So much takleef want true diagnosis

Question #21695

45 days ago

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So much takleef want true diagnosis - #21695

Ilma

Dr I have been diagnosed with triegimmal neuraliga on 12 dec taken oxetol 300mg daily pain relived.but now i am having vertigo so much vomiting loss of appetite i am on anti depressent too fluoxetine 40 bd escitalopram 15mg bd..this vertigo can't made me to stnd straight feeling of vomit vertigo immediately..plse help to understnd what ks actually happening..vomit yesterday I done only watery..

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Dr. Prasannajeet Singh Shekhawat

I am a 2023 batch passout and working as a general physician right now, based in Hanumangarh, Rajasthan. Still kinda new in the bigger picture maybe, but honestly—every single day in this line teaches you more than textbooks ever could. I’ve had the chance to work under some pretty respected doctors during and after my graduation, not just for the clinical part but also to see how they handle people, real people, in pain, in panic, and sometimes just confused about their own health. General medicine covers a lot, right? Like from the smallest complaints to those random, vague symptoms that no one really understands at first—those are kinda my zone now. I don’t really rush to label things, I try to spend time actually listening. Feels weird to say it but ya, I do take that part seriously. Some patients just need someone to hear the whole story instead of jumping to prescription pads after 30 seconds. Right now, my practice includes everything from managing common infections, blood pressure issues, sugar problems to more layered cases where symptoms overlap and you gotta just... piece things together. It's not glamorous all the time, but it's real. I’ve handled a bunch of seasonal disease waves too, like dengue surges and viral fevers that hit rural belts hard—Hanumangarh doesn’t get much spotlight but there’s plenty happening out here. Also, I do rely on basics—thorough history, solid clinical exam and yeah when needed, investigations. But not over-prescribing things just cz they’re there. One thing I picked up from the senior consultants I worked with—they used to say “don’t chase labs, chase the patient’s story”... stuck with me till now. Anyway, still learning every single day tbh. But I like that. Keeps me grounded and kind of obsessed with trying to get better.

45 days ago

Hello IIma
Thank you for sharing these details. You have a history of trigeminal neuralgia (for which you’re taking Oxetol/oxcarbazepine), and you’re also on high doses of antidepressants (fluoxetine and escitalopram). Now you’re experiencing severe vertigo, vomiting, and loss of appetite, and you can’t stand straight due to the vertigo.
Here’s what could be happening:
1. Medication Side Effects:

- Both Oxetol (oxcarbazepine) and your antidepressants can cause dizziness, vertigo, nausea, and vomiting, especially when used together or at higher doses.
- Combining fluoxetine and escitalopram (both are SSRIs) is unusual and can increase the risk of side effects, including something called “serotonin syndrome,” which can cause confusion, dizziness, nausea, and more.
2. Electrolyte Imbalance:

- Oxcarbazepine can lower sodium levels in your blood (hyponatremia), which can cause severe dizziness, confusion, and vomiting.
3. Inner Ear or Neurological Issue:

- Less likely, but sometimes vertigo can be due to an inner ear problem or a neurological issue, especially if you have a history of nerve problems.
What you should do:
- This situation is serious. You need to see a doctor as soon as possible—preferably today.

- Bring all your medications with you and tell the doctor about your symptoms and the combination of antidepressants.
- Do not stop or change your medicines on your own, but do not take any more doses until you speak to your doctor.
Why urgent care is needed:

Severe vertigo, vomiting, and inability to stand can be dangerous and may need blood tests (especially sodium and other electrolytes), medication review, and possibly IV fluids or other treatment.
Thank you and get well soon

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Dr. Arsha K Isac

I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.

