Nexito plus uses and side effects

Nexito plus is a combination of escitalopram 5mg and 0.5mg clonazepam in a single tablet. It is effective against anxiety disorders and in depression with poor sleep. This combination is effective against panic disorder, where the patient’s anxiety symptoms usually get worse initially with SSRI (Selective serotonin reuptake inhibitors).

In addition, this medication can be given to people who have sleep problems. It is because escitalopram alone will reduce sleep and clonazepam increases sleep. So the combination can balance out. However, side effects of both compounds occur with this medication.

Problems with Nexito plus

Since this medication has fixed combination, it is impossible to change a single medication. Therefore, during early treatment phase, this medication is not recommended. It is better to have both types of medications given as single tablets, so they can be changed individually.

In addition, some mental health professionals do not agree about continuing benzodiazepines for long time. It is due to habit forming potential of benzodiazepines (clonazepam in Nexito plus).
Escitalopram alone is usually prescribed for long duration. Therefore, this medication is not recommended for longer duration. In such patients pure Nexito will be the choice.

Advantages of Nexito plus

This medication has the advantage of having less SSRI side effects such as insomnia, tremors and agitation. It is especially useful for patients who are sensitive for such side effects. In addition, this combination simplifies medication schedule so people will have less tablets to swallow.

You can see the comprehensive account on Nexito (Pure escitalopram) here.

Anxit is medication prescribed for sudden anxiety attacks

Side effects of Nexito plus

Side effects are combination of both escitalopram and clonazepam. Compared to pure Nexito, Nexito plus causes less tremors, less sleep disturbances and less agitation.

1. Nausea
2. Vomiting
3. Headache
4. Weight loss
5. Loss of appetite
6. Sexual dysfunction
7. Sleep disturbances

Sexual dysfunction is common side effect of SSRI class medications

In addition to above side effects, this medication can have following side effects.

1. Increased risk of mania in patients with bipolar affective disorders. 
2. Reduced blood sodium level
3. Serotonin syndrome
4. Increased bleeding
5. Yawning
6. Impaired concentration

Due to the presence of clonazepam, this medication can cause drowsiness, dizziness, loss of memory and unsteady walking. In addition, there is danger in working next day after this medication is taken in the night. It is safe not to engage in driving or operate machinery in the next day until you know how this medication affects you.

Operating machinery can be dangerous when you are on this medication

It is also advisable not to take alcoholic beverages as this medication can increase intoxication and side effects of alcohol.

Due to the presence of clonazepam, this medication can become habit forming. In addition, if you suddenly discontinued this medication, then you may experience more withdrawal symptoms (agitation, poor sleep, increased anxiety).

Summary

Nexito plus is a mixture of escitalopram and clonazepam. It is useful in patients who are sensitive to side effects of SSRI medications. Side effects are nausea, dizziness and sexual dysfunction.

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.

Paxidep CR tablets uses and side effects

Paxidep CR is an Indian brand of SSRI (Selective serotonin reuptake inhibitor) antidepressant. Its generic name is paroxetine. It is prescribed for depression, panic disorder and other anxiety disorders. It is especially prescribed for breastfeeding mothers due to low concentration of the medication in breast milk. CR is shortened name for controlled release. It means once the medication is ingested, tablet will release the active drug into the blood  slowly. Therefore it will cause less side effects. 

However, this medication is having side effects common to SSRI class medications such as nausea, heartburn and headache. In addition, compared to other SSRI medications, it can cause more fetal malformations. Therefore, this medication should be discontinued in pregnancy.

Paxidep controlled release tablets can  be used less frequently and at low doses to minimize side effects

Pregnant women should not take this medication due to risk to the baby

Uses of Paxidep CR

This medication is prescribed for major depression, panic disorder and other anxiety disorders. Clinical depression is characterized by persistent low mood, low energy, and lack of enjoyment of previously enjoyable activities lasting for more than two weeks. In addition, depression can cause suicidal ideation.

Depression is a common indication for this medication

Panic and other anxiety disorders are characterized by inappropriate anxiety (“a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.”) that can cause severe functional impairment in the affected individual.

Panic disorder can be treated with Paxidep

In addition, Paxidep CR is effective in obsessive compulsive disorders (OCD). Obsessive compulsive disorder is characterized by inappropriately repetitive behavior which is senseless and resisted by the individual. E.g Repetitive hand washing to wash away germs.

This medication is preferred antidepressant in breastfeeding due to minimal drug concentration in breast milk. However, it should not be used by pregnant women. Therefore, breast feeding women should take adequate contraception during treatment.

What are the common side effects of Paxidep CR?

1. Nausea
2. Heartburn
3. Headache
4. Loss of appetite
5. Sexual dysfunction
6. Yawning
7. Abnormal dreams
8. Sleep problems
9. Increased blood cholesterol

What are the rare side effects of this medication?

