Friday, April 29, 2011

What are the features of Acute Alcohol Intoxication

GLASGOW, SCOTLAND - NOVEMBER 10:  Alcohol offe...

Image by Getty Images via @daylife


According to the ICD 10 diagnostic criteria, Acute alcohol intoxication is defined as A transient condition following administration of alcohol, resulting in disturbance of level of consciousness, cognition, perception, affect (mood) or behavior.

It is usually a dose related phenomena. More you drink, more chance of becoming intoxicated. If a person has underlying organic problems, such as renal failure or hepatic failure then alcohol intoxication may occur in less than normal doses of alcohol. In addition, some people are more prone to get alcohol intoxication, due to their genetic makeup.

Alcohol intoxication is a transient phenomena, that means it usually goes away once the blood alcohol concentration drops. In addition, recovery from alcohol intoxication is complete.

But pathological alcohol intoxication is different from normal acute alcohol intoxication.


ICD – 10 Diagnostic guidelines

Further reading on alcohol related issues

1. What is acute alcohol intoxication emedicine health article.

2. How alcohol affects mental health

3. Signs of alcohol abuse

4. Symptoms and treatment of of delirium tremens : - A condition seen during alcohol withdrawal syndrome. This can become a medical emergency.

5. What is wernickes encephalopathy and Korsakoff's psychosis : - Another condition associated with alcohol abuse. It is a condition that will result in memory loss.

Friday, April 22, 2011

FDA issues a warning regarding use of Topamax (Topiramate) during pregnancy

cleft lip and palate left seen from bottom
Image via Wikipedia
Following several marketing surveillance reports, FDA issued a warning for the use of Topiramate or Topamax during pregnancy (especially in first trimester). This drug was found to cause increase incidence of cleft lip and/or cleft palate (oral clefts).

Topiramate or Topamax is primarily prescribed for epilepsy, bipolar disorder and various other nerve pains. Therefore, it is advised to take birth control, if you are on this drug. In addition, it is important to inform your doctor whether you are pregnant or planning to get pregnant.

However, most of other antiepileptic drugs are also known to cause various birth defects, if used during pregnancy. In addition, your doctor may decide to continue Topamax, if the risk of discontinuing the drug is higher (getting serious fits).

Further reading
Side effects of Topamax

Tuesday, April 19, 2011

Side effects of Fludac

Fludac is a brand of the generic drug Fluoxetine that is sold in India. It’s original brand name is Prozac. Therefore side effects of Fludac and Prozac are similar. Fludac is an antidepressant in SSRI drug class. Most common side effects are nausea, vomiting, dyspepsia, abdominal pain and skin rashes.

Fluoxetine HCl 20mg Capsules (Prozac) Fludac

In addition, certain patients can report short term anxiety and agitation. Insomnia or lack of sleep is also another troublesome side effect. However, it can be controlled by taking the medication in the morning.

Sexual dysfunction is one of the major side effect of concern. It is said around 80% of patients who take Fludac experience some sort of sexual side effect. Most common side effect is lack of desire. In addition, it can cause erectile dysfunction in males. It is one of the main cause of drug discontinuation in patients.

However, sexual dysfunction can also be due to the disorder itself (e.g. Depression). Therefore, some patients may experience more satisfactory sexual function when the depression is settling.

Most commonly prescribed alternative medication, when sexual dysfunction is present is Mirtazapine. But it can cause drowsiness.

Other more problematic side effects are syndrome of inappropriate ADH secretion or SIADH. It can result in reduced blood concentration of sodium or hyponatremia. Another potentially life threatening complication of Fludac (Fluoxetine) is serotonin syndrome.

In addition, Fludac can cause increased bleeding due to platelet malfunction. It is rarely a problem in normal individuals but it can cause problems in surgical procedures. Therefore, it is important to inform the surgeon and anesthetist before going to surgery that you are on Fludac.

What should you discuss with your doctor before getting the prescription

If you have liver disease, kidney disease, past history of SIADH, heart disease, myasthenia gravis, seizure disorder, gastric ulcer disease, or bleeding disorder you need to inform your doctor before getting the prescription. In addition, if you have bipolar disorder it is very important to discuss that with your doctor as this medication alone can cause mania in patients with bipolar disorder.

When should you take Fludac?

Some patients may experience poor sleep with Fludac. They should take it in the morning. If you get drowsy with this medication then it is better to take it in night.

What is the maximum dose of Fludac?

80mg per day can be used safely without significant side effects. But risk of toxicity is rare even in very high doses. This makes it preferable to use in highly suicidal patients.

How to minimize side effects?

You can minimize side effects by taking capsule as a whole and taking it with a full glass of water. In addition, it should be taken after a meal. Otherwise, it can resul stomach upset and nausea.  

Sunday, April 17, 2011

Side effects of Celepra

Celepra is a common SSRI medication prescribed for depression, panic disorders and anxiety disorders. Main problematic side effects are sexual dysfunction and increased suicidal risk among youngsters. Celepra is a brand of Escitalopram sold in India.

How Celepra works?

Celepra acts by inhibiting serotonin reuptake pumps in certain neuronal synapses. This inhibition of serotonin reuptake increases the levels of serotonin. Then the increased serotonin initiates a cascade of reactions, which ultimately results in the therapeutic action. But increased serotonin levels in unfavorable areas in the brain can results in the side effects.

Celepra is most commonly prescribed in clinical depression. Depression is characterized by persistent low mood, lack of enjoyment in life, suicidal thoughts and lack of energy. However the patients must take this medication for more than two weeks to see an effect.

What the doctor should know before taking Celepra?

If you have following problems then you must discuss them with the doctor.

1. Liver problems
2. Kidney problems
3  Epileptic Seizures
4. Heart problems
5. Bipolar disorder

In addition you must tell your complete medical history to the doctor including all the over the counter medications, herbal drugs and recreational drugs you use.

What are the dangerous side effects?

Some patients can rarely get allergic to Celepra. They can have a condition called anaphylactic reaction characterized by wide spread hives, shortness of breath and chest tightness. If present, emergency medical treatment must be sought.

Rarely certain patients can develop a condition called neuroleptic malignant syndrome. It is characterized by sudden onset muscle rigidity, fever and loss of consciousness. Immediate medical attention should be sought.

Certain patients can see or hear things that do not exist with this drug. In addition seizures can occur rarely.

What are the interactions?

In addition Clexa can have dangerous interactions with certain drugs such as Theophylline and Aminophylline. They are common ingredients of over the counter cough syrups. So patient must inform their complete drug history to the prescribing doctor.  In addition, patients should not take alcohol containing beverages with Celepra, since it can elevate effects of the drug as well as alcohol.
Increased suicidal risk?

Even though this is an anti-depressant, this medication is known to increase suicidal risk in susceptible individuals.

Usually depressed people tend to have lack of energy. It prevents them from harming themselves. Celepra increases energy level in the patient before relieving depression. This may be the main cause for increased suicidal risk.

What are the less dangerous but common side effects?

Nausea, vomiting, dyspepsia, abdominal pain and skin rashes are main side effects. Rarely certain patient can report short term anxiety and agitation. Insomnia is also another troublesome side effect. But it can be controlled by taking the medication in the morning. Sexual dysfunction such as impotence and lack of desire can occur with both male female patients.


Celepra is a SSRI medication with some side effects. However most people tolerate the side effects. Main problem associated with this drug is sexual dysfunction.

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