Feeling Faint And Tired. Diagnosed With Anxiety And Given Cipralex. Having Soft Stools Like Diarrhea. Suggest?
Thanks for choosing health care magic for posting your query.
I have gone through your question in detail.
First of all, dont worry so much and there is no need to panic. Cipralex has escitalopram in it and is a good serotonin re-uptake inhibitor. It is a very mild antidepressants, however, like any other medication, there are a couple of side-effects that can occur with this drug.
Of those side-effects the two most common ones are diarrhoea and some bleeding tendency and both have occurred to you. You have not damaged anything cause of diarrhea. Both these side-effects are completely reversible. However you would need to change your antidepressant / anti anxiety drug from cipralex to other drugs such as bupropion or mirtazapine or something else.
Also you can try non-medication treatment for anxiety disorder like cognitive behavioral therapy which has shown results as good as cipralex.
If there is a mild abrasion cause of your hard stools, then the healing is very fast and you need not bother. but do change your medications with the help of your treating psychiatrist.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
bit.ly/dr-srikanth-reddy
Wish you good health,
Dr. Srikanth Reddy M.D.
.. I will get a VERY fast pounding heart and pass out before I get to the hospital... can I be sedated or have something done that would calm me. I really want to get it done I'm trying to start a family and I want to be in best health
Thanks for choosing health care magic for posting your follow-up query.
I understand how bad the needle phobia can be. I also understand your concerns about being healthy to start a family.
I would personally suggest that you should ask your psychiatrist to put you on sessions for cognitive behavioural therapy. They are safe and equally efficacious. Regarding sedation before taking blood, clonazepam 0.5 mg and propranolol 40mg may help but you need to discuss this thing with your treating psychiatrist for prescription.
Mirtazapine and venlafaxine will be good drugs for you.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
In future if you wish to contact me directly, you can use the below mentioned link:
bit.ly/dr-srikanth-reddy
Wish you good health,
Dr. Srikanth Reddy M.D.
Medication doesnt make blood in stools. While the food is moving along the food pipe, there may be many strains. There may be many places where there could be an injury. Now normally, these injuries do not bleed as they are controlled by good platelet functions.
While taking cipralex, it is an serotonin reuptake inhibitor and it interferes with the serotonin system of the platelets as well making them reduced in their capacity to contain bleeding.
Hence even these minor wounds keep bleeding and you can see the blood in stools. There could be other causes of bleeding as well but this is probably the most understandable.
First switch your medication and if problem persists then you may get investigated for other causes as well. But as I said earlier, there is no need to panic.
Thanks and regards,
Dr. Srikanth Reddy MD
It may not be an interaction of your muscle relaxants and cipralex. However even the muscle relaxant can cause bleeding tendency.
I would suggest you change the anti-depressant as well as avoid taking the same muscle relaxant.
There are plenty of other antidepressants and muscle relaxants.
Hope I am able to solve your concerns.
Thanks and regards,
Dr. Srikanth Reddy
If the symptoms have gone after stopping cipralex then you should discuss. If the symptoms have perished despite continuing using cipralex then the body may have adapted to it and youmay continue using it but look out for the similar sideeffects.
Regards
Dr. Srikanth Reddy
Yes, it was something minor and you need not bother about it at this stage. It happens sometimes with the medications.
Unless it happens again you need not bother.
Regards,
Dr. Srikanth Reddy
MD
I can understand your concerns.
Its your anxiety that is making you think about all those big illnesses.
One thing you have not mentioned is that whether you are still using cipralex or have you stopped using it.
Hope to hear from you.
Regards
Dr.Srikanth
Please don't panic . At this stage it doesn't appear like a cancer at all.
I am still sure that cipralex does cause this side effect. Sometimes these side effects do get adjusted with time. Probably your doctor wants to give it a try.
If its possible do try taking a second opinion from a psychiatrist. I think you still need a change in the medications.
But believe me it won't be a cancer.
Also try to add up cognitive behavioural therapy to your medications. It will help in early recovery.
Hope this helps.
Regards
Nice to know that you are doing well. Whatever it was its good that it has settled down.
Your mentioned 3 medications for cold doesnt have and any major interaction with cipralex.
Hope you get well soon.
Dr. Srikanth Reddy
Yeah it is possible for certain medications can cause serotonin syndrome. However the chances of causing such a side-effect and its severity varies from drug to drug. There are certain drugs like MAO inhibitors and tri cyclic antidepressants when taken with cipralex which have a high chances of causing serotonin syndrome but chances of the same with the above mentioned medications is less.
You can always look for
Cognitive effects: Agitation, hypomania, mental confusion, hallucinations, coma.
