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What causes sleeplessness after having Stalopam plus?

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Posted on Tue, 12 May 2015
Question: Hello doctor,

My mother is suffering from advance cervical spondylosis, she was prescribed (by her neurologist) stalopam plus (escitalopram 10mg) because she was feeling very restless and could not sleep after talking that medicine she started sleeping all the time we stopped the medicine after 5 (1per day) dose but still she is sleeping a lot and of late has become forgetful and confused, could this be because of the above medicine or could there be any other underlying conditions that the docs should try to find out. Please help me.
Thanks in advance,
XXXXXX
doctor
Answered by Dr. Seikhoo Bishnoi (40 minutes later)
Brief Answer:
Such symptoms can denote early dementia

Detailed Answer:
Hello, Welcome to Health Care Magic

I can understand your concern. Stalopam Plus consists of Escitalopram and Clonazepam. The drug is a good anti anxiety and anti depressant drug. As it also consists of Clonazepam so this can cause increased sleep and drowsiness. She has stopped the drug in 5 days and have persistent complaints of drowsiness. In most cases these symptoms usually reduce in about two days of stopping the drug. But she is also showing symptoms like confusion, forgetfulness. These symptoms can occur in some dementia or memory loss due to age. Restlessness is also one presented feature. So as per my opinion she should be evaluated by a Neuropsychiatrist for proper treatment. MMSE or XXXXXXX mental status examination is a test that can help in making diagnosis. Don't take excess stress regarding her symptoms but get her evaluated once for proper diagnosis.

In most cases with similar complaints medicines like Donepezil or Memantin can help. For anxiety low dose SSRIs as Escitalopram can help. Discuss with her doctor for prescription.

Thanks, Hope this helps you, if you have more doubts you can ask again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Seikhoo Bishnoi (28 minutes later)
thank you for the quick response Dr. Seikhoo, I wanted to know if onset of dementia or memory can be so sudden because she was doing fine before she took stalopam plus, as far as her psychology is concerned, she had become very weak because of her spondylosis, as she suffered from sever nausea and gaudiness and that was treated successfully by her neurologist.
thanks in advance,
XXXXXX
doctor
Answered by Dr. Seikhoo Bishnoi (7 minutes later)
Brief Answer:
Clonazepam can also worsen memory impairment

Detailed Answer:
Helol again, thanks for a follow up question

No in usual cases progression of dementia is gradual over long time. She had been given Clonazepam also which is a benzodiazepine drug. The drug can worsen memory impairment and may precipitate it, especially in elderly. But fortunately the memory impairment caused by that drug is reversible and most cases recover in about a week. If her symptoms developed abruptly then this is our first provisional diagnosis. So please wait for some time and even then symptoms remain persistent then visit her doctor again.

Thanks, still have more doubts please don't hesitate to ask again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Seikhoo Bishnoi (2 days later)
Hello again Dr. Seikhoo,

So sorry to bother you again, it as been more than a week now since we stopped the medication and there is no improvement, following your advice we took her to her doctor again, now he has prescribed.

Tab Cerebrain 90 mg ( cerebroprotein hydrolysate)
(twice a day)

Tab Daxid 50 mg (once a day)

Injection Methycobol 500mg (twice a week)

do you think in your opinion this might help in improving her condition.

thanks in advance,
XXXXX
doctor
Answered by Dr. Seikhoo Bishnoi (3 hours later)
Brief Answer:
These medicines will help in improving her condition

Detailed Answer:
Hello again XXXXX and thanks for asking a follow up

Cerebroprotein Hydrolysate is Cerebrolysin protein and it helps in reducing the toxic damage to neurones and help in protection from oxidative damage. The drug is relatively newer in market but there are claims that the drug reduces progression to dementia and cause marked improvement in symptoms based upon case reports.

Daxid is Sertraline and the drug is related to Escitalopram but is more safer than Escitalopram. It is relatively better tolerated in elderly.

Injection methylcobal will also reduce the toxic damage and will cause quick recovery.

As per my opinion these drugs should work and she should improve in coming weeks. Ask her to stimulate the brain by playing brain stimulation games like solving puzzles, Sudoku or cross word or even chess helps a lot. This will result in early recovery.

If possible also get her MRI brain done to rule out any vascular damage to neurones considering her acute onset symptoms.

Thanks, I hope this helps you. Please feel free to ask again.
Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5187 Questions

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What causes sleeplessness after having Stalopam plus?

Brief Answer: Such symptoms can denote early dementia Detailed Answer: Hello, Welcome to Health Care Magic I can understand your concern. Stalopam Plus consists of Escitalopram and Clonazepam. The drug is a good anti anxiety and anti depressant drug. As it also consists of Clonazepam so this can cause increased sleep and drowsiness. She has stopped the drug in 5 days and have persistent complaints of drowsiness. In most cases these symptoms usually reduce in about two days of stopping the drug. But she is also showing symptoms like confusion, forgetfulness. These symptoms can occur in some dementia or memory loss due to age. Restlessness is also one presented feature. So as per my opinion she should be evaluated by a Neuropsychiatrist for proper treatment. MMSE or XXXXXXX mental status examination is a test that can help in making diagnosis. Don't take excess stress regarding her symptoms but get her evaluated once for proper diagnosis. In most cases with similar complaints medicines like Donepezil or Memantin can help. For anxiety low dose SSRIs as Escitalopram can help. Discuss with her doctor for prescription. Thanks, Hope this helps you, if you have more doubts you can ask again.