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How can I get rid of the addiction to Amixide?

Saturday, 23 April 2005
Answered by: Chandra M. Gulhati
Editor,
MIMS,
New Delhi
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Q. I went into depression and anxiety in my late teens. Now I am 30 years old. I was prescribed Amixicide-H twice a day along with other vitamins. The prescription was successful and my health improved. I started maintaining a good health. The doctor told me to continue Amixicide -H for 1 year with reduced dose. After a year I tried to stop taking it. But I felt uneasiness, so the doctor asked to continue it for 2 more years with reduced dose to 1/2 tablet. Now, even after 9-10 years, I am not able to do without 1/2 tab of Amixcide-H daily at night. If I dont take it I start have problems the next day like palpitations, insecurity, fears etc. I can't do without it for more than 2 days. Due to this I always to have some stock of the medicine with me. Now, my health is not so good. I have to do restrictive physical work. My eyes remain swollen. I have less stamina. I feel too cold in winters. I underwent thyroid tests, which were OK, though I have symptoms of hyperthoridism. Recently I went to buy this medicine from a local medical shop. But the shopkeeper refused to give it without medical prescription. He said that the narcotics department has banned the sale of this drug without prescription. I have to go to USA for 1 year. And I have read that this product is not approved in any advanced country. How will I get my medicine there? I have also read that Amixcide-H has side effects too. How can I stop taking this drug? Does taking this medicine daily means that I am abnormal? I have some disorder, though none of friends or family feels so. Where can I get this medicine or a substitute in USA? Does having this daily will affect my health? For how long can I take this?

A.  It is obvious that you are hooked to the combination of amitryptyline and chlordiazepoxide. Essentially it is nothing but drug addiction. There is hardly any justification to prescribe and take a combination product that too for more than 8 years! The best way is to reduce the dose gradually, say, every two-three weeks but you can do so only if you take the two drugs individually. Amitriptyline is sold under the brand name of Tryptomer and is available as 10mg tablets also. Chlordiazepoxide is available under the trade name of Equilibrium as 10mg tablets. For about a month you can take one tablet of Tryptomer and half a tablet of Equilibrium. Then reduce it to half tablet of Tryptomer and continue with half a tablet of Equilibrium; then reduce it to half a tablet of Tryptomer and quarter tablet of Equilibrium. Equivalent of Amixide-H is not marketed in USA. Amitryptyline has also been discontinued. You will need to take adequate stocks of Tryptomer and Equilibrium from India. In any case no pharmacy will sell you these psychotropic drugs in USA without psychiatrists prescription. Fixed-Dose Combinations (FDCs): Medicines are discovered individually and are supposed to be taken separately. A huge number of irrational, illegal combinations of drugs are being sold in India; quite a few without mandatory approval of the Drugs Controller General, India (DCGI). Except in a few cases (such as TB medicines), it is always better to take medicines separately so that dosage can be adjusted and side effects monitored.

A.  It is obvious that you are hooked to the combination of amitryptyline and chlordiazepoxide. Essentially it is nothing but drug addiction. There is hardly any justification to prescribe and take a combination product that too for more than 8 years! The best way is to reduce the dose gradually, say, every two-three weeks but you can do so only if you take the two drugs individually. Amitriptyline is sold under the brand name of Tryptomer and is available as 10mg tablets also. Chlordiazepoxide is available under the trade name of Equilibrium as 10mg tablets. For about a month you can take one tablet of Tryptomer and half a tablet of Equilibrium. Then reduce it to half tablet of Tryptomer and continue with half a tablet of Equilibrium; then reduce it to half a tablet of Tryptomer and quarter tablet of Equilibrium. Equivalent of Amixide-H is not marketed in USA. Amitryptyline has also been discontinued. You will need to take adequate stocks of Tryptomer and Equilibrium from India. In any case no pharmacy will sell you these psychotropic drugs in USA without psychiatrists prescription. Fixed-Dose Combinations (FDCs): Medicines are discovered individually and are supposed to be taken separately. A huge number of irrational, illegal combinations of drugs are being sold in India; quite a few without mandatory approval of the Drugs Controller General, India (DCGI). Except in a few cases (such as TB medicines), it is always better to take medicines separately so that dosage can be adjusted and side effects monitored.

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