Your TSH change from 6.59 to 3.59 is actually a positive sign, showing that your thyroid medication, Thyronorm (levothyroxine), is successfully bringing your levels into the normal range. However, some individuals are highly sensitive to thyroid hormone adjustments, which can occasionally trigger palpitations or tension, even when blood levels look normal. Since your anxiety medications, Nexito (escitalopram) and Anxit (alprazolam), aren't easing these symptoms, please consult your doctor. They can check your blood pressure, monitor your heart rate, and ensure your dosage is perfectly tailored to your body. Please do not alter your doses without their guidance.

It is very common to experience sleep issues alongside anxiety, and I understand how disruptive this can be. However, please consult your doctor before restarting Nexito (escitalopram) and clonazepam. Escitalopram is a long-term medication that takes several weeks to work and can sometimes initially affect your sleep. Clonazepam is highly effective for short-term relief but carries a risk of dependency if not carefully monitored. Because your symptoms or health needs may have changed over the last two months, your doctor will want to evaluate you to ensure this is still the safest, most effective treatment plan for your sleep and anxiety.

Yes, switching your Nexito (escitalopram) to the morning is a very reasonable step. Since it is not helping you sleep, taking it in the morning can often help target your daytime anxiety more effectively and prevent any medication-related nighttime restlessness. I highly recommend discussing this change with your doctor first to ensure a smooth transition. Please be gentle with yourself; we will find the right routine to help you feel better.

Escitalopram is the active medicine, while 'oxalate' is simply the salt form used to formulation the tablet. Because Nexito contains escitalopram, you can safely switch to another medicine containing escitalopram oxalate, as long as the dose remains exactly the same. However, I highly recommend consulting your doctor or pharmacist before making the switch to ensure a seamless transition and verify the quality of the new brand.

Since your current medications aren't providing relief after a week, it is very important to contact your prescribing doctor or a healthcare professional for a re-evaluation. Sometimes, ear-related pain requires a different treatment plan, such as adjusting your current prescription or trying a different generic medication, like an antibiotic or a targeted pain reliever, depending on the cause. Please monitor for any new symptoms like fever, swelling, or hearing changes.

While taking Nexito (escitalopram) and Clonapax (clonazepam), it is highly recommended to completely avoid alcohol. Both of these medications and alcohol can slow down your brain's activity. Combining them can cause severe drowsiness, dizziness, and slow your reactions, which can be unsafe. Even a small amount of alcohol can unpredictably worsen these side effects and also impact how well your treatment works. Your safety and well-being are the top priorities, so please steer clear of alcohol for now. Do discuss this with your prescribing doctor for personalized guidance.