Uses and side effects of Restyl Tablets

Restyl  is a brand of Alprazolam manufactured in India. It is used for anxiety disorders and to induce sleep. At smaller doses it reduces anxiety and cause less drowsiness. However, it can cause fatigue and dizziness. In addition, this medication can be habit forming on long term use.

Uses of Restyl

 Restyl is mainly used to control anxiety. It can be useful medication in anxiety disorders such as Panic disorder, Social phobia and phobias. In addition, this medication has a seizure control effect. But there are other medications that are more effective for this purpose. Some use this medication to help sleeping, But medications like Zolfresh or Nitrest would serve purpose better. 

However, long term use of this medication for anxiety can become troublesome as you will need higher doses to control same anxiety. In addition, sudden discontinuation of this medication after long term use (more than three months) can cause severe reaction that may need medical attention.

Restyl 0.5mg Tablets

Usual dose of Restyl

This medication is used in the doses of 0.25mg to 1mg to control anxiety. Higher doses in the range of more than 2mg can cause significant drowsiness.

Uses and side effects of Lonazep (Brand of Clonazepam)

Uses and side effects of Manorest (Another brand of Alprazolam)

Common side effects of this medication

As mentioned earlier this medication can cause drowsiness and sedation. These side effects can go into the next day morning if you have taken this medication for sleep. It can cause problems in operating machinery and driving.

 In addition, to above side effects using this medication frequently can cause sleep problems as Restyl is known to disrupt sleep architecture. Even though you are able to sleep with this medication, it does not produce natural sleep. So you may not be feeling refreshed after the sleep.

In addition, using this medication frequently can cause depression and sometime it can cause suicidal tendencies.

Some people may lose inhibitions after using this medication and may become aggressive or show increased risk taking behavior.

In addition to above problems this medication can cause fatigue, memory loss and confusion.

List of commons side effects of Restyl

1.       Nausea

2.       Drowsiness

3.       Problems in driving and operating machinery

4.       Depression with suicidal tendencies

5.       Fatigue

6.       Memory loss

7.       Confusion

8.       Disinhibition causing aggressiveness and increased risk taking behavior

List of rare side effects

1.       Sexual difficulties

2.       Headache

3.       Urinary incontinence

4.       Difficulties in walking

What the doctor should know before prescribing?

This medication is prescription only. Therefore, you need to consult a doctor and explains your problems before getting this medication. Before getting the prescription you need to inform the doctor if you have following problems.

 If the patient has following diseases they should tell it to the doctor before taking the drug.

* Kidney disease

* Liver disease

* Breathing disorder

* Ataxia (poor control of body movements)

* Clinical depression

* Myasthenia gravis

General guidelines when you take this medication

Take the medicine at around the same time(s) every day.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

Take Restyl exactly as directed. Do not take more or less of it, or take it more often than prescribed by your doctor. Do not stop taking this without informing your doctor.

Summary

Restyl is a Indian brand of Alprazolam. Its main uses include anxiety and helping to sleep. Main side effects is drowsiness. It can become habit forming in long term use.

Even though the author of this article is a medical doctor, contents of this article are for information only. You should always consult your doctor, before starting or stopping any drug containing Alprazolam e.g. Restyl. In addition, medical information can change over time. Please ask your doctor for information on the latest studies.

Side effects of Electroconvulsive therapy (ECT)

ECT or electroconvulsive therapy is a procedure performed by the doctors to induce an artificial seizure (fit). It is because, seizures are found to reduce psychiatric symptoms. This effect was observed in people who have both psychosis and epilepsy. Doctors treating these patients observed that psychotic symptoms were reduced immediately after they experienced a seizure. Later when they induce seizures to people who have psychosis, same effect was observed.

Earlier days, doctors used to induce seizures by way of injecting large doses of insulin. This causes severe hypoglycemia which induces the fit (It was depicted in the popular film “beautiful mind”). However, it was found to be quite dangerous and caused unacceptable side effects.

After that doctors start to induce seizures by way of passing an electric current through the brain. It is called Electroconvulsive therapy.

Common uses of ECT (Electroconvulsive therapy)

ECT is useful in patients with severe depression and severe mania with aggressiveness and exhaustion. In addition, ECT is indicated in psychiatric patients with poor oral food and water intake. ECT is also given to mothers with psychotic symptoms, immediately after delivery. In addition, ECT is also given to patients with significant suicidal and homicidal ideas with plans. However, ECT is not indicated in uncomplicated schizophrenia.Basically ECT is indicated when a rapid symptom relief is needed such as in a case with a mother with a small infant. It is because drugs usually take around two to three weeks to show any action.

How to prepare for ECT

Preparation is similar to any procedure that is performed under general anesthesia. Salient features are

1.Fasting for solid foods for eight hours. Four hours for water.

2.Bowels and bladder should be emptied before the procedure

3.May need to undertake several blood tests and electrocardiographic tests before the procedure.

Some procedures may vary from institution to institution.

Side effects and problems of ECT

1.Problems of general anesthesia: - ECT or Electroconvulsive therapy is given under general anesthesia. Problems of general anesthesia includes allergic reactions, difficulty in getting up from anesthesia, muscle pain and stuff in the stomach going into the lungs (aspiration).

