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Change of meds
Hello All,
Ongoing nexito 10 and Quitipine 50.Quitipin helped in sleep issues a lot but gained 5.5 kgs in 3 months. Any suitable alternative like tryptomer or Doxepin. For sleep as i wish to stop the med. Regards
📌 My Opinion
Quitipin (Quetiapine) is commonly used off-label for sleep but does carry a known risk of weight gain, especially at doses like 50 mg. If sleep is the main concern and Nexito (Escitalopram) is already ongoing, we can consider safer alternatives with less metabolic burden. Among your suggestions, Tryptomer (Amitriptyline) and Doxepin are both viable, but they too can cause weight gain and anticholinergic side effects.
A more weight-neutral option may include Melatonin (2–5 mg).
Next Steps
🩺 Next Step (What should the patient do next?)
Please consult your psychiatrist before switching medications. A gradual taper of Quitipin is advised rather than abrupt discontinuation to avoid rebound insomnia. Based on your sleep pattern and psychiatric history, your doctor can personalize a safer, effective alternative — possibly even non-pharmacological like CBT for Insomnia (CBT-I).
Health Tips
⚠️ Helpful Tips / Word of Caution
Never stop psychiatric medications on your own — withdrawal insomnia can be severe.
Monitor sleep, mood, and weight weekly during the medication change.
Lifestyle factors (screen time, caffeine, routine) can strongly influence sleep quality.
📍 Dr Shivam Bhandari Jain — Consultant Psychiatrist
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Definitely you can take a combination of zolpidem and melatonin and there are there options too, that do not cause weight gain but a holistic assessment and history taking will be needed for the symptoms so that proper management can be done, personality assessment, habits (addiction - mobile, tobacco, caefine), work pattern, all need to be assessed,
Next Steps
should discuss with the doctor
Health Tips
follow sleep hygiene, daily activity schedule, relaxation exercises, healthy diet
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