Use and side effects of Clonotril

Clonotril ® is a brand of clonazepam available in Indian sub-continent. It is a benzodiazepine class medication prescribed for epilepsy, anxiety disorders and for sleep disorders. Most common side effects reported by patients are drowsiness, dizziness, light headedness and walking difficulties (ataxia).

Long term side effects of Clonotril 

In addition to the common short term side effects mentioned above this medication has habit forming properties (Where the person need increasingly higher dosage to get the same effect esp. Sleep and reduction in anxiety) in long term use.

Clonotril 2mg tablets

What are the Uses of Clonotril ®

Epilepsy is the primary use of this medication. It decreases seizure frequency in epileptic patients. But it is commonly used in combination with other anti-epileptic medications. In psychiatry, it can be used to calm down severely disturbed patients and it is also used to treat sleep problems.

However, when it is used for sleep problems, it is very important to identify the underlying cause for the sleep problem. It is important to practice sleep hygiene techniques before getting treatment from sleep medications.

There are many causes for sleep problems that can be treated without sleep inducing medications. Depression and anxiety disorders are common causes for sleep disturbances. These problems settle once underlying cause is treated. In addition, there can be numerous medical problems associated with sleep difficulties.

Clonotril is prescribed in sleep problems, but sleep hygiene techniques should be tried first

Following sleep hygiene methods should be tried before taking medications

1. It is important to use the bed only for sleep

2. Do not take daytime naps or minimize them

3. It is very important not to take alcohol, coffee, coke or chocolate (Caffeine) just before sleep. Alcohol causes serious sleep disturbances. 

4. When you are having difficult time falling asleep then you need to get up from the bed and do something else without staying on the bed.

5. It is also important to make the sleeping environment comfortable, quiet and calm. Make your bed sheets clean and tidy.  

6. Exercise in day time, but not in night before sleep. 

Dose of Clonotril and how to use it

Dosage range is between 0.5mg to 4mg. However, most doctors prescribe between is 1mg and 2mgs. It is usually taken in the night to make sure drowsiness would not interfere with day to day activities. In addition, this medication has long action (30 – 40 hrs), so it is usually prescribed once a day.

Crushing this medication would increase side effects. E.g. Taking half a tablet would increase blood levels rapidly and cause more side effects so take the dose similar to ½ tablet as whole. In addition, take this medication with meal and with a full glass of water. 

It is very important not to exceed the dose prescribed by the doctor. If you feel you need more medication, then discuss with your prescribing doctor. This medication is having habit forming properties, therefore do not take it for long term without explicit advice from your doctor. If you discontinue it suddenly after prolonged use then there is possibility that it will cause severe withdrawal symptoms. 

What are the side effects of Clonotril

Following are a list of common side effects

1. Drowsiness

2. Dizziness

3. Unsteady gait (walking)

4. Muscle weakness

Drowsiness is a very significant side effect. It can affect driving and machinery operation. Sometimes it can persist into the morning even after night dose. Therefore, it is very important that you to see how you feel before driving or operating machinery. 

Operating machinery and driving can be dangerous when you are on this medication

What are the less common side effects of this medication? 

1. Headache and pain

2. Vertigo or unbalanceness 

3. Slurred speech

4. Low blood pressure 

5. Tremors of hands and body

6. Urine problems: - Common in elderly people

7. Respiratory depression: - It is important to tell whether you have respiratory problems such as Asthma, before getting the prescription. 

8. Blood disorders

9. Skin reactions

10. Paradoxical excitation: - Can cause disinhibition and increased activity in certain group of people.

What you should to tell your doctor, before getting the prescription?

If you are known to have following problems or medical condition, it is important that you tell that to your family doctor.

1. Liver problems

2. Kidney problems

3. Heart problems

4. Snoring in the night: - It is an indication of a condition called obstructive sleep apnea. In such people, it can cause dangerous lowering of breathing which causes the blood oxygen levels to drop during sleep. It may result in brain damage. Due to poor sleep at night, people with snoring complaints daytime drowsiness. 

5. Any medications or drugs you are taking, including street drugs

6. If you are a woman, then it is important to mention whether you are pregnant. 

You need to tell whether you are pregnant before getting prescription

Summary

Clonotril ® is a benzodiazepine class medication prescribed for epilepsy, calm down disturbed patients and for sleep problems. Common problems associated with this medication are drowsiness, lightheadedness and it can be habit forming in long term use.