Autonomic effects: shivering, sweating, hyperthermia, hypertension, nausea.
Somatic effects: myoclonus (muscle twitching), hyperreflexia (manifested by clonus), tremor.
If you find any of these, do consult your treating psychiatrist. But please remember that it is not very common.
Thanks and regards,
Dr. Srikanth Reddy MD
Psychiatrist
Thanks for the follow-up query.
You can take cough and cold medications.
Along with that you should do repeated warm saline gargles and steam inhalation. Drink plenty of water. Avoid drinking very cold water. Keep yourself warm and take plenty of rest.
you should be fine in 2-3 days.
Hope I am able to help you with your concerns.
Thanks and regards.
Dr. Srikanth Reddy
MD, Psychiatrist
Thanks for the follow-up query.
Cipralex will reduce the anxiety and anxiety causes excess eating. That could explain your fall in appetite and weight.
With cipralex generally there is a loss of appetite and weight initially but with time generally there is weight gain. So if you are exercising, do continue it and dont bother about these small weight changes.
Its good that you are eating healthy. Do continue that.
Hope that answers your concerns.
Thanks for the appreciation. I will be glad to answer you on XXXXXXX each time yoh have a query. You can ask me a query by directing the question to me directly.
Thanks and regards
Dr. Srikanth Reddy MD
You may take acetaminophen also popularly known as Paracetamol. It comes in the strength of 500 mg and is a good antipyretic (reducing fever) and pain killer. It is a very safe drug. Ibuprofen is also good but has some hepato toxicity problems. You may take paracetamol and if it doesnt help may take ibuprofen.
All said any drug can cause allergic reaction and adverse drug reactions, but these two medications are relatively safe. They dont seem to have any major interaction with the kind of drugs you are taking.
It would be wise to consult your treating doctor before you take any of these medications over paracetamol.
You should always try warm saline gargles and steam inhalation. they are safe and very helpful.
Thanks and regards,
Dr. Srikanth Reddy
Thanks for the new query.
From what you have stated, it appears that the incident has just occurred and not much time has passed out.
You need not worry about it. Drink plenty of water and mostly the contaminated stuff will either wash out from your kidneys or will come down in your poop. Look for any nausea or vomitings. Unless you have nausea and vomiting, you need not worry. Our stomach has lot of acid in it and it generally kills what ever live happens to enter your stomach. These are natural protection of our body and they will take care of you. Even if you develop vomiting, it could be just ones, and all you need to do is hydrate yourself by drinking more water. If it happens repeatedly, you will require some anti emetic medications like emset.
At present you need not worry, drink water and do your routine stuff.
Hope I am of help to you,
Thanks and regards,
Dr. Srikanth Reddy
Thanks for the follow-up query,
The tension head ache and stroke are not very much related. If you have tension headache, it doesn't say that you are predisposed to develop stroke.
Secondly if your father had a hereditary vascular lesion in the brain which burst open and caused stroke, then you should get evaluated for such more hereditary lesions in the brain. MRI brain with contrast is the investigation of choice.
The investigation is safe and wont cause any problem to you. You really don't need any sedatives for the investigations to get it done.
For you tension headache Amitriptylline is a good drug for the tension head ache and come is the strengths of 25 mg and 75 mg. Generally the practice is to start the medications at 25mg. You can discuss this issue with your practicing doctor.
Also get a visual acuity done, many times visual disturbances are the main reason for tension headache.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
bit.ly/dr-srikanth-reddy
Wish you good health,
Dr. Srikanth Reddy M.D.
Thanks for the add on question.
Venlafaxine is a drug which is recently suggested to be better than cipralex as it acts like cipralex on serotonine receptors and also on norepinephrine receptors which cipralex doesnt. It add on action helps in beating depression better. But the effect is not demonstrable in all the human beings.
But you should give it a try. The other way is to add an antipsychotic or lithium to the antidepressant.
Hope that helps
Regards
Dr. Srikanth Reddy
Thanks for the query.
The symptom you are trying to explain is probably hesitancy in urination where in she has cramps and she feels she should pee. Sometimes she does and sometimes she doesn't. Its a very common symptom in UTI is common among sexually active females.
She should drink excess of water and try to flush out the bacteria. Further she should try out a course of antibiotics such as ofloxacin or cefexime for 4-5 days and the problem should subside. Taking Vit C tablets or Urine alkalizer syrup may also help. She can get it confirmed by taking a urinary culture but even if its a negative still a course of antibiotics should help her.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
bit.ly/dr-srikanth-reddy
Wish you good health,
Dr. Srikanth Reddy M.D.