Are these drug combinations OK for treating epilepsy and depression?
Q: My father has diabetes type 1 for the past 3 years. He had his fist seizure 3 years ago and then again in January 2005, August 2005 and August 2006. We stopped the medicine Valparin, which he was taking unknowingly. He has shivering of hands since he started taking Valparin. He suffered from depression and maniac face during this time. Since August 2006 he is completely OK. The doctor stopped Valparin and prescribed Lameez 250 mg, Epsolin 400, Triex, Olanze 7.5 for depression and Cloze 2mg for sleep. Along with these he takes hypoglycaemic medicines also. His psychiatrist said to stop Cloze slowly and side by side start Zolfresh for sleep. He also said to stop Triex and instead give him Vitamin E . He also advised that Epsolin and Lameeze counteract each other. We are in a fix as to, which doctor to believe. Are the combinations OK? Which medicines should be given to him so that he does not have seizures and depression?
A:Medicines for epilepsy can only be stopped when the patient is free from fits for at least 3 years. Since you stopped the medicine too early, the patient got fits. Now Epsolin 400mg daily should be continued for at least 3 years. No other medicine for epilepsy is required. Olanze is the brand name of a medicine called olanzapine. (This brand does not appear on the national and international list of quality products. It is indicated in the treatment of schizophrenia and acute mania (short term therapy only). It should not be used in mild to moderate cases of depression. Besides it makes diabetes worse; hence should not be used in diabetics. Cloze is the brand name of a medicine called clonazepam. This medicine is also used in the treatment of epilepsy though it has anti-anxiety effect also. It is not meant for inducing sleep. It can make depression worse. Triex (trihexphenidyl) is indicated in the treatment of Parkinsonism. Its side effects include confusion, delusions and hallucinations. Zolfresh is the brand name of a medicine called zolpidem. It is also sold under the brand name of Zleep by Wockhardt. It is indicated in the short term treatment of insomnia (sleeplessness). It can be used for a few days but must not be used for more than 4 weeks at the most since long use can lead to rebound sleeplessness. On the basis of information given by you, it would be rational to give only Epsolin for three years at the least and Zolfresh or Zleep 10mg at bedtime for a few days.