Pictures  Courtesy : Wikimedia

Uses and side effects of Lamosyn

Lamosyn is an Indian brand name of generic anti-epileptic lamotrigine. In addition to epilepsy, it is also prescribed for mental health problems such as bipolar affective disorder. Skin rash is the most significant side effect. In addition, this medication can cause nausea, dry mouth and unsteady walking.

Lamosyn 25mg tablets

Uses of Lamosyn

This medication is classified as an anti-epileptic. But it was found that this medication is also effective in psychiatric disorders such as Bipolar affective disorder. It is prescribed to prevent bipolar depressive episodes in patients who are in predominantly depressive phase.

25mg and 50mg tablets

Use in neurology

This medication is used in most types of epilepsies. It is used in focal and generalized seizures. In addition, it is used in Lennox – Gastaut syndrome. It is also used in typical absence seizures in children.

Use in psychiatry

 Bipolar depression is depressive phase in patients with bipolar affective disorders. Bipolar affective disorder is characterized by different phases of mood and activity. In manic phase patients have extremely elevated mood, increased energy and disruption in social function. In depressive phase, patients get exact opposite of manic phase. They get low mood, suicidal ideation, low energy and feeling of worthlessness.

Compared to major depressive disorder, depression associated with bipolar disease is challenging to treat. It is because most antidepressants do not work in bipolar depression.

Lamosyn is one of the medications that is proven to be effective in preventing depressive episodes in bipolar illness.

What are the common side effects?

Commonest side effects of this medication are nausea and vomiting. To minimize these side effects, you need to take it with a full glass of water without crushing the medication. In addition, taking this medication after a meal will reduce the stomach side effects.

Other common side effects list

1. Dry mouth
2. Dizziness
3. Tremors
4. Poor sleep
5. Vision problems
6. Rash

Skin rash is the most problematic common side effect. It can occur in 1% of individuals who take this medication. If you develop any skin problem while on Lamosyn, then stop the medication immediately and consult your doctor. Skin reactions can go into life threatening conditions. This is one reason doctors start this medication very slowly.

Skin rash that occur in 1% of patients. Courtesy : http://www.newhealthguide.org

Rare side effects of Lamosyn

1. Inflammation of eye
2. Liver failure
3. Unsteadiness in walking
4. Confusion
5. Hallucinations
6. Blood problems

Dose and administration

This medication starts with 25mg once daily for 14 days then 50mg daily for another two weeks usually up to maximum dose of 600mg per day with two weekly dose increments. Very slow increase of dose is required to prevent the rash from developing.

Pregnancy

This medication can harm the unborn child. But the discontinuation of medication in pregnancy can result in aggravation of epilepsy or bipolar depression (which may have more risk of harm to mother as well as to the baby). Therefore, continuation or discontinuation of this medication should be done by an experienced clinician.

Breast feeding

Lamosyn occur in breast milk. Again the decision to stop medication should be done by an experienced clinician.

It is very important that you should consult your doctor before planning to get pregnant and you need to use contraception to prevent unexpected pregnancies.

Summary

Lamosyn is prescribed for epilepsy and bipolar depression. Most troublesome side effect is the skin rash. In addition, it should be cautiously used in pregnancy and breast feeding under super vision of an experienced clinician.

Uses and side effects of Manorest

Manorest is a trade name of the generic medication Alprazolam. It is manufactured in India and popular in Indian sub-continent. It is prescribed for Anxiety disorders and to help sleep problems. This medication is known to cause fatigue, drowsiness and dizziness. This medication should not be used in long term as it is habit forming and causes addiction.

Uses of Manorest

Manorest is prescribed primarily in anxiety disorders such as social phobia, simple phobia, agoraphobia and panic disorder. Addition to above use this medication can help to reduce seizures. But it is rarely used for this purpose.

This medication should not be used long term, by people with anxiety disorders, as they will need higher doses to control anxiety. In addition, they become more anxious when they are not on medication.

Sudden discontinuation of Manorest after prolonged use can cause severe withdrawal syndrome. It is similar to alcohol withdrawal reaction and should be treated by medical professionals.

Manorest 0.5mg tablets

What are the dose range of Manorest?

This medication is usually prescribed in the range 0.25mg to 1mg. It should be taken as a complete tablet with full glass of water. Never crush the tablet before taking as it will increase the side effects.

