HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Can Nexito Aggravate IBS Symptoms?

Posted on Thu, 5 Jan 2017

Question: Dear doctor - I have been taking nexito 5 mg for the last two weeks along with the following medicines :
Quetiapine 100 sr, sizopin 25 and tynept od in the night
Nexito 5, inderal la 20, zapiz 1/4of o.25. was taking sulpitac 100, have stopped that.
With nexito, my ibs symptoms are back with bloating, burning and flatulence. Spoke to my doctor, he has asked to stop nexito, my anxiety is lil better with nexito at the same time stomach is troubling me. Don't know what to do. Pls help me with the following:
If I stop nexito, what else can I take that will help me with my anticipatory anxiety and keep my stomach calm
What else can I take along with nexito to calm my ibs problem
I was taking 100mg sulpitac, made 50 for a week and then stopped, a lot of thoughts are coming to my mind, are these withdrawal symptoms of sulpitac, if yes how long will they continue

Answered by Dr. Seikhoo Bishnoi (1 hour later)

Brief Answer:
Amidulpiride 25 should help

Detailed Answer:
Hi thanks for asking from HCM again

I don't think stopping Nexito is a good option. The drug is controlling your symptoms and in my opinion this should be continued. Nexito 5 mg doesn't usually cause or aggravate IBS symptoms especially since you are on this drug since some weeks.

The mild aggravation could be occuring due to Amisulpiride withdrawal but severe symptoms are not seen usually. You can take 25 mg of Amisulpiride for one more week and this should help you. After one week you can stop the drug.

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (44 minutes later)

It was happening while amisulpride was on. Don't think it has anything to do with stopping amisulpride. I can only think of nexito adding to it. What else along with nexito I can take to help me with my stomach problem?is there something when taken with nexito helps with the gi distress caused by nexito?

Answered by Dr. Seikhoo Bishnoi (1 hour later)

Brief Answer:
Low dose Zapiz on sos basis can help

Detailed Answer:
Hello again

In that situation taking 0.125-0.25 mg Zapiz can help to relieve the symptoms. This will help in providing relaxation from IBS symptoms.

Recently I have started using a newer drug Rifaximin in my clinic for IBS patients. The drug has came in XXXXXXX recently and got approval in 2015 for IBS patients. Though I haven't received the following up of this drug but in initial studies the drug has proved efficacy in reducing bloating, flatulence associated with IBS patients. You can talk with your doctor for this drug.

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (24 minutes later)

Is starting libras or amitryn or colospa retard an option?

Answered by Dr. Seikhoo Bishnoi (22 hours later)

Brief Answer:
Rifaximine is better option

Detailed Answer:
Hi again, please excuse me for late reply

You have taken these medicines in past too and symptoms persisted even after that. So I don't think taking these drugs is good option.

If you have access to your doctor then ask for the drug I've mentioned.

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (6 minutes later)

Since SSRIs just don't suit me is there any tricyclic drug that will help me with my anticipatory anxiety? Say imipramine, clomipramine or anything else...

Answered by Dr. Seikhoo Bishnoi (13 minutes later)

Brief Answer:
TCAs like Imipramine can help.

Detailed Answer:
Hi again

If we consider TCAs then Imipramine can prove better option. In various studies the drug has shown proven efficacy in controlling IBS symptoms especially in diarrhoea and flatulence predominant IBS. Doxepine is also a TCA and has good roles in constipation predominant IBS.

But frankly speaking I usually avoid using TCA in my patients. I have used Clomipramine for generalised resistant anxiety and it showed great results.

Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (19 minutes later)

Since nexito is not suiting me, in the past paxil and dveniz didn't suit me either. I don't think my system can handle SSRIs or SNRIs, out of the tcas mentioned by you, which one should I try that will help me with my anticipatory anxiety, pls suggest. Also I am on nexito 5, should I stop it cold turkey or taper it off and then stop. If yes, how do I go about tapering?

Answered by Dr. Seikhoo Bishnoi (27 minutes later)

Brief Answer:
Take half of tablet for about one more week.

Detailed Answer:
Hello again

Nexito 5 is a low dose and can be stopped cold turkey. But since you are sensitive to withdrawal so its better to take 2.5 mg (half of 5 mg) for about a week followed by stopping the drug. This will not cause any withdrawal related issues.

Clomipramine should be better of all these drug. You can start with 25 mg dose in addition to other drugs you are taking. Avoid increasing the dose to 75 or more because this might worsen the constipation.

Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (23 hours later)

Went for another opinion today and that doctor has added prothiaden 25 and asked me to stop sizopin, tynept and make quetiapine 1/2of 100mg sr. I have following doubts:
Since my body is very sensitive, I am scared of making such drastic changes. If at all these medicines need to stop, how do I go about tapering, pls advice.
Does prothiaden help with anticipatory anxiety? Does it interfere with sleep? Can i take it in the morning? Is it better than imipramine or clomipramine for controlling anticipatory anxiety? Pls advice

Answered by Dr. Seikhoo Bishnoi (50 minutes later)

Brief Answer:
Prothiaden is a good drug for anxiety and somatic symptoms.

