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Taking Rabeprazole for IBS and Clonazepam for anxiety. What are the long-term effects of these medicines?

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Practicing since : 2004
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IBS with constipation predominant. Taking Rabeprazole sodium 10 mg tablet daily in the morning with empty stomach. Suffering from anxiety and taking Clonazepam 0.25 mg tablet BD, 1/2 tablet of Levogastrol 25 mg tablet in the night and 2/3rd tablet of Mirtaz 7.5 mg at bed time. All these medicines except Levogastrol (Taking from one month) are taking for the last four years. Also reducing weight (Reduced 50 kg from 53 kg within 2-3 months). Taking 10 g husk (fibre) in the morning and 10 g at bed time. Please tell me more suitable treatment for above mentioned symptoms and also the long term side effects of the mentioned medicines.
Posted Mon, 21 May 2012 in Medicines and Side Effects
Answered by Dr. Ashish Mittal 18 hours later
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     47 year old male
•     Known case of IBS and anxiety
•     Concern related to more suitable combination of medicines and drug side effects

First you need to understand every drug even vitamin has long list of side effects which you can get easily on google, but more important is the experience of side effect by individual patient. If we see your medicines: clonazepam leads to sedation and habit formation, Mirtaz/levogastrol lead to weight gain. As you are taking most of the medicines for 4 years then no need to worry much. But medicine should be taken under supervision of your physician.

Apart from that following information will help you:
•     You are taking very less dose of Mirtaz. Its usual effective dose between 15-30mg per day. Mirtaz is a good drug for long term treatment of anxiety and associated IBS. It will also help in stabilizing your weight.
•     It is not good to take clonazepam for long term which can lead to its addiction. It is used for anxiety for short duration only and replaced by long term medicine like Mirtaz.
•     For relaxation: do morning walk and breathing exercise.

We do not prescribe any medicine here, as in person examination of person is must before prescribing medicines according to guidelines. So, discuss treatment with your physician with above information

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Above answer was peer-reviewed by
Follow-up: Taking Rabeprazole for IBS and Clonazepam for anxiety. What are the long-term effects of these medicines? 1 hour later
If i increase the dose of mirtaz even upto 1 tablet of 7.5 mg daily then its sedative effect is more and it also causes more constipation. Moreover, by profession I am Professor in Agriculture University and i have to teach the students so after taking 1 tablet of mirtaz, it effects my teaching due to the sedative effect.
Answered by Dr. Ashish Mittal 6 minutes later
Hello again,

I understand your concern. Mirtaz has sedative effects at initiation of treatment or after dose increment. For that you have to just wait...wait.. and it will improve within few days.

Same time, You can stop night dose of clonazepam as it also add and lead to sedation.

Wish you good health.
Above answer was peer-reviewed by
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