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Takin zolpidem tartarate, alprax and larpose. Suggest some way to stop these medicine

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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Neurologist
Practicing since : 1994
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Dear Dr Grief,
I was taking Zolpidem Tartarate-5mg for nearly three weeks for my Insomnia.I have also been periodically taking Alprax-0.5 mg or Larpose-2mg,that is maybe once in 7 days or so.On Friday nights ,I tried to sleep without anything but could not sleep much.
Can you suggest some way to taper off the medicine or can I stop taking them altogether.I am also taking Herbal medicine.
Posted Sun, 4 Nov 2012 in Medicines and Side Effects
 
 
Answered by Dr. Sudhir Kumar 42 minutes later
Hi,
Thank you for contacting Healthcare magic.
It is good to note that you want to come off the sleeping pills.

Of the medicines that you have been taking, alprax and larpose are the drugs with addiction potential. When someone uses them, it is difficult to stop them, as it may lead to withdrawal symptoms, in addition to causing sleep disturbances.

I suggest at this point of time, you can continue zolpidem for sleep problems.
Try avoiding alprax and larpose totally. If you are sleeping well, that's good.

If required, you may continue the zolpidem for a longer period. However, if you are able to sleep well at a later date, you can stop zolpidem. Decrease it to 2.5 mg (half) for two weeks and then stop it.

I hope it clarifies. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad
Above answer was peer-reviewed by
 
Follow-up: Takin zolpidem tartarate, alprax and larpose. Suggest some way to stop these medicine 15 minutes later
Thanks,Doctor.However,I was taking Zolpidem for some time but then the effect started wearing out.So,I shifted to Alprax and Larpose and I have not taken these for more than 2 days.
How safe is Zolpidem? I know none of them are safe.But what is your opinion to stop all medicines totally.Is it safe?
Due to lack of sleep,I am in a bad shape.My immune system has weakened and I have throat and digestion problems.It is difficult to walk and there is pain in both elbows and head is heavy.This is why I feel it may be better to stop these drugs altogether since in any case they are not helping me.Question is the withdrawl symptoms.
 
 
Answered by Dr. Sudhir Kumar 10 minutes later
Thank you for getting back.

I appreciate your concern regarding the safety of these sleeping pills.

I have a lot of interest in these drugs, and I commonly see patients with insomnia. I also follow the latest research on them.

Among sleeping pills, benzodiazepines (such as alprax and larpose) are not safe because:

1. They have addiction potential- if someone starts it on a regular basis, they can not have normal life without taking them on a daily basis.
2. They have tolerance- as the time goes by, people require higher and higher doses to get sleep.
3. There is hangover effect- people feel sleepy and tired during day time also, and hence can not do anything well, including driving.
4. They have withdrawal effects.

On the other hand, zolpidem is safe and is free of the above four bad effects.

I feel you should continue zolpidem, as good sleep is also important for good health. However, the most appropriate dose would be 10 mg (please get a prescription from your doctor, as it is a prescription drug).

I hope it clarifies.
Please get back if you have any more queries.
Best wishes,
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by
 
Follow-up: Takin zolpidem tartarate, alprax and larpose. Suggest some way to stop these medicine 6 minutes later
Thanks doctor.When I take zolpidem,the side effects are more .I lose appetite and the there is hangover.I do not know whether I should go to 10mg dose?How long can I take it.?Is it OK to take it everyday.?
 
 
Answered by Dr. Sudhir Kumar 15 minutes later
Hi,
Thank you for getting back.
I commonly prescribe Stilnoct brand from Sanofi, and patients tolerate it very well.
It is very safe to take on a daily basis too.

I have a young lady patient who has been taking zolpidem for five years on most of the days, and recently, she successfully completed her PhD at a prestigious place in Hyderabad.

You can take it for as long as needed, and it is OK to take it every day. 10 mg is the preferred dose till 75 years of age, after that 5 mg is advised.

Best wishes,
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by
 
Follow-up: Takin zolpidem tartarate, alprax and larpose. Suggest some way to stop these medicine 10 minutes later
Thanks Doc.But Zolpidem-10mg will have enough side effects and I hope I will be able to function the next day.You have given the example of a young lady.I am 58 yeats old.I should not really get addicted to zolpidem.It should not happen that even 10mg is not enough and I have to go to 12.5 mg.
Is there an Indian version of Stilnoct?
 
 
Answered by Dr. Sudhir Kumar 10 minutes later
Thank you for getting back.

Stilnoct is the Indian version (Stilnox is the US version) and is available in Indian cities on prescription.

As I mentioned earlier, it is safe in all age groups and there is no risk of addiction. Also, the action does not last for more than 8 hours, so, you can function well the next day.
I agree 58 is not very young, but it is not old too! Old age is after 75!
In any case, I would not recommend any dose above 10 mg for you.

Best wishes,
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by
 
Follow-up: Takin zolpidem tartarate, alprax and larpose. Suggest some way to stop these medicine 12 hours later
Dear Doc,I slept well with zollfresh-5mg after a number of days.But in the morning now,I am feeling the after effects like heaviness of head,Bad appetite ,anxietyetc.
My main problem is anxiety .I used to take Mirtaz-7.5 mg but had to discontinue since a have Glaucoma.I was even asked to discontinue Sensival for the same reason
How to control anxiety in a non-medicinal way?
You are mentioning that zolpidem is safe.But reports on-line are suggesting not to take it for more than 10 days.One important side effect is 'Loss of Memory in short time"
Is there anything which I can take with zolpidem to reduce such side effects and have more energy?
 
 
Answered by Dr. Sudhir Kumar 2 hours later
Hi,
Thank you for getting back.
It seems zolpidem 5 mg may suffice for you.
Regarding the online reports, I wish to tell you that I attend many seminars on sleeping pills, and also follow all the research papers on the same.
In addition, I have many patients of mine who are taking zolpidem.
In practice, no sleeping pill is safe; but if one has to take a sleeping pill, zolpidem is the safest.
Regarding anxiety, you can practice yoga and/or meditation.
For energy, you can take one of the nutritional supplements available in the market. Plus multivitamin tablets, methycobal, etc may also be useful.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Takin zolpidem tartarate, alprax and larpose. Suggest some way to stop these medicine 8 hours later
Hi Doctor.Thanks.At the moment I am having stomach and appetite problems.Hence I have to discontinue zolpidem.By the way ,have people got over zolpidem.What is the withdrawl procedure?How long does it take?Even wikipedia says it is addictive.
 
 
Answered by Dr. Sudhir Kumar 2 hours later
Thank you for getting back.

In my practice, most people have been able to stop zolpidem. And they have not reported any withdrawal symptoms. Only symptom some people report on stopping is the lack of good sleep.

Regarding stopping zolpidem, I ask them to reduce the dose gradually and stop over 3-6 week period.

Best wishes,
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by
 
Follow-up: Takin zolpidem tartarate, alprax and larpose. Suggest some way to stop these medicine 12 hours later
Hi Doc,I am surprised by your answer.On one side you are saying Zolpidem is completely safe but when you withdraw you have sleep problems?To stop the drug,how to reduce the drug gradually?.This means say for 3weeks you take 5mg and then for next two weeks take 2.5 mg