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What Causes Persistent Throat Infection While On Olanzapine?
Question: I am currently taking mirtaz 7.5 mg along with olimelt 2.5+1/2of 2.5 (3.75mg) in the night. 0.5 mg etizolam +betacap tr 40 in the morning + 1/2 of 0.5mg etizolam in the eve. Need your advice regarding the following :
I have been getting persistent throat problem (sore throat) and slight difficulty in swallowing and feel a lot of pressure in the ears for the last approx. 20 days. Did antibiotic course for 7 days but in vain. Went to an ENT specialist, he put me on Rabonik 40mg in the morning empty stomach and asked me to do the following tests:
CBC
Vitamin B12 and D13
Thyroid
Anti thyroid antibody
Anti nuclear antibody
All the tests are normal but my throat/ear problem still continues
Since I was not getting better, I started surfing internet and read that olimelt can cause throat and ear problem. Feeling quite helpless
Though I am fighting out my anxiety (some days are less anxious and some days are more anxious), now this persistent throat/ear problem is adding to my worrisome nature.
What would your advice be?
SSRIs just don't suit me as I start getting my stomach problem with them. My doc tried putting me on serta 25, took it for 2 days and started getting major stomach problems so i stopped it, i suffer from ibs as well. Have tried paroxetine in the past, but it gave me similar stomach problems so stopped it.
Also, I keep checking my sugar levels at home on and off, earlier they were always in the range of 90s, after i have started taking olimelt, they have jumped to the range of 100+
With the above combo, my sleep is better, though i feel heavily sedated in the morning
Was thinking of if I can be put on another atypical antipsychotic or any other drug other than olimelt at a dose that takes care of my throat/ear/sugar/anxiety/stomach issues at the same time does not disturb my sleep
I have been getting persistent throat problem (sore throat) and slight difficulty in swallowing and feel a lot of pressure in the ears for the last approx. 20 days. Did antibiotic course for 7 days but in vain. Went to an ENT specialist, he put me on Rabonik 40mg in the morning empty stomach and asked me to do the following tests:
CBC
Vitamin B12 and D13
Thyroid
Anti thyroid antibody
Anti nuclear antibody
All the tests are normal but my throat/ear problem still continues
Since I was not getting better, I started surfing internet and read that olimelt can cause throat and ear problem. Feeling quite helpless
Though I am fighting out my anxiety (some days are less anxious and some days are more anxious), now this persistent throat/ear problem is adding to my worrisome nature.
What would your advice be?
SSRIs just don't suit me as I start getting my stomach problem with them. My doc tried putting me on serta 25, took it for 2 days and started getting major stomach problems so i stopped it, i suffer from ibs as well. Have tried paroxetine in the past, but it gave me similar stomach problems so stopped it.
Also, I keep checking my sugar levels at home on and off, earlier they were always in the range of 90s, after i have started taking olimelt, they have jumped to the range of 100+
With the above combo, my sleep is better, though i feel heavily sedated in the morning
Was thinking of if I can be put on another atypical antipsychotic or any other drug other than olimelt at a dose that takes care of my throat/ear/sugar/anxiety/stomach issues at the same time does not disturb my sleep
Brief Answer:
Tianeptine, tofisopam.
Detailed Answer:
Hello
Thanks for asking a direct query here.
I have gone through your details. I understand that you are facing tough time due to your illness.
SSRIs don't suit you. You are having persistent ear/throat infection. You also suffer from IBS.
Considering the whole scenario, I have following suggestions for you:
1. Ear/throat infection is a very rare side effect of olanzapine. I have practically never observed olanzapine induced ear/throat infection in my patients.
2. I have been using two newer drugs in my patients and has seen excellent respond in anxiety and depression. These are tianeptine (antidepressant, not an SSRI) and tofisopam (a non-sedating anxiolytic). Fortunately, both drugs have shown to be beneficial in IBS as well (apart from their antianxiety effect). These drugs are to be taken in daytime.
I would suggest you to try these drugs after discussing with your doctor. This will help you to eliminate olanzapine and related side effects.
3. If a 7-day antibiotic course has not helped, You can take an extended 14-day antibiotic course of drugs like azithromycin or ciprofloxacin (prescription drugs). Do hot water gargles and valsalva maneuver.
Hope this helps.
Feel free to ask further.
Thanks.
Tianeptine, tofisopam.
Detailed Answer:
Hello
Thanks for asking a direct query here.
I have gone through your details. I understand that you are facing tough time due to your illness.
SSRIs don't suit you. You are having persistent ear/throat infection. You also suffer from IBS.
Considering the whole scenario, I have following suggestions for you:
1. Ear/throat infection is a very rare side effect of olanzapine. I have practically never observed olanzapine induced ear/throat infection in my patients.
2. I have been using two newer drugs in my patients and has seen excellent respond in anxiety and depression. These are tianeptine (antidepressant, not an SSRI) and tofisopam (a non-sedating anxiolytic). Fortunately, both drugs have shown to be beneficial in IBS as well (apart from their antianxiety effect). These drugs are to be taken in daytime.
I would suggest you to try these drugs after discussing with your doctor. This will help you to eliminate olanzapine and related side effects.
3. If a 7-day antibiotic course has not helped, You can take an extended 14-day antibiotic course of drugs like azithromycin or ciprofloxacin (prescription drugs). Do hot water gargles and valsalva maneuver.
Hope this helps.
Feel free to ask further.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you doctor for your reply. Between mirtaz and oleanz, which one can cause throat/ear problem. I dont see any other reason than one of these two drugs for my ear/throat problem. Apart from this, I have following doubts:
How do i taper off olimelt 3.75 mg (2.5+1/2of 2.5) so that i dont get any discontinuation symptoms?
