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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Treated for anxiety and depression. Took serta for sleep disorder. Feeling nausea, fatigue. Side effect?

Answered by
Dr. Ashish Mittal


Practicing since :2004

Answered : 1856 Questions

Posted on Thu, 10 Jan 2013 in Mental Health
Question: hi, i was seeking treatment for anxiety and panic disorder and mild depression since XXXXXXX 2012. i started with paxidep cr 25 and oleanz 7.5 and then the doze was lowered to oleanz 2.5mg in XXXXXXX 2012 with paxidep cr dose remaining same. however, i started suffering from withdrawal symptoms of oleanz so the doc asked me to restart it again. however i gained 13 kilos in a span of 9 months so i changed my psychiatrist. my only problem was sleep disorder because of which i went to the new doctor. he prescribed me serta 25mg, and zolipax 0.25 mg along with paxidep cr 25 in the night and paxidep 12.5 in the morning. i am on this new course of medication since 10 days but since the time i have started ths new medication, i lost my appetite completely, extreme fatigue and weakness, slight nausea and disorientation, as if my head is not in my place . before this medication, i was completely fine, and could exercise regularly. now i donot feel like going to the gym , and during the evening, i start feeling jittery and out of place . i told this to my new psychiatrist who told me to take half of serta 25mg now . i am tired of this experimentation. i want to know if these are side effects of serta and how long would they continue . also, did i do a mistake of starting a new medication when my old symptoms had completely worn off. i have lost trust in the doctor . please guide me what to do? i want to stop serta completely . will i experience withdrawal symptoms because i took them only for 10 days ? with serta i lost 2 kilos also . Also i smoke a lot . atleast 6 to 7 a day . mostly after and before medication. is this harmful. i am also suffering from bad cough and cold and my smell sensation is gone. is this related to my new medication. i read online that one of the withdrawal symptoms of serta is inflammation of sinus
Answered by Dr. Ashish Mittal 1 hour later
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

Anxiety , panic disorder, mild depression can occur in mixed anxiety and depressive disorder, which is a subtype of anxiety disorder.

Anxiety occur due to neurotransmitters imbalance in brain most commonly involving serotonin neurotransmitter.

In drug treatment two types of medicine used:
1)For immediate relief of anxiety benzodiazepines group (zolipax) or antipsychotic (oleanz) of medicines are used.
2)For long term relief most commonly SSRI (selective serotonin reuptake inhibitors) (like paxidep and serta) are used. SSRI takes around 3-4 weeks to show its effect. Non drug treatment like cognitive behaviour therapy (form of psychotherapy) also takes weeks to show its effect.

All these process is complex. I have just simplified it to make you understand it.

Most Common side effects of SSRI (like paxidep and serta):
-Nausea, dry mouth, acidity, loss of appetite, trouble sleeping, constipation, tiredness, drowsiness, dizziness, or increased sweating may occur.

These side effects appear frequently at start of treatment and during increasing dose of medicine. Paxidep and serta belong to same class of medicine (SSRI). There is no much benefit to combine them, as chances of side effects will increase. Serta 25 mg is low dose, you can stop it without much difficulty.

So your current symptoms are the side effects of SSRI which is very common at start of treatment and during increasing dose of medicine. The common strategy to deal with this side effect is.........wait for few days and continue medicine, as these side effects are self limiting and stop after few days.

If any of these effects persist or worsen or affect your personal/social/occupational life, tell your doctor. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects.

Apart from above advice following simple measures will help you:
-Diet monitoring to loose weight.
-Decrease worrying by keeping yourself busy and distracted from worrisome thoughts by talking to family members or watching T.V. or counting back (100 to 0).
-Healthy diet: Milk and fruits in diet.
-Daily morning walk
-Breathing exercise, yoga and meditation (which you can learn from some expert in person)

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.
Dr Ashish XXXXXXX Mittal
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Ashish Mittal 42 minutes later
thank you for your advice . does smoking affect worsening of side effects ?
Answered by Dr. Ashish Mittal 10 hours later
Hello again,
Thanks for follow up.

Smoking can affect you in following ways:
-By increasing anxiety symptoms.
-Increasing metabolism of medicine, due to that less medicine is available for body.

So, in your case it is better to quit smoking. You can reduce 1 Cigarette every week to quit smoking in 6-7 weeks.

Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.

Wish you good health.

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

The User accepted the expert's answer

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