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Depression Query
Hi, I am over 65 years old and have been experiencing severe depression since 1990. I have been relying on Alprax for many years. I have previously tried SSRIs, but they did not suit me. I am now considering switching to Nexito Plus. Is it safe for me to make this switch, and are there any potential side effects I should be aware of?” Doctor has prescribed Nexito but because of my age I am wary of side effects.
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Answer:
Hello sir, thank you for sharing your concern. Considering your age and long-standing history of depression, it's important to proceed cautiously. Nexito Plus (Escitalopram + Clonazepam) is commonly used for anxiety and depression and can be effective, even in elderly patients, if monitored carefully.
Helpful Tips / Word of Caution:
Avoid alcohol or any additional sedative medications while on Nexito Plus.
Report any symptoms like excessive sleepiness, muscle stiffness, or unsteadiness immediately.
The switch can be safe and beneficial if done with close psychiatric supervision.
Next Steps
Next Steps (What should the patient do next?):
1. Ensure a gradual tapering of Alprax under supervision before initiating Nexito Plus to avoid withdrawal.
2. Start Nexito Plus at the lowest effective dose, and your psychiatrist will slowly increase if needed.
3. Regularly monitor for sedation, confusion, balance issues, or falls — especially in elderly patients.
4. Get routine follow-ups to assess blood pressure, sodium levels, and ECG if needed, as SSRIs in older adults can affect these parameters.
5. Maintain a fixed sleep-wake cycle, hydration, and gentle physical activity, which can improve response to treatment.
Health Tips
Dr. Shivam Bhandari Jain
Consultant Psychiatrist
🕕 Mon–Sat: 6 PM – 8 PM
📍 Health 4 U Clinic, 249 Gufa Mandir Road, Lalghati, Bhopal
📞 887158270
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Treating the biological aspect is only one side of the treatment. We need to focus on a treatment plan that helps you identify triggers of your symptoms and find effective strategies to help you prevent and manage these symptoms without them getting to such an extreme. These symptoms require psychotherapy, medications alone won't do.
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Seminology suggests an alternative outcome , probably TRD/dysthymia + BZD dependence. A thorough evaluation is required for evaluation and management of symptoms
Alprax is not suitable for u at this age
More details are needed for diagnosis and management
Next Steps
consult a psychiatrist for optimization
Health Tips
don't self medicate
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