1. Heart problems
2. Documented harm to the baby when the mother takes this medication.
3. Initial increase of anxiety when prescribed for anxiety disorders. Due to this risk many doctors prescribe low doses at the initial period of illness. But this effect usually wanes after that.
4. Hives and allergic reaction
5. Risk of mania (Opposite of depression with excessive energy, elevated self-esteem that can cause severe social malfunction)
6. Reduced salt levels in blood
7. Increased risk of bleeding
8. Serotonin syndrome

Most of the side effects go off after some time. But most troublesome side effects such as sexual dysfunction, may persist. It is characterized by erectile dysfunction in men and reduced sexual desire in females. In addition, this medication can cause delayed ejaculation which can be used in the treatment of premature ejaculation.

Since depression can also cause sexual dysfunction, some will experience elevated sexual activity due to reduced depression. So it is a balance of effects of depression and medication.

In anxiety disorders, at the initial period of treatment, this medication can cause elevated anxiety. This usually wanes over time.  

How Paxidep CR is prescribed?

This medication is available as tablets. Usual dose range is between 12.5 to 37.5mg per day. Elderly patients will get maximum daily dose of 25mg. Usually the medication is prescribed in morning due to the disturbance of sleep associated with this medication.

This medication should be taken with meals to minimize side effects. It should be taken with a full glass of water and the tablet should not be crushed/broken.

What the doctor should know before prescribing this medication

1. Bipolar affective disorder
2. Liver problems
3. Kidney problems
4. Pregnancy status (should not be given in first trimester of pregnancy)
5. Bleeding problems
6. Long standing gastritis

"If you are a woman in reproductive age then this medication should be taken with adequate contraception to prevent exposure to baby. "

Oxat is another paroxetine brand that is popular in India. 

Summary

Paxidep CR is a controlled release SSRI class medication prescribed for depression and anxiety disorders. Main side effects are nausea, heart burn and sexual dysfunction. This medication should not be prescribed for pregnant women who are in their first trimester. 

Venlift OD uses and side effects

Venlift OD ("Once daily") is a medication prescribed for major depression and anxiety disorders. It is an Indian brand name of Venlafaxine manufactured by Torrent pharmaceuticals. This medication is a SNRI or selective serotonin and noradrenalin reuptake inhibitor class medication.

This medication acts by increasing serotonin and noradrenaline in nerve terminals.
Its commonest side effects are dry mouth, reduced sleep and constipation. Venlift OD is the extended release preparation of the Venlift. Venlift OD has to be given less frequently than Venlift.

Sections

1. Side effects of Venlift OD

Uses of Venlift OD

This medication is prescribed for depressive disorder, anxiety disorder such as panic disorder and social phobia.

Venlift OD capsules

Depression is characterized by persistent low mood, difficulty in enjoying pleasure and inability to work due to lack of energy. In addition, patients with severe form of depression get suicidal ideas and can end their lives.

Venlift OD is prescribed for depression

In addition to depression, this medication is useful in treating anxiety disorders such as social phobia and panic disorder. Panic disorder is characterized by sudden onset out of the blue attacks of anxiety associated with fear of death, fear of suffocation or fear of heart attacks. It is common for general medical clinic to get patients with panic disorder.

Social anxiety disorder is characterized by severe disabling anxiety in social situations. They become severely anxious to talk to strangers and participate in social events.

How to take Venlift OD

This medication should be taken with a full glass of water. In addition, it should be taken with food to minimize side effects. Since this medication comes as a capsule, you should not break or remove the cover of the capsule.

Always follow your doctor’s advice and do not stop taking this medication without medical advice.

Usual dose range of this medication is 37.5mg to 375mg per day. Venlift OD preparation can be given once daily but most of the time prescribed twice daily to minimize side effects.

Take this medication with full glass of water to minimize side effects

Taking this medication after a meal would reduce side effects

What are the things you should tell your doctor before getting the prescription?

1. High blood pressure
2. Heart disease
3. Bipolar disease
4. Liver and Kidney failure
5. Myasthenia gravis
6. Hyperthyroidism

It is very important to tell your doctor whether you have hypertension as this medication is known to increase blood pressure.

High blood pressure is a common side effect

How Venlift OD works

Venlift increases serotonin and noradrenaline neurotransmission in the brain counteracting changes that are occurring in depression and other conditions. Compared to SSRI medications, this medication increase both noradrenaline and serotonin levels at higher doses. Which explains its higher efficacy.

What are the common side effects of Venlift OD?

This medication can cause nausea, and sometimes vomiting. In addition, it can cause heart burn and gastric irritation. It can also cause significant sexual dysfunction including lack of desire and erectile dysfunction in men.

At the initial part of the therapy you would experience increase of anxiety symptoms including dry mouth, increased heart rate, sweating and mild tremors. But they will usually goes off as time pass. In addition, you may experience sleep problems with this medication and some will experience poor sleep. In such patients it is advised to take this medication at morning.

