Which anti-anxiety and insomnia medicine will not raise blood pressure and heart rate?

Question

Hello doctor,

One of the doctors prescribed me XeFexor Duo (a combination of Flupentixol and Escitalopram) for psychosomatic symptoms due to persistent anxiety. All my tests, like TMT, 2D echo, 48-hour Holter monitor, ECG, kidney or liver tests, blood tests, vitamin tests, etc., are normal.

I read the side effects of Flupentixol, like thrombosis, embolism, QT prolongation, etc., and I am a little nervous about this medicine. I have yet to start it.

I am currently taking Metoprolol Tartrate (50) twice a day, Amlodipine 5 mg (twice a day), and Atorvastatin 10 (once at night). For insomnia, a general physician (MD) prescribed Mirtazapine 7.5. I have been taking Mirnite 7.5 for the last 3 months. I was convinced about Mirtazapine's safety and decided to give it a try. It makes me sleep, though the quality of sleep is not great.

Are Flupentixol and Escitalopram safe and effective for anxiety-induced somatic symptoms?
What is your opinion on XeFexor Duo?
Do you recommend any other medicine for persistent anxiety and insomnia? I need something that should not increase my BP and heart rate. My BP is well controlled (less than 110/80), and my resting heart rate is normal too (70).

Kindly assist.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

You must understand that there is a difference between potential side effects, such as thrombosis, embolism, and QT prolongation that are reported with the drug, and commonly seen side effects with a drug.

While the side effects that you mentioned have been reported in the literature, they are not common, and I have not seen any of my patients having them while on the medicine. Still, this does not mean that there is no risk of having them. But the risk is minimal, and almost every medicine (psychiatric or otherwise) has a risk of developing some or the other side effects. I use it for anxiety and psychosomatic symptoms in my patients, and I find it effective.

However, it may not work for everybody. The only way to ascertain is by taking it for two to four weeks. By the way, Mirtazapine at a dose of 15 to 30 mg is also effective for anxiety and psychosomatic symptoms, and you can ask your doctor about it.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Yes, you can safely take these two medicines together. Besides, they have a synergistic action (combined efficacy is greater than the sum of the individual efficacies). I think you should give these medicines a try before thinking of other options.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.