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How Long Can I Take Zyven-OD For Anxiety?
Question: Hi I was facing problems like anxiety, negative thoughts, over sensitiveness, restlessness, sleeplessness for which I was prescribed zyvan od +50 once a day. I am 69 years of age and have been taking this medicine for last two years. My condition is improved overall. How long can I safely continue to take this?
Brief Answer:
duration of t/t depends on many factors
Detailed Answer:
Hello,
I think the spelling and dosage that you have mentioned in the query are wrong. As far as I can get -you meant to say zyban 150mg.
You have been on it for past 2 yrs and not have any major side effect and are also keeping fine. In such cases we try to reduce and stop the drug and see if one is able to remain asymptomatic or not. But if you want to continue with it then please get your basic blood test every 6 months- CBC, LFT, RFT & Sr. Cholesterol.
The duration of treatment depends on the number and severity of episodes one has had. You did not mention if it was your first or what episode and were you feeling suicidal also anytime during illness or made an attempt of self harm; is there any family history of this illness?
Ideally anyone above the age of 50yrs should be put on something mild like esciatlopram or sertraline (,as these are cardio cafe and less interactive). You may discuss them with your doctor ( espically if you want to continue meds for long time).
Get your blood pressure checked regularly.
Eat more salad and take enough water- both will help for adequate drug elimination and good digestion.
Remain social and try to take walk daily.
Hope the reply is useful. Please feel free to ask more questions for clarification.
Dr. Manisha Gopal
MD Neuropsychiatry
duration of t/t depends on many factors
Detailed Answer:
Hello,
I think the spelling and dosage that you have mentioned in the query are wrong. As far as I can get -you meant to say zyban 150mg.
You have been on it for past 2 yrs and not have any major side effect and are also keeping fine. In such cases we try to reduce and stop the drug and see if one is able to remain asymptomatic or not. But if you want to continue with it then please get your basic blood test every 6 months- CBC, LFT, RFT & Sr. Cholesterol.
The duration of treatment depends on the number and severity of episodes one has had. You did not mention if it was your first or what episode and were you feeling suicidal also anytime during illness or made an attempt of self harm; is there any family history of this illness?
Ideally anyone above the age of 50yrs should be put on something mild like esciatlopram or sertraline (,as these are cardio cafe and less interactive). You may discuss them with your doctor ( espically if you want to continue meds for long time).
Get your blood pressure checked regularly.
Eat more salad and take enough water- both will help for adequate drug elimination and good digestion.
Remain social and try to take walk daily.
Hope the reply is useful. Please feel free to ask more questions for clarification.
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks but your answer is not satisfying since I believe you got the drug name wrong. its zyven OD plus 50. the salts are Desvenlafxine ER (50mg)and Clonazepam (0.5mg). I also suffer from cardiomyopathy and have been suggested this drug to be safe in heart condition. tried to withdraw the drug 1 year back but faced anxiety symptoms therefore again resumed as suggested by doctor. is it safe if I continue taking the drug long term...say for years ?? so the question is about long term safety?
Brief Answer:
its ok, but sertraline is best for cardiac patient
Detailed Answer:
Hello,
Ok, its desvenalafaxine but the spelling you wrote was more suggestive of zyban (you wrote zyvan)...
now coming to the improtant part - long term safety - desvenalafaxine is a part of venelafxaine but without side effects which venelafaxine has..so,in a way it is fine for heart or other organs.
However, the best anti depressant or anti-anxiety drug for any cardiac patient is sertraline. It is a recommeneded cardio safe molecule in most of the clinical studies and is most commonly prescribed. If that does not help the person concerned then we move forward to another molecules like desvenalafaxine. If you want, you can discuss it with your team or study yourself.
So, had I been treating you on long term anti depressant I would prefer sertraline.
You had an episode when you tried to stop it an year back - suggest that you should continue with it for another 2-3 yrs.
Also, you are actually on two drugs - desvenalafaxine and clonazepam. This means that desvenelafaxine is not enough to crub your anxiety on the current dosage level (or else your doctor would have used plain desvenalafaxine and not a combination;even sleep disturbance is also a common feature of anxiety).
I dont find it good to keep some one on benzodiazapines ( clonazepam) for so long...it is not good for liver. Its better to raise desvenelafaxine so that your anxiety is controlled and clonazepam can be stopped.
Monotherapy is always better.
So, for long term use either you:
1. go for plain desvenalafaxine and increase its dose (in case your doctor dosent want to change the drug to sertrailne).
Or 2. Switch over to sertraline 50-100mg.
Hope now the answer was helpful for you.
Please feel free to ask more questions for clarification.
Wish you good luck!
Dr. Manisha Gopal
MD Neuropsychiatry
its ok, but sertraline is best for cardiac patient
Detailed Answer:
Hello,
Ok, its desvenalafaxine but the spelling you wrote was more suggestive of zyban (you wrote zyvan)...
now coming to the improtant part - long term safety - desvenalafaxine is a part of venelafxaine but without side effects which venelafaxine has..so,in a way it is fine for heart or other organs.
However, the best anti depressant or anti-anxiety drug for any cardiac patient is sertraline. It is a recommeneded cardio safe molecule in most of the clinical studies and is most commonly prescribed. If that does not help the person concerned then we move forward to another molecules like desvenalafaxine. If you want, you can discuss it with your team or study yourself.
So, had I been treating you on long term anti depressant I would prefer sertraline.
You had an episode when you tried to stop it an year back - suggest that you should continue with it for another 2-3 yrs.
Also, you are actually on two drugs - desvenalafaxine and clonazepam. This means that desvenelafaxine is not enough to crub your anxiety on the current dosage level (or else your doctor would have used plain desvenalafaxine and not a combination;even sleep disturbance is also a common feature of anxiety).
I dont find it good to keep some one on benzodiazapines ( clonazepam) for so long...it is not good for liver. Its better to raise desvenelafaxine so that your anxiety is controlled and clonazepam can be stopped.
Monotherapy is always better.
So, for long term use either you:
1. go for plain desvenalafaxine and increase its dose (in case your doctor dosent want to change the drug to sertrailne).
Or 2. Switch over to sertraline 50-100mg.
Hope now the answer was helpful for you.
Please feel free to ask more questions for clarification.
Wish you good luck!
Dr. Manisha Gopal
MD Neuropsychiatry
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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