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Does Intake Of Nextril Help In Treating IBS?

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Posted on Sat, 30 Apr 2016
Question: Good afternoon doctor, met my doctor today. He has made the following changes:
Mirtaz 7.5 from 15 in the night
Olimelt 1/2 of 2.5 in the night
Librax 1/2 in the morning from 1
Lesuride 25 mps in the night..
Added nextril 50 morning/evening
Checked with him about making Lesuride mps 50 in the morning but he did not seem keen and he eventually wants me to go off librax gradually as according to him it's potentially habit forming. I have following questions :
What's your view on the above combo of medication?
Is it safe to take nextril in the long term as it is a benzodiazipine? Is it addictive or habit forming like other benzodiazipine? Does it have any bothersome side effects like memory problems and stomach issues?
Will reducing librax aggravate my IBS?
Does nextril help with IBS as well?
In the absence of librax, will Lesuride take care of my IBS?
Loom forward to an honest advice!


doctor
Answered by Dr. Seikhoo Bishnoi (6 hours later)
Brief Answer:
Yes the drug is safe to use.

Detailed Answer:
Hello thanks for asking again

Nextril is Tofisopam and the drug is launched recently and have shown promising results. The drug is a benzodiazepine drug but has very less or minimal sedation. The drug helps to control anxiety but without increasing the risk of abuse. The drug can be used safely even for longer periods of time. If the drug show response in you then that would be a great thing.

Reducing Mirtaz is a good idea and this would help to reduce the weird dreams and should help in good sleep. The rest of prescription is also good. Tofisopam will compensate for reduced doses of Librax (especially Chlordiazepoxide).

Coming to your doubts-

1) The medicines combo is right.

2) Yes its safe to take the drug even on long term. The drug is considered as safe in terms of abuse potential.

3) The drug is not habit forming. The drug is non sedative.

4) No effects on cognitive functions including memory, concentration etc. The drug will reduce anxiety and thus should help in reducing stomach issues also.

5) No Tofisopam and Levosulpiride will compensate for reduced doses of Librax.

6) Yes the drug will reduce anxiety and thus will help in IBS symptoms also. No direct specific actions are there on gut but the drug will definitely help.

Thanks, Please don't hesitate to ask again for more doubts.

Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Seikhoo Bishnoi (1 hour later)
Read on the net that it can give epigastric pain and sleep problems, is it true? And what is your experience with your patients with this drug?
doctor
Answered by Dr. Seikhoo Bishnoi (7 hours later)
Brief Answer:
Tofisopam is good for anxiety symptoms.

Detailed Answer:
Hello again and thanks for asking again

No the drug doesn't give epigastric pain at the dose you are advised. In high doses the drug is known to cause some epigastric distress. I am using the drug in doses up to 200 mg per day but none has reported this side effect. The drug is a good drug, though to some extent less in efficacy than conventional benzodiazepines but still in control of anxiety symptoms the drug is great. You should go with this drug.

Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Seikhoo Bishnoi (10 hours later)
Thanks doc. Does it interfere with sleep?


Also wanted to check if it helps with panic/ anxiety attacks. In the meeting today felt breathless for a while as if panic attack was coming. Is it because of reduction in mirtaz from 15 to 7.5 and reduction of librax to half from one? Kind of worrying me. Do you think it's because my body is taking time to adjust to change in dosage and will it settle down with time? More importantly, wanted to check if tofisopam helps with anxiety attacks/ feeling of anxiety attacks? If yes, how long will it take to show its effects? How long does the effect of tofisopam 50 last?
doctor
Answered by Dr. Seikhoo Bishnoi (3 hours later)
Brief Answer:
Tofisopam helps to control anxiety symptoms.

Detailed Answer:
Hi, thanks for asking again. Please excuse me for late reply.

The drug doesn't cause sedation but it doesn't result in insomnia. Take the drug in morning hours and in after noon, avoid using it in evening hours. The drug doesn't interfere with sleep.

Yes the slight breathlessness you had probably occurred due to reduction of dose of Librax. But that would improve in a day or two. No need to remain worried. The anxiety will definitely settle down with time.

Yes Tofisopam helps in severe anxiety symptoms also. The drug cause relaxation without causing sedation. The half life of drug is about 6-8 hours. I prefer to use the drug in 2-3 times dosing. The drug can even help to control anxiety on SOS basis also.

Thanks. Still have doubts please ask again. Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Seikhoo Bishnoi (2 days later)
Dear doc - since the time I have started taking tofisopam 50 morning/eve, I am not able to sleep and getting dryouth, both these issues are really bothersome. Took evening tofisopam at 5pm yesterday, could not sleep in the night. After taking today's morning dose again could not sleep in the afternoon. Feeling quite miserable. Dry mouth and dry lips are also quite bothersome . don't know what to do? Wondering whether I should continue with tofisopam! Pls advice.
doctor
Answered by Dr. Seikhoo Bishnoi (20 hours later)
Brief Answer:
Wait for some days and the side effects will reduce.

Detailed Answer:
Hello thanks for asking again

I apologise for late reply because of limited internet access here due to ongoing agitation in XXXXXXX

Its better if you take Tofisopam tablets in morning and afternoon. This will prevent any disturbance in sleep if its being caused by the drug. The symptoms dry mouth, lips will reduce in some days. If on altering the time the symptoms still persist then in evening you can think of taking low dose Etizolam 0.25 mg. This will help in sleep for some days till you become stabilised on Tofisopam. Please don't stop the drug, continue for at least a couple of weeks.

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5193 Questions

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Does Intake Of Nextril Help In Treating IBS?

Brief Answer: Yes the drug is safe to use. Detailed Answer: Hello thanks for asking again Nextril is Tofisopam and the drug is launched recently and have shown promising results. The drug is a benzodiazepine drug but has very less or minimal sedation. The drug helps to control anxiety but without increasing the risk of abuse. The drug can be used safely even for longer periods of time. If the drug show response in you then that would be a great thing. Reducing Mirtaz is a good idea and this would help to reduce the weird dreams and should help in good sleep. The rest of prescription is also good. Tofisopam will compensate for reduced doses of Librax (especially Chlordiazepoxide). Coming to your doubts- 1) The medicines combo is right. 2) Yes its safe to take the drug even on long term. The drug is considered as safe in terms of abuse potential. 3) The drug is not habit forming. The drug is non sedative. 4) No effects on cognitive functions including memory, concentration etc. The drug will reduce anxiety and thus should help in reducing stomach issues also. 5) No Tofisopam and Levosulpiride will compensate for reduced doses of Librax. 6) Yes the drug will reduce anxiety and thus will help in IBS symptoms also. No direct specific actions are there on gut but the drug will definitely help. Thanks, Please don't hesitate to ask again for more doubts. Take care