Brief Answer:
Gradual taper would be advisable

Detailed Answer:
Hi, thanks for writing through HCM.

I have read your query and understood your concerns.

Duzela is a brand name of the drug duloxetine which is a SNRI antidepressant. Sudden or abrupt discontinuation would result in some adverse symptoms or withdrawal symptoms.

In my patient I would have decreased it by 20 mg every 15 to 20 days and stopped within next 2 months. If you are not able to meet your prescribing doctor then visit another psychiatrist at new place, he will guide you.

Hope I have answered your query. If you have further query then I shall be happy to help.

Wish you good health.

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Brief Answer:
I would have stopped duzela long before

Detailed Answer:
Hi, thanks for writing again.

If you are stable on duzela for more than 6 months then according to my knowledge and clinical practice, you need not continue the drug. I would have stopped duzela in my patients after 6 to 8 months of symptoms free period.

Duzela can cause sexual dysfunction in around 20 to 40% of patients taking it. It means that you shall develop but that is not sure. You may not develop sexual problems with it.

Bupropion is very good drug and there are very less chances of sexual problem with it. But if you are taking asenapt then I would suggest not to go for bupropion.

You can discontinue duzela as per your doctor's advice. She might have suggested you bupron because you are about to marry and it is a big life event. Some patient might have re-emergence of symptoms due to this positive stress, it comes with responsibility and that makes person vulnerable to depression again.

In my patient I would have stopped all the drugs with gradual taper. I feel that you shall do better without drugs. Discuss this with your doctor and follow her advice.

Hope I have answered your query. If you do not have further query then close the discussion and rate the answer. wish you good health.

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Brief Answer:
Why antipsychotic was given in first place?

Detailed Answer:
Hi, thanks for writing again.

You have depression after you lost your job before 2 years ago. Your doctor had started antidepressant that is duloxetine, that I can understand but why you were given antipsychotic, that is asenapt?

Apart from sadness, decreased activity, low feeling, fatigue etc. What were the other symptoms you were facing? like fearfulness that someone would harm you or kill you, suspiciousness that people are conspiring against you, hearing of voices that was not heard by others etc. Were these present?

Another possibility is that, you were given antipsychotic because you were not improving satisfactorily with duzela. After how many months of duzela, asenapt was added/

Asenapt can be gradually tapered as duzela. Asenapt 7.5 mg for 15 days then gradually decreasing 2.5 mg every 15 days. You shall off the medication within 45 to 50 days.

Give answers to my above questions. I am waiting for reply.

Wish you good health.

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Brief Answer:
I have already explained how it can be stopped

Detailed Answer:
Hi, thanks for writing again.

So, I am now clear that you were having severe depression and suicidal thoughts, but now you have complete improvement. If you were my patient then I would have stopped all the drugs gradually.

'How to reduce asenapt?' I have already told you. According to me there is no risk in stopping the drugs now. Taper the dose under the supervision of your treating psychiatrist because he was treating you from the beginning and knows better about you.

Hope I have answered your query. If you do not have further clarifications then close the discussion and rate the answer. Wish you good health.

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