Detailed Answer:
Hello again

Prothiaden is used in mild to moderate symptoms and though not very efficacious than Clomipramine but is relatively better tolerated. The drug is commonly used in situations like anxiety associated with somatic symptoms.

Stopping Sizopin and starting Quetiapine will not cause much effects because Quetiapine will help in sleep and both are antipsychotics so chances of withdrawal are very less.

Tynept in my opinion should be reduced in about 1-2 weeks. Though the withdrawal symptoms will be mild.

Prothiaden helps in reducing anxiety symptoms. The dose of 25 mg will not cause much effects on sleep. No need to worry. Yes you can take it in morning.

Thanks. Take care

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Seikhoo Bishnoi (10 minutes later)

I have been taking sizopin 25 and quetiapine 100 sr together. Doctor has told me to stop sizopin and make 1/2 of quetiapine, therefore I am worried. Can't stop tynept, sizopin and make quetiapine 1/2 in one go. Pls advice. How should I go about it? Normally, prothiaden is taken in the morning or night?

Answered by Dr. Seikhoo Bishnoi (16 minutes later)

Brief Answer:
Take Tynept 12.5 mg for next one week.

Detailed Answer:
Hello again

I am sorry for reading it wrong. In that cause you will suffer insomnia. Because you have no psychotic symptoms so stopping Clozapin or reducing dose of Quetiapine will not worsen any symptoms. But since both drugs help in sleep so you may suffer disruption of sleep. Quetiapine also helps in anxiety but even 50 mg dose will do the work.

But if you have prescription of Clonazepam (Zapiz) then you can take increased dose of the drug like 0.25-0.5 mg in evening in order to beat the withdrawal symptoms. You should take Tyneptin 12.5 for next one week and then stop the drug. In the mean time your doctor will advise you to increase the dose of Prothiaden to 50 mg per day. This should prevent any withdrawal symptoms.

Prothiaden is usually advised in BD doses so can be taken in morning or evening without worries. You can start the drug in morning hours.

Thanks

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Seikhoo Bishnoi (22 minutes later)

I have made nexito 5 half from today, thinking of stopping it in next 2-3 days since prothiaden has been started. Will prothiaden help me with my anticipatory anxiety?

Answered by Dr. Seikhoo Bishnoi (2 minutes later)

Brief Answer:
Yes the drug will help

Detailed Answer:
Hello again

Yes Prothiaden will help in anticipatory anxiety but this will take some time (about 3-4 weeks). The doses should be increased to 50 mg in next week and then if needed to 75 mg.

Thanks

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Seikhoo Bishnoi (3 days later)

Dear doctor - I have started prothiaden 25 in the night on 6th december. Have been waking up at 3-4 am in the morning and feel very strange light headedness. What would your advise be? Along with it I am taking the following medication:
Quetiapine 100 sr, sizopin 25 , tynept od in the night
Inderal la 40, zapiz 1/2of 0.25 in the morning

Answered by Dr. Seikhoo Bishnoi (5 hours later)

Brief Answer:
Take Prothiaden in morning

Detailed Answer:
Hi thanks for asking again.

In such situation my advice would be either to start Prothiaden in morning or to take half to one tablet of Zapiz in evening. Both options would help in better sleep.

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (11 hours later)

How about strange light headedness that I get with prothiaden?

Answered by Dr. Seikhoo Bishnoi (5 hours later)

Brief Answer:
Take the drug in morning

Detailed Answer:
Hello again

In some days you will develop tolerance to it. No need to worry. Taking the drug in day time will make it more tolerable.

Just start the tablet in morning and for some days if needed take Zapiz on Sos basis.

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (26 hours later)

Took prothiaden in the morning today. Feeling lethargic, low and a bit sedated. Will it settle down with time. Should I continue taking in the morning?

Answered by Dr. Seikhoo Bishnoi (6 hours later)

Brief Answer:
Yes please continue to take in morning

Detailed Answer:
Hello again

Just wait for some days and this lethargy and sedation will go away. No need to worry.

Yes continue to take in morning.

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (2 days later)

Can tianeptine od be stopped cold turkey? Does it have any withdrawal symptoms?

Answered by Dr. Seikhoo Bishnoi (8 hours later)

Brief Answer:
The drug should not be stopped cold turkey

Detailed Answer:
Hi thanks for asking again

Though the withdrawal risk with Tynept OD is very less still it should not be stopped cold turkey.

Better to take 12.5 mg dose for about one week and then you can stop it. This will not cause any serious withdrawal symptoms.

Thanks

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar