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Suggest Alternative Medication For Depression

Posted on Wed, 14 Oct 2015

Question: hello sir, i am undergoing treatment for deppression for 9months.
my medicines are nexito 10mg daily one at night and mirtaz 7.5mg daily at night.

As there is no progress in my condition, could you prescribe any other medicine.
i am sleepless and nightmares every day. my concentration level is reduced getting angry easily very mucha tired especially in morning

Answered by Dr. Chintan Solanki (21 minutes later)

Brief Answer:
dose of both medicines are not sufficient, for sleep add benzodiazepine

Detailed Answer:
Hello XXXX,

Thanks for writing to us.

I can understand your concern.

Nexito (Escitalopram) is used up to 20 mg and Mirtaz (Mirtazapine) is used up to 30 mg. You are not given optimum dose of either of the drugs.

If dose of mirtazapine is increased it can help in sleep also. Even after increasing mirtazapine or if dose of nexito is increased benzodiazepine like clonazepam can used for sleep disturbance for some time.

Discuss all these aspects with your treating doctor and change treatment approach. Continue psychotherapy also.
Hope I have answered your query, I will be happy to help further.

Regards,

Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (45 hours later)

Hello Sir,
Thank you for your reply.
Is there any side effects in taking these medicines?
How long do i need to take these medicine?

Answered by Dr. Chintan Solanki (50 minutes later)

Brief Answer:
no serious side effects, you can stop gradually after complete improvement

Detailed Answer:
Hi XXXX,

Thanks for follow up.

Any medicine for any physical or psychiatric problem has some side effects. But it is not always there in all patients and not all side effects in one patient.

Escitalopram overall is the drug with the least side effects. Headache, nausea and sexual dysfunction are common side effects. Others are insomnia or somnolence, dry mouth, fatigue and flu like symptoms. But only 5-10% people stop escitalopram due to side effects and very good drug for young people.

Mirtazapine has some more side effects but still is it safe. The most common side effect is sedation and so it is good for sleep and should be taken at night.
Other side effects are constipation, dry mouth, increase appetite , weight gain.

I have mentioned side effects for your information only. If any of them is there you can discuss with your treating doctor. But no need to worry at all about side effects. They are not always there. And there are no long term side effects.

You should continue the medicines at least for 3 months after complete improvement and after that medicines can be reduced gradually as per doctor's instructions and stop.

Feel free to discuss further.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar