Get a second opinion currently on bupropionxl 300mg, venlafaxineer 225mg, emgality 120mg/month, nurtec 75mg/needed, buspirone 30mg/day, topaminarate 100mg. shaking postural hands (no caff.), extreme heat intolerance, nausea, 50lb loss in 4 months?

This is not the ideal forum for personalized medical decision making, but for general medical inquiries. You need to follow up with a doctor on the ground or at the very least by telemedicine to discuss more. Labs & physical examination are required. Your medications are likely playing a role in your symptoms but they should not be changed without close medical supervision.

50 lb wt loss if you are not trying means something not good is going on. But get a third opinion. Go to Drugs.com and read about side effects of each med and enter them into the interaction checker. Discuss with your prescribing Dr would be my recommendation after 2nd or 3rd opinion. Complex drug interactions. Almost certainly taking too many different ones. But your Dr knows you we do not.