Can you discontinue Contrave (bupropion and naltrexone) abruptly?

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From the Guidelines

It is not recommended to stop Contrave (naltrexone/bupropion) cold turkey, as this can lead to potential withdrawal symptoms, and instead, a gradual tapering schedule should be followed under the guidance of a healthcare provider. Contrave contains bupropion, which, when stopped abruptly, can cause withdrawal effects including irritability, anxiety, insomnia, headaches, and in rare cases, seizures 1. The naltrexone component generally doesn't cause significant withdrawal when discontinued. A typical tapering schedule might involve reducing your dose by half for one week before stopping completely, but your doctor will provide personalized guidance based on your specific situation, including how long you've been taking the medication and your current dose. Some key points to consider when stopping Contrave include:

  • Monitoring for worsening depression or suicidal ideation, as bupropion can affect mood regulation 1.
  • Being aware of potential increases in heart rate and blood pressure, as well as other common side effects like nausea, headache, and constipation 1.
  • The importance of staying hydrated and maintaining regular sleep patterns during the tapering period to minimize discomfort.
  • Reporting any concerning symptoms to your healthcare provider promptly. Given the potential risks associated with abrupt discontinuation, a gradual taper under medical supervision is the safest approach to stopping Contrave, allowing your body to adjust to the decrease in medication and minimizing the risk of severe withdrawal symptoms 1.

From the Research

Stopping Contrave Cold Turkey

  • Contrave is a combination of naltrexone and bupropion, used for weight loss in obese individuals 2, 3.
  • There is limited research on stopping Contrave cold turkey, but studies on bupropion suggest that abrupt discontinuation can lead to withdrawal symptoms such as irritable mood, anxiety, sleeplessness, headache, and generalized aches and pains 4.
  • A slow taper is recommended when discontinuing bupropion to minimize withdrawal symptoms 4.
  • Naltrexone, the other component of Contrave, has been studied in the context of opioid detoxification, where it has been shown to shorten the duration of withdrawal symptoms when combined with buprenorphine 5.
  • However, the safety and efficacy of stopping Contrave cold turkey is not well established, and it is recommended to consult a healthcare professional before discontinuing the medication.

Potential Risks and Side Effects

  • Stopping Contrave cold turkey may lead to withdrawal symptoms, although the severity and likelihood of these symptoms are not well established 4, 5.
  • Common side effects of Contrave include nausea, vomiting, headaches, and constipation, which may be more severe when stopping the medication abruptly 3.
  • It is essential to weigh the benefits and risks of continuing or discontinuing Contrave under the guidance of a healthcare professional.

Recommendations

  • Consult a healthcare professional before stopping Contrave or any other medication 4, 2, 3.
  • A slow taper may be recommended to minimize withdrawal symptoms when discontinuing bupropion, a component of Contrave 4.
  • Careful monitoring and follow-up are necessary when stopping Contrave to manage potential side effects and withdrawal symptoms.

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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