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What Are The Side Effects Of Risperidone, Fluoxetine And Bupropion?
Question: Hi my close family member is taking 4 different medications- Mirazapine, Risperidone, Fluoxetine and Bupropion for depression and we are concerned about side effects. He is now having tremors or shaking hands and sleeping most of the day. He was a lot more energetic and content before these medications but he says this is what the doctor has prescribed it must be for best. Do you feel taking these medications is contributing to the shaking hands and excessive sleep? Are there specific drugs that can have interaction problems? Should he get a second opinion? He is a veteran and we are concerned so thank you so much for your help.
Brief Answer:
drug side effects, consider use of single antidepressant drug only
Detailed Answer:
Dear,
welcome to HCM
We understand your concern for him.
As i could see the major issue that he is facing besides his underlying depressive condition, is that of tremors, sleeping for most of the day and being less energetic.
Mirtazepine, Fluoxetine, Bupropion belong to the class of SSRI and SNRI group of antidepressants, which has a tendency to produce tremors and anxiety when poorly tolerated. If the tremors has begun newly especially after the use of these medication, i am very certain that it is due the side effects of these medications. Especially, bupropion when given in doses of 300-450 mg daily, very commonly result in tremors.
The other important issue here is that all these SSRI group drugs are potent antidepressants, and when given together can result in potential fatal adverse condition of serotonin syndrome. Moreover, in elder patients where the liver function is further weak, the prescription should be kept with minimum drugs in least possible doses.
Excessive sleepiness could be a symptom of depression itself or it could be a drugs side effects.
Considering the facts my suggestion to you are..
1) Kindly provide a detail dosage of each drugs and duration for which he has been taking these. Also other medication he is having for hypertension and diabetes.
2) Get the Liver function test, Renal function lest, Complete blood count, Serum LDH and CPK levels, ECG, Electrolyte levels.
3) WATCH OUT FOR SIGNS of confusion, blurred vision reporting, temperature, difficult in walking, etc in case of which take him immediately to hospital.
4) Maintain adequate hydration.
5) URGENTLY CONSULT THE TREATING PSYCHIATRIST as it is strongly suggested to discontinue use of few drugs and keep the doses of them to minimum. The drug to which there was good response can be continued. Stopping the drugs abruptly may trigger a withdrawal and precipitate underlying depression, therefore consult the doctor before changing the drug use.
Revert back with more details and further suggestions.
Regards,
Dr Pankaj Borade
drug side effects, consider use of single antidepressant drug only
Detailed Answer:
Dear,
welcome to HCM
We understand your concern for him.
As i could see the major issue that he is facing besides his underlying depressive condition, is that of tremors, sleeping for most of the day and being less energetic.
Mirtazepine, Fluoxetine, Bupropion belong to the class of SSRI and SNRI group of antidepressants, which has a tendency to produce tremors and anxiety when poorly tolerated. If the tremors has begun newly especially after the use of these medication, i am very certain that it is due the side effects of these medications. Especially, bupropion when given in doses of 300-450 mg daily, very commonly result in tremors.
The other important issue here is that all these SSRI group drugs are potent antidepressants, and when given together can result in potential fatal adverse condition of serotonin syndrome. Moreover, in elder patients where the liver function is further weak, the prescription should be kept with minimum drugs in least possible doses.
Excessive sleepiness could be a symptom of depression itself or it could be a drugs side effects.
Considering the facts my suggestion to you are..
1) Kindly provide a detail dosage of each drugs and duration for which he has been taking these. Also other medication he is having for hypertension and diabetes.
2) Get the Liver function test, Renal function lest, Complete blood count, Serum LDH and CPK levels, ECG, Electrolyte levels.
3) WATCH OUT FOR SIGNS of confusion, blurred vision reporting, temperature, difficult in walking, etc in case of which take him immediately to hospital.
4) Maintain adequate hydration.
5) URGENTLY CONSULT THE TREATING PSYCHIATRIST as it is strongly suggested to discontinue use of few drugs and keep the doses of them to minimum. The drug to which there was good response can be continued. Stopping the drugs abruptly may trigger a withdrawal and precipitate underlying depression, therefore consult the doctor before changing the drug use.
Revert back with more details and further suggestions.
Regards,
Dr Pankaj Borade
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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