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What Causes Heavy Head Post Prothiadin Withdrawal?
Question: I am 50 years old taking Prothiedine 75 mg for last 10 years. Recently, I stopped Prothiedine (Dosulepin) and switched to Szetol (Escitalopram Oxalate ) 10 mg, for last 1 week. I no longer feel depression or sadness but if I do not take Prothiedine, I feel becomes heavy and I feel moderate pain as in swelling. How can I improve my cognition abilities through medication? (Please do not suggest exercise, diet...lifestyle...that is not going to change)
Brief Answer:
This may be due to sudden stoppage of Dosulepin
Detailed Answer:
Dear XXXXXXX
Thanks for using Healthcaremagic.
I read your query and understand your concern.
First in regard to new onset heavy head, there are two possible reasons.
Most importantly it is just an withdrawal side effect of Dosulepin. It is common observation that if you stop it suddenly, you encounter this kind of side effects. For treatment of this condition it is advisable to reduce down the dose about 20 % a week. You can go for 50 + 10 mg for one week than about 25mg + 10 mg following week. The dose should be gradually tapered down taking at least four to five weeks before it is stopped completely.
You can talk to your doctor about doing gradual reduction of dosulepin dose.
The another reason may be Escitalopram that you started recently with brand name Szetalo. I am not aware that what dose you started but I like to inform you that even the low dose of Escitalopram can cause head ache or heavy head.For this you do not need to do anything as it is an transient side effect which last from one to two weeks.
The another side effect which escitalopram causes is Hyponatremia. I suggest you to get serum electrolytes from nearby laboratory as soon as possible to rule out this cause of your current problem.
For betterment of cognition the most important things are life style modification that you already tried.
The second thing is to put in use of all your mental faculty. That can be done doing puzzles, Playing different sort of games, Doing sodoku, Playing cards etc.
Regarding medication I like to make it clear that modafinil can be used to increase attention and concentration. Other than this there is not much available to increase cognition for a normal person like you.
'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks
This may be due to sudden stoppage of Dosulepin
Detailed Answer:
Dear XXXXXXX
Thanks for using Healthcaremagic.
I read your query and understand your concern.
First in regard to new onset heavy head, there are two possible reasons.
Most importantly it is just an withdrawal side effect of Dosulepin. It is common observation that if you stop it suddenly, you encounter this kind of side effects. For treatment of this condition it is advisable to reduce down the dose about 20 % a week. You can go for 50 + 10 mg for one week than about 25mg + 10 mg following week. The dose should be gradually tapered down taking at least four to five weeks before it is stopped completely.
You can talk to your doctor about doing gradual reduction of dosulepin dose.
The another reason may be Escitalopram that you started recently with brand name Szetalo. I am not aware that what dose you started but I like to inform you that even the low dose of Escitalopram can cause head ache or heavy head.For this you do not need to do anything as it is an transient side effect which last from one to two weeks.
The another side effect which escitalopram causes is Hyponatremia. I suggest you to get serum electrolytes from nearby laboratory as soon as possible to rule out this cause of your current problem.
For betterment of cognition the most important things are life style modification that you already tried.
The second thing is to put in use of all your mental faculty. That can be done doing puzzles, Playing different sort of games, Doing sodoku, Playing cards etc.
Regarding medication I like to make it clear that modafinil can be used to increase attention and concentration. Other than this there is not much available to increase cognition for a normal person like you.
'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Hi,
Thanks for the reply.
Here are some facts.
(1) I really tapered off Dosulepin 75 mg i.e.
2 Weeks => Dosulepin 50 mg + escitalopram 5 mg
Next 2 weeks => Dosulepin 25 mg + escitalopram 10 mg
Last One week => escitalopram 10 mg only
(2) Currently I am taking
Morning: Piracetam 2400 mg after breakfast + Modafinil 100 mg
Night: Escitalopram 10 mg only
(3) I am a Software Architect and I am fortunately getting a fair daily dose of challenges in terms of Analysis, Problem Solving, Communication to Client
(4) I see next 15 years of my life as productive i.e. to complete my responsibilities for my family and save enough for old age.
