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What Is The Dosage Of Pexep CR For Anxiety And Sleeplessness?
Question: Dear Doctor,
I am 32 year old.
Weight 85kg, Height 5ft 5inch.I am G6PD deficient and having grade 3 non alcoholic fatty lever. Lost 4 kgs 8n tension about health.
I am a person who is a bit nervous when it comes to my health. I want everything normal. I never had such anxiety or sleep issue in past.
In the month of XXXXXXX 2015 I felt a bit restless and felt fast heartbeats and I thought that something is wrong with my heart. That time I panicked a bit and dint get sleep for 2 days. I was tired and even sleepy but as soon as I went to bed I would wake up with thoughts as if my mind was constantly thinking something.
Later on I conducted all the tests and all were normal after which I got proper sleep and was worry free.
After a month one day my dad monitored his even i just checked it up and it was 148-90-98. So i got a bit worried as well. I never had BP in past when i used to monitor it.
Next day i went to My doctor and when he checked it was 141-100. So he told it is high. I dint take medicine for 3 days thinking it that it can be my anxiety and psychology for rise in BP. Even i dint want to get dependent on medicine. So i thought i would exercise and control salt intake and it would be fine. After sometime I came to know that it was white coat hypertension so stopped the medicine of bp as it was normal.
In between I got a bit of loss in my business as my partner cheated with me but that was quite ok as i am not worried about it.
In March I felt the same anxiety again and this time I felt very bad about some repeated mistakes I did recently and I felt guilty facing my wife. I used to get same symptoms of anxiety and worry as i wanted to tell everything to my wife.
I got admitted to hospital and again there all my reports we're normal. I was given restyl 0.25 tablet and anxiozap 10 for 2 days and later I was discharged and was asked to take panazep 12.5 for a month. Since I felt good that I told my wife everything about what happened and I said I was guilty about it I dint feel that I should take panazep as i thought I would be addicted to it and was also mind fresh and I was getting sleep too.
After one and half month in mid may I suddenly felt anxiety of not getting sleep of no reason and also there was some tensed situation with my wife and being a bit depressed as i was guilty conscious and hence I went to a nearby psychiatrist who told me that I need medication for anxiety.
I was asked to take Tab pexep cr 12.5mg (paroxetine hydrochloride) once at night after dinner(7days)
Tab lonazep 0.25mg once at night after dinner(7days)
Tab benfomet plus once at night after dinner.(7 days)
I immediately felt very nice and dint worry at all about getting sleep or any guilty feeling as i loved my wife and even had daily confidence as i used to have earlier in my work.
Even i took my wife to same doctor and even she is on medication as she was depressed.
After completion of 7 days I went to doctor again for myself thinking that she will reduce my dosage as i felt better and had no sleep or anxiety issues. But to my supreme she told me to take same medicines for more 10 days while increasing the power of tab pexep cr 25mg from previous 12.5 mg. Another two tablets power remains the same.
Please guide me why the power of dose got increase? She told me that I will feel more good and this is routine that the dosage increases.
I am worried because i might get addicted to the medicine and have side effects and it can have effect on my liver and even i m G6PD defecient.
Why can't I continue with 12.5 mg instead of 25 mg?
Also let me know what is use of benfomet plus tablet?
Thanks a lot. Waiting for a favourable response.
XXXXX
I am 32 year old.
Weight 85kg, Height 5ft 5inch.I am G6PD deficient and having grade 3 non alcoholic fatty lever. Lost 4 kgs 8n tension about health.
I am a person who is a bit nervous when it comes to my health. I want everything normal. I never had such anxiety or sleep issue in past.
In the month of XXXXXXX 2015 I felt a bit restless and felt fast heartbeats and I thought that something is wrong with my heart. That time I panicked a bit and dint get sleep for 2 days. I was tired and even sleepy but as soon as I went to bed I would wake up with thoughts as if my mind was constantly thinking something.
Later on I conducted all the tests and all were normal after which I got proper sleep and was worry free.
After a month one day my dad monitored his even i just checked it up and it was 148-90-98. So i got a bit worried as well. I never had BP in past when i used to monitor it.
Next day i went to My doctor and when he checked it was 141-100. So he told it is high. I dint take medicine for 3 days thinking it that it can be my anxiety and psychology for rise in BP. Even i dint want to get dependent on medicine. So i thought i would exercise and control salt intake and it would be fine. After sometime I came to know that it was white coat hypertension so stopped the medicine of bp as it was normal.
In between I got a bit of loss in my business as my partner cheated with me but that was quite ok as i am not worried about it.
In March I felt the same anxiety again and this time I felt very bad about some repeated mistakes I did recently and I felt guilty facing my wife. I used to get same symptoms of anxiety and worry as i wanted to tell everything to my wife.
I got admitted to hospital and again there all my reports we're normal. I was given restyl 0.25 tablet and anxiozap 10 for 2 days and later I was discharged and was asked to take panazep 12.5 for a month. Since I felt good that I told my wife everything about what happened and I said I was guilty about it I dint feel that I should take panazep as i thought I would be addicted to it and was also mind fresh and I was getting sleep too.
After one and half month in mid may I suddenly felt anxiety of not getting sleep of no reason and also there was some tensed situation with my wife and being a bit depressed as i was guilty conscious and hence I went to a nearby psychiatrist who told me that I need medication for anxiety.
