Uses and side effect of Zosert tablets

Zosert is a brand of Sertraline manufactured by the Sun Pharmaceuticals, India. It is a SSRI (Selective serotonin reuptake inhibitor) class medication. It is prescribed for major depression, Obsessive compulsive disorder and other anxiety disorders. Most common side effects are nausea, gastric irritation and reduction in sexual desire. In addition, Zosert is one of the safest SSRI medication for patients with com morbid heart disease.

Zosert 50mg tablets

Depression is associated with many physical problems. Recent study has identified prolonged depression can cause heart problems such as heart attacks. 

Depression can cause Heart problems 

Uses of Zosert

This medication is mainly used for depressive disorder. Depression is characterized by more than two weeks period of low energy, low mood and lack of pleasure (unable to get pleasure from previously pleasurable activities). Zosert is given to patients with moderate to severe depressive episodes. A person need to take the medication for at least 7 – 10 days to experience a response.

In addition, Zosert is prescribed for obsessive compulsive disorder, anxiety disorders such as panic disorder, social anxiety disorder and post-traumatic stress disorder.

Depression is one of the  most common indication of Zosert

How Zosert is available and how should it be taken?

Zosert is available as tablets. Usually it is available as 25mg, 50mg and 100mg tablets. Maximum dose is 200mg. Maximum doses are tried for patients with obsessive compulsive disorder.

To minimize side effects, it should be taken fully without crushing after a meal. In addition, a full glass of water should be taken with it.

Another brand of Sertraline common in India

What are the common side effects associated with Zosert tablets?

One of the most common side effect is heart burn and nausea. It can be minimized by taking it after a meal. In addition, some people develop headache especially after several days. Paracetamol (Acetaminophen 1g for an adult) can be taken as a treatment for this side effect.

In addition, sleep disturbances are common with this medication. Some people will experience poor sleep and others may experience drowsiness. Depending on the type patient can adjust the dosage time. E.g if it causes drowsiness take the medication in the evening.

Other more side effect of concern is sexual dysfunction. It can manifest as lack of sexual desire or erectile dysfunction (Impotence).

Summary of common side effects

1.       Nausea

2.       Heartburn

3.       Headache

4.       Sleep problems

5.       Sexual dysfunction

6.       Weight loss and loss of appetite

What are the serious side effects associated with Zosert tablets?

Zosert increases serotonin neurotransmission in the brain. Therefore, it can rarely cause serotonin syndrome. It’s a life-threatening side effect associated with initiation, dose escalation and mixing serotonergic medications. Common symptoms of serotonin syndrome are fever, tremors, muscle rigidity, confusion, delirium, sweating and changes in blood pressure/ pulse rate. Patients with serotonin syndrome should be managed in an Intensive care unit.

In addition, this medication can cause bleeding due to interference with platelet function. It is significant in patients with bleeding disorders, but it is rare.

When Zosert is given to bipolar affective disorder, it can precipitate manic episode. It is a common problem as many patients with bipolar affective disorder presents to doctors in their depressive phase.

In addition, when this medication is given to patients with gastric ulcers, they can be aggravated and sometimes can cause serious bleeding.

There is also concern that SSRI class medications increase suicidal risk when given to teenagers. But the research findings are conflicting.

Summary of serious side effects of Zosert

1.       Serotonin syndrome

2.       Bleeding problems

3.       Aggravation of gastric ulcers

4.       Precipitation of manic symptoms

5.       Increased suicidal risk when given to teenagers

6.       SIADH – Syndrome of inappropriate ADH secretion. This can cause reduced serum Sodium level and it’s a cause for mental confusion.

Summary

Zosert is a SSRI class medication and its generic name is Sertraline. It’s mainly prescribed for major depression anxiety disorders. This is the most cardiac safe drug in SSRI class. Its main side effects are nausea, headache and heartburn. In addition, it can cause serotonin syndrome and can aggrevate gastric ulcers.

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.