(5) I practically find myself 3 times better than then I was at age 20-30 years. Better in terms of getting results, trouble shooting, team handling, and sustaining extreme work pressure.
I need some advice from expert like you that will help me realize my future goals (even if I am able to improve my cognitive abilities by 10%, I will be able to materialize my future plans)
(1) Can more potent Nootropic help me like Memorai Forte, Phenylpiracetam, Pramiracetam, and supplements like ALA, L-Glutamine, Phosphatidylserine? (BRAHMI has very good main effect on me but it gives by worst ever bout of cough and cold which I have observed by re challenging myself over a period of time)
(2) Can you suggest any other medicine which can increase my concentration level, memory and mental stamina?
For achieving my goal, I am ready to experiment with anything
Regards,
XXXXXXX
Mob: 0000
Thanks for the reply.
Here are some facts.
(1) I really tapered off Dosulepin 75 mg i.e.
2 Weeks => Dosulepin 50 mg + escitalopram 5 mg
Next 2 weeks => Dosulepin 25 mg + escitalopram 10 mg
Last One week => escitalopram 10 mg only
(2) Currently I am taking
Morning: Piracetam 2400 mg after breakfast + Modafinil 100 mg
Night: Escitalopram 10 mg only
(3) I am a Software Architect and I am fortunately getting a fair daily dose of challenges in terms of Analysis, Problem Solving, Communication to Client
(4) I see next 15 years of my life as productive i.e. to complete my responsibilities for my family and save enough for old age.
(5) I practically find myself 3 times better than then I was at age 20-30 years. Better in terms of getting results, trouble shooting, team handling, and sustaining extreme work pressure.
I need some advice from expert like you that will help me realize my future goals (even if I am able to improve my cognitive abilities by 10%, I will be able to materialize my future plans)
(1) Can more potent Nootropic help me like Memorai Forte, Phenylpiracetam, Pramiracetam, and supplements like ALA, L-Glutamine, Phosphatidylserine? (BRAHMI has very good main effect on me but it gives by worst ever bout of cough and cold which I have observed by re challenging myself over a period of time)
(2) Can you suggest any other medicine which can increase my concentration level, memory and mental stamina?
For achieving my goal, I am ready to experiment with anything
Regards,
XXXXXXX
Mob: 0000
Brief Answer:
Nootropics are more a placebo than a drug
Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.
I am happy to learn the withdrawal of dosulepin was done using standard protocol. It is possible that your heavy headedness is due to another reason as we discussed earlier. As I said there is no need to worry about it as this is a transient side effects.
You need to continue escitalopram as prescribed so there is no more side effects.
I hope you also checked your serum electrolytes to rule out the possible hyponatremia as a side effect of escitalopram. If it is not done, I request you to get it as soon as possible from nearby laboratory.
I was puzzled about the list of medicines you are receiving/ received/planning to receive for increasing cognition. To be XXXXXXX I like to tell you that they are not even medication. These are the fancy things marketed by greedy pharma industry. I have observed over the years that they do no cause any positive effect other than making a big hole in pocket leading to psychological benefit or so called placebo effect. Believe me if that is the case, I will start taking to become the most wise doctor. Nootropics are studied widely and in most of the research they do not make sense of anything.
If they have some use, That is limited to someone who has some problem with their brain. As you said that "you are 3 times better than 20 years ago" I do not feel your brain is diseased at all in regard to cognition. Having ambition is right thing and we want to excel in our respective field, that does not mean we need to risk our health by using something whose usefulness is doubtful.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
Thanks and regards
Nootropics are more a placebo than a drug
Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.
I am happy to learn the withdrawal of dosulepin was done using standard protocol. It is possible that your heavy headedness is due to another reason as we discussed earlier. As I said there is no need to worry about it as this is a transient side effects.
You need to continue escitalopram as prescribed so there is no more side effects.
I hope you also checked your serum electrolytes to rule out the possible hyponatremia as a side effect of escitalopram. If it is not done, I request you to get it as soon as possible from nearby laboratory.
I was puzzled about the list of medicines you are receiving/ received/planning to receive for increasing cognition. To be XXXXXXX I like to tell you that they are not even medication. These are the fancy things marketed by greedy pharma industry. I have observed over the years that they do no cause any positive effect other than making a big hole in pocket leading to psychological benefit or so called placebo effect. Believe me if that is the case, I will start taking to become the most wise doctor. Nootropics are studied widely and in most of the research they do not make sense of anything.
If they have some use, That is limited to someone who has some problem with their brain. As you said that "you are 3 times better than 20 years ago" I do not feel your brain is diseased at all in regard to cognition. Having ambition is right thing and we want to excel in our respective field, that does not mean we need to risk our health by using something whose usefulness is doubtful.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi,
I understand the placebo effect. May be I have not been expressive enough and unintentionally provided incorrect information about my problem.
It has been 6 weeks taking escitalopram and 2 weeks since completely stopping Dosulepin, but the heavy head is still there.
Even if I stop taking any medicine be it Escitalopram or Dosulepin, my cognitive abilities take a sharp improvement over a few days but with the extremely limiting problem of heavy head and equally sharp decline in ability to sustain work for even say 2 hours continuous. It pains to think anything. The pain is mild, restrictive and distributed all over the scalp and upper portion of neck and reduces with rest (but I can not have all day of rest).
I tried pain killers (when tried to stop anti depressants sometime back) like Powergesic which gives brief interval of relief. But, when I take Dosulepine, the heaviness goes away overnight
Can you suggest something which can relieve me of heavy head and restrictive burning sensation/pain without compromising my cognitive abilities? This will help me.
I understand the placebo effect. May be I have not been expressive enough and unintentionally provided incorrect information about my problem.
It has been 6 weeks taking escitalopram and 2 weeks since completely stopping Dosulepin, but the heavy head is still there.
Even if I stop taking any medicine be it Escitalopram or Dosulepin, my cognitive abilities take a sharp improvement over a few days but with the extremely limiting problem of heavy head and equally sharp decline in ability to sustain work for even say 2 hours continuous. It pains to think anything. The pain is mild, restrictive and distributed all over the scalp and upper portion of neck and reduces with rest (but I can not have all day of rest).
I tried pain killers (when tried to stop anti depressants sometime back) like Powergesic which gives brief interval of relief. But, when I take Dosulepine, the heaviness goes away overnight
Can you suggest something which can relieve me of heavy head and restrictive burning sensation/pain without compromising my cognitive abilities? This will help me.
Brief Answer:
SNRI is one option
Detailed Answer:
Dear XXXXXXX
Welcome back to healthcaremagic.
First of thing that is missing in your query is about the electrolyte level particularly sodium. I requested in both previous queries to get it done as it may be related to current heavy headedness and dizziness.
To be XXXXXXX after going through your recent narration, I feel that your headache is more of tension type. In tension type of headache although tricyclic antidepressant like dothiepin or amitryptiline.
I understand that you recently stopped one of them and do not want to move back on them. In such situation SNRI group of medications can be used for tension headache as well as depression. This group of medication includes desvenlafaxine, venlafaxine and duloxetine.
You can talk to your doctor to change the escitalopram to venlafaxine or desvenlafaxine.
'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks
SNRI is one option
Detailed Answer:
Dear XXXXXXX
Welcome back to healthcaremagic.
First of thing that is missing in your query is about the electrolyte level particularly sodium. I requested in both previous queries to get it done as it may be related to current heavy headedness and dizziness.
To be XXXXXXX after going through your recent narration, I feel that your headache is more of tension type. In tension type of headache although tricyclic antidepressant like dothiepin or amitryptiline.
I understand that you recently stopped one of them and do not want to move back on them. In such situation SNRI group of medications can be used for tension headache as well as depression. This group of medication includes desvenlafaxine, venlafaxine and duloxetine.
You can talk to your doctor to change the escitalopram to venlafaxine or desvenlafaxine.
'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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