I was asked to take Tab pexep cr 12.5mg (paroxetine hydrochloride) once at night after dinner(7days)
Tab lonazep 0.25mg once at night after dinner(7days)
Tab benfomet plus once at night after dinner.(7 days)
I immediately felt very nice and dint worry at all about getting sleep or any guilty feeling as i loved my wife and even had daily confidence as i used to have earlier in my work.
Even i took my wife to same doctor and even she is on medication as she was depressed.
After completion of 7 days I went to doctor again for myself thinking that she will reduce my dosage as i felt better and had no sleep or anxiety issues. But to my supreme she told me to take same medicines for more 10 days while increasing the power of tab pexep cr 25mg from previous 12.5 mg. Another two tablets power remains the same.
Please guide me why the power of dose got increase? She told me that I will feel more good and this is routine that the dosage increases.
I am worried because i might get addicted to the medicine and have side effects and it can have effect on my liver and even i m G6PD defecient.
Why can't I continue with 12.5 mg instead of 25 mg?
Also let me know what is use of benfomet plus tablet?
Thanks a lot. Waiting for a favourable response.
XXXXX
Brief Answer:
Doses of the drug should be increased.
Detailed Answer:
Hello Dear XXXXX, Thanks for asking from HCM for your health related queries
I have read the clinical history you have mentioned in query and I can understand your concern. Coming directly to your doubts-
1) Why did the power of drug increase?
- The history has shown that you have significant issues of anxiety related to health. These health anxiety ideas or hypochondrical ideas are causing significant distress to your functioning. Hypochondrical ideas or related to obsessive ideation to some extent. Obsessions are recurrent, repetitive, dominating, distressing, intrusive, repugnant thoughts, that remain in individuals mind despite the individual's try to get rid of these thoughts. So your major issues are health anxiety and hypochondrical thoughts.
In hypochondriasis the treatment runs a long course. Medicines especially SSRIs are given at high doses. Paroxetine 12.5 mg is also a SSRI drug and gradual dose escalation is done in doses to get full remission of symptoms. So even if you are feeling better in anxiety symptoms right now still there is need to escalate the doses to prevent the health anxiety and intrusive thoughts completely. So your psychiatrist is totally right in increasing the dose.
2) Why cant you continue with 12.5 mg doses?
This would be better for your psychological health that the doses should be increased. 12.5 mg doses are normal or low doses and these doses would not result in effective symptoms control. Don't get fear of addiction. Paroxetine is not an addicting drug. It is totally safe in terms of abuse potential. Yes the doses shouldn't be stopped abruptly but should be lowered gradually over 4-6 weeks on completion of treatment to prevent withdrawal symptoms. Be assured the drug is not a dependence producing drug.
3) Benfomet Plus uses?
Benfomet plus is a multivitamin tablet and consists of Benfotiamine (B1), Methylcobalamine (B12), Lipoic acid and Pyridoxin (B6). The drug is a supplement drug and has been added to your prescription to improve the nutrient deficiencies if any. A lot of individuals with anxiety disorders show low vitamin levels especially B12, so most likely she has added the drug to replenish that amounts.
Thanks, I hope this helps you. Please don't hesitate to ask again for more doubts.
Take care. Don't remain distressed about your health, you are absolutely fine. Most of humans have anxiety related to health at any time in their life so no need to worry about improvement. You will come out of that anxiety.
Doses of the drug should be increased.
Detailed Answer:
Hello Dear XXXXX, Thanks for asking from HCM for your health related queries
I have read the clinical history you have mentioned in query and I can understand your concern. Coming directly to your doubts-
1) Why did the power of drug increase?
- The history has shown that you have significant issues of anxiety related to health. These health anxiety ideas or hypochondrical ideas are causing significant distress to your functioning. Hypochondrical ideas or related to obsessive ideation to some extent. Obsessions are recurrent, repetitive, dominating, distressing, intrusive, repugnant thoughts, that remain in individuals mind despite the individual's try to get rid of these thoughts. So your major issues are health anxiety and hypochondrical thoughts.
In hypochondriasis the treatment runs a long course. Medicines especially SSRIs are given at high doses. Paroxetine 12.5 mg is also a SSRI drug and gradual dose escalation is done in doses to get full remission of symptoms. So even if you are feeling better in anxiety symptoms right now still there is need to escalate the doses to prevent the health anxiety and intrusive thoughts completely. So your psychiatrist is totally right in increasing the dose.
2) Why cant you continue with 12.5 mg doses?
This would be better for your psychological health that the doses should be increased. 12.5 mg doses are normal or low doses and these doses would not result in effective symptoms control. Don't get fear of addiction. Paroxetine is not an addicting drug. It is totally safe in terms of abuse potential. Yes the doses shouldn't be stopped abruptly but should be lowered gradually over 4-6 weeks on completion of treatment to prevent withdrawal symptoms. Be assured the drug is not a dependence producing drug.
3) Benfomet Plus uses?
Benfomet plus is a multivitamin tablet and consists of Benfotiamine (B1), Methylcobalamine (B12), Lipoic acid and Pyridoxin (B6). The drug is a supplement drug and has been added to your prescription to improve the nutrient deficiencies if any. A lot of individuals with anxiety disorders show low vitamin levels especially B12, so most likely she has added the drug to replenish that amounts.
Thanks, I hope this helps you. Please don't hesitate to ask again for more doubts.
Take care. Don't remain distressed about your health, you are absolutely fine. Most of humans have anxiety related to health at any time in their life so no need to worry about improvement. You will come out of that anxiety.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Thank you so much for your revert. I am doing what you advised me. Further i would like to know whether these medicine have any adverse effects on my liver since I already mentioned that I m G6PD and have non alcoholic grade 3 fatty liver. Also sometimes if I eat much or have acidity I feel like having digine cyrup or pudin XXXXXXX in past but can I take the same along with my current medicines... Because I have heard that it decreases the effect of medicines.
