Suggest Treatment For Nausea, Sleeplessness And Weakness

Posted on Wed, 7 May 2014

Question: Doctor have adviced medicine like feliz-s-10 (for 6 month) gradually with 1/2 tablet, 1 tablet and 2 tablet a day, prothiaden (for 6 month) gradually with 25 mg, 50 mg and 75 mg and clobakem-10 (for 1 month) for patient who has developed nurvousness, worriedness, sleepless , weakness etc due to family member health issue since last 2-3 months. Before this the patient was quite healthy and strong mentally . I want to know that is there any chance of developing new health complition in future due to side effect of taking these medicine . Is there any chance of addiction and above health problem be repeated when discontinued.

Answered by Dr. Manisha Gopal (12 hours later)

Brief Answer: avoid prothiaden, not good for heart patients Detailed Answer: Hello, The meds are fine except that we prefer to treat patient with one drug and not three for same complaint. Secondly, prothiaden is not given in any patient who has any kind of cardiac history including hypertention. it is best avoided. Otherwise, it is a very good molecule for the complaints the patient has. The patient is taking 20mg escitalopram along with clobakem and prothiaden -suggests that she needs more meds and the illness is not controlled with one molecule. So, had I been treating her, i would have preffrably put her on soee effective molecule which alone would have been sufficient for her. Please donot worry about her addiction or side effcts of the drugs except that prothiaden is best avoided to help heart muscles. Wish you good luck. Please aks more questions for clarificataion Dr. Manisha Gopal MD psychiatry

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Manisha Gopal (50 minutes later)

Hi. Thank you for your reply. She have started Prothedine since last two days. Should she stop taking this immediately and continue other two medicine as advice? Will these medicine of six month course be sufficient to cure permanently or is there chances of reoccurance ? Request to kindly elaborate on what is soee effective molecucule as you have suggested. Regards.

Answered by Dr. Manisha Gopal (12 minutes later)

Brief Answer: paroxetine is good for her symptoms Detailed Answer: Hello, In my opinion +which you can corraborate with any doctor), prothiaden is best avoided in her case. In depresion or anxiety disorder we try to attain 100% sympyom free level with drugs and when this is done, the dosage is kept at that level for next 6-9months. Then the tapering is started. Tapering is done slowly to prevent any return or relapse of illness. The point that maximum dose of escitalopram (20mg) is not enough to control her symptom neccesiates the need to add another drug. There are many good options available but i think she will get help from paroxetine as her anxiety symptoms are also prominent. This can be started at 12.5mg dosage and latrr increased after a week to 25mg, to 50mg maximum. Once there is good improvement, then we can start tapering escitalopram. Please donot worry, it is an easy process and she will be fine. Many times in clinical practice one molecule is not very effective and has to be replaced by different one. With paroxetine her anxiety will reduce and so will her need to take clobakem too. So, i hope with this new molecule she will need only one medicine and she will get well. I hope the answer is helpful and calrifies your doubts. Please ask more questions if you have. Dr. Manisha Gopal MD psychiatry

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Above answer was peer-reviewed by : Dr. Shanthi.E