What drug could replace Oxazepam with the same effect and few side effects? I don't want to gain weight
66-year-old woman
I take Oxazepam 15 mg, 1/4 co, occasionally when I have a situation that stresses me too much (I'm naturally anxious) it calms me down for 24 hours and doesn't put me to sleep, but I noticed that with the Covid pandemic I took it regularly being more anxious and that caused me to have significant hair loss (after checking it would be the probable cause), I would like to find another medication to replace it, such a small dose is enough for me
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Jean-Sébastien Lecompte · 4 years ago
Hello,
The dose of oxazepam you are currently taking is very low. Basically, this molecule is one of the least potent in its class, so they will be difficult to substitute it for another. The other molecules, being more potent, may well give you drowsiness.
The only choice I would see in your situation would be lorazepam (Ativan) 0.5 mg 1/2 to 1 tablet as needed.
Obviously, I would need to know what other medications you are taking to determine if Ativan is compatible with your pharmacological record.
For your hair loss, this is not normally a side effect associated with oxazepam. It could, however, be an anxiety-related effect, more so than the medication.
Is there more hair loss since you are taking more oxazepam?
Also, since you are experiencing more anxiety, how many doses of oxazepam do you need per day to calm your symptoms?
66-year-old woman · 4 years ago
Yes the hair loss is worse since I take more oxazepam, the day after a dose I notice a triple amount of hair on my brush. I never need more than one dose a day to calm down and it also helps my digestion because when I am anxious my digestion blocks (spasm style)...but I have done several searches to identify the cause.
See this link in skin tabs: file:///Users/marielle/Downloads/110418%20(1).pdf
Does the CPS mention this?
I don't take any other medications except Dexilant on occasion as well
Ativan causes me a lot of drowsiness and short-term memory loss...
Jean-Sébastien Lecompte · 4 years ago
I took the initiative this morning to do several searches for your case and according to different sources, hair loss is not reported with oxazepam or any other molecule in this class of medication. I also checked the list of drugs that can cause hair loss, most of them are hormonal drugs, anticonvulsants and some cardiovascular molecules.
On the other hand, the causal link between hair loss and anxiety is well documented.
So, given that this molecule is working well for you and you are experiencing side effects with Ativan, I think the best course of action would be to see your doctor to review the treatment for your anxiety. Digestive symptoms are also an indicator that your anxiety is not currently well controlled. Some treatments taken regularly 1 time a day are more effective in controlling anxiety symptoms than taking oxazepam as needed.
I hope I was able to answer your questions. If you have any further questions, please do not hesitate, I will be happy to help you again.
66-year-old woman · 4 years ago
I can't bring myself to take the other anxiety meds on a daily basis because they are antidepressants and can cause weight gain (I've already taken Celexa). They have significantly more side effects, and my anxiety is liveable right now
Would there be any new medications that don't cause weight gain and have few side effects, as nausea, headache, drowsiness, and apathy are what I've experienced and that doesn't appeal to me.
66-year-old woman · 4 years ago
Did you look at the link I sent you that documents hair loss and oxazepam? I once took Welbutrin in a more depressive phase and it had not caused any weight gain but when I tried to take it for my anxiety it increased it instead of decreasing it. I took Celexa for 4 years and gained 45 pounds which was exceedingly difficult to lose and I hated myself, even though I was less anxious I had lost my self esteem and confidence it wasn't any better
I have already looked at Pristiq but there are still a lot of side effects there. So I don't know anymore, I'm looking at natural or homeopathic products, I took passionflower for a while which was doing well, but I just get irritated eyes with it and it makes my dry eyes worse I think, because since I stopped my eyes are much improved. I'm really looking for ways to prevent myself from having more problems. So me and my doctor are a bit lost and I understand, that's why I wanted to check the avenues with a pharmacist, maybe new molecules or other ideas?
Jean-Sébastien Lecompte · 4 years ago
I understand you, with side effects like that, it's less tempting to go to those molecules. Some molecules may be less worse than others for weight gain and other side effects. On the other hand, natural products are less recommended, not because they are ineffective, but because their effects are less predictable and they have many interactions with drugs.
Effectively, Celexa can make you gain between 10 and 30 lbs on average. Most first generation molecules like Celexa have this effect (the worst being Paxil). More recent molecules, such as Trintellix, Fetzima have a more neutral effect on weight. However, they are more expensive and are only reimbursed by private insurers (not reimbursed by RAMQ).
Wellbutrin can help with weight loss, but since it can increase anxiety (it's used more for depressive disorders), it's not a good choice for you (you've already tried it anyway)
In your situation, my opinion (again this will have to be decided with the doctor) is that Prozac might be a good choice for you. It is reimbursed and, despite being a first generation agent, it has the least effect on weight.
As a second, Zoloft would also be a good choice. It controls anxiety very well and is generally very well tolerated in terms of side effects. The effect on weight is variable from person to person, but the majority of my patients do not gain much weight on Zoloft.
The third one that could be tried is Cipralex. It also plays a little less on weight, is relatively well tolerated. I put it on par with Pristiq as well.
Two other molecules that are effective for anxiety and are not in the same family as antidepressants are Remeron and Seroquel. However, I would not suggest them to you they make you gain even more weight than antidepressants (despite being very effective for anxiety symptoms.
I hope this review of the different molecules can enlighten you on the choice. Before I finish, I would like to mention that with the information you have given me, it is crucial that you have a treatment that is effective, well tolerated, affordable and improves your quality of life. When you find the right molecule, you're going to be fine. That's what every patient who is well controlled tells me.
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