.

 

I put your list into the Drug Checker to help identify where to start your taper (I've pasted the results below).  The major issue is between Zoloft and Welbutrin (besides the fact you're doubled up on antidepressants).  Wellbutrin is quite activating, so I'd be inclined to start with that, but have a read through these yourself before you decide. 

 

Tips for Tapering Wellbutrin

Tips for Tapering Zoloft

 

Tapering by no more than 10% of your current dose each month should help to minimise withdrawal symptoms.  Have you been having any side-effects while you've been on this lot, or are you feeling quite stable at the moment?  Going slow and gentle is the key to tapering safely. 

 

Would you also like to fill out a signature so we can easily see your situation whenever you post?  Thank you.  This thread can be your journal to record your tapering progress, and once you've read the links you can come back here to ask any further questions.  There are lots of people here to help you work out a good plan.

 

Best wishes,

Karen

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Interactions between your selected drugs

Major bupropion sertraline

Applies to: Wellbutrin (bupropion), Zoloft (sertraline)

Talk to your doctor before using buPROPion together with sertraline. Combining these medications may increase the risk of seizures, which may occur rarely with either medication. In addition, buPROPion can increase the blood levels of sertraline, which may increase other side effects. You may be more likely to experience seizures with these medications if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should avoid or limit the use of alcohol during treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate bupropion nebivolol

Applies to: Wellbutrin (bupropion), Bystolic (nebivolol)

BuPROPion may increase the blood levels and effects of nebivolol. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience increased side effects or your condition changes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate sertraline nebivolol

Applies to: Zoloft (sertraline), Bystolic (nebivolol)

Using nebivolol together with sertraline may increase the effects of nebivolol. Contact your doctor if you experience uneven heartbeats, shortness of breath, bluish-colored fingernails, dizziness, weakness, fainting, or seizure (convulsions). If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.

Other drugs that your selected drugs interact with

• Bystolic (nebivolol) interacts with more than 400 other drugs.
• Wellbutrin (bupropion) interacts with more than 300 other drugs.
• Zoloft (sertraline) interacts with more than 500 other drugs.

Interactions between your selected drugs and food

Moderate bupropion food

Applies to: Wellbutrin (bupropion)

Using buPROPion with alcohol may increase the risk of uncommon side effects such as seizures, hallucinations, delusions, paranoia, mood and behavioral changes, depression, suicidal thoughts, anxiety, and panic attacks. On the other hand, sudden withdrawal from alcohol following regular or chronic use can also increase your risk of seizures during treatment with buPROPion. If you are prone to frequent or excessive alcohol use, talk to your doctor before starting buPROPion. In general, you should avoid or limit the use of alcohol while being treated with buPROPion. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate sertraline food

Applies to: Zoloft (sertraline)

You should avoid or limit the use of alcohol while being treated with sertraline. Alcohol can increase the nervous system side effects of sertraline such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication Antidepressants

Therapeutic duplication

The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'antidepressants' category:

• bupropion (active ingredient in Wellbutrin)
• sertraline (active ingredient in Zoloft)

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

[Altostrata]

KarenB posted at the same time I did, thank you for the drug check, Karen.

 

I added Belviq to the list here http://www.drugs.com/interactions-check.php?drug_list=276-0,3401-15754,2788-12478,440-2469,2057-1348

 

Major bupropion lorcaserin

Applies to: Wellbutrin XL (bupropion), Belviq (lorcaserin)

Using lorcaserin together with buPROPion may increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

Major sertraline lorcaserin

Applies to: Zoloft (sertraline), Belviq (lorcaserin)

Using lorcaserin together with sertraline may increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

Moderate nebivolol lorcaserin

Applies to: Bystolic (nebivolol), Belviq (lorcaserin)

Lorcaserin may increase the blood levels and effects of nebivolol. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience increased side effects or your condition changes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

According to FDA info at http://www.drugs.com/pro/belviq.html, it has many effects on the nervous system. Frankly, it sounds like a very nasty drug.

 

Anecdotal reports confirm withdrawal symptoms https://treato.com/Belviq,Withdrawal/?a=s

[Campbejo]

Thank you for the reply. I have taken Belviq for two months to assist with weight loss. I have been taking Bystolic for about 6 months for blood pressure and heavy face reddening, which becomes brutal for self esteem and confidence. I will go ahead and refill the Belviq so I can do a proper taper.

 

Thanks again.

 

 

Welcome, Campbejo.

 

That looks to be quite the cocktail. Sometimes drugs interact and cause a lot of problems. Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and copy and paste the results in this topic.

 

I'm not very familiar with Belviq, but I see it's a serotonergic. How long have you been taking it? Generally, all serotonergics need to be tapered. You may wish to get your prescription refilled so you can go off it more gradually rather than quitting it cold turkey.

 

Belviq could have been interacting with Wellbutrin and Zoloft in a way that could cause agitation, sweating, anger, rage, etc.

 

At what point and for what reason was the Bystolic added?

 

This is your topic for tracking your progress off drugs. Please follow this topic so you can see responses to your questions.

 

[Campbejo]

Thank you KarenB for pulling all that data. I will do some reading in hopes of determining the most effective taper plan.

[Altostrata]

How long have you been off Belviq?

 

What drugs were you taking when you had the high blood pressure and face reddening, etc.? Did you have these symptoms before you took the drugs?

[Campbejo]

I've been off Belviq for less than a week.

 

Face reddening is something I have dealt with for a long time. It seems to happen if I am on meds or not. Although the Bystolic works very well to keep that under control. I wasn't really on anything when I started blood pressure meds.

[Altostrata]

Do you have any symptoms from going off Belviq?

 

Was your blood pressured measured and found to be high?

[Campbejo]

No symptoms from stopping the Belviq, except for the intended weight loss, which is why I started taking it to begin with.

 

Yes, BP was a bit high, far from extreme, but getting close to moderately high. However, I do not recall the numbers.

[Altostrata]

Can you remember exactly when you took the last tablet of Belviq? Did you take it only once a day?

[Campbejo]

At first it was twice per day but the last few weeks was one in the morning. Last one was probably Monday.

[Altostrata]

You might have already tapered off it. It has a very short half-life, only about 11 hours. If you don't get any withdrawal symptoms in the next week, it may be behind you already.

[Campbejo]

Very good. Thank you for the info.