Sleep problems are common side effect

Common side effects

1. Nausea
2. Gastric irritation
3. Headache
4. Sexual dysfunction
5. High blood pressure
6. Sleep problems
7. Dry mouth
8. Sweating
9. Increased anxiety

Sexual side effects can be annoying - But successful treatment of depression would improve sexual function

What are the more serious side effects associated with Venlift OD

This medication can cause manic shift in patients with bipolar disorder. It is characterized by increased energy, increased wellbeing and increased activity followed by more disinhibited behavior which is out of character.

In addition, certain group of people would develop serious complication called serotonin syndrome. It is characterized by high fever, sweating, course tremors and confusion. It usually occurs when you were changed from one medication to another or in case of rapid increase in dose.

List of serious side effects associated with Venlift OD

1. Serotonin syndrome
2. Bipolar mania
3. Increased bleeding
4. Increased gastric ulceration
5. Dangerous increase in blood pressure (Usually in over dose)

This medication can become toxic in overdose and therefore doctors prescribe Venlift carefully to patients with high suicidal risk.

Summary

Venlift OD is a SNRI class medication. Its generic name is Venlafaxine. It is prescribed for major depression and anxiety disorders. Its main side effects are nausea, gastric irritation, increased blood pressure, sexual dysfunction and sleep problems.

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.

Veniz XR uses and side effects

Veniz XR is a brand of Venlafaxine extended release preparation manufactured by Sun pharmaceuticals, India. Venlafaxine is an SNRI (Selective serotonin and Noradrenaline reuptake inhibitor) medication prescribed for depression, anxiety disorders, and nerve pain.

Uses of Veniz XR

This medication is primarily prescribed for depressive disorder. According to recent clinical trials it is found marginally more effective than Fluoxetine (Prodep™ / Prozac™). Therefore, it is commonly prescribed for resistant depression.

Veniz XR 75mg tablets

Depression is characterized by persistent low mood, inability to work due to lack of energy and inability to experience pleasure. In addition, patients with depression is at risk of committing suicide.

In addition, this medication is prescribed for Anxiety disorders such as social phobia, generalized anxiety disorder and panic disorder.

Artists depiction of Clinical Depression

Social phobia is characterized by persistent fear of negative evaluation of self by others and severe anxiety in social situations. e.g parties.

Panic disorder is characterized by sudden out of the blue anxiety attacks which results in fear of dying, breathlessness and chest/ muscle pain.

Panic attack

Generalised anxiety disorder is characterized by persistent anxiety and worries that impair functioning.

This medication also prescribed for nerve pain. Nerve pain is caused by damage or destruction of a pheripheral nerve. Common example would be phantom limb pain in amputees. In addition, this medication is also effective in nerve pain associated with Herpes Zoster (Shingles) infection.

Dosage and use of this medication

This medication is available as extended release capsules. Extended release preparations usually taken less frequently than their normal release preparations. E.g. Veniz XR is usually taken once daily and Veniz normal preparation taken twice daily. Usually dose range is around 37.5mg to 375mg daily. To prevent side effects take this medication with meals. Do not remove capsule or do not take the medication when the capsule is broken. Take this medication with a full glass of water.

Veniz 75mg capsules

If you experience side effects (Mentioned below), tell your doctor and do not stop this medication on your own (Unless in a medical emergency).

Tell your doctor if you have following conditions, before getting prescription

1.       Any heart disease

2.       High blood pressure

3.       High cholesterol

4.       Any liver disease

5.       Any kidney disease

6.       Bipolar disorder

7.       Bleeding problems

8.       Eye problems (Poor vision, glaucoma)

Increased blood pressure is a common side effect - Pic Wikimedia

Side effects of Veniz XR

Most commons side effects are nausea, gastritis, and dizziness. These side effects can be minimized by taking according to the above paragraph.

Take with full glass of water to minimize side effects - Pic - Deviant art

This medication can cause initial increase in anxiety when prescribed. But it is usually short lasting and wanes off after some time.

Another significant side effect is sexual dysfunction. It is manifested as both reduced sex drive and erectile dysfunction. Since depression and other psychiatry problems can also cause sexual dysfunction overall outcome would be the balance of both.

It can increase blood pressure in some people, therefore you need to tell your doctor if you are having high blood pressure or heart problems. In addition, this medication is known to cause heart beat irregularities, especially at higher doses.

In addition, Veniz XR is known to cause following side effects.

1.       Constipation

2.       Yawning

3.       Dry mouth

4.       Headache

5.       Reduced sleep

6.       Abnormal dreams

7.       Sexual problems

8.       Excessive Sweating

9.       Mania

10.   Agitation

11.   Incoordination

Summary

Veniz XR is an extended release medication in SNRI category and its generic name is Venlafaxine. It is prescribed for major depression, panic disorder, generalized anxiety disorder and social phobia. Main side effects are gastric disturbances and problematic side effects are increased blood pressure and sexual dysfunction.

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