Withdrawal symptoms of viibryd

Vilazodone (Viibryd) | NAMI: National Alliance on Mental Illness

Brand name: Viibryd®

  • Tablets: 10 mg, 20 mg, 40 mg

Generic name: vilazodone (vil AZ oh done)

All FDA black box warnings are at the end of this fact sheet. Please review before taking this medication.

What Is Vilazodone And What Does It Treat?

Vilazodone is an antidepressant medication that works in the brain. It is approved for the treatment of major depressive disorder (MDD).

Symptoms of depression include:

  • Depressed mood - feeling sad, empty, or tearful
  • Feeling worthless, guilty, hopeless, and helpless
  • Loss of interest or pleasure in your usual activities
  • Sleep and eat more or less than usual (for most people it is less)
  • Low energy, trouble concentrating, or thoughts of death (suicidal thinking)
  • Psychomotor agitation (‘nervous energy’)
  • Psychomotor retardation (feeling like you are moving and thinking in slow motion)
  • Suicidal thoughts or behaviors

What Is The Most Important Information I Should Know About Vilazodone?

Do not stop taking vilazodone, even when you feel better. With input from you, your health care provider will assess how long you will need to take the medicine.

Missing doses of vilazodone may increase your risk for relapse in your symptoms.

Stopping vilazodone abruptly may result in one or more of the following withdrawal symptoms: irritability, nausea, feeling dizzy, vomiting, nightmares, headache, and/or paresthesias (prickling, tingling sensation on the skin).

Depression is also a part of bipolar illness. People with bipolar disorder who take antidepressants may be at risk for "switching" from depression into mania. Symptoms of mania include "high" or irritable mood, very high self-esteem, decreased need for sleep, pressure to keep talking, racing thoughts, being easily distracted, frequently involved in activities with a large risk for bad consequences (for example, excessive buying sprees).

Medical attention should be sought if serotonin syndrome is suspected. Please refer to serious side effects for signs/symptoms.

Are There Specific Concerns About Vilazodone And Pregnancy?

If you are planning on becoming pregnant, notify your health care provider to best manage your medications. People living with MDD who wish to become pregnant face important decisions. Untreated MDD has risks to the fetus, as well as the mother. It is important to discuss the risks and benefits of treatment with your doctor and caregivers.

Caution is advised with breastfeeding since vilazodone does pass into breast milk.

What Should I Discuss With My Health Care Provider Before Taking Vilazodone?

  • Symptoms of your condition that bother you the most
  • If you have thoughts of suicide or harming yourself
  • Medications you have taken in the past for your condition, whether they were effective or caused any adverse effects
  • If you experience side effects from your medications, discuss them with your provider. Some side effects may pass with time, but others may require changes in the medication.
  • Any other psychiatric or medical problems you have, including a history of bipolar disorder
  • All other medications you are currently taking (including over the counter products, herbal and nutritional supplements) and any medication allergies you have
  • Other non-medication treatment you are receiving, such as talk therapy or substance abuse treatment. Your provider can explain how these different treatments work with the medication.
  • If you are pregnant, plan to become pregnant, or are breastfeeding
  • If you drink alcohol or use drugs

How Should I Take Vilazodone?

Vilazodone is usually taken one time per day with food or milk.

Typically patients begin at a low dose of medicine and the dose is increased slowly over several weeks.

The dose usually ranges from 20 mg to 40 mg. Only your health care provider can determine the correct dose for you.

Consider using a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication. You may also ask a family member or friend to remind you or check in with you to be sure you are taking your medication.

What Happens If I Miss A Dose Of Vilazodone?

If you miss a dose of vilazodone, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your health care provider. Do not double your next dose or take more than what is prescribed.

What Should I Avoid While Taking Vilazodone?

Avoid drinking alcohol or using illegal drugs while you are taking antidepressant medications. They may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication.

What Happens If I Overdose With Vilazodone?

If an overdose occurs, call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.

A specific treatment to reverse the effects of vilazodone does not exist.

What Are The Possible Side Effects Of Vilazodone?

Common side effects

Diarrhea, nausea, vomiting, dry mouth, dizziness, insomnia

Rare/serious side effects

Night sweats, decreased appetite, migraine headaches, sleepiness, tremor, blurry vision, dry eyes, abnormal dreams, agitation, restlessness, increased urination, sexual dysfunction, angle closure glaucoma (symptoms of angle closure glaucoma may include eye pain, changes in vision, swelling or redness in or around eye), Serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death), palpitations, irregular heartbeat

Vilazodone may increase the risk of bleeding events. Combined use of aspirin, nonsteroidal anti-inflammatory drugs (e.g., ibuprofen, naproxen), warfarin, and other anti-coagulants may increase this risk. This may include gums that bleed more easily, nose bleed, or gastrointestinal bleeding. Some cases have been life threatening.

