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What are the side effects of Nexito Plus?

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Posted on Sat, 19 Jul 2014
Question: Hi

I am using Nexito Plus 5Mg since August2013 to June2014.Is it dangerous.any side effects will occur.Can I have to continue this tablet or have to stop immediately.Keep me posted soon.
doctor
Answered by Dr. Sunil Gupta (5 hours later)
Brief Answer:
Please see details below.

Detailed Answer:
Hi,

I can understand your concern regarding your medicine. You are taking Nexito plus which is a combination of escitalopram 5 mg and clonazepam 0.5 mg.

I would have liked to know the reason for which you sought consultation and current set of symptoms if any. That will help determine the need of your medications.

Escitalopram is a selective serotonin reuptake inhibitor used for anxiety and depression. The effective dose range of escitalopram is 10-20 mg /day. Clonazepam is a benzodiazepine which is used as a sedative. The reason that you can't sleep without the medicine is due to clonazepam. It should be tapered and stopped.

Escitalopram is a very safe an effective medicine for anxiety and depression. It usually has some minor side effects like nausea, etc when it is initiated. In some patients it can cause weight gain and sexual problems. But if you didn't have any side effect over this time, you need not worry. It can be taken for years together if need arises. Clonazepam is a drug which usually is given for short periods of time as it has a propensity to cause dependence. Slowly, there may be a need to increase the dose to get sleep and it will lead to withdrawal symptoms when it is stopped.

Had I been your psychiatrist, I would have increased the dose of escitalopram to 10 mg/day if you are having any symptoms currently. In addition, I would have decreased the dose of clonazepam to 0.25 mg/day. Of course, preparations with the two medicines separately would be needed. Further dose reduction of clonazepam after 2-3 weeks could be attempted and thereafter stopped.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Sunil Gupta (8 hours later)
Thanks for your reply.

Yes I explain about the treatment.

I was unwell due to hyperacidity on Jan2013.So unable to sleep properly on that time.more than 1month taken Restyl tablet then stopped due to side effects problem occurred.Then consulted with one of the doctor about sleeping disorder and digestion problem.So the doctor advised to take Nexito Plus 5mg for long use upto 6months.It will not arise any side effects when he explained me.but at this time nearly 10months gone without this tablet I cant sleep now.after taken this tablet my sleep time is around 8hours at night time and after noon 2hours.But after taken this tablet morning digestion side effects arised.If 1day I am not taking this tablet the next day I am uncomfortable due to nervous and some giddiness problem coming.so how to stop this tablet and is there any remedy for normal sleep without tablets.Reply me back soon.
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Answered by Dr. Sunil Gupta (16 minutes later)
Brief Answer:
Please see details below.

Detailed Answer:
Hi,

Thanks for following up and updating me regarding your condition.

From what you have mentioned, it seems you had some problems which included sleep disturbances and that Nexito plus helped you sleep better. Now, when you are trying to stop, you are having sleep disturbances as well as anxiety problems.

As I mentioned in my last reply, you are having withdrawal symptoms due to suddenly stopping the medicine. My suggestion will be to take the two tablets separately rather than taking as a combination which will make it easier adjusting the dose of each medicine individually.

Initially, the dose of clonazepam can be reduced to 0.25 mg/day, which need to be continued for few weeks. In case you have anxiety, the dose of escitalopram can be increased to 10mg/day. The dose of clonazepam can then be further reduced to half after 2-3 weeks and thereafter be reduced.

Escitalopram alone can be be continued for few months at either 10 mg/day. It will take care of the underlying anxiety. Further, depending on your symptoms, it can be tapered off at a very gradual pace of 2.5-5 mg every few weeks. You can discuss the above option with your psychiatrist. It is recommended that you regular follow up with a psychiatrist so that monitoring and supervision of the symptoms and dose of medicines can be done.

In addition, you should start exercising daily morning which will help you relax. Try avoiding tea/coffee and avoid taking day time naps as that will cause difficulty in night time sleep. Also avoid alcohol and tobacco in case you use it. Avoid using lap-top and mobiles and watching TV while lying down on your bed in the night. Such small steps can help you improve your sleep and also reduce the symptoms that you are having.

I do hope that I was able to help you. Please feel free to ask any further doubt that you might have. In case you don't have any further query, please close the discussion and rate the answer.

Best wishes,

Dr. Sunil Gupta


Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Sunil Gupta (1 hour later)
Thanks again for your reply.

I have some clarification now.

As per your recommendations

Escitalopram is safe and

Clonazepam us dangerous for health


Can I have to get Escitalopram tablet seprately in the medical shop or what is the tablet name for using this Escitalopram. Since August2013 to till date my weight increased 10kg now. Let me know.
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Answered by Dr. Sunil Gupta (38 minutes later)
Brief Answer:
Please see details below.

Detailed Answer:
Hi,

Thanx for following up. I think I sent across a wrong message. I am sorry for the confusion. Its not that clonazepam is dangerous. Its a very useful drug and we do use it quite often. But in general it is preferred for very short duration. The main issue is high chances of development of dependence. So, it is recommended that it is stopped as soon as possible (generally a few weeks).

Regarding availability of escitalopram, it is available as multiple brands including Nexito, Censpram, etc. But please remember that it is a prescription medicine.

Coming to weight gain, it is possible that it might be due to the medications. The best possible solution is regular exercise and a balanced diet. It will help you reduce and keep a check on weight. Another alternative is to use a medicine in place of escitalopram which is weight neutral and can take care of anxiety as well. Bupropion is one such drug. However, the better option is to continue escitalopram and start exercising as
escitalopram has been helpful for you.

I do hope I have been able to provide some help to you. I will be glad to answer any further queries and provide information anytime ahead.

Wishing you the very best of health,

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

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What are the side effects of Nexito Plus?

Brief Answer: Please see details below. Detailed Answer: Hi, I can understand your concern regarding your medicine. You are taking Nexito plus which is a combination of escitalopram 5 mg and clonazepam 0.5 mg. I would have liked to know the reason for which you sought consultation and current set of symptoms if any. That will help determine the need of your medications. Escitalopram is a selective serotonin reuptake inhibitor used for anxiety and depression. The effective dose range of escitalopram is 10-20 mg /day. Clonazepam is a benzodiazepine which is used as a sedative. The reason that you can't sleep without the medicine is due to clonazepam. It should be tapered and stopped. Escitalopram is a very safe an effective medicine for anxiety and depression. It usually has some minor side effects like nausea, etc when it is initiated. In some patients it can cause weight gain and sexual problems. But if you didn't have any side effect over this time, you need not worry. It can be taken for years together if need arises. Clonazepam is a drug which usually is given for short periods of time as it has a propensity to cause dependence. Slowly, there may be a need to increase the dose to get sleep and it will lead to withdrawal symptoms when it is stopped. Had I been your psychiatrist, I would have increased the dose of escitalopram to 10 mg/day if you are having any symptoms currently. In addition, I would have decreased the dose of clonazepam to 0.25 mg/day. Of course, preparations with the two medicines separately would be needed. Further dose reduction of clonazepam after 2-3 weeks could be attempted and thereafter stopped.