44 days ago

Hello,
Dear you need urgent evaluation 🛑🛑
You may need modification or adjustment in your medication
🛑Your symptoms are NOT from trigeminal neuralgia.
They are most likely due to 🛑medicine-induced severe vertigo and vomiting.
Why this is happening:
Oxetol (oxcarbazepine) commonly causes vertigo, nausea, vomiting, loss of appetite
Taking high-dose antidepressants together
(Fluoxetine 40 mg BD + Escitalopram 15 mg BD) greatly worsens dizziness, nausea, imbalance
Combination can also cause low sodium (hyponatremia) → severe vertigo, vomiting, weakness
🛑🛑So likely this is Drug-induced vertigo ± hyponatremia
What to do URGENTLY:
Get blood test TODAY: Serum sodium, potassium
Contact your doctor immediately to:
Reduce or stop Oxetol
Do NOT take two SSRIs together without specialist supervision
For immediate relief :
Ondansetron for vomiting
Iv if vomiting continues
Betahistine for vertigo
🛑🛑🛑This is a medication reaction, not disease progression.
Please act today — this is reversible if treated quickly.
I trust this helps
Thank you

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Dr. Aarav Deshmukh

I am a general physician with 8 years of practice, mostly in urban clinics and semi-rural setups. I began working right after MBBS in a govt hospital in Kerala, and wow — first few months were chaotic, not gonna lie. Since then, I’ve seen 1000s of patients with all kinds of cases — fevers, uncontrolled diabetes, asthma, infections, you name it. I usually work with working-class patients, and that changed how I treat — people don’t always have time or money for fancy tests, so I focus on smart clinical diagnosis and practical treatment. Over time, I’ve developed an interest in preventive care — like helping young adults with early metabolic issues. I also counsel a lot on diet, sleep, and stress — more than half the problems start there anyway. I did a certification in evidence-based practice last year, and I keep learning stuff online. I’m not perfect (nobody is), but I care. I show up, I listen, I adjust when I’m wrong. Every patient needs something slightly different. That’s what keeps this work alive for me.

43 days ago

Vertigo and accompanying symptoms like vomiting and loss of appetite can sometimes be side effects of medication, such as the ones you’re taking for trigeminal neuralgia and depression. Oxcarbazepine (Oxetol), can cause dizziness and nausea, especially when you first start or adjust the dose. Some antidepressants also contribute to such symptoms. However, if the vertigo is severe and preventing you from standing or functioning, it’s important to consider other possible causes. Inner ear issues, such as labyrinthitis or vestibular neuritis, can cause vertigo; these often follow infections like colds. Another possibility could be Meniere’s disease, which involves episodes of vertigo, alongside tinnitus and hearing changes. To target the root cause effectively, I’d advise seeing your healthcare provider as soon as possible. They may want to evaluate your current medication regimen, considering potential interactions and side effects. Also, they might perform physical exams or tests, like an MRI or hearing tests, to rule out other causes of vertigo. Until you’re able to see a healthcare provider, try to stay hydrated by taking small sips of water even if you feel nauseous. Avoid sudden head movements and bright lights, as these can sometimes worsen vertigo. It also might be wise to avoid driving or operating machinery until you have better control of your symptoms. If symptoms worsen or you experience any new, concerning symptoms, seek medical attention immediately.

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Dr. Bharat Joshi

I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.

45 days ago

Hello dear
See as per clinical history it seems drug induced side-effects due to multiple medication interaction.
Fluoxetine and escitalopram are interacting and causing theses side-effects of vertigo and dizziness.
Iam suggesting modification in current medication
Please discuss with concerned physician only for modification or replacement of medication.
Please not there are less chances of
Stroke
Brain fog
Cardiac arrest
So i expect modification in medication will bring improvement in symptoms
Regards

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Dr. Shayeque Reza

I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.

45 days ago

Your current symptoms severe vertigo, repeated vomiting, loss of appetite, inability to stand straight, and watery vomiting are most likely due to medication-related side effects and interaction, rather than trigeminal neuralgia itself.
You are taking:
Oxetol (oxcarbazepine) 300 mg
Fluoxetine 40 mg twice daily
Escitalopram 15 mg twice daily
This combination can strongly affect the brain’s balance and nausea centers.
What is most likely happening:
Oxcarbazepine commonly causes vertigo, dizziness, nausea, and vomiting, especially after initial relief of pain
Taking two SSRIs together (fluoxetine + escitalopram) is not recommended and can significantly worsen:
Dizziness
Nausea and vomiting
Loss of appetite
Imbalance and weakness
Oxcarbazepine can also cause low sodium levels (hyponatremia), which leads to severe vertigo, vomiting, confusion, and inability to stand