What are the common side effects of this medication?

Drowsiness is a commons side effect of Manorest

Most common side effects are sedation, dizziness and drowsiness. These side effects can go on to next day morning, when you takes the medication at night (It is prescribed at night). Therefore it is very important you should avoid operating machinery and driving vehicles, when you are on Manorest. However, after sometime you may find the side effects become tolerable.

Operating machinery can be dangerous if you took this medication at night

Driving can be dangerous if you are on Manorest

If this medication is taken to induce sleep, you may find the quality of sleep is less than the natural sleep. It is because this medication is known to disrupt natural sleep cycle.

Few people have reported that taking this medication can cause depression and suicide tendencies. In addition, some people will lose their social inhibition and can become irritable and aggressive. In addition, it can increase risk taking behavior in certain individuals.

Other common side effects are memory impairment, confusion, and fatigue. Confusion is more common among elderly people who take this medication.

List of commons side effects of Manorest

1.       Sedation

2.       Drowsiness

3.       Dizziness

4.       Loss of quality sleep

5.       Depression

6.       Disinhibition

7.       Aggression

8.       Memory impairment

9.       Confusion

10.    Fatigue

Clinical depression is a common side effect

Rare side effects of Manorest

1.       Sexual problems

2.       Allergic reactions

3.       Headache

4.       Walking difficulty

5.       Urine incontinence

Information you need to give to your doctor before getting your prescription

1.       Kidney disease

2.       Pregnancy status

3.       Breast feeding

4.       Liver disease

5.       Breathing problem such as Asthma

6.       Clinical depression

7.       Myasthenia gravis

Summary

Manorest is a prescription only benzodiazepine class medication, its generic name is Alprazolam. It is prescribed for Anxiety disorders and to induce sleep. Its main side effects are sedation, drowsiness, confusion and memory impairment.

Sources

Drug treatment for anxiety - Australian prescriber

Uses and side effects of Lonazep tablets

Lonazep is a brand of clonazepam manufactured by Sun pharmaceuticals, India. It is a benzodiazepine class medication prescribed for epilepsy, calm down disturbed patients, and induce sleep and to treat anxiety. Its main side effects are drowsiness, dizziness and unsteadiness or ataxia.

What are the uses of Lonazep?

Lonazep is mainly prescribed to treat epilepsy. It is effective in most types of epilepsies and it is usually prescribed in combination with other anti epileptic medications. It is also prescribed immediately to prevent further seizures when a seizure attack occurs.

In addition, it is prescribed for short term relief of insomnia (poor sleep). However, it should not be used for more than three weeks for the purpose of insomnia, as it is known to cause dependence (habit forming).

It is also used to treat alcohol dependence. In addition, it is helpful for people with poor sleep following discontinuation of alcohol. Medications like Zolfresh would also help people with sleep problems. 

Another brand of clonazepam that is commonly prescribed is Anxit. 

Summary of uses

1.       To induce sleep

2.       To calm down disturbed patients

3.       Epilepsy

4.       To relieve Alcohol withdrawal symptoms

Who should not use this medication?

Lonazep should be used carefully in patients with breathing difficulties. It is known to cause breathing difficulties, especially in higher doses. It should not be used in patients with myasthenia gravis.

In addition, it should not be used in patients with sleep apnea. Therefore, if you have poor sleep associated with snoring at night then you need to inform that to your doctor.

Lonazep should be used cautiously in patients with severe liver and kidney problems.

You should be cautious when you have following problems and inform them to the prescribing doctor.

1.       Breathing difficulties

2.       Snoring at night with poor sleep

3.       Kidney and liver problems

Lonazep 2mg tablets pack.

What are the common side effects of Lonazep?

Drowsiness and light headedness can go on to next day when it is taken in the night. In addition, it can cause unsteadiness or ataxia. It is also dangerous to operate machinery or drive vehicles when its effects are present.

Operating machinery can be dangerous when taking Lonazep tablets

In addition, some patients who were given Lonazep can become more agitated and it is called paradoxical excitation.

In addition, this medication is habit forming in long term use. People can become addicted to this medication and they may find that sleeping is becoming dependent on medication. It is common when this medication is taken more than three weeks.

