Brief Answer:
Start Nexito in morning

Detailed Answer:
Hello again.... I hope you are in good health....

Nexito causes insomnia and a little activation in a number of individuals. These effects can cause decrease in sleep if a person take Nexito in evening. Most probable reason of your insomnia is this only. Secondly when an individual start taking Escitalopram after long period of time then for some days rebound increase in anxiety occur. The effect last for few days only. This can also be a possibility that you have decreased sleep. As per my opinion you should take medicine in morning hours and you should get relief in sleep.

Pregabalin is a good drug for neuropathic pain and in seizures. The drug also causes relaxation and decrease in anxiety. These effects can be utilised for your sleep. The drug is not a addicting drug. You can go with this and the drug will help in sleep also.

There are no significant interactions between the two drugs. When taken together drowsiness and dizziness can be seen but this can be minimised by takin Nexito in morning and Pregabalin in evening.

If that doesn't suit you then other option is to take some Z-drug for short time for sleep. Zolpidem or Zopiclone can help in sleep. These drugs are useful in early insomnia and are not having abuse potential as compared to benzodiazepines. You can discuss with your doctor for these medicines also.

Escitalopram is safe medicine. There are no significant side effects. Nausea, diarrhoea, giddiness, lowers seizure threshold etc can be seen. Over all medicine is well tolerated and no significant serious side effect on long term use. Few people experience sexual side effects like delayed ejaculation in long term use but these are reversible. Pregabalin is also a safe drug. There are no serious side effects with it. Sedation, dizziness, weight gain can be seen in some but overall it's safe drug.


Hope this helps you. You can ask again for more unresolved doubts.

Thanks

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Brief Answer:
Nexito in morning

Detailed Answer:
Hello again

You can skip night dose or can take 5 mg doses for next 1 week then start with morning 10 mg dose. Pregabalin you can start with 75 mg doses in evening.

Zolfresh 5 mg will work and help in sleep. I usually prescribe 10 mg doses to my patients.

You will have to discuss the dosage and management all of these medications since they are all prescription strength. I can help guide you, but ultimately the prescription has to come from your local doctor.

In case you miss your dose you can take at any time you come to know about missed dose, till evening.

Thanks, consult your doctor for detailed prescription.

You can ask again for unresolved doubts.

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Brief Answer:
The episode was nothing but mild anxiety

Detailed Answer:
Hello again

Hope you are doing well

The sudden episode of giddiness (chakkar) was probably due to sudden anxiety. As it was gone after reassurance and deep breathing so there is no need to fear. Even on medicines individuals suffering from anxiety disorder may develop episodic anxiety. This will remain for some time but will improve after that. Just keep one thing in mind that this is anxiety and you can control this. Breathing exercise helped you. Alternately in such situation you can take one glass of cold water and drink it sip by sip over a couple of minutes. Keep reassuring yourself during that and you will see symptoms of anxiety decreasing.

Yes you can continue to take even after stopping Pregabalin. You can discuss with your psychiatrist and can increase the dose of Nexito to 10 mg in a week and continue to take the dose in morning hours.

Second thing don't stop Pregabalin abruptly. I usually ask my patients to decrease the doses of pregabalin to half for a couple of weeks and then stop completely. You can also take half of tablet for two weeks and then stop it. In this way rebound rise is pain will not be seen.

I hope you are getting better sleep due to change in timings of medicines. Consult a psychiatrist for written prescription.

Thanks, you can ask again at any time for any uncleared doubts.

Regarding payment issue if you suffered any problem please contact customer care at Health Care Magic, they will surely help you.

Take Care

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Brief Answer:
Increase to old dose

Detailed Answer:
Hello again

Yes the dose should be increased to 10 mg after a week, coz initially you were taking this dose only.

Thanks

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Brief Answer:
Change life style and routine

Detailed Answer:
Hello thanks for asking again

Your mother had Alzheimer's disease so it increases the risk in you. You are 62 year old so mild form of memory loss in some domains is considered as normal but if this is hampering day to day routine then treatment is needed. For prevention of dementia and to prevent progress of memory loss I would advise you to follow following steps-

- Eat healthy, sleep good. Sleep properly for at least 7 hours a day. Eat foods rich in protein.

- Include green tea in your routine. Tea, coffee help to prevent progression. Avoid alcohol.

- Mental stimulation methods like playing sudoku, crossword help to improve cognition.

- Omega 3 Fatty Acid is a fat that help to prevent neuronal degeneration and help to prevent dementia. Start taking soft gels containing Omega 3 Fatty Acids. If you are non-vegan then fish oils, salmon are rich source of these fatty acids. For vegans nuts especially peanuts, walnuts are rich source.

- Exercise daily and don't overburden you with work. Spend weekend with family in going out. Maintain your social life.

- Mehtylcobalamin is a source of B12 and you are already taking it. This supplement is also useful in dementia.

- Get your BP checked at weekly interval for maintenance of your health.

If you will follow the methods I have mentioned then the progression will be slowed down. No need to take medicines for now. Continue taking the medicines of anxiety and depression.

Thanks, take care

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Brief Answer:
Yes you can take half tablet for 20 days, there will be no risk

Detailed Answer:
Hello thanks for asking again, hope you are doing well

Yes you can take the half tablet for 20 days. It will not make a big difference. If you are finding difficult to break tablet then PREGABALIN 50 mg can be used.

Now coming to your second question-

Zolfresh is Zolpidem. The drug is a drug of Z-Drug class. The drug is commonly prescribed for short term management of insomnia. It helps in inducing sleep and is short acting drug. Over all the drug is safe to use and is free of serious side effects. The symptoms occurring in her like sleepiness throughout a day, headache, weakness and lack of energy are probably due to drug. She has been given low dose of Zolpidem but still during start of therapy it can cause such symptoms which mimic like mild hangover. The symptoms will go in some day. Strong coffee in morning will reduce such symptoms. If she is getting sleep with half tablet then it is good as this will reduce day time side effects also.

The drug should not be used continuously for more than 4 weeks because it may produce dependence. I would advise you to ask her to take the medicine on SOS basis only.

Thanks, hope this helps you.

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