Are There Any Risks For Taking Vilazodone For Long Periods Of Time?

To date, there are no known problems associated with long term use of vilazodone. It is a safe and effective medication when used as directed.

What Other Medications May Interact With Vilazodone?

Vilazodone should not be taken with or within 2 weeks of taking monoamine oxidase inhibitors (MAOIs). These include phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), rasagiline (Azalect®) and selegiline (Emsam®).

Although rare, there is an increased risk of serotonin syndrome when vilazodone is used with other medications that increase serotonin, such as other antidepressants, migraine medications called “triptans” (e. g., Imitrex®), some pain medications (e.g., tramadol (Ultram®), and the antibiotic linezolid (Zyvox®).

The following medications may increase the levels and effects of vilazodone requiring decreased dose of vilazodone:

  • Antibiotics, such as clarithromycin (Biaxin®), erythromycin (Ery-Tab®), and telithromycin (Ketek®)
  • Antifungals, such as fluconazole (Diflucan®), ketoconazole (Nizoral®), and itraconazole (Sporanox®)
  • Blood pressure medications, such as verapamil (Calan®, Covera-HS®, Isoptin SR®) and diltiazem (Cardizem®, Tiazac®)
  • HIV medications such as protease inhibitors: indinavir (Crixivan®), ritonavir (Norvir®), saquinavir (Fortovase®, Invirase®), and lopinavir/ritonavir (Kaletra®)
  • Nefazodone

The following medications may decrease the levels and effects of vilazodone requiring increased dose of vilazodone: carbamazepine (Tegretol®), oxcarbazepine (Trileptal®), rifampin (Rifadin®), phenytoin (Dilantin®), and phenobarbital

How Long Does It Take For Vilazodone To Work?

Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.

Summary of FDA Black Box Warnings

Suicidal thoughts or actions in children and adults

Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients with major depressive disorder (MDD), both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior, whether or not they are taking antidepressant medications. This risk may persist until significant remission occurs.

risk may persist until significant remission occurs.
In short-term studies, antidepressants increased the risk of suicidality in children, adolescents, and young adults when compared to placebo. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24. Adults age 65 and older taking antidepressants have a decreased risk of suicidality. Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia. If these symptoms emerge, they should be reported to the patient’s prescriber or health care professional. All patients being treated with antidepressants for any indication should watch for and notify their health care provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment.


Provided by

(December 2020)

©2020 The College of Psychiatric and Neurologic Pharmacists (CPNP) and the National Alliance on Mental Illness (NAMI). CPNP and NAMI make this document available under the Creative Commons Attribution-No Derivatives 4.0 International License. Last Updated: January 2016.

This information is being provided as a community outreach effort of the College of Psychiatric and Neurologic Pharmacists. This information is for educational and informational purposes only and is not medical advice. This information contains a summary of important points and is not an exhaustive review of information about the medication. Always seek the advice of a physician or other qualified medical professional with any questions you may have regarding medications or medical conditions. Never delay seeking professional medical advice or disregard medical professional advice as a result of any information provided herein. The College of Psychiatric and Neurologic Pharmacists disclaims any and all liability alleged as a result of the information provided herein.

Viibryd Withdrawal Help | Vilazodone Side Effects, Symptoms

Alternative to Meds News & Blog Articles

Last Updated on December 14, 2022 by Diane Ridaeus

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

Table of Contents:
  • Video:  Viibryd Withdrawal
  • Viibryd Withdrawal
  • Common Viibryd Withdrawal Symptoms
  • Severe and Rare Viibryd Withdrawal Symptoms
  • Viibryd Half-life and Withdrawal Timeline
  • Can You Stop Taking Viibryd Cold Turkey?
  • Tips for Safe, Healthy Viibryd Withdrawal
  • About Viibryd Withdrawal Protocols Used at Alternative to Meds Center
  • Find Help Now for Viibryd Withdrawal at Alternative to Meds Center

A prescription of Viibryd may not have provided the relief you were seeking and perhaps now is the time to consider Viibryd withdrawal as a positive step along the journey to natural mental health. It is possible to transition to natural alternative treatments without the harsh side effects common to all SSRIs.

We do not doubt that your suffering is real. But we doubt that you have been correctly treated if you are still suffering. We’ve been there too, and we have a comprehensive non-toxic toolbox to share with you.