Thanks.
XXXXX
Thank you so much for your revert. I am doing what you advised me. Further i would like to know whether these medicine have any adverse effects on my liver since I already mentioned that I m G6PD and have non alcoholic grade 3 fatty liver. Also sometimes if I eat much or have acidity I feel like having digine cyrup or pudin XXXXXXX in past but can I take the same along with my current medicines... Because I have heard that it decreases the effect of medicines.
Thanks.
XXXXX
Brief Answer:
These drugs are safe drugs
Detailed Answer:
Hello again and thanks for asking a follow up question
All these drugs are safe to use in G6PD deficiency and are also safe in mild to moderate liver impairment. So no need to worry about this. You have fatty liver and this is a reversible condition and is mild hepatic impairment.
Yes these herbal medicines can be taken, no significant interactions are there with these drugs. No no effect on Paroxetine concentration would occur.
Thanks, Still have more doubts please ask again.
These drugs are safe drugs
Detailed Answer:
Hello again and thanks for asking a follow up question
All these drugs are safe to use in G6PD deficiency and are also safe in mild to moderate liver impairment. So no need to worry about this. You have fatty liver and this is a reversible condition and is mild hepatic impairment.
Yes these herbal medicines can be taken, no significant interactions are there with these drugs. No no effect on Paroxetine concentration would occur.
Thanks, Still have more doubts please ask again.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Thanks for revert. Since my wife is also on same medication and started almost same time as me. Medicine looks same only name is different. But she is not given benfomet plus.
Tab pexidep cr 12.5mg (paroxetine hydrochloride) once at night after dinner(7days)
Tab lonazep 0.25mg once at night after dinner(7days)
She is complaining of constipation and pain in lower abdomen. Can this be a side effect of it?
Further i usually have food at 9.30 and go to bed by 12. So exactly when I can take medicines..
Any thing to do to get rid of it naturally or medically.
Thanks
XXXXX
Thanks for revert. Since my wife is also on same medication and started almost same time as me. Medicine looks same only name is different. But she is not given benfomet plus.
Tab pexidep cr 12.5mg (paroxetine hydrochloride) once at night after dinner(7days)
Tab lonazep 0.25mg once at night after dinner(7days)
She is complaining of constipation and pain in lower abdomen. Can this be a side effect of it?
Further i usually have food at 9.30 and go to bed by 12. So exactly when I can take medicines..
Any thing to do to get rid of it naturally or medically.
Thanks
XXXXX
Brief Answer:
Constipation is one of side effects of Paroxetine
Detailed Answer:
Hello again, thanks for asking again
Paroxetine is known to cause anticholinergic side effects which can result in constipation, sedation, dryness of mouth, weight gain etc side effects. The constipation she is having is due to these side effects only. If the constipation become severe the other SSRIs can be used which are as efficacious as Paroxetine and doesn't cause constipation like Fluoxetine or Escitalopram etc.
Best time to take medicines is about half hour after meals and then try to go to the bed. This will help in sleep and maximum absorption of medicines will occur.
Thanks, Hope this helps you, if you have more doubts you can ask again
Constipation is one of side effects of Paroxetine
Detailed Answer:
Hello again, thanks for asking again
Paroxetine is known to cause anticholinergic side effects which can result in constipation, sedation, dryness of mouth, weight gain etc side effects. The constipation she is having is due to these side effects only. If the constipation become severe the other SSRIs can be used which are as efficacious as Paroxetine and doesn't cause constipation like Fluoxetine or Escitalopram etc.
Best time to take medicines is about half hour after meals and then try to go to the bed. This will help in sleep and maximum absorption of medicines will occur.
Thanks, Hope this helps you, if you have more doubts you can ask again
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Suddenly yesterday afternoon at around 3 pm I got fast heart beats and I got nervous and sweat as to how suddenly heart beats became fast.Since there was water logging I got worried how I will get any medical help. Later on I relaxed on bed thinking nothing has happened and felt some what better. But still I was getting nervous suddely with cold splash feeling.
Then at night I had little food at 10 pm and took medicines at 11 pm. I slept at 12 and woke up at 5 for loo. Then I tried to sleep but could not. My mind was not allowing me to sleep nor I was that much sleepy.
I just want to know why suddenly this happened as i was doing good and what else I can do to get good sleep as in day time I feel exhausted and with heavy head.
Pls let me know what is also the use of lonazep 0.25?
Thanks
XXXXX
Suddenly yesterday afternoon at around 3 pm I got fast heart beats and I got nervous and sweat as to how suddenly heart beats became fast.Since there was water logging I got worried how I will get any medical help. Later on I relaxed on bed thinking nothing has happened and felt some what better. But still I was getting nervous suddely with cold splash feeling.
Then at night I had little food at 10 pm and took medicines at 11 pm. I slept at 12 and woke up at 5 for loo. Then I tried to sleep but could not. My mind was not allowing me to sleep nor I was that much sleepy.
I just want to know why suddenly this happened as i was doing good and what else I can do to get good sleep as in day time I feel exhausted and with heavy head.
Pls let me know what is also the use of lonazep 0.25?