Summary of common side effects

1.       Drowsiness

2.       Light headed ness

3.       Ataxia

4.       Danger of operating machinery and driving even in next day

5.       Habit forming

6.       Paradoxical excitation

How do you take Lonazep?

This medication is taken as oral tablet. It should be taken without crushing or breaking. It should be taken with a full glass of water. Also it should be taken as prescribed by the doctor. Never adjust dose for yourself or use it for poor sleep for more than three weeks.

This medication is available as 1 - 2mg tablets.

Lonazep mouth dissolving tablets

Mouth dissolving tablets are useful when the patient is violent and refusing medications. In such situations putting the tablets into the mouth causes rapid disintegration and patient cannot spit out the medication.

In addition,  they can be given in covert medication administration. Here the tablets are dissolved into a drink without patient’s knowledge. However, it has associated legal and ethical problems.

Lonazep mouth dissolving tablets

Summary

Lonazep is a benzodiazepine class medication prescribed for epilepsy, poor sleep and to calm down agitated patients. Its main side effect is drowsiness and difficulty in operating machinery and driving. In addition, this medication has abuse potential and can be habit forming.

Uses and side effects of Encorate chrono tablets

Encorate is a brand of Sodium Valproate manufactured by Sun pharmaceuticals India. Encorate chrono is long acting preparation that can be given once daily. It is prescribed for epilepsy, migraine and bipolar disorder. Main side effects are nausea, weight gain and hair loss with curly regrowth.

What are the uses of Encorate ?

Primary use of this medication is for epilepsy. In addition, recently it has been licensed in bipolar affective disorder. In addition, it is used for people with migraine to prevent further attacks.

Encorate is prescribed for all major forms of epilepsy. In fact it is one of the most prescribed anti-epileptic.

Encorate 200mg tablets

Use in Bipolar disorder

In addition to epilepsy, Encorate is prescribed for people with bipolar disorder. Bipolar disorder is characterized by episodes of depression and mania. These patients at times get depressed and at times they get manic. In the manic phase patients experience extreme elevation of mood, increased energy, and reduced need to sleep. In mild form of the disorder, they tend to work more, get more sexual desire and spend more money. Most of the time spending excessive money and sexual disinhibitions can cause serious social harm. When the manic phase is serious, the patients would become irritable, violent and start getting psychotic experiences. They become destructive and need to be treated in a secure psychiatric facility.

Bipolar disorder - Mania and depression in same person 

At the other extreme, same patient can develop depressive episodes. Depressive episode is characterized by Low mood, lack of energy, and getting lack of pleasure from previously enjoyable activities.

Encorate is used to prevent severity of episodes, therefore classified as a mood stabilizer. It is prescribed for patients with serious or frequent episodes (more than two within five years).

Side effects of Encorate

Most common side effects

Nausea, vomiting and diarrhea are the most common side effects. In addition, hair loss with curly regrowth can occur. Ankle edema and obesity can be troublesome side effects. In addition, some patients may experience tremors of limbs.

                                  

Serious side effects that can rarely occur with Encorate

1.    Liver dysfunction

2.    Increased ammonia in the blood

3.    Blood disorders

4.    Pancreatitis

5.    Allergic reactions

Encorate should not be given to pregnant women(Especially at the early pregnancy). It is documented to cause harm to the unborn baby. Therefore, always tell the last menstrual period to the doctor and whether you are pregnant to the doctor.

Should avoid in Early pregnancy

If you are on Encorate, then make sure you use adequate contraception and plan the pregnancies after discussing with your doctor.

In addition, if you have liver disease, you should inform that  to the doctor before he/she prescribe this medication.

Different formulations of Encorate

Encorate is available as tablets, syrups and long acting preparation. Generally it is prescribed twice or thrice per day. 

What is Encorate Chrono ?

Encorate chrono is a long acting preparation of Sodium Valproate. Unlike normal preparation, it causes fewer short term side effects such as Nausea. In addition, it can be prescribed once daily, compared to twice or thrice daily prescription of its normal sibling. However, it is more expensive than the normal preparation.

Encorate chrono - Long acting preparation

When you are taking this medication, make sure you do not crush or break tablets. It will reduce the effectiveness and cause more side effects. In addition, take this medication with meals and with a full glass of water.

Summary

Encorate is a anti epileptic medication that is also used in bipolar disorder and migraine prophylaxis. It can cause liver failure and should not be taken by pregnant mothers.