Do Your Symptoms Require Viibryd?

Alternative to Meds is a world leader in recovery after prescription drug therapy didn’t meet your expectations. We offer safe, medically monitored Viibryd withdrawal supported by a staff of over 40 amazing practitioners and medical doctors to guide you step by step. Our success rate of over 77% is documented by published evidence and we want you to share in that success. Despite the fact that we have successfully helped over 20,000 clients, we recognize you as a unique individual requiring a tailored treatment program made just for you. We are here to help you reach your mental wellness goals.

Viibryd Withdrawal

Viibryd withdrawal symptoms are common to all antidepressants according to research documents spanning from at least 1959, and continuing on to the present.5-7 Back in the 50s doctors and researchers (and pharmaceutical companies) were looking for something better than electroconvulsive therapy, or even better than nothing. In fact, most drug trials today are still looking for something that is better than nothing (placebo-controlled). Much debate has developed over the decades as to whether the promise of relief to patients has really ever been fulfilled with drug-based therapy. Each new drug was supposed to surpass the last. Perhaps it is time to drop some of the false promises of the past and look forward to real relief through the use of holistic approaches to improved mental wellness. And, with holistic and effective remedies to support Viibryd withdrawal, one can discard the liability of a lifetime of antidepressant side effects and lack of efficacy.

Below you will find some information we hope you will find useful on Viibryd withdrawal including common and more rare adverse Viibryd withdrawal symptoms, strategies to overcome these, and information on how natural and holistic treatments are used at Alternative to Meds Center for a safe and gentle Viibryd withdrawal experience, and recovery of mental wellness without drugs.

Common Viibryd Withdrawal Symptoms

SPECIAL NOTE RE PREGNANCY:  Viibryd is not recommended during late pregnancy due to potential withdrawals in the newborn, as well as heart complications in the infant.1

The most common symptoms of Viibryd withdrawal may resemble those of other SSRIs and involve both physical and psychological symptoms.2,3

Symptoms of Viibryd withdrawal may include:
  • Emotional lability:  sudden changes in mood, worsening mood, dysphoric mood, crying spells
  • Irritability, agitation, anxiety, nervousness
  • Flu-like symptoms:  headaches, muscle pain, shivers, fatigue, weakness, excessive sweating
  • Insomnia, nightmares, unusual or vivid dreams
  • Vertigo, dizziness
  • Tremors, involuntary jerking motions, ataxia (unsteady or uncoordinated walking)
  • Brain zaps or feeling of electric shocks in the head or neck
  • Nausea, vomiting
  • Abdominal pain
  • Constipation, diarrhea
  • Paresthesia:  burning or prickling skin sensation
  • Sensory or visual disturbances, blurred vision
  • Sexual dysfunction
  • Itching
  • Altered taste
  • Tinnitus
  • Confusion, disorientation
Severe and Rare Viibryd Withdrawal Symptoms

Though relatively rare, there have been severe and even life-threatening reactions to Viibryd withdrawal, especially where the dosage was dropped too quickly or upon abrupt cessation, and where other health conditions were present and untreated. It should be noted that some adverse drug reactions associated with SSRIs may persist after drug discontinuation. Reported rare and severe withdrawal reactions have included the following:

  • Suicide, suicidal thinking
  • Seizures
  • Psychosis, delirium
  • Visual and auditory hallucinations
  • Mania (severe, lasts at least 7 days) and hypomania (less severe, lasts up to 4 days)

It should be well-noted that published research studies on Viibryd withdrawal are near to non-existent. Studies on other SSRI withdrawal phenomena are much more prevalent and should be considered for the full breadth of the subject. There could be other adverse discontinuation symptoms besides the ones listed above.

Viibryd Half-life and Withdrawal Timeline

The half-life of a medication is how long it takes for the concentration in the system to decrease by half. Viibryd has a half-life estimated at about 25 hours. This may vary from person to person because of individual rates of metabolism, age, and other health considerations. The half-life is typically when withdrawals may begin to manifest, anywhere from a day to several days after the last dose in this case. The medical consensus is that instead of abruptly stopping, decreasing the dose gradually is a recommended strategy to help reduce harsh Viibryd withdrawals.