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Dr. Alan Reji

I'm Dr. Alan Reji, a general dentist with a deep-rooted passion for helping people achieve lasting oral health while making dental visits feel less intimidating. I graduated from Pushpagiri College of Dental Sciences (batch of 2018), and ever since, I've been committed to offering high-quality care that balances both advanced clinical knowledge and genuine compassion for my patients. Starting Dent To Smile here in Palakkad wasn’t just about opening a clinic—it was really about creating a space where people feel relaxed the moment they walk in. Dental care can feel cold or overly clinical, and I’ve always wanted to change that. So I focused on making it warm, easygoing, and centered completely around you. I mix new-age tech with some good old-fashioned values—really listening, explaining stuff without jargon, and making sure you feel involved, not just treated. From regular cleanings to fillings or even cosmetic work, I try my best to keep things smooth and stress-free. No hidden steps. No last-minute surprises. I have a strong interest in patient education and preventive dentistry. I genuinely believe most dental issues can be caught early—or even avoided—when patients are given the right information at the right time. That’s why I take time to talk, not just treat. Helping people understand why something’s happening is as important to me as treating what’s happening. At my practice, I’ve made it a point to stay current with the latest innovations—digital diagnostics, minimally invasive techniques, and smart scheduling that respects people’s time. I also try to make my services accessible and affordable, because good dental care shouldn’t be out of reach for anyone.

42 days ago

Your severe vertigo, vomiting, and loss of appetite are very likely medication-related, especially from Oxetol (oxcarbazepine) and the high combined doses of fluoxetine + escitalopram, which can cause dizziness, nausea, imbalance, and even electrolyte disturbances. This is not typical trigeminal neuralgia itself and should not be ignored, particularly since you can’t stand straight and are vomiting watery fluid. Please consult a neurologist or psychiatrist urgently (or go to the ER) for medication review, possible dose adjustment, blood tests (especially sodium), and safe symptom control—do not stop or change medicines on your own.

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Dr. Nirav Jain

I am a qualified medical doctor with MBBS and DNB Diploma in Family Medicine from NBEMS, and my work has always been centered on treating patients in a complete, not just symptom based way. During my DNB training I rotated through almost every core department—Internal medicine, Pediatrics, Obstetrics & Gynecology, Surgery, Orthopedics, ENT, Dermatology, Psychiatry, Emergency medicine. That mix gave me the skill to manage acute illness, long term disease and preventive care together, something I find very important in family practice. In psychiatry I worked closely with patients who struggled with depression, anxiety, stress related problems, insomnia or substance use. I learned not just about medication but also about simple psychotherapy tools, psycho education and how to talk openly without judgement. I still use that exp in family medicine, specially when chronic disease patients also face mental health issues. My time in General surgery included assisting in minor and major procedures, managing wounds, abscess, sutures and emergencies. While I am not a surgeon, this gave me confidence to recognize surgical cases early, provide first line care and refer fast when needed, which makes a big difference in online or OPD settings. Now I work as a consultant in General medicine and Family practice, with focus on both in-person and online consultation. I treat conditions like fever, infections, gastrointestinal complaints, respiratory illness, and also manage diabetes, hypertension, thyroid disorders, and lifestyle related chronic diseases. I see women for PCOS, contraception counseling, menstrual health, and children for common pediatric issues. I also dedicate time to preventive health, lifestyle counseling and diet-sleep-exercise advice, since these small changes affect long term wellness more than we often realize. My key skills include holistic diagnosis, evidence based treatment, chronic disease management, mental health support, preventive medicine and telemedicine communiation. At the center of all this is one thing—patients should feel heard, safe, and guided with care that is both professional and personal.

40 days ago

Hello Ilma, I understand how uncomfortable and frightening this is. Your current symptoms do NOT fit trigeminal neuralgia itself. They strongly suggest a medication-related problem, not a new disease.
This is Not worsening trigeminal neuralgia, Not brain tumor, Not stroke, Not permanent damage.
Contact or visit your treating doctor today, make sure he/she is a certified phychiatrist. He/she will adjust/modify the medicines.
Get done this blood test - Sr. Electrolytes.
Take Tab. Ondansetron 4mg before meals twice a day for vomiting.
Go to ER if: You cannot stand, Continuous vomiting, Confusion, Severe weakness, Palpitations, Fainting.
Feel free to reach out again.
Regards,
Dr. Nirav Jain
MBBS, D.Fam.Medicine

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