Conversation: The conversation between human and AI assistant.
[|Human|] Hello Doctor I am 40 yr Male. I have RHD AR/MR but asymptomatic, recently, within few years i developed episodic, about once in a month, muscular pains quite generalised but more severe at the left shoulder trapezium and ?rhomboid muscles pain. I am much sure its not physical pain only. My Dr gave me Escitalopram 10mg , But i am afraid to use it because of RHD. Please tell me about the side effects and suggestions. Shiv
[|AI|]  Hello, Mr Shiv, Escitalopram can cause gastric irritation, nausea, decreased sleep, constipation and weight gain.  If you are having muscle aches and pains it is unlikely to be related to RHD and more commonly can be because of Muscular trigger points which can be tackled with simple physiotherapy and massage therapy alone.  Do take fish and milk in your diet to improve your vitamin D levels which can be beneficial in these conditions.  You can also use Escitalopram in RHD, but it may not be needed for muscle aches and pains.  Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor.