
Suggest Treatment For Persistent Sore Throat And Difficulty In Swallowing

I have been getting persistent throat problem (sore throat) and slight difficulty in swallowing and feel a lot of pressure in the ears for the last approx. 20 days. Did antibiotic course for 7 days but in vain. Went to an ENT specialist, he put me on Rabonik 40mg in the morning empty stomach and asked me to do the following tests:
CBC
Vitamin B12 and D13
Thyroid
Anti thyroid antibody
Anti nuclear antibody
All the tests are normal but my throat/ear problem still continues
Since I was not getting better, I started surfing internet and read that olimelt can cause throat and ear problem. Feeling quite helpless, is it olimelt or mirtaz causing it
Though I am fighting out my anxiety (some days are less anxious and some days are more anxious), now this persistent throat/ear problem is adding to my worrisome nature.
What would your advice be?
SSRIs just don't suit me as I start getting my stomach problem with them. My doc tried putting me on serta 25, took it for 2 days and started getting major stomach problems so i stopped it, i suffer from ibs as well. Have tried paroxetine in the past, but it gave me similar stomach problems so stopped it.
Also, I keep checking my sugar levels at home on and off, earlier they were always in the range of 90s, after i have started taking olimelt, they have jumped to the range of 100+
With the above combo, my sleep is better, though i feel heavily sedated in the morning
Was thinking of if I can be put on another atypical antipsychotic or any other drug other than olimelt at a dose that takes care of my throat/ear/sugar/anxiety/stomach issues at the same time does not disturb my sleep. i wanted to consult you over phone, dont know how to go about it?
Olanzapine or Mirtazapine don't cause such symptoms.
Detailed Answer:
Hi, thanks for asking from HCM for your health related doubts
I have read the details you have mentioned in query and I can understand your concern. You are taking total of 7.5 mg Mirtazapine and 3.75 mg of Olanzapine. Olanzapine is a second generation antipsychotic drug and is a very safe drug. The doses you are taking are very low doses and these doses we commonly use in children. So even if we assume (as per some rare case reports) Olanzapine might cause sore throat still in such low dose its not possible.
The dose of Mirtazapine you are taking is also very low dose and the drug is not associated with sore throat as side effect. I have never observed sore throat occurring due to Olanzapine or Mirtazapine in my patients. So be assured the sore throat is not persisting due to these medicines.
Yes both these medicines are known to worsen metabolic parameters. The elevated sugar levels you are observing could be occurring due to these medicines. But since these are in normal range so this is not at all alarming. SO IF YOU ARE FEELING IMPROVEMENT IN YOUR SYMPTOMS WITH THESE MEDICINES THEN NO NEED TO CHANGE THESE MEDICINES.
Coming to other drugs you are taking, Etizolam is a benzodiazepine drug and is a very safe drug. The drug is not associated with such side effects. Now the last drug Betacap TR 40. Betacap is Propranolol and the drug is a beta blocker drug. The drug is known to cause broncho-constriction and congestion in throat. Though as such the drug doesn't cause sore throat as side effect but the drug might result in persistent congestion of throat which might complicate into persistent sore throat. Repetitive throat clearing, mild cough, foreign body sensation in throat etc symptoms might occur due to congestion.
If possible try to reduce the doses of Propranolol after consulting your doctor and stop using this drug for some days. In my opinion your symptoms should reduce in some time after stopping the drug.
Thanks, Hope this helps you. Please don't hesitate to ask again for more doubts or if you need more clarifications.
Take care


The dose should not be stopped abruptly.
Detailed Answer:
Hello again and thanks for asking a follow up
No the dose of the drug should be reduced gradually. Betacap is also available in 20 mg dose. Reduce the dose to 20 mg for about 2 weeks and then stop the drug totally. On stopping the drug the symptoms you are having should improve.
Thanks, Still have more doubts please ask again. Take care


Thanks and take care.
Detailed Answer:
Thanks and take care.


Call comes from anonymous number
Detailed Answer:
Hello again
Please contact the customer care for the problem because I get call from anonymous number which can't be called again.
Thanks


No need to worry.
Detailed Answer:
Hello again
No need to worry, just increase the doses gradually and you will not have any stomach issues. Try not to concentrate on mild bodily symptoms.
Thanks.


Gradual dose increase will not cause side effects related to stomach.
Detailed Answer:
Hello again and thanks for asking a follow up
Yes on reducing the dose of Mirtazapine to half some reduction is sleep will be there. But since you are already on Olanzapine low dose. This should cover the slight disturbance in sleep. If sleep problems occur the for some time you can use Etizolam or if possible Clonazepam on SOS basis. This will help to maintain sleep.
There should be no stomach issues because you have started with very low dose. Gradual progression of doses will not cause any side effects. Please increase the dose of the drug to at least 40 mg per day. If needed we can further increase the dose to 60 MG per day. Even if mild symptoms would occur they will reduce by own in a couple of weeks.
Please don't feel sorry for anything. You can clarify your doubts without any hesitation. No need to worry.
Thanks.


Don't be worried the symptoms will reduce in some days
Detailed Answer:
Hello again and thanks for asking a follow up
The dose of 10 mg is very very less and it will not cause any serious symptoms. Even if you are having some stomach discomfort still don't stop the medicine. Tolerance to this low dose will develop in some days. No need to worry. If symptoms are intolerable take half of 0.5 mg Etizolam and this will make drug tolerable. Have light, high protein and low fat diet. You will be able to continue the drug, no need to worry. Aciloc (Ranitidine) for some days will reduce the problem of any epigastric fullness.
Thanks, still have doubts please ask again.


Please remain strong
Detailed Answer:
Hello again
Please don't stop the medicine. These effects will pass away in few days. If the pain and burning is severe then medicine combination like Clinidium and Chlordiazepoxide can help. The tablet is available in name of Libratax (prescription medicine). This will reduce abdominal complaints and anxiety also.
Please don't feel bad, these symptoms will reduce in some days. Just remain strong.
Thanks

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