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This is why Fishman says those with a history of anxiety and insomnia arent great candidates for a bupropion-naltrexone prescription, and thats also why it carries a warning from the FDA that it may lead to suicidal thoughts and behaviors (though the risk is very small)

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[19] [20] The risk of hypoglycemia increases when these medications are combined with insulin or sulfonylureas, often requiring dose adjustments of these agents