Thanks
XXXXX
Brief Answer:
The symptoms occurred due to severe anxiety or panic
Detailed Answer:
Hello again and thanks for asking a follow up question
First of all the symptoms you developed like anxiety during water logging, racing heart, nervousness, sweating, fear that how would you get medical help etc occurred most likely due to severe anxiety or panic symptoms. Panic is nothing but very severe paroxysmal anxiety associated with impending sense of doom. Try to relax yourself in such situations in future. Breath holding can even help to reduce the palpitations. Low dose benzodiazepines like Clonazepam can help to control anxiety in such situations. As you couldn't sleep properly also so I'd advise you to take Clonazepam on PRN basis for some days. This would make you relaxed. Don't get stressed regarding this episode, a lot of individuals with anxiety show panic symptoms, but these can be controlled effectively with medicines.
Clonazepam is benzodiazepine drug and the drug is used to control symptoms of anxiety, panic disorder. It is also a one of commonly used sleep medicines. If taken on PRN basis then drug is a safe drug free of serious side effects. Try to avoid using this drug regularly because of risk of abuse potential and dependence associated with it.
Thanks, hope this helps you. Still have more doubts please feel free to ask again.
Take care
The symptoms occurred due to severe anxiety or panic
Detailed Answer:
Hello again and thanks for asking a follow up question
First of all the symptoms you developed like anxiety during water logging, racing heart, nervousness, sweating, fear that how would you get medical help etc occurred most likely due to severe anxiety or panic symptoms. Panic is nothing but very severe paroxysmal anxiety associated with impending sense of doom. Try to relax yourself in such situations in future. Breath holding can even help to reduce the palpitations. Low dose benzodiazepines like Clonazepam can help to control anxiety in such situations. As you couldn't sleep properly also so I'd advise you to take Clonazepam on PRN basis for some days. This would make you relaxed. Don't get stressed regarding this episode, a lot of individuals with anxiety show panic symptoms, but these can be controlled effectively with medicines.
Clonazepam is benzodiazepine drug and the drug is used to control symptoms of anxiety, panic disorder. It is also a one of commonly used sleep medicines. If taken on PRN basis then drug is a safe drug free of serious side effects. Try to avoid using this drug regularly because of risk of abuse potential and dependence associated with it.
Thanks, hope this helps you. Still have more doubts please feel free to ask again.
Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
I have trust in your replies so I am clearing some doubts . Yesterday I did my ech as i felt the same feeling about fast heart beats suddenly and sweat. When I visited my family doctor he told ech is normal and my bp was 145/94. He told me it was a bit high but not to worry. As you know Earlier in march I was given Tazloc 40 for bp but when I got admitted to hospital it was showing normal so doctor stopped and when I visited his clinic it was 150/100 so he prescribed me with Nebicard 2.5 which I dint take as i thought it was white coat hypertension as my bp was 135/85 or 130/80 when I checked at home.
My psycriatrist told me to take lonazep half of 0.25 in morning and again half in afternoon if I am anxious and continue taking 0.25 full at night.
Now what should I do whom to follow...
Should I take nebicard. 2.5 in morning after breakfast?
If yes than will my bp and heart beat go very low as i am worried?
Further still if I feel the same thing than can I take lonazep half of 0.25 and half in afternoon and continue taking 0 25 full at night?
Will nebicard 2.5 react with lonazep and pexep cr 25?
Further even if something small happens to my health I get worried nowadays and when I wake up in morning I feel a bit of acidity and head heavy.
Currently I am sleeping for around 5-6hours and if i try to sleep more after I get up in morning 6 than my mind thinks something or the other and I don't get sleep.
Pls help.
XXXXXX
I have trust in your replies so I am clearing some doubts . Yesterday I did my ech as i felt the same feeling about fast heart beats suddenly and sweat. When I visited my family doctor he told ech is normal and my bp was 145/94. He told me it was a bit high but not to worry. As you know Earlier in march I was given Tazloc 40 for bp but when I got admitted to hospital it was showing normal so doctor stopped and when I visited his clinic it was 150/100 so he prescribed me with Nebicard 2.5 which I dint take as i thought it was white coat hypertension as my bp was 135/85 or 130/80 when I checked at home.
My psycriatrist told me to take lonazep half of 0.25 in morning and again half in afternoon if I am anxious and continue taking 0.25 full at night.
Now what should I do whom to follow...
Should I take nebicard. 2.5 in morning after breakfast?
If yes than will my bp and heart beat go very low as i am worried?
Further still if I feel the same thing than can I take lonazep half of 0.25 and half in afternoon and continue taking 0 25 full at night?
Will nebicard 2.5 react with lonazep and pexep cr 25?
Further even if something small happens to my health I get worried nowadays and when I wake up in morning I feel a bit of acidity and head heavy.
Currently I am sleeping for around 5-6hours and if i try to sleep more after I get up in morning 6 than my mind thinks something or the other and I don't get sleep.
Pls help.
XXXXXX
Brief Answer:
In my opinion anxiety is the main reason for your all symptoms
Detailed Answer:
Hello again XXXXX and thanks for asking a follow up question
First of all I'd like to tell you after reading our all conversations again that in my opinion your all symptoms are occurring due to anxiety. I don't think problem of hypertension is significant, in my opinion BP will normalise after relief of anxiety. Anxiety is causing racing heart even on rest and is resulting in rise in BP. So please consider to continue treatment of psychiatrist. Also if possible do relaxation exercises as well as if possible Yoga to keep yourself relaxed. Daily exercise will normalise your BP.
- Nebicard is Nebivolol and it is a cardioselective drug. The drug is very safe and is found to be useful in controlling BP as well as racing heart rate. So in my opinion you can take the drug as per your prescribed doses without any fear.
