Uses and side effects of Nexito tablets

Nexito is an Indian brand name of Escitalopram. It is a SSRI (Selective serotonin reuptake inhibitor) class medication. Nexito is commonly prescribed for clinical depression, anxiety and panic disorders. In addition, it is effective for wide variety of disorders including premenopausal syndrome to premature ejaculation.

Uses of Nexito

This is primarily prescribed for clinical depression. In addition, it is prescribed for panic disorder. Depression is characterized by persisting (more than two weeks) low mood, lack of energy, and inability to feel happiness. Nexito is given in moderate to severe forms of depressive disorder and it is generally not recommended for mild depressive disorder. In addition, it is not recommended in normal bereavement and grief.

Nexito 5mg tablets

Clinical Depression

Panic disorder

Nexito is also effective in treating anxiety disorders such as obsessive compulsive disorder and social phobia. It is specifically indicated in panic disorder. Panic disorder is characterized by attacks of sudden out of the blue episodes of severe anxiety. In social phobia the person feels extremely anxious in social situations which can cause marked functional impairment.

In addition to main indications, Nexito is also used in wide variety of conditions. It is prescribed for male premature ejaculation when it is quite distressing. In addition, some doctors prescribe it for premenopausal syndrome, behavioural problems in dementia and chronic fatigue syndrome.

Side effects of Nexito

This medication is a SSRI class medication. Therefore all side effects of medications in this class apply to this medication. These are the common side effects of SSRI medications.

1. Nausea
2. Heartburn
3. Diarrhea
4. Headache
5. Weight loss
6. Loss of appetite
7. Sexual dysfunction
8. Poor sleep

Sexual dysfunction is a common and annoying side effect of Nexito. 

In addition to above side effects, following side effects can occur rarely.

1. Allergic reaction : Hives, edema of the lips and anaphylaxis
2. Increased anxiety at the beginning of treatment, which settles after sometime.
3. Risk of mania: Other extreme of depression. Therefore, it is prescribed carefully in patients with Bipolar affective disorder
4. Reduced blood sodium level
5. Serotonin syndrome
6. Increased bleeding

In addition to above side effects Nexito specifically causes following side effects.

1. Reduced heart rate and heart problems
2. Yawning
3. Impaired concentration

Most of the side effects go off after some time. Most people will experience increased anxiety and tremulousness at the beginning of treatment but it usually go off. Therefore, most doctors prescribe low initial dose and increase the dose as time goes by.

However, one of the troublesome side effect and that can cause treatment discontinuation is Sexual side effects. These side effects manifest as erectile dysfunction in males and lack of sexual desire in females. But when prescribed for depression, it should be noted that depression can itself cause sexual problems. Therefore, for some patients with depression, taking Nexito will improve sexual function.

Even though this medication has certain side effects, it is generally well tolerated.

Pregnancy and breast feeding

There were no documented birth defects in mother who take this medication during pregnancy. But the risk cannot be completely eliminated. However, having depression during pregnancy is more likely to cause problems in new born (depression and anxiety in later life) due to various disruption in neurochemical pathways. Usually it is recommended to take this medication during pregnancy.

In breastfeeding all of the SSRI medications including Nexito goes into breast milk. But scientists discovered that Oxat (paroxetine) is least secreted into breast milk. Therefore, during lactation Oxat (paroxetine) is recommended by most psychiatrists.

Nexito plus ® 

Nexito plus is combination of both nexito and clonazepam. It is combined as escitalopram 5mg with clonazepam 0.5mg. You can read more about Nexito plus from here. 

How Nexito is prescribed

Nexito is available as tablets. Usual dose range is 5mg to 20mg. It should be taken as a whole tablet without crushing as it will increase side effects. It should be taken after a meal to minimize side effects.

When it is prescribed your doctor should know whether you have

1. Bipolar affective disorder
2. Liver problems
3. Kidney problems
4. Heart problems
5. Bleeding problems
6. Chronic gastritis

Tranax ® is another medication that is usually prescribed with Nexito to prevent initial aggravation of anxiety.

Summary

Nexito is a SSRI class medication prescribed for depression, panic disorder and other anxiety disorders. Its most common side effect is heartburn, nausea and headache. Sexual dysfunction is the most annoyed side effect. However, compared to other antidepressants this medication is well tolerated among patients.

Health risks of stress and tips for dealing with it

Stress is defined as the human body's response to a change. Even though it is good in short term, it can cause harm to your body in long term. Stress can increase certain hormonal levels in the body. This can cause certain changes in long term which can cause heart attacks, stroke and various other problems.
Importance of stress in our current society
Even though our society increased its sophistication, our body's mechanisms are lagging behind in the Stone Age.

Our body has two main roles. They are rest and face threats (fight/flight). During rest, our body increases digestion of food, stores energy and do general housekeeping jobs. But in a threat it increases energy expenditure, increases metabolism and prepare our body to fight or run. 

In the stone stage, threats are not persistent. Once the caveman saves itself from a predator he can relax. But in the current society our body identifies normal day to day stressors as threat to its survival and switch to fight/flight mode. The difference is that our day to day stressors never end like in the Stone Age. 

In addition, our day to day stressors do not need a flight/fight response (anxiety). They need a calm mind to sort the things out. 

Our body is not prepared to maintain a fight/flight mode forever. Maintaining in that mode for longer duration would result in various diseases such as heart diseases and diabetes mellitus.

This maladaptation of physiology in current society makes stress one of the main causes of disease.

How stress increase the health risks

Stress increases adrenaline, noradrenaline and cortisol levels in the body. These hormones increase blood lipid and sugar levels. When the stress is persistent for long time, above risk factors can cause ischemic heart disease and precipitate diabetes mellitus. In addition, Stress hormones increase heart rate and power of the heart contractions. These actions could cause wear and tear of heart muscles. It could lead to heart failure and heart muscle dysfunction (cardiomyopathy). 

Stressed out heart

In addition, elevated levels of stress hormones for longer duration can cause hypertension. This could further increase the heart dysfunction.

Addition to above methods stress could lead to unhealthy coping strategies such as increased smoking, increased alcohol intake and unhealthy dietary habits (taking fast foods, salty foods).





Tips for dealing with stress

• Don't worry about things you can't control, such as the weather.
• Solve the little day to day problems. This can help you gain a feeling of control.
• Prepare to the best of your ability for events you know may be stressful, such as a job interview.
• Try to look at change as a positive challenge, not as a threat.
• Work to resolve conflicts with other people.
• Talk with a trusted friend, family member or counselor.
• Set realistic goals at home and at work. Avoid overscheduling.
• Exercise on a regular basis.
• Eat regular, well-balanced meals and get enough sleep.
• Meditate.
• Participate in something you don't find stressful, such as sports, social events or hobbies.

Long term stress affects our health badly. It can cause increase heart diseases and hypertension. However, you could control your stress levels by way of good coping strategies, meditation and exercises. 

Further reading


Stress - NIH article
Stress: How to Cope Better With Life's Challenges