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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Vomiting Urge While Having Food. Having Gas Problems, Headache. Took Solaze, Mdd Xr For Anxiety. Have High BP. Suggestion?

hellow ,let's come to the point:
patient: my mother
age : 59 +
sex : female
country: India

problem: ..from the last few months my mom can't eat properly,when she tries to eat her meal vomiting tendency comes,even she few times do .with this she suffering from gas problems,head pain...but after vomit she gets some relief.
let me also.inform you that our local physician has done. various test like endoscopy,ecg etc..all reports are norlam.

she also has tention anxiety due to some problems arrond us .so last week we took her to an neuro psychiatric and he gave her two medicin : solaze 50 and mdd xr 50..from now she is feeling sleepy all the time..although still she can't eat properly..and last night again vomit.

other things I notice : she ha high blood pressure ..eats tablet daily for that...and when she sleeps her hands legs fingure had some movements light.


I , am waiting for your suggation...what to do now ..is she getting right treatment ...please reply..
Wed, 30 Oct 2013
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General & Family Physician 's  Response
Hello there!
your mom is currently being treated with antipsychotics.
you said she already had some gastreic reflux issues. at this age they do. we need to combat them. with some lifestyle modificaions and some medications(we will talk about that at the end)

now the main issue is anxiety and major depression disorder and it needs to be addressed.
the medicines for it are fine. but the vomiting is a trouble.
and antipsychotics are notorious for it specially your case Amisulpride (solaze) so here is wha you gonna do. treat the vomits symptomatically with prokinetics etcs, you can use prednisone too if vomius is severe. if still not controllable you will need a triad of steroids(dexamethasone), prokinetics(metoclopromide) and Ondensetron.
or you can switch to lithium but that should be discussed with the current prescriber.

now the blood pressure. again a morbidity, psychology adds to the trouble. so here is what you gonna do,
fight the stress. lifestyle modification, lower weight and all other measures for a hypertensive patient, excercise, vegatables diet, salt intake less than 1 gm per day etc etc, and a lifestyle change,. it will fix he hypertensive issues and bring it under control. regular usage of medication is very necessary. i would recommend renal friendly Antihypertensives like Ace inhibitors or spironolactones. do look for your moms potassium levels. vomiting damages electrolytes. and might be arrhythmogenic to your moms heart. use some electrolyte solutions as a remedy, a sip or two after every vomit and boom.

now reflux issues, acidity, gas etc
A. First tips.
1.lose weight ( if overweight) divide your weight to the height in meters twice and if the result is more than 25 reduce the weight.
2.Avoid alcohol, chocolate, citrus based fruits,tomato based products
3.avoid pepper mint coffe and possibly the onion family
4.eat small freequent meals rather than large meals.
5.wait at least 3 hours after the meal to lie down or sleep.
6.refrain from ingesting food (except liquids) with in 3 hours of bed time.
7.eleate te head of your bed at least 8 inches
8.avoid bending or stooping positions
9.dont use nsaids
10.dont smoke
11. have a proper sleep routine
12. use cold milk as drink avoid all hot beverages and carbonated ones

B. now lets talk some medicines
1.H2 blockers like ranitidine famotidine nizatidine cematidine etc if the problem is more at the night timings
2.proton pump inhibitors like omeprazole, rabeprazole , lansoprazole, esomeprazole,pentoprazole etc if severe symptoms 40 mg once a day
3.use prokinetics like aluminium hydroxide or metoclopromide
4.use ant acids like aluminium hydroxide, magnesium hydroxide

following my lead till here i am sure will fix your issue.

Regards and good luck, your mama will be proud for you caring
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Vomiting Urge While Having Food. Having Gas Problems, Headache. Took Solaze, Mdd Xr For Anxiety. Have High BP. Suggestion?

Hello there! your mom is currently being treated with antipsychotics. you said she already had some gastreic reflux issues. at this age they do. we need to combat them. with some lifestyle modificaions and some medications(we will talk about that at the end) now the main issue is anxiety and major depression disorder and it needs to be addressed. the medicines for it are fine. but the vomiting is a trouble. and antipsychotics are notorious for it specially your case Amisulpride (solaze) so here is wha you gonna do. treat the vomits symptomatically with prokinetics etcs, you can use prednisone too if vomius is severe. if still not controllable you will need a triad of steroids(dexamethasone), prokinetics(metoclopromide) and Ondensetron. or you can switch to lithium but that should be discussed with the current prescriber. now the blood pressure. again a morbidity, psychology adds to the trouble. so here is what you gonna do, fight the stress. lifestyle modification, lower weight and all other measures for a hypertensive patient, excercise, vegatables diet, salt intake less than 1 gm per day etc etc, and a lifestyle change,. it will fix he hypertensive issues and bring it under control. regular usage of medication is very necessary. i would recommend renal friendly Antihypertensives like Ace inhibitors or spironolactones. do look for your moms potassium levels. vomiting damages electrolytes. and might be arrhythmogenic to your moms heart. use some electrolyte solutions as a remedy, a sip or two after every vomit and boom. now reflux issues, acidity, gas etc A. First tips. 1.lose weight ( if overweight) divide your weight to the height in meters twice and if the result is more than 25 reduce the weight. 2.Avoid alcohol, chocolate, citrus based fruits,tomato based products 3.avoid pepper mint coffe and possibly the onion family 4.eat small freequent meals rather than large meals. 5.wait at least 3 hours after the meal to lie down or sleep. 6.refrain from ingesting food (except liquids) with in 3 hours of bed time. 7.eleate te head of your bed at least 8 inches 8.avoid bending or stooping positions 9.dont use nsaids 10.dont smoke 11. have a proper sleep routine 12. use cold milk as drink avoid all hot beverages and carbonated ones B. now lets talk some medicines 1.H2 blockers like ranitidine famotidine nizatidine cematidine etc if the problem is more at the night timings 2.proton pump inhibitors like omeprazole, rabeprazole , lansoprazole, esomeprazole,pentoprazole etc if severe symptoms 40 mg once a day 3.use prokinetics like aluminium hydroxide or metoclopromide 4.use ant acids like aluminium hydroxide, magnesium hydroxide following my lead till here i am sure will fix your issue. Regards and good luck, your mama will be proud for you caring