- At 2.5 mg doses the drug will normalise the heart rate and BP. These will not go in lower ranges so no need to worry.
- In my opinion continue to take Clonazepam as you were taking previously. The drug will normalise the heart rate and you will feel relaxed.
- There are no significant interactions between Nebicar and Lonazap, Paroxetine. So nO need to worry.
The symptoms you are having like feeling anxiety on water logging, feeling fear that how would you get medical attention, remaining anxious about health, not ignoring even minor health symptoms etc all are due to anxiety. With proper medicines your symptoms will decrease. Try to reassure yourself again and again that nothing is wrong. Remain relaxed and have good meals and sleep.
Thanks, Still have more doubts please ask again.
Take care
In my opinion anxiety is the main reason for your all symptoms
Detailed Answer:
Hello again XXXXX and thanks for asking a follow up question
First of all I'd like to tell you after reading our all conversations again that in my opinion your all symptoms are occurring due to anxiety. I don't think problem of hypertension is significant, in my opinion BP will normalise after relief of anxiety. Anxiety is causing racing heart even on rest and is resulting in rise in BP. So please consider to continue treatment of psychiatrist. Also if possible do relaxation exercises as well as if possible Yoga to keep yourself relaxed. Daily exercise will normalise your BP.
- Nebicard is Nebivolol and it is a cardioselective drug. The drug is very safe and is found to be useful in controlling BP as well as racing heart rate. So in my opinion you can take the drug as per your prescribed doses without any fear.
- At 2.5 mg doses the drug will normalise the heart rate and BP. These will not go in lower ranges so no need to worry.
- In my opinion continue to take Clonazepam as you were taking previously. The drug will normalise the heart rate and you will feel relaxed.
- There are no significant interactions between Nebicar and Lonazap, Paroxetine. So nO need to worry.
The symptoms you are having like feeling anxiety on water logging, feeling fear that how would you get medical attention, remaining anxious about health, not ignoring even minor health symptoms etc all are due to anxiety. With proper medicines your symptoms will decrease. Try to reassure yourself again and again that nothing is wrong. Remain relaxed and have good meals and sleep.
Thanks, Still have more doubts please ask again.
Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Sorry to disturb you once again.
On sunday I took one nebicard 2.5 after breakfast and I felt ok the full day. My heart beats went near 55-60 beats when I measured it routinely. Now fearing that it will go below that rate I dint take nebicard 2.5 on Monday.
I visited my psycriatist and she told me that it was anxiety and therefore in such situations I should take half lonazep of 0.25. And don't take nebicard 2.5 as i don't have blood pressure when I check at home.
I want to know 2 things.
Suppose if my heart beat is between 55-60 after taking nebicard will it go below that rate if i continue taking it on regular basis? And how much it will effect my blood pressure rate as it will also bring that down?
Secondly why I m getting this sudden anxiety feeling regularly ?
Even today afternoon I felt the same thing but I don't take any medicine neither nebicard nor lonazep.
Currently I am only taking Pexep CR 25 and lonazep 0.25 at night after meals. Are these medicines working on me and when they will show results. I am quite ok full day but suddenly I get this anxiety feeling all of a sudden and sweat with fast heart beats.
Pls adivse me
XXXXXX
Sorry to disturb you once again.
On sunday I took one nebicard 2.5 after breakfast and I felt ok the full day. My heart beats went near 55-60 beats when I measured it routinely. Now fearing that it will go below that rate I dint take nebicard 2.5 on Monday.
I visited my psycriatist and she told me that it was anxiety and therefore in such situations I should take half lonazep of 0.25. And don't take nebicard 2.5 as i don't have blood pressure when I check at home.
I want to know 2 things.
Suppose if my heart beat is between 55-60 after taking nebicard will it go below that rate if i continue taking it on regular basis? And how much it will effect my blood pressure rate as it will also bring that down?
Secondly why I m getting this sudden anxiety feeling regularly ?
Even today afternoon I felt the same thing but I don't take any medicine neither nebicard nor lonazep.
Currently I am only taking Pexep CR 25 and lonazep 0.25 at night after meals. Are these medicines working on me and when they will show results. I am quite ok full day but suddenly I get this anxiety feeling all of a sudden and sweat with fast heart beats.
Pls adivse me
XXXXXX
Brief Answer:
Try to ignore the beats and don't check again and again.
Detailed Answer:
Hello again xxxxx, thanks for asking a follow up
I'd like to request you again that please dont pay attention to your heart beats. Attention is leading to awareness and consequent palpitations. Don't get your BP checked again and again. Don't count your heart rate again and again. It is physiological in individuals to have variations in heart rate with time in a day.
Coming to your questions-
- No your heart rate will not come below the range on taking the Nebicard 2.5. It will not affect your blood pressure rate so no need to worry. Your bodies physiological functions will correct any changed heart rate and BP.
- It is common in anxiety to have such symptoms regularly. Try to remain relaxed and avoid thinking about heart rate and BP. Even don't count your beats. Try to avoid and ignore any physical symptom that result in anxiety. Your main issues are anxiety and some components of health anxiety. With proper relaxation exercises and medicines the symptoms will decrease.
Please try to understand what I am saying. Ignore the beats and don't count your beat.
Thanks, Hope this helps you. Still have more doubts please ask again.
Take care
Try to ignore the beats and don't check again and again.
Detailed Answer:
Hello again xxxxx, thanks for asking a follow up
I'd like to request you again that please dont pay attention to your heart beats. Attention is leading to awareness and consequent palpitations. Don't get your BP checked again and again. Don't count your heart rate again and again. It is physiological in individuals to have variations in heart rate with time in a day.
Coming to your questions-
- No your heart rate will not come below the range on taking the Nebicard 2.5. It will not affect your blood pressure rate so no need to worry. Your bodies physiological functions will correct any changed heart rate and BP.
- It is common in anxiety to have such symptoms regularly. Try to remain relaxed and avoid thinking about heart rate and BP. Even don't count your beats. Try to avoid and ignore any physical symptom that result in anxiety. Your main issues are anxiety and some components of health anxiety. With proper relaxation exercises and medicines the symptoms will decrease.
Please try to understand what I am saying. Ignore the beats and don't count your beat.
Thanks, Hope this helps you. Still have more doubts please ask again.
Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
As you said I am trying my best to remain calm and relaxed and even not measuring bp nor pulse. But still I m getting sudden symptoms of sweat and palpitations.
I was very much ok till I took the of pexep 12.5 and clonazep 0.25 at night for the very first week but since I started taking increased dosage of Pexep 25 mg and clonazep same i guess I am having these repeated symptoms.
Can it be a side effect of this? My anxiety has increased Even i feel like nausea in morning as I wake up.
Pls advise
XXXX
As you said I am trying my best to remain calm and relaxed and even not measuring bp nor pulse. But still I m getting sudden symptoms of sweat and palpitations.
I was very much ok till I took the of pexep 12.5 and clonazep 0.25 at night for the very first week but since I started taking increased dosage of Pexep 25 mg and clonazep same i guess I am having these repeated symptoms.
Can it be a side effect of this? My anxiety has increased Even i feel like nausea in morning as I wake up.
Pls advise
XXXX
Brief Answer:
Wait for some days and your symptoms will decrease
Detailed Answer:
Hello XXXXX, thanks for asking again
It will take a little time and your anxiety will decrease in some days. Paroxetine is safe drug and dose increase will help to control the symptoms. Give some time to the drug to show its effects. Don't get worried a lot of individuals some times develop increased anxiety after increasing the dose of antidepressants. But these symptoms reduce in 7-10 days.
It is not a side effect of the drug. Be assured you are absolutely normal. If you have prescription of Clonazepam 0.25 mg drug then start taking the drug 2-3 times a day and your symptoms will reduce. After some days reduce the doses of drug by yourself. Don't take Clonazepam regularly for long periods of time.
I'd also advise you to get your Thyroid hormone levels (T3, T4 and TSH) checked to rule out any thyroid abnormality. Hyper and hypo thyroidism can cause sudden onset resting racing heart rate.
Don't get worried about your symptoms, remain relaxed this is not a serious thing.
Thanks, Still have more doubts please ask again. Take care
Wait for some days and your symptoms will decrease
Detailed Answer:
Hello XXXXX, thanks for asking again
It will take a little time and your anxiety will decrease in some days. Paroxetine is safe drug and dose increase will help to control the symptoms. Give some time to the drug to show its effects. Don't get worried a lot of individuals some times develop increased anxiety after increasing the dose of antidepressants. But these symptoms reduce in 7-10 days.
It is not a side effect of the drug. Be assured you are absolutely normal. If you have prescription of Clonazepam 0.25 mg drug then start taking the drug 2-3 times a day and your symptoms will reduce. After some days reduce the doses of drug by yourself. Don't take Clonazepam regularly for long periods of time.
I'd also advise you to get your Thyroid hormone levels (T3, T4 and TSH) checked to rule out any thyroid abnormality. Hyper and hypo thyroidism can cause sudden onset resting racing heart rate.
Don't get worried about your symptoms, remain relaxed this is not a serious thing.
Thanks, Still have more doubts please ask again. Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
As you said I am doing so and feeling ok.
But I have noticed one thing which is quite true that my overall sexual libedo or you can say sexual sensation drive or feeling in my genital organ has quite decreased. Is this a side effect of pexep cr 25, lonazep 0.25 or benfomet plus? ....
How common it is and how to regain it. Will it be permanent or its just temporary till I take these medicines.
Regards
XXXXX
As you said I am doing so and feeling ok.
But I have noticed one thing which is quite true that my overall sexual libedo or you can say sexual sensation drive or feeling in my genital organ has quite decreased. Is this a side effect of pexep cr 25, lonazep 0.25 or benfomet plus? ....
How common it is and how to regain it. Will it be permanent or its just temporary till I take these medicines.
Regards
XXXXX
Brief Answer:
The sexual side effects are temporary and reversible
Detailed Answer:
Hello again XXXXX, thanks for asking a follow up
Lack of sexual desire or libido is a known side effect of Paroxetine. In most individuals delayed ejaculation occurs but sometimes reduction in libido is also observed. There is no need to worry for that. These side effects are not permanent and on stopping the drug these side effects will decrease. These are totally reversible.
Wait for some days and if the symptoms worsen then consult your doctor and other medicines like Bupropion can be used. The drug is relatively safe in terms of sexual side effects. Have healthy meals and wait for some days, your symptoms will reduce. No need to worry for that.
Thanks, hope this helps you. Continue to take medicines and your symptoms will reduce don't worrry about the sexual side effects. These are totally reversible.
