Uses and side effects of Deprex tablets

What is Deprex?

Deprex is a brand of olanzapine manufactured by Square Pharmaceuticals, India. It is a drug prescribed for psychosis and bipolar disorder.

When administered as an injection, it quite useful for treating acutely disturbed patients who are unable take oral medications. Its principal side effects are drowsiness, weight gain, and problems with blood sugar patients predisposed to diabetes.

Uses of Deprex

Deprex can be used in a wide variety of mental disorders

·         Schizophrenia—Deprex is effective in managing the symptoms Schizophrenia including delusions, hallucinations, disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions.

·         Bipolar disorder—This exhibits itself as an extreme and often persistent mood swings that can disrupt a person’s day to day functioning. Mania and depression can be sometimes accompanied by psychotic symptoms such as auditory hallucinations and grandiose delusions. Deprex is found to be effective in treating both the manic and depressive phases of the illness and it stabilizes the mood of the patients.

·         Depression—Current evidence suggest that in combination with Prodep (Fluoxetine), Deprex is quite effective in treating depression resulting in bipolar disorder.

·         Controlling disturbed patients—Deprex have a sedative and calming profile and patients with acutely disturbed behavior, especially psychotic patients. Deprex is available as both intramuscular injection and rapid ingestion tablets that dissolves quickly inside the mouth.

How to Take Deprex

Deprex comes as a pill in an Aluminium wrapping or as orally disintegrating tablet (tablet that dissolves quickly in the mouth). Usual dosage is once a day.

You need to follow the prescription carefully, and need to ask your doctor or your if you do not understand what it says. You need to take the medication as exactly as directed by the psychiatrist. You should not take more or less of the medication.

Orally dissolving tablets will quickly dissolve in the mouth and do not have an unpleasant aftertaste.

Usually, your doctor start you on a low dose of Deprex then gradually increase the dose.

It is very important to understand that this medication would control your symptoms, but will not cure your underlying condition. In addition, it may take around several weeks or may be longer before you feel the full benefit of the treatment. It is also very important to continue to take the medication even though you feel well.

Do not stop the medication without explicit advice from your doctor.

Picture of bipolar illness depicting both mania and depression

Warnings and Precautions Before You Take Deprex

·         Tell your doctor or pharmacist if you are allergic to olanzapine or any other medications and food stuffs

·         Tell your doctor or pharmacist the prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you take or plan to take because this could affect your treatment.

·         Tell your doctor if you have or have ever had a stroke, a mini-stroke, heart disease or a heart attack, an irregular heartbeat, fits, breast cancer,

·         Any condition that makes it difficult for you to swallow,

·         High or low blood pressure,

·         a high level of fats (cholesterol and triglycerides) in your blood,

·         a low number of white blood cells,

·         liver or prostate disease, Stomach problems, glaucoma (an eye condition),

·         High blood sugar, or if you or anyone in your family has or has ever had diabetes.

·         Tell your doctor if you have severe vomiting or diarrhea

·         Tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or whether you plan to become pregnant or are breast-feeding.

·         If you become pregnant while taking olanzapine, call your doctor immediately.

• Olanzapine may cause problems in newborns after delivery

·         It is very important You should know that Deprex may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.

·         You should know that alcohol can add to the drowsiness

·         Cigarette smoking may decrease the level of blood levels of this medication.

You should not smoke as it will reduce blood level of this medication causing less effect

Important Warning Before Taking Deprex

Newer Studies have shown that patients with dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and that may cause changes in mood and personality) who take medication similar to deprex

Senior citizens with dementia may also have a greater chance of having a stroke or mini-stroke during treatment with deprex.

