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Wednesday, November 16, 2011

Librium for alcohol withdrawal

Librium is the generic name of Chlordiazepoxide. It is benzodiazepine class medication similar to Diazepam or Valium. Librium is mainly used for treating alcohol withdrawal. It acts via activating GABA type A receptors in the brain. In addition, Librium is the first benzodiazepine to hit the market.  

What is alcohol withdrawal?

Even though alcohol is a simple molecule, it acts on various brain receptors. One important receptor that it acts is GABA type A receptor. It activates GABA type A receptor. Prolonged use of alcohol can cause adaptive changes in this receptor which makes the person addicted to alcohol. When such a person stops taking alcohol, he may experience very drastic withdrawal response. This withdrawal response can even be life threatening.  Since Librium is acting on the GABA type receptor, it can be used to alleviate withdrawal response and give time to the brain to adapt.

How Librium is given for alcohol withdrawal?

Librium is usually started in a high dose and then gradually the dose will be tailed off. Common doses to start with are (30mgs 6hrly, 20mg 6hrly). Then the dose is gradually reduced until the withdrawal features are disappeared. It usually takes one to two weeks to completely detoxify alcohol dependent person. However, his/her craving for the alcohol will not subside with Librium. It needs careful psychotherapy.

Problems associated with Librium?

Librium can cause drowsiness, sedation, cognitive impairment, and ataxia. Due to this reason a Person who is on Librium should not operate machinery or drive vehicles. But they can do these tasks once he/she is off drugs for more than a week, so the drug is cleared from the body. 

Further reading

1. How alcohol affects mental health

First published in
Mental health information blog

Tuesday, November 15, 2011

What is Cytop (citalopram) depression medication prescribed for?

Cytop is a medication is SSRI drug class.SSRI stands for Selective serotonin reuptake inhibitors. Its generic name is citalopram. It is prescribed for clinical depression, Premenstrual dysphoric disorder (PMDD), Panic disorder, generalized anxiety disorder, Post traumatic stress disorder, Social anxiety disorder and obsessive compulsive disorder.

However, Citalopram is a racimic mixture of R and S enantiomer . S - enantiomer is the most effective active component. Escitalopram is the pure form of S - Citalopram and it is more effective in treating depression. But the clinical evidence is not so convincing.

Treatment most often reduces or even eliminates symptoms, but not a cure since symptoms can recur after medicine stopped. Once symptoms are gone, this medication should be continued for 1 year for the first episode of depression. For second and subsequent episodes of depression, treatment may need to be indefinite.  Use in anxiety disorders may also need to be indefinite ( Panic disorder, generalized anxiety disorder, Post traumatic stress disorder, Social anxiety disorder ).

Usual dosage is 20–60 mg/day. This drug usually is prescribed in the morning to avoid insomnia or sleep disturbances.


1. What is Citalopram or Cytop is prescribed for?

2. What are the side effects Cytop or Citalopram?


British National Formulary 59th edition

First published in
Mental health information blog

Thursday, November 3, 2011

Use and side effects of Arima (Moclobemide)

Arima is a brand name of Moclobemide. It is prescribed for depression and social anxiety disorder. It acts via inhibiting Mono amine oxidase enzyme present in certain areas of the body. This causes accumulation of mono amines (serotonin, Noradrenealin and dopamine). Increased levels of above mono amines results in neuronal changes that ultimately treats depression and social anxiety disorder.


Common side effects of Arima (Moclobemide)

1. Insomnia, dizziness, agitation, anxiety, restlessness

2. Dry mouth, diarrhea, constipation, nausea, vomiting

3. Abnormal milk secretion from the breasts

4. Rarely hypertension

Dangerous side effects

1. Hypertensive crisis (especially when Arima is used with certain tyramine containing foods (Cheese and wine) - risk is less compared to irreversible MAOIs such as Phenelzine (Nardil))

2. Induction of mania in susceptible people (patients with underlying bipolar disorder)

3. Rarely activation of suicidal ideation and behavior (suicidality)

4. Seizures or fits

Weight gain and sedation are minimal with Ariima (Moclobemide)

Trazadone can be used in Arima (Moclobemide) induced insomnia.

First published in
Mental health information blog

Use and side effects of Absenor

Absenor is a brand name of Sodium Valproate. It is prescribed in various mental health problems such as,

1. Bipolar affective disorder with mania and mixed episodes.

2. Complex partial seizures that occur either in isolation or in association with other types of seizures.

3. Simple and complex absence seizures.

4. Other seizure types

5. Migraine

6. Maintenance treatment of bipolar disorder

7. Bipolar depression

8. Psychosis, schizophrenia

Common Side Effects of Absenor

1. Sedation, tremor, dizziness, abnormal movements and headache

2. Abdominal pain, nausea, vomiting, diarrhea, reduced appetite, constipation, heart burn and weight gain

3. Loss of hair and curly regrowth

4. Polycystic ovaries (controversial)

5. Increased androgens, increased insulin levels leading lower blood sugar, lipid abnormalities (controversial)

6. Decreased bone mineral density (controversial)

Life Threatening or Dangerous Side Effects of Absenor

1. Rarely Liver toxicity with liver failure. Sometimes liver failure can become severe and fatal, particularly in children under 2 years.

2. Rarely pancreatitis, sometimes fatal

Weight Gain associated with Absenor

1. Many people experience weight gain

2. Can become a health problem in some people

3. Can be controlled by adhering to proper dietary advice and following a weight reduction program.


1. Sedation is Frequent and can be significant.

2. Some patients may not tolerate it

3. Usually goes off over time

4. Can reemerge as dose increases and then wear off again over time

5. Not recommend to drive vehicles or operate machinery until you know how Absenor acts on your body.

How to manage side effects of Absenor

Following advices must be followed after seeing your doctor.

1. Take at night to reduce daytime sedation

2. Switch to long acting preparation

3. Lower the dose

4. Switch to another agent

5. Propranolol 20–30 mg 2–3 times/day may reduce tremor

6. Multivitamins fortified with zinc and selenium may help reduce alopecia

First published in
Mental health information blog

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