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Diarrhea, weakness, sleepiness after taking Nexito forte. How can we take medicine?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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hi
my mom has been taking nexito forte for a month now and we think because of this - she is having symptoms of diarrea, having upto 6 -7 loose motions and also feeling very weak - combined with lots of sleep.
She tried taking Lomotil for 4 days and they seem to have reduced, again - now once she stopped lomotil, symptoms are back. kindly guide us, - our questions - how long we can take / stop nexito forte. and how long she can continue Lomotil. She will go back to India in 45 days, we are looking for temporary resolution. she will visit her regular doctor once she is back
Posted Wed, 19 Sep 2012 in Brain and Spine
 
 
Answered by Dr. Sudhir Kumar 2 hours later
Hi XXXXXXX
Thank you for contacting Healthcare Magic.
Nexito forte contains escitalopram and clonazepam. Excitalopram is an antidepressant and is used for treating depression. Diarrhea can occur in about 10% of people taking excitalopram (nexito). Clonazepam is an anxiolytic and is used for treating anxiety. Excessive sleep is an effect of clonazepam. So, here she most likely has adverse effects of both escitalopram and clonazepam.
If she does not have very prominent features of depression, you can advise your mom to stop nexito forte till her diarrhea stops. Lomotil should not be used long-term. Intermittent use is alright.
Please get back if you have any more queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Health City, Hyderabad
Above answer was peer-reviewed by
 
Follow-up: Diarrhea, weakness, sleepiness after taking Nexito forte. How can we take medicine? 1 hour later
Thanks a lot for your response
The answer gave us good hope, however we have few questions
Kindly guide us:

My mom is not having prominent symptoms of depression. Prior to this, she was using / given stugeron 25 mg. (for sensation of rotation inside the head ,especially when she goes to bed after finishing work) - She took this Stugeron for about year till XXXXXXX 2012 - the symptoms have come down.
After MRA scan - please refer the case sheet by clicking link below - doctors have advised to take Nexito forte from July 2012.
Can she restore using stugeron 25mg,till she goes to india (for abt 45 days), if its OK. [Main reason being - how long we can use nexito forte and lomotil alternatively - if symptoms persist and comb back]
Case sheet: (pdf and also image file)
WWW.WWWW.WW WWW.WWWW.WW

It is understood that Nexito-forte probably should be continued after her diarrea stops, she is taking 10mg/day - Can we reduce it to 5 mg / day - if at all above statement is true

Also how many days should we continue before stopping Nexito forte, if you think we could stop nexito forte.

If she has to take Lomotil - Can she use 5 mg, twice a day? (She has taken Lomotil 2mg - twice a day for 5 days)

Thanks a lot for your help and guidance - looking for positive response.
 
 
Answered by Dr. Sudhir Kumar 1 hour later
Hi Mr XXXXXXX
Thank you for getting back. I am pleased to respond to your queries.
Regarding nexito forte, it is indicated only for treating depression and has no other indication. So, if your mom is not depressed, nexito forte can be totally stopped (till she consults her doctor after 45 days). However, if she still has depression, options include lowering the dose to 5 mg (as you have suggested) or switching to any other antidepressant (such as sertraline, dothiepin, etc).
Stugeron is a medicine used for symptomatic treatment of dizziness (sense of rotation). Therefore, there is no reason for its long-term continuous use. It should be used as and when she has dizziness. Continuous long term use of stugeron may lead to adaptation/tolerance (when patients stop responding to it well).
Lomotil can be used at a dose of 5 mg twice daily.
I hope it clarifies. Please get back if you have any more queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Health City, Hyderabad
Above answer was peer-reviewed by
 
Follow-up: Diarrhea, weakness, sleepiness after taking Nexito forte. How can we take medicine? 52 minutes later
Thanks a lot for your help / advise
we will follow and will probably stop the nexito forte medicine
Also in case (may be in next 10 days or so), and If I ask a new question - will it be you who would be responding or a new doctor?
Thanks once again for reviving hopes of my mother/ and us...
rgds
 
 
Answered by Dr. Sudhir Kumar 1 hour later
Hi Mr XXXXXXX
Thank you for writing back.
If you want me to answer your question, you may address it directly to me (mention my name in the query). If my name is not mentioned, it may get answered by any neurologist on Healthcare Magic panel.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Health City, Hyderabad
Above answer was peer-reviewed by
 
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