Between Tianeptine and tofisopam, which one will be better for me?
Since both these drugs are not aptypical antipsychotic, therefore, how do i substitute olimelt with one of them so that the switch is smooth without much of problem?
Since i am taking etizolam 0.5 in the morning and 1/2of 0.5 in the eve, do i need to continue with it after i switch to either Tianeptineor tofisopam, if not how do i taper off etizolam? Let say i switch to tofisopam and at the same time continue with etizolam, then i'll be taking two anti-anxiety tablets, is that ok?
Do you think i should be replacing olimelt with another atypical antipsychotic? or Tianeptine/tofisopam will help me with my anxiety better? will i face any sleep issues?
How do i taper off olimelt 3.75 mg (2.5+1/2of 2.5) so that i dont get any discontinuation symptoms?
Between Tianeptine and tofisopam, which one will be better for me?
Since both these drugs are not aptypical antipsychotic, therefore, how do i substitute olimelt with one of them so that the switch is smooth without much of problem?
Since i am taking etizolam 0.5 in the morning and 1/2of 0.5 in the eve, do i need to continue with it after i switch to either Tianeptineor tofisopam, if not how do i taper off etizolam? Let say i switch to tofisopam and at the same time continue with etizolam, then i'll be taking two anti-anxiety tablets, is that ok?
Do you think i should be replacing olimelt with another atypical antipsychotic? or Tianeptine/tofisopam will help me with my anxiety better? will i face any sleep issues?
Brief Answer:
My choice would be tianeptine.
Detailed Answer:
You are most welcome.
In my opinion, both mirtaz and olimelt do not commonly cause ear/throat infection. It would be a very rare side effect of olimelt.
3.75mg is a very low dose. You can stop it at once. There would be no discontinuation symptoms. Olanzapine does not cause these symptoms.
(here I assume that you do not have any psychotic symptoms and take olimelt only for anxiety).
My choice would be tianeptine. Its dose is 37.5mg once a day. You can directly stop olimelt and start with tianeptine.
Tianeptine will take 2-3 weeks to show its effects. Till then you should take etizolam.
If you take tofisopam, then you can stop daytime etizolam. You can continue with night time etizolam for sleep.
Its not necessary to replace olimelt with another antipsychotic. (I assume that you do not have psychotic symptoms).
Tianeptine/Tofisopam will help you better. Along with that, there will be not olanzapine related side effects.
As you will continue with your night dose of etizolam and mirtaz, there should be no sleep issues.
Kindly discuss these issues with your doctor.
I wish you speedy recovery.
Regards.
My choice would be tianeptine.
Detailed Answer:
You are most welcome.
In my opinion, both mirtaz and olimelt do not commonly cause ear/throat infection. It would be a very rare side effect of olimelt.
3.75mg is a very low dose. You can stop it at once. There would be no discontinuation symptoms. Olanzapine does not cause these symptoms.
(here I assume that you do not have any psychotic symptoms and take olimelt only for anxiety).
My choice would be tianeptine. Its dose is 37.5mg once a day. You can directly stop olimelt and start with tianeptine.
Tianeptine will take 2-3 weeks to show its effects. Till then you should take etizolam.
If you take tofisopam, then you can stop daytime etizolam. You can continue with night time etizolam for sleep.
Its not necessary to replace olimelt with another antipsychotic. (I assume that you do not have psychotic symptoms).
Tianeptine/Tofisopam will help you better. Along with that, there will be not olanzapine related side effects.
As you will continue with your night dose of etizolam and mirtaz, there should be no sleep issues.
Kindly discuss these issues with your doctor.
I wish you speedy recovery.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
can betacap give throat/ear problem? if its so, can i stop betacap at once?
Brief Answer:
Betacap can cause tinnitus.
Detailed Answer:
Betacap (propranolol) can infrequently cause tinnitus but not infection.
Betacap has good antianxiety effect. I think you should continue with it.
But yes, Betacap has no discontinuation symptoms. Do not worry about that.
Hope this helps.
Thanks.
Betacap can cause tinnitus.
Detailed Answer:
Betacap (propranolol) can infrequently cause tinnitus but not infection.
Betacap has good antianxiety effect. I think you should continue with it.
But yes, Betacap has no discontinuation symptoms. Do not worry about that.
Hope this helps.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Almost similar gastric effects of effexor.
Detailed Answer:
Effexor is a SNRI. It can cause almost similar gastric side effects.
Also, it is most notorious to cause discontinuation symptoms.
I personally do not prefer this drug in my patients unless very necessary. It us difficult to taper off this drug later.
Hope this answers your query.
Thanks.
Almost similar gastric effects of effexor.
Detailed Answer:
Effexor is a SNRI. It can cause almost similar gastric side effects.
Also, it is most notorious to cause discontinuation symptoms.
I personally do not prefer this drug in my patients unless very necessary. It us difficult to taper off this drug later.
Hope this answers your query.
Thanks.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Consulted a doc, he is of the view I should try fluoxetine. Was wondering if its safe on stomach or it has similar stomach issues like dveniz, serta and paroxetine. An early revert will be appreciated. Thanks
Brief Answer:
Fluoxetine will cause same stomach upset as sertraline.
Detailed Answer:
Fluoxetine is an SSRI just like sertraline and paroxetine.
As far as stomach effects are concerned, in my opinion, fluoxetine will cause same stomach upset as others.
Regards.
Fluoxetine will cause same stomach upset as sertraline.
Detailed Answer:
Fluoxetine is an SSRI just like sertraline and paroxetine.
As far as stomach effects are concerned, in my opinion, fluoxetine will cause same stomach upset as others.
Regards.
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Above answer was peer-reviewed by :
Dr. Prasad
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