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Stress and sleeplessness when travelling. Have IBS. Problem resumed after stopping Nexito plus

Dear sir, I am having stress , sleeplessness and fear while travelling and when i think about travelling. For about 5 yrs i have IBS problem which results in fear while travelling. I became restless 2days before travelling. then i consulted a pyshtriact, who prescribed nexito plus (Morning) and Nexito Forte (night) for 1 month. After that i feel better, then he told to change to Neito 5ml and Nexito Forte at night and stopped nexito plus. After 1 week again i feel the stress & restlessness. what should i do now.
Asked On : Sat, 10 Nov 2012
Answers:  1 Views:  215
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Emergency Medicine Specialist 's  Response
Hello and welcome to Healthcare Magic. Thanks for your query.

Nexito Plus is a combination medication containing 5 mg of Escitalopram (an SSRI anti-depressant) and 0.5 mg of Clonazepam (a Benzodiazepine anti-anxiety medication). Nexito Forte is also a similar combination medication containing 10 mg of Escitalopram and 0.5 mg of Clonazepam.
Both SSRI antidepressants like Escitalopram and anti-anxiety medication like Clonazepam are useful in controlling anxiety as well as in the treatment of IBS.

Benzodiazepine anti-anxiety medication like Clonazepam are usually given only on a short-term basis to give you quick relief of your anxiety symptoms. But if they are stopped suddenly, they can produse "withdrawal effects" and "rebound anxiety". In your case since the Clonazepam (which was included in the Nexito Plus) was suddenly stopped, this has resulted in the recurrence or worsening of your anxiety and restlessness.

Don't get too worried about this recurrence of the stress / anxiety, because this "withdrawal effect" and "rebound anxiety" will settle down on its own soon. Moreover, antidepressants like Nexito may take a few weeks to bring about their full effects. So, as the anti-depressant effects become more pronounced, your stress and anxiety should come under control.

Also, your anxiety / fears seem to be mostly related to your IBS. So, taking steps to minimize your bowel irregularities will also help in reducing this stress / anxiety.
- Try dietary adjustments such as increasing the fibre content in your diet, avoiding foods that 'stimulate' your intestines like spicy foods, coffee, tea, carbonated drinks, etc. (Smoking can also be an irritant)
- Try to have a healthy lifestyle with regular exercise and proper sleep habits.
- Try to avoid stress and try relaxation methods like deep breathing, meditation, etc.

Best wishes,
Dr. Sheeba Stephen
Answered: Mon, 12 Nov 2012
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