Side Effects of Deprex

·         Drowsiness

·         Dizziness

·         Restlessness

·         Unusual behavior

·         Sleep difficulties

·         Weakness

·         Difficulty in walking

·         Constipation

·         Weight gain is common

·         Dry mouth

·         Pain in various body parts

·         Breast enlargement 

·         Late or missed periods

·         Decreased sexual potency

Some can be serious, call your doctor immediately. If you experience any of the following symptoms,

·         Seizures (Fits)

·         Visual disturbances

·         Swelling of the arms, hands, feet, ankles, or lower legs

·         Sore throat, fever, chills with rigors, and other signs of infection

·         Very stiff muscles

·         Excess sweating

·         Fast or irregular heartbeat

·         Rash

·         Hives

·         Difficulty breathing or swallowing

Overdose Symptoms

Symptoms of overdose may include:

·         Excessive Drowsiness

·         Slurred speech

·         Fast heartbeat

·         Sudden movements that you cannot control or extrapyramidal side effects

·         Coma (loss of consciousness for a period of time)

If any of this symptoms are experienced, call the doctor immediately.

Please note that this author does not have any affiliation to Square Pharma, India or Deprex. The only purpose for this article is to highlight the uses and side effects of this medication. Always see a doctor before starting any treatment.

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.

Problems associated with Lithosun (Lithium carbonate) therapy

Lithosun is a brand name of Lithium carbonate. It is a medication prescribed for bipolar disorder and resistant depression. However it can cause various toxic effects and side effects. Since it is a toxic chemical there are many problems associated with it.

Problems related to medications can be classified as relative and absolute. In absolute, the treatment should not be commenced for reason. But in relative, the treatment can be commenced after weighing the risks and benefits by an expert in the field. Most of the problems in Lithosun therapy are in the relative type.

What are the conditions, Lithosun is prescribed?

Lithosun is considered as a mood stabilizer, where it prevents mood swings (mania to depression and vice versa) of the bipolar disorder.

In addition Lithosun is prescribed in resistant depression. It is used to augment the effects of anti-depressant medications. Some psychiatrists use this medication to treat resistant schizophrenia as well.

Lithosun acts by a complex mechanism, which is not fully understood. It is thought that Lithosun acts by changing various complex neurotransmitters.

What are the Problems associated?

Severe hypothyroidism

Lithosun is known to reduce the thyroid gland function. So doctors will not usually prescribe Lithosun to severe hypothyroidism patients. However it can be prescribed to people with mild to moderate hypothyroidism. Here thyroxin hormone is co prescribed with Lithosun. In addition patients should monitor there thyroid function levels during the therapy.

Courtesy : Wikipedia

Severe renal failure

Lithosun is excreted from the kidneys. So in renal (kidney) failure, Lithosun accumulates inside the body. So it can lead to Lithosun toxicity. However Lithosun can be given very cautiously in mild to moderate renal impairment. In addition Lithosun can itself cause renal impairment, so renal functions should be checked during Lithosun treatment.

Courtesy : www.kidneytreatment.space

Heart disease

Lithosun can cause several electrocardiogram changes that may cause confusion with existing cardiac problems. In addition Lithosun is usually not given to patients with severe heart failure.
In addition Lithosun is also used very cautiously in sodium metabolism problems such as Addison’s and Conn's disease.

Courtesy : www.materheartfailureservice.ie

Pregnancy

Lithosun is known to cause cardiac problems in an unborn child. There are documented cases of cardiac anomalies (Epstein anomaly), so most doctors will change this medication to something else during pregnancy. So if you happened to get pregnant while on Lithosun then you must inform your doctor immediately.

Lactation

Lithosun should not be used in breast feeding. So patients are usually advised to bottle feed there babies.

Courtesy : Wikipedia

Conclusion

Lithosun is an essential drug in bipolar disorder treatment. However, due to the toxicity it is not used in many co existing conditions.

Uses and side effects of Sizodon

Sizodon is a brand of Risperidone manufactured by the Sun Pharma, India. It is an atypical antipsychotic medication prescribed primarily for Schizophrenia, Delusional disorder and Bipolar disorder. Main notable side effects of Sizodon are movement problem called acute dystonia and drug induced Parkinsonism.

Uses of Sizodon

Sizodon is prescribed primarily for psychotic disorders such as schizophrenia, bipolar mania and delusional disorder. In addition, it is prescribed for acute and transient psychotic disorders. It is available as tablets and usual dose range is 0.5mg to 16mg. But it is usually prescribed in the range 2mg – 8mg.

