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Can Lithium, Bupropian, And Ziprasidone Be Taken Together?

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Posted on Mon, 18 Apr 2022
Question: I had a psychiatrist prescribe lithium, bupropian, & ziprasidone for me all at the same time. What do you think of the combination & they'r potential for doing harm?
doctor
Answered by Dr. Mahboob Ur Rahman (1 hour later)
Brief Answer:
Can be combined for severe disease but more care needed .

Detailed Answer:

Hi,

Your concern is very right, too much medicine may cause many problems. This is specially true when psychiatric medicines are used. However some times disease is so severe that their use is justified but care must be taken. Same is your case, generally we don't use all these drugs (as yours) at same time but yes it can be used if needed.

They are all three from different classes and work differently, So sometimes combining them becomes necessary, though should not be done if disease could be controlled with a single agent.
So if you understand your disease was more resistant, you may use these 3 drugs at same time though it's not the ideal case and we avoid combining.

When such drugs are used, you should take care as side effects are also increased like excessive sleep, dryness, dizziness etc.
Also check your drug level of Lithium as advised. Avoid dehydration and diuretics that can worse the side effects of lithium.

So for severe disease we can use all these three at same time with special care.

Report to your doctor If you feel major side effects or If you find your body very stiff or abnormal movements of body, or if you develop high grade fever, confusion, then you should urgently talk to your doctor.

Hope I have answered your question. I will be glad to answer any further question about this. Please don't hesitate to ask anything else you need to know.
Regards,
Dr. Rahman
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Mahboob Ur Rahman (5 days later)
Not a question. Just a statement that I have developed symptoms in the warnings from these drugs to the degree I cannot sleep in bed. I sleep in a chair for no more than 3 hours at a time & wake up with intense pain from my toes to my head. I am o weak I can't do normal tasks a child could do. My balance is terrible & little curbs or steps could easily lead to fall. Walking just a short distance leads to pain in my back, knees, & hips.

All this started about 6 weeks ago when zip was added to bup, & lithium by an incompetent psychiatrist who has expedited removal of services of the whole Health System for not only me but my wife.

It is interesting that one of their week end staff told me on Aug. 4th to see Urgent care, which I did on the 6th. I was told to stop taking the zip. When I informed the dr.'s nurse of that & the pain's etc.it was causing, he said it could not be the zip & unbelievably told me to take 2 of them at bedtime.

After that he did some other stupid things, but I type with 1 finger & the pain is growing
in my shoulder. I am wondering if this is reversible because it's going to take a miracle from God to do so!
doctor
Answered by Dr. Mahboob Ur Rahman (39 minutes later)
Brief Answer:
See detailed answer please

Detailed Answer:

Hi,

The sleep disturbance and weakness and difficulty in walking all commonly occur with these drugs. However this much severe pain we need to see a little more. In fact this may also be the effect of the drug but we should also see it in more details if it can be caused by any thing else like any disease of the nerve, muscles, or bones.

Whatever, I understand your concern of the bad effects of the drugs, if you are not feeling well with this, these can always be changed. We do it many times as side effects are not uncommon with these drugs and we have better options. So this is time we should reassess you in more details and to decide about the drugs to continue with them are not. Unfortunately I am not in a position to decide final about it. So I would personally advise you should make an appointment with your doctor and express all your concern. If you are not happy with your doctor you can always ask for another doctor's opinion. You may also see an enternalist to assess you as what is going wrong with you. If he does not find any other cause for your problems then we can definitely think that these are drug effects and may think of changing it or stopping the drugs. However do not do it with out your doctor prescription.

I am Hopeful things would get better however it may take little time though I understand your problem and cannot ignore your pain but let us go logically toward the solution of the problem. I wish you best luck.

Let me know if you have any further queries. I would be glad to answer your question.
Regards
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Mahboob Ur Rahman

General & Family Physician

Practicing since :2012

Answered : 2305 Questions

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Can Lithium, Bupropian, And Ziprasidone Be Taken Together?

Brief Answer: Can be combined for severe disease but more care needed . Detailed Answer: Hi, Your concern is very right, too much medicine may cause many problems. This is specially true when psychiatric medicines are used. However some times disease is so severe that their use is justified but care must be taken. Same is your case, generally we don't use all these drugs (as yours) at same time but yes it can be used if needed. They are all three from different classes and work differently, So sometimes combining them becomes necessary, though should not be done if disease could be controlled with a single agent. So if you understand your disease was more resistant, you may use these 3 drugs at same time though it's not the ideal case and we avoid combining. When such drugs are used, you should take care as side effects are also increased like excessive sleep, dryness, dizziness etc. Also check your drug level of Lithium as advised. Avoid dehydration and diuretics that can worse the side effects of lithium. So for severe disease we can use all these three at same time with special care. Report to your doctor If you feel major side effects or If you find your body very stiff or abnormal movements of body, or if you develop high grade fever, confusion, then you should urgently talk to your doctor. Hope I have answered your question. I will be glad to answer any further question about this. Please don't hesitate to ask anything else you need to know. Regards, Dr. Rahman