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Is it safe to take these drugs for depression?

Q: I am taking Alprazolam 1.5 mg daily. My treating psychiatrist advised me to take Librium 25 mg and Mirtazepane 15 mg daily and avoid Alprazolam. I tried that for one month and was away from Alprazolam. My family doctor told me that I should not go to a psychiatrist as they will make me sick with sedatives and it will be a perennial process and warned me to stop Librium. I did as he said. So I was back to Alprazolam 1.5 mg. Is it safe to take either Alprazolam or Zolpidem 10 mg daily throughout one's life? In particular for a person like me who doesn't get good sleep. Psychiatrist said Librium 25 mg and Mirtaz 15 (mirtazepane) are maintenance doses which they normally give. Does this mean that these have to be taken throughout to maintain good sleep? Will there be any side effects of these in years to come? Please advise.

A:Alprazolam is the chemical name. Librium is the trade name. It contains a medicine called chlordiazepoxide. Both alprazolam and chlordiazepoxide belong to the same group called benzodiazepines. Since they belong to the same group, by and large their actions and adverse effects are similar if not identical. Zolpidem is the chemical name. Its most known brand name is Zleep by Wockhardt. It is meant for Short term treatment of lack of sleep in situations where the patient is in great distress. This can be used for short term. Prolonged use can lead to many side effects and hence must not be used. Mirtaz is the brand name of a medicine called mirtazepine. It is meant to be used in what we clinically call Major depression not responding to other conventional drugs. It has many serious side effects including - (a) worsening of depression (b) development of tendency to commit suicide (c) high blood pressure (d) increase in cholesterol and triglycerides (e) oedema (f) development of mania (g) bone marrow depression (h) jaundice (i) convulsions (j) blood dyscrasias etc. There is a very long list of other side effects. Unfortunately many toxic drugs are being prescribed in India due to incentive-driven promotional practices by some pharma companies. I think you should try to get rid of not just one but all medicines by trying alternative therapies. Yoga is proven to be highly effective in depression.

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