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Sleeplessness, depression, on stalopam plus, itching. Physical disease?

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General & Family Physician
Practicing since : 2003
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Hi, I am 24 male suffering from sleep problem since 3 months. Due to this I was deppressed for some times and consulted a doctor, Doctor prescribed me stalopalm plus and i have taken it for 1tablet for 1months and then half for 15days, by taking tablet I can easily sleep and stopped it can not able to sleep till late night, Isince some days feeling itching in whole body and due to that cannot able to sleep till late night and also I have to go for potty 3times a day. Am I suffering for any physical dieseas or Is this just My thought? Please help me or suggest some alternative or should I need to consult doctor again? Regards, XXXXXXX.
Posted Sun, 15 Apr 2012 in Anxiety and Stress
Answered by Dr. Deepak Anvekar 3 hours later

Thanks for the query.

From the history provided, and also your young age, it does not seem that you might be having a serious medical condition. They are very benign and easily treatable conditions.

The medication, STALOPAM PLUS is a combination of escitalopram 10 mg and clonazepam 0.5 mg.

This medication helps to calm the mind and improve sleep.

Generalised itching is a common sign of many conditions and is easily treatable with Over The Counter medications. The underlying cause could be due to allergy, dermatitis or due to insect bites.

Before treatment is started, it is important to know if you have any rashes, eruptions or excoriations on the skin. In absence of such signs application of Hydrocortisone Ointment 1 %, available as a OTC medication will be helpful.

In addition, Chlorpheniramine tablets 4 mg tablets can be taken to relieve the itching after discussing with your doctor.

Since you are very young, the cause for lack of sleep would be stress and lifestyle issues. Hence stress management techniques including yoga and pranayama, might help you calm your mind and help you relax.

Continuing Stalopam Plus, for the time being might help you sleep better. But this is not the definitive treatment and it also does not cure the underlying issues. Hence the cause of your lack of sleep has to be addressed and corrected.

I hope this helps. I shall be happy to answer any additional questions or doubts that you might be having.

Above answer was peer-reviewed by
Follow-up: Sleeplessness, depression, on stalopam plus, itching. Physical disease? 15 hours later
Dear sir,

I appreciate your answer but let me inform you that currently I have really not more stress in life but still not getting enough sleep, from last 3 days I got sleep for 7to 8 hours but during the next day i fill not fresh enough, Is this due to withdrawal of stalopalm plus ? please give me some withdrawal symptom of this pill.

Sir, some time I fill hope less that without any reason why I m suffering from this problem? Why it is happening to me?

Answered by Dr. Deepak Anvekar 10 hours later

Thanks for the additional input.

Before I can explain, about your question, I would assume that you might have stopped taking the medication on your own.

In such a scenario, your symptoms can be attributed to a probable withdrawal of clonazepam ( a component of stalopam plus). This medication has an elimination half life of 18 - 50 hours, and withdrawal symptoms can be expected to develop within 24 - 72 hours of stopping it and to reach their maximum intensity after about 5 - 7 days.

Withdrawal symptoms from high potency benzodiazepines such as clonazepam can range from headaches, anxiety, sleep problems, weight loss to more severe and life threatening symptoms including suicidal ideation, epileptic seizures and psychosis.

To prevent such symptoms the dose of clonazepam has to be tapered along with the addition of diazepam (Valium) over a few weeks and then clonazepam can be stopped. This must be followed by slow tapering of diazepam over a few weeks before stopping.

The way forward from now, would be to consult your treating doctor who can prescribe you Diazepam ( Valium) for a few weeks and then reduce the dosage over a few weeks before stopping it.

In addition, I would like to give you some more tips to have a good sleep.

Simple measures (called sleep hygiene) is important to rest and enjoy a refreshing ‎sleep.‎ ‎

Regular bedtime hours: A reasonable and regular time to go to bed each night and stick to it. ‎Your body will appreciate it after a while when it feels it can rely on the routine, it will begin to ‎repay the favor by letting you to sleep when you want. Once you’ve awakened, get up. Don’t lie ‎in bed awake, thinking about getting up. Just do it.‎

Your sleep environment should be comfortable: Keep the bedroom quiet, well-ventilated and as ‎dark as possible when you are sleeping. Fresh air and optimal room temperature will give you ‎the best sleeping conditions. Sleep on a good firm bed; a firm bed will give your entire body the ‎support it needs to really relax. It’s better for your spine, too.‎

Mind & identify bed with sleep: no working, reading, watching television, and doing cross ‎puzzles or whatever occupies you in evening. If you can’t sleep within 30 minutes get out of bed: ‎don’t lie awake trying to get to sleep. Do something quiet and non-stimulating. When you feel ‎tired again, go back to bed.‎

AVOID Stimulants like caffeine, alcohol and tobacco at least 4-5 hours before bedtime. Coffee is not ‎the only drink that contains caffeine, tea, chocolate and cola drinks are high caffeine. Alcohol ‎and tobacco (Smoking or chewing) must also be avoided.

Avoid Sleeping with full stomach: have dinner at least two or three hours before bedtime. It ‎ensures that you don’t have a full stomach when you sleep and also prevent acid reflux ‎‎(heartburn).‎

Some physical exercise on regular basis, preferably in morning improves restful sleep. Do not ‎exercise just before going to bed as it can detrimental to your sleep.

Relaxation Techniques: Some common relaxation techniques that have proven to be beneficial ‎are warm bath, massage, listening to music, yoga & meditation. ‎
Observing these simple sleep hygiene measures will eventually make you just goes to sleep and ‎enjoy it.‎

I hope this helps to clear your doubts.

In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

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