2.Memory loss: - ECT or Electroconvulsive is associated with loss of memory for certain events. This loss is usually irreversible. In addition, level of memory loss is directly proportionate to the amount of electric current given (dose).

3.Possibility of aggravating intra-cranial (inside the head) problems: - If the patient has a defect in blood vessels inside the brain then there is a possibility intracranial hemorrhage that can be lethal.

4.Possibility of getting uncontrollable fits (status epilepticus): - If the patient has a history of epilepsy then there is a limited chance of getting a seizure that is prolonged.

Can depression cause heart problems

According to a recent study published in Psychophysiology ( Volume 48, Issue 11, pages 1605–1610, November 2011) there seems to be  a statistically significant relationship between DSM IV Major depressive disorder and cardiovascular recovery after exercise.

There were numerous studies done to determine relationship between heart problems and depression. According to (Barth, Schumacher, & Herrmann-Lingen, 2004; Carney et al., 2008; Lavoie & Fleet, 2000; Lesperance, Frasure-Smith, Talajic, & Bourassa, 2002; Rozanski, Blumenthal, & Kaplan, 1999; Rutledge et al., 2006) Major depressive disorder is associated with heart problems. In fact, heart diseases can be caused by Major depression  as well as existing heart problems can be aggravated by major depressive disorder.

During vigorous exercises our heart rate increases exponentially. But immediately after physical exercise, heart rate becomes normal within a short period of time. But people with a dysfunctional autonomic nervous system have delayed heart rate recovery after exercise. This delayed recovery is linked to heart diseases by several studies (Cole, Blackstone, Pashkow, Snader, & Lauer, 1999; Jouven et al., 2005; Mora et al., 2003; Nishime, Cole, Blackstone, Pashkow, & Lauer, 2000).

According to the above “The effect of major depression on post exercise cardiovascular recovery” study researcher’s found a statistically significant delay in recovery of heart rate following exercise by way of stress testing (treadmill). Therefore, there can be a autonomic nervous system dysfunction in Major depressive disorder. 

In addition to the biological vulnerability for heart disease, people with major depression have many life style issues that is detrimental to the heart such as lack of exercises and bad food habits.

Depression increases risk of heart disease

Most people with depression do not care about the healthy food choices, because of lack of energy and motivation. In addition, they do not do regular exercises again due to lack of energy. In addition, depressed people with diabetes or ischemic heart disease tend to miss their pills.

Diabetic patients with depression tend to forget monitoring their health and take medications

Depressed people tend to ignore healthy food choices

Depressed people tend to do less exercise

Conclusion

Major depression is associated with significant heart problems. It is due to both life style issues such as lack of exercises seen in major depression as well due to biochemical and physiological abnormalities seen in depression.

Therefore, it is very important to treat depression in people with cardiovascular risk. 

Sources

The effect of major depression on post exercise cardiovascular recovery

Relationship between violent behavior and mental illnesses

Most people who do not know about mental illnesses think mentally ill patients can become easily violent. But the truth is little different. Most people with mental illnesses are not violent. According to the MacArthur Violence Risk Assessment Study, “the prevalence of violence among those with a major mental disorder who did not abuse substances was indistinguishable from their non-substance abusing neighborhood controls (normal people)”.

In addition, schizophrenia shows lowest incidence of violence. Bipolar affective disorder and major depression patients are more violent than schizophrenic patients. Patients with substance abuse issues are the most violent.

Who are at risk?
According to the above study and the personal experience of this author, close relatives of the mentally ill are at most risk. Risk to general public is much less than expected. In fact incidence of violence is almost similar to non-mentally ill people.

What are the predictions of violence in mentally ill?

One of the best predictor is past violence. Past unprovoked violence carries the greatest risk. In addition, substance abuse issues increase the violence of mentally ill patients. Other factors that are thought to increase violence are command hallucinations, and severe prosecutory delusions. In addition, people with severe depression may harm their dependents. E.g. severely depressed mother may kill her young children just to save them from her imagined misery.

How to control violence in a mentally ill?

Even the risk of violence is low, they do occur and most people who deal with mentally ill patients need to know how to tackle them.
 

1. Talking to the patient calmly will alleviate most of the violence. Most people with mental illnesses become violent because they do not get their basic needs. In fact for some of the reasons even the most normal sane people could get violent. For an example, one of the patients who really got violent and try to break the door of the seclusion room became so because he could not contact his mother. Contacting his mother stopped his violence completely.

2. Even most patients can be calmed down by talking, some do need drugs. First option is oral antipsychotics with sedating properties such as Olanzapine.

3. Third option is intramuscular sedative drugs such as Olanzapine, Haloperidol and Midazolam. These drugs will quickly calm down a patient but they can cause side effects such as abnormal movements and respiratory depression (Midazolam).

In extreme rare cases patients need to be physically restrained. Usually it is to allow an intramuscular injection. When the patient is sedated physical restrain should be removed.

Sources

Violence and mental illness: an overview
Violence and Mental Illness — How Strong is the Link?

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Relationship between violent behavior and mental illnesses