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Difficulty In Getting Sleep. Taken Zollfresh And Alprax Alternatively. Stopped Taking Alprax And Not Able To Sleep. Advice?

Posted on Wed, 3 Oct 2012

Question: I am having difficulties in getting Sleep for quite some time.I used to take Zollfresh-5mg and Alprax-0.5mg alternatively(not together).One Doctor XXXXXXX in your panel advised me to take only Zollfresh and stop Alprax.But as of now,I am not getting sleep with Zollfresh.It is better with Alprax.What should I do now?Pl.Advise?

Answered by Dr. Sairajesh Koonamsetty (33 minutes later)

Hi XXXXXXX,

Thanks for writing to us.

Firstly you need to know how Zolfresh (contains Zolpidem)works. Zolpidem is commonly used in cases of insomnia( lack of sleep). But the thing is Zolpidem can initiate sleep but is less effective in sustaining sleep( based on the data from various clinical trials done on Zolpidem).

Alprax contains Alprazolam which is has got anxiolytic action and is moderately sedating and you should not have any difficulty in maintaining sleep.

You can safely take Alprax 0.5mg daily as tolerance and addiction liability is not seen with Alprazolam

The difficulty in sleeping in your case could be due to anxiety and / or stress. Address the root cause also with the help of an expert Psychiatrist / Psychologist you will have a good outcome.

Also please note that switching and changing of drugs should be under the guidance of the same expert whom you can XXXXXXX and discuss.

Please feel free to share your problems regarding health, so that I can guide you better.

Hope you got the solution you were looking for.

Regards
Dr K. Sai XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sairajesh Koonamsetty (2 days later)

Dear Dr XXXXXXX
Thanks for your reply!But it conflicts with what I received from Dr XXXXXXX who has stated that I should take only Zollfresh.I guess this is the problem with allopathic medicines.You can never get to the root of the problem.However,you are better than Dr XXXXXXX in my case,since Alprax is more effective at least in my case.If you can suggest a good psychiatrist in Mumbai/Thane,I shall be grateful.
Perhaps,you can prescribe some Melatonin tablets.
In fact,I also have gas and indigestion problems due to Ecosprin.Any solution to this,please?

Answered by Dr. Sairajesh Koonamsetty (19 hours later)

Hi XXXXXXX,
Thanks for writing back.
We are sorry for confusing you on the choice of treatment( conflict of interests).
As you know medicine is an ever evolving sciences, new things and facts about health and medicines come to fore everyday.

Sleep disorders are of various types- difficulty in initiation of sleep, difficulty in maintaining sleep.
Zolfresh does work for people who experience difficulty in initiation of sleep.
For your information, Zolfresh was long considered as the drug of choice for insomnia(as Dr XXXXXXX had advised you). But latest studies proved that Zolfresh is effective only in initiating sleep and it is highly ineffective in maintaining it.

Of course the root cause also needs to be attended. That is why i have advised you to see a psychiatrist to get evaluated .
As far as treatment of sleep disorder is concerned , it is highly individualized and choice of therapy varies with the type of sleep disorder and the underlying cause.

As far as prescribing Melatonin is concerned, I am sorry to say that I cannot prescribe through this portal as it is not an over the counter drug and is supposed to be taken only after complete evaluation was done and no other organic cause was found.
As far as best psychiatrist in and around Mumbai/thane is concerned, there are many experienced and good psychiatrists available in mumbai. Please tell me where you reside in mumbai, so that I can give you the details of the doctor nearer to you.

For the gas and indigestion problem you have been facing, using capsule Omeprazole 20 mg( Omez 20mg available as over the counter drug) atleast 1hr before having breakfast one capsule a day will help you. You can take this for 1-2 weeks. Along with that you need to change your diet. Avoid taking high fat and spicy diet. Avoiding hot dairy products like milk especially before going to bed.

Hope you are satisfied with the answer. Please provide me the details of the area where you reside so that I can guide you better.

Awaiting your reply.
Take Care

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Sairajesh Koonamsetty (24 hours later)

Dear Dr XXXXXXX
I thank you very much for your extremely logical and practical answer.
I am having problems in maintaining sleep with Alprax also.
I reside in the XXXXXXX suburb of Mumbai.However any good psychiatrist between Ghatkopar and XXXXXXX is fine.You can also provide his telephone number.I require this information urgently since I am tarvelling abroad with my family in the 3rd week of XXXXXXX and I have to start the treatment quickly.

Answered by Dr. Sairajesh Koonamsetty (16 hours later)

Hi AAAAA,
Thanks for providing the details.
You can contact Dr XXXXXXX Nadakarni. He is a renowned psychiatrist in XXXXXXX Here are his contact details
Dr XXXXXXX Nadakarni,
9th floor, Shri XXXXXXX XXXXXXX Wing A-2, LBS road, Naupada, XXXXXXX west.
Contact number-000-0000

Hope you get the desired response from him.
You may ask me a query directly in future, if you wish, at this link WWW.WWWW.WW

Wish you a healthy life.
Take Care

Regards
Dr Sairajesh koonamsetty

Above answer was peer-reviewed by : Dr. Aparna Kohli