Sizodon 1mg tablets

Sizodon 2mg tablets

Schizophrenia is a psychiatry disorder characterized by delusions and hallucinations. Delusions are strongly held beliefs that are culturally unacceptable and not amenable to logical arguments. Hallucinations are perceptions (sounds, visions and sensations) without a stimulus (e.g hearing voices when nobody is talking). It is found scientifically, that patients with schizophrenia experience above symptoms due to abnormalities in their brain chemistry.

Artists Depiction of Schizophrenia

Bipolar disorder is a mood disorder where the patients experience extreme mood swings. They sometime become severely depressed with ideas of worthlessness, having inability to experience pleasure, and hopelessness. Some patients commit suicide when the depression overwhelms them. In addition, at other times they have normal mood and sometimes get very high elevation of mood. At the time of elevation of mood they can become destructive, over spend their money and have sexual misadventures.

Having both happy and sad moods in Bipolar disorder

Sizodon is especially effective in the mood elevated phase or the manic phase. In addition, it has some mood stabilizing properties. Therefore, some doctors prescribe it after their manic phase.

This medication is also prescribed in Delusional disorder. It is a disorder characterized by persisting delusions. Common example of Delusional disorder is morbid jealousy. Here the person suspects his/her sexual partner fidelity without any adequate evidence.

Side effects of Sizodon

Sizodon is an antipsychotic medication and it shares side effects of other anti psychotics. Most common side effects are nausea, gastric upset and drowsiness. They are common to most of western medications.

Most notable side effects are movement problems named acute dystonia and drug induced Parkinsonism. Acute dystonia occurs within hours of taking the medication and Parkinsonism occur within days of taking it. These side effects are common in higher doses of the medication (Usually more than 4mg).

It can cause restlessness in legs and the person gets a feeling that he need to continue to move. It is very distressing symptom and if you get this symptom, you need to meet your doctor.

These movement related side effects are described in the following post.

Causes, symptoms and treatment of extrapyramidal side effects

In addition, Sizodon is known to aggravate glaucoma, cause acute urine retention, cause constipation and male erectile dysfunction. It is also causes menstrual problems in women. Some people experience severe drowsiness and sedation.

Sexual dysfunction is a common cause for discontinuation of medication. It can be addressed by doctors. 

Some people would experience weight gain, increased blood sugar and increased blood lipid levels with this medication. It is called metabolic syndrome.

A list of common side effects

1. Anxiety
2. Changes in vision, including blurred vision
3. Difficulty concentrating
4. Difficulty speaking or swallowing
5. Inability to move the eyes
6. Loss of balance and control
7. Mask like face
8. Memory problems
9. Muscle spasms of face, neck, and back
10. Problems with urination
11. Need to keep moving the legs
12. Shuffling walk
13. Skin rash or itching
14. Stiffness or weakness of the arms or legs
15. Tic-like or twitching movements
16. Trembling & shaking of the fingers/hands
17. Trouble sleeping
18. Twisting like body movements

How to minimize side effects

You should take the dose recommended by your doctor. You should also take the medication with a full glass of water. Take the medication after a meal. In addition, never crush the medication before taking it. If you experience abnormal movements, inability to keep still (constantly in need of moving the legs) or drooling of saliva or severe constipation then you need to meet your doctor again.

Sometimes your doctor would prescribe medications that would alleviate or prevent you from getting side effects. Common such medication is Benzhexol (or Trihexyphenidyl).

What are the rare but dangerous side effects?

Most significant dangerous side effect would be neuroleptic malignant syndrome. It is characterized by fever, muscle rigidity, confusion and can cause multi organ failure. It is a serious complication of all the antipsychotic medications including Sizodon.

Symptoms of Neuroleptic malignant syndrome  

Summary

Sizodon is an antipsychotic medication called risperidone. It is prescribed for schizophrenia and other psychotic disorders. Main side effects are movement abnormalities called acute dystonic reaction and drug induced parkinsonism.

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.