The sexual side effects are temporary and reversible
Detailed Answer:
Hello again XXXXX, thanks for asking a follow up
Lack of sexual desire or libido is a known side effect of Paroxetine. In most individuals delayed ejaculation occurs but sometimes reduction in libido is also observed. There is no need to worry for that. These side effects are not permanent and on stopping the drug these side effects will decrease. These are totally reversible.
Wait for some days and if the symptoms worsen then consult your doctor and other medicines like Bupropion can be used. The drug is relatively safe in terms of sexual side effects. Have healthy meals and wait for some days, your symptoms will reduce. No need to worry for that.
Thanks, hope this helps you. Continue to take medicines and your symptoms will reduce don't worrry about the sexual side effects. These are totally reversible.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Dear Doctor,
As i have observed and gone through the online data it really states that pexip cr 25 does cause sexual problems and they are also difficult to get back after medicine is stopped.
I am really having very less penis sensation something like numbness or like penile anesthesia. Hope it's not something serious as it feel numb.
So i m planning to tell my physiatrist this and hope she gives me bupropion as you said...
I think such thing started after I increased dose from 12.5 to 25... is this possible?
How much starting dose of bupropion is should be suggested?
Will clonazepan also cause this sexual problem?
Thanks
XXXXX
As i have observed and gone through the online data it really states that pexip cr 25 does cause sexual problems and they are also difficult to get back after medicine is stopped.
I am really having very less penis sensation something like numbness or like penile anesthesia. Hope it's not something serious as it feel numb.
So i m planning to tell my physiatrist this and hope she gives me bupropion as you said...
I think such thing started after I increased dose from 12.5 to 25... is this possible?
How much starting dose of bupropion is should be suggested?
Will clonazepan also cause this sexual problem?
Thanks
XXXXX
Brief Answer:
Increasing the dose is probable reason for your symptoms.
Detailed Answer:
Hello again and thanks for asking a follow up question
I have prescribed Paroxetine to a lot of patients and their sexual side effects reversed with in 6 months of stoppage of drug. You have just developed symptoms so I don't think these side effects will persist for long. The numbness like symptoms you are having are most likely due to psychological reasons so no need to worry. Just try to divert your attention from all these symptoms.
If the problem is really bothering you then discuss with your psychiatrist and ask about some other drug like I have mentioned as Bupropion or Mirtazapine etc. Alternatively herbal supplements like Tantex Forte or Confido can help. Start taking these tablets one tablet each twice a day and your sexual symptoms will improve. These are herbal medicines and are relatively safer.
Increasing the dose could be the reason for these symptoms.
In normal cases Bupropion is started with 150 mg per day and in a week doses are increased to 300 mg per day. Discuss with your doctor for proper prescription.
Clonazepam doesn't cause sexual side effects so no need to worry about this.
Thanks. Still have more doubts please ask again. Take care
Increasing the dose is probable reason for your symptoms.
Detailed Answer:
Hello again and thanks for asking a follow up question
I have prescribed Paroxetine to a lot of patients and their sexual side effects reversed with in 6 months of stoppage of drug. You have just developed symptoms so I don't think these side effects will persist for long. The numbness like symptoms you are having are most likely due to psychological reasons so no need to worry. Just try to divert your attention from all these symptoms.
If the problem is really bothering you then discuss with your psychiatrist and ask about some other drug like I have mentioned as Bupropion or Mirtazapine etc. Alternatively herbal supplements like Tantex Forte or Confido can help. Start taking these tablets one tablet each twice a day and your sexual symptoms will improve. These are herbal medicines and are relatively safer.
Increasing the dose could be the reason for these symptoms.
In normal cases Bupropion is started with 150 mg per day and in a week doses are increased to 300 mg per day. Discuss with your doctor for proper prescription.
Clonazepam doesn't cause sexual side effects so no need to worry about this.
Thanks. Still have more doubts please ask again. Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor ,
Please suggest something for cronic constipation as my wife who is also on same medication i.e pexidep cr 25 and clonazepan 0.25 mg at night. She has tried with lots of water and even cremafin but does not work.
Also please let me know which is the near thing for me
1. Should I reduce dosage of Pexep from 25 to 12.5 after consulting my psycriatist ?
2. Change the medication?
3. Which is better for my symptoms of delayed orgasm and sensation in glans due to ejaculation delay.
Tantex Forte or Confido.
Thanks
XXXXX
Please suggest something for cronic constipation as my wife who is also on same medication i.e pexidep cr 25 and clonazepan 0.25 mg at night. She has tried with lots of water and even cremafin but does not work.
Also please let me know which is the near thing for me
1. Should I reduce dosage of Pexep from 25 to 12.5 after consulting my psycriatist ?
2. Change the medication?
3. Which is better for my symptoms of delayed orgasm and sensation in glans due to ejaculation delay.
Tantex Forte or Confido.
Thanks
XXXXX
Brief Answer:
Ask for drug change if constipation is intolerable.
Detailed Answer:
Hello again XXXXX, thanks for asking a follow up
As I have mentioned that Paroxetine is a SSRI drug which is associated with anticholinergic side effects and this is resulting in constipation. The drug at 25 mg is causing the constipation and if the constipation is not improving with Cremaffin and other dietary measures then in my opinion drug should be changed. Other SSRIs like Escitalopram, Sertraline have almost same efficacy as Paroxetine but are free of side effects like constipation. So in my opinion you should talk to her psychiatrist and discuss about constipation and drug change if needed.
Coming to your problem-
- Yes that would be a good move (Dose adjusement) but if possible ask for other drug like Mirtazapine or Bupropion as these are free of sexual side effects. Paroxetine is known to reduce libido and cause delayed ejaculation.