There can be no fixed timeline for successfully coming off Viibryd because each individual can have unique responses after lowering the dose. With proper support, preparation, and medical monitoring, the timeline for comfortable Viibryd withdrawal is expected to be 8 weeks but could extend up to one year, depending on the individual factors as noted above.13,18 Clinical research advises that lowering the dose during antidepressant withdrawal should be not only gradual, but that near the end, the doses be incrementally cut even more slowly, and should gradually decrease to levels well below the lowest therapeutic dosage level. Much evidence has shown that a misdiagnosis of relapse is not uncommon when withdrawal symptoms come on too harshly and may be misinterpreted as a relapse. Be informed before you start Viibryd withdrawal so that you have a good grasp on what to expect and you can accurately inform your prescriber what you are experiencing so it will not be misdiagnosed.

Can You Stop Taking Viibryd Cold Turkey?

Though some may have been able to abruptly stop Viibryd without many consequences, that would be the exception, and could likely include persons who took Viibryd only for a few days or a few weeks at most or took only very low doses. In any case, a cold turkey approach is not recommended as it can lengthen the process of Viibryd withdrawal, and may encourage misdiagnosis and incorrect treatment measures, as previously cautioned, above.18

The recommended route is to go slow and gradual, and if the taper should still become too harsh for the body to tolerate, reinstating at a higher dosage until stable and then resuming the taper more gradually would be preferable to ease the process.

Tips for Safe, Healthy Viibryd Withdrawal

  • Enlist competent medical support before starting Viibryd withdrawal. Inpatient treatment is best but if this is not possible, put together a solid support team including a prescriber who is sympathetic to your situation and familiar with antidepressant withdrawal. Let trusted friends and/or family know what your plans are so they can understand your efforts. A spouse or close associate may be able to assist with cooking, cleaning, or other chores. Don’t be afraid to ask for help, even if it is only for some moments of companionship with someone you feel comfortable spending quiet time with. Most people are happy and quite willing to help others given the opportunity to do so.
  • You may find it necessary to take time off work or school for a time to allow for a more relaxed schedule, extra rest, outdoor walks, reading, or other mild, relaxing activities, and to keep environmental stress to an absolute minimum during Viibryd withdrawal.
  • Stay in close contact with your prescriber if you are not able to enter an inpatient setting, so that minor changes in dosage (which can make major differences) can be well-managed as you go through the process.

If you have attempted Viibryd withdrawal and found the process too difficult to manage on your own, we strongly recommend considering inpatient help. At Alternative to Meds Center, we specialize in the most difficult of cases. The process of Viibryd withdrawal need not be torturous or overly long with the proper help in place. We are here to help.

About Viibryd Withdrawal Protocols Used at Alternative to Meds Center

Protocols used in antidepressant withdrawal have been carefully designed at the center, and offer services that can markedly ease the process, including these examples:

  • Holistic, medically monitored slow and gradual medication tapering.
  • Orthomolecular medicine
  • Neurotoxin Removal
  • Neurotransmitter rehabilitation
  • IV + NAD therapy
  • Counseling services
  • Acupuncture
  • Massage and spa services
  • Equine-assisted therapy
  • Nebulized glutathione
  • Colon hydrotherapy

We invite you to visit a more complete description of other therapies that can be found on our services overview page where they are described in much greater detail.

Find Help Now for Viibryd Withdrawal at Alternative to Meds Center

At the Alternative to Meds Center, we have been helping thousands of clients for more than 15 years to reach their goals by thoroughly investigating and addressing root causes for symptoms using effective, drug-free therapeutics that can provide authentic relief.

Please contact us for more information for you or your loved one on the very real opportunity to experience recovery of natural mental health through safe Viibryd withdrawal and get the tools for true relief from the symptoms that drug therapy could not resolve.

1 (800) 301-3753 for Viibryd Withdrawal Help

1. FDA label Viibryd (vilazodone hydrochloride) tablets, approval 2011 [cited 2022 May 6]

2. Siwek M, Chrobak AA, Gorostowicz A, Krupa AJ, Dudek D. Withdrawal Symptoms Following Discontinuation of Vortioxetine-Retrospective Chart Review. Pharmaceuticals (Basel). 2021;14(5):451. Published 2021 May 11. doi:10.3390/ph24050451 [cited 2022 May 6]

3. Haddad P,  Anderson I, Recognizing and managing antidepressant discontinuation [published online 2 Jan 2018] [cited 2022 May 6]

4. Dailey MW, Saadabadi A. Mania. [Updated 2021 Aug 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493168/  [cited 2022 May 6]

5. Mann A, MacPherson A, Clinical Experience with Imipramine (G22355) in the Treatment of Depression, Canadian Journal of Psychiatry Vol4, no.1, January 1, 1959 [online] [cited 2022 May 6]

6. Rosenbaum JF, Fava M, Hoog SL, Ascroft RC, Krebs WB. Selective serotonin reuptake inhibitor discontinuation syndrome: a randomized clinical trial. Biol Psychiatry. 1998 Jul 15;44(2):77-87. doi: 10.1016/s0006-3223(98)00126-7. PMID: 9646889. [cited 2022 May 6]

7. Hengartner MP, Plöderl M. Prophylactic effects or withdrawal reactions? An analysis of time-to-event data from antidepressant relapse prevention trials submitted to the FDA. Ther Adv Psychopharmacol. 2021 Aug 10;11:20451253211032051. doi: 10.1177/20451253211032051. PMID: 34394912; PMCID: PMC8361519. [cited 2022 May 6]

8. Lane RM. SSRI-induced extrapyramidal side-effects and akathisia: implications for treatment. J Psychopharmacol. 1998;12(2):192-214. doi: 10.1177/026988119801200212. PMID: 9694033. [cited 2022 May 6]

9. Batla A. Dystonia: A review. Neurol India. 2018 Mar-Apr;66(Supplement):S48-S58. doi: 10.4103/0028-3886.226439. PMID: 29503327. [cited 2022 May 6]

10. Brigo F, Erro R, Marangi A, Bhatia K, Tinazzi M. Differentiating drug-induced parkinsonism from Parkinson’s disease: an update on non-motor symptoms and investigations. Parkinsonism Relat Disord. 2014 Aug;20(8):808-14. doi: 10.1016/j.parkreldis.2014.05.011. Epub 2014 Jun 3. PMID: 24935237. [cited 2022 May 6]

11. Friedman JH. Movement disorders induced by psychiatric drugs that do not block dopamine receptors. Parkinsonism Relat Disord. 2020 Oct;79:60-64. doi: 10.1016/j. parkreldis.2020.08.031. Epub 2020 Aug 26. PMID: 32871538. [cited 2022 May 6]

12. Perahia DG, Kajdasz DK, Desaiah D, Haddad PM. Symptoms following abrupt discontinuation of duloxetine treatment in patients with major depressive disorder. J Affect Disord. 2005 Dec;89(1-3):207-12. doi: 10.1016/j.jad.2005.09.003. Epub 2005 Nov 2. PMID: 16266753. [cited 2022 May 6]

13. Henssler J, Heinz A, Brandt L, Bschor T. Antidepressant Withdrawal and Rebound Phenomena. Dtsch Arztebl Int. 2019;116(20):355-361. doi:10.3238/arztebl.2019.0355 [cited 2022 May 6]

14. Rusconi AC, Carlone C, Muscillo M, Coccanari de’ Fornari MA, Podda L, Piccione M. Sindrome da sospensione di SSRI: incidenza e differenze su tre gruppi di pazienti in trattamento con paroxetina [SSRI discontinuation syndrome: incidence and differences on three groups of patients treated with paroxetine]. Riv Psichiatr. 2009 May-Jun;44(3):169-75. Italian. PMID: 20066803. [cited 2022 May 6]

15. Simeon D, Stein DJ, Hollander E. Depersonalization disorder and self-injurious behavior. J Clin Psychiatry. 1995;56 Suppl 4:36-9; discussion 40. PMID: 7713864. [cited 2022 May 6]

16. Wolfe RM. Antidepressant withdrawal reactions. Am Fam Physician. 1997 Aug;56(2):455-62. Erratum in: Am Fam Physician 1998 Feb 15;57(4):646. PMID: 9262526. [cited 2022 May 6]

17. Schwasinger-Schmidt TE, Macaluso M. Other Antidepressants. Handb Exp Pharmacol. 2019;250:325-355. doi: 10.1007/164_2018_167. PMID: 30194544. [cited 2022 May 6]

18. Gabriel M, Sharma V. Antidepressant discontinuation syndrome. CMAJ. 2017;189(21):E747. doi:10.1503/cmaj.160991 [cited 2022 May 6]

19. Cruz MP. Vilazodone HCl (Viibryd): A Serotonin Partial Agonist and Reuptake Inhibitor For the Treatment of Major Depressive Disorder. P T. 2012;37(1):28-31. [cited 2022 May 6]

20. Carvalho AF, Sharma MS, Brunoni AR, Vieta E, Fava GA. The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature. Psychother Psychosom. 2016;85(5):270-88. doi: 10.1159/000447034. Epub 2016 Aug 11. PMID: 27508501. 9cited 2022 May 6]

Originally Published May 5, 2022 by Diane Ridaeus

This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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Diane Ridaeus

Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.

Medical Disclaimer:
Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.

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