- Start taking one tablet of each drug twice a day. This would help in early improvement. Tantex Forte would help in orgasm and will help in good libido.
Thanks, I hope this helps you. Still have more doubts please ask again.
Take care
Ask for drug change if constipation is intolerable.
Detailed Answer:
Hello again XXXXX, thanks for asking a follow up
As I have mentioned that Paroxetine is a SSRI drug which is associated with anticholinergic side effects and this is resulting in constipation. The drug at 25 mg is causing the constipation and if the constipation is not improving with Cremaffin and other dietary measures then in my opinion drug should be changed. Other SSRIs like Escitalopram, Sertraline have almost same efficacy as Paroxetine but are free of side effects like constipation. So in my opinion you should talk to her psychiatrist and discuss about constipation and drug change if needed.
Coming to your problem-
- Yes that would be a good move (Dose adjusement) but if possible ask for other drug like Mirtazapine or Bupropion as these are free of sexual side effects. Paroxetine is known to reduce libido and cause delayed ejaculation.
- Start taking one tablet of each drug twice a day. This would help in early improvement. Tantex Forte would help in orgasm and will help in good libido.
Thanks, I hope this helps you. Still have more doubts please ask again.
Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
As per your advice I discussed the case and problem with my psycriatist and asked her to reduce my dosage as i was facing sexual problem of delayed orgasm and ejaculation. Sometimes no ejaculation.
Hence I reduced dosage of pexcep Cr 25 to pexcep CR 12.5. And continued same Benfomet plus and clonazepam 0.25 at night after dinner.
First 2 days it was all very fine and great as if I am taking same dosage.
But yesterday after taking third dose at night I dint get proper sleep as i used to get daily when I was on higher dosage..
I was not having any other symptom although when I tried to sleep my mind was having vavouring thoughts and continously something dreaming even when I tried to focus to sleep. What could be this doctor.
I slept nearly at 12 at night till 4 am and then just lied on bed without sleep keeping eyes shut.
Is this a withdrawal symptom if yes than what I could do in this case. Any other natural way or medicine so that I can sleep well
Pls advise.
Regards
XXXXX
As per your advice I discussed the case and problem with my psycriatist and asked her to reduce my dosage as i was facing sexual problem of delayed orgasm and ejaculation. Sometimes no ejaculation.
Hence I reduced dosage of pexcep Cr 25 to pexcep CR 12.5. And continued same Benfomet plus and clonazepam 0.25 at night after dinner.
First 2 days it was all very fine and great as if I am taking same dosage.
But yesterday after taking third dose at night I dint get proper sleep as i used to get daily when I was on higher dosage..
I was not having any other symptom although when I tried to sleep my mind was having vavouring thoughts and continously something dreaming even when I tried to focus to sleep. What could be this doctor.
I slept nearly at 12 at night till 4 am and then just lied on bed without sleep keeping eyes shut.
Is this a withdrawal symptom if yes than what I could do in this case. Any other natural way or medicine so that I can sleep well
Pls advise.
Regards
XXXXX
Brief Answer:
Wait for some days and your sleep will improve.
Detailed Answer:
Hello again and thanks for asking a follow up
This is good that they have reduced the doses of PAROXETINE to 12.5 and in few days your sexual side effects would reduce. No need to worry.
As I have mentioned earlier also Paroxetine causes sedation and reduction of doses of Paroxetine has resulted in less sedation and thus less sleep. But no need to worry, your body will adjust to reduced doses of Paroxetine in some time. I would advise you to not to think about not getting sleep again and again. Sleep is a spontaneous phenomenon and your body will sleep properly when you would need it. So don't wait for sleep, remain relaxed. You might find it difficult to pass nights for some days but in some time your sleep will improve again. Keep one thing in mind "Don't think about sleep again and again".
If the problem is worse then for some days instead of one 0.25 mg dose take two tablets. This would make a good sleep, but please try not to take Clonazepam regularly. Green tea in evening at around 4 pm would help in relaxation and you will feel better. Take warm water bath in evening and this will also help in sleep. AvAoid brain stimulation activities for some time in evening like doing work on computer or reading a book. All these steps result in good sleep.
Take the medicines as per your prescribed doses only.
Thanks, Hope this helps you. Please ask again if you have more doubts to ask.
Take care
Wait for some days and your sleep will improve.
Detailed Answer:
Hello again and thanks for asking a follow up
This is good that they have reduced the doses of PAROXETINE to 12.5 and in few days your sexual side effects would reduce. No need to worry.
As I have mentioned earlier also Paroxetine causes sedation and reduction of doses of Paroxetine has resulted in less sedation and thus less sleep. But no need to worry, your body will adjust to reduced doses of Paroxetine in some time. I would advise you to not to think about not getting sleep again and again. Sleep is a spontaneous phenomenon and your body will sleep properly when you would need it. So don't wait for sleep, remain relaxed. You might find it difficult to pass nights for some days but in some time your sleep will improve again. Keep one thing in mind "Don't think about sleep again and again".
If the problem is worse then for some days instead of one 0.25 mg dose take two tablets. This would make a good sleep, but please try not to take Clonazepam regularly. Green tea in evening at around 4 pm would help in relaxation and you will feel better. Take warm water bath in evening and this will also help in sleep. AvAoid brain stimulation activities for some time in evening like doing work on computer or reading a book. All these steps result in good sleep.
Take the medicines as per your prescribed doses only.
Thanks, Hope this helps you. Please ask again if you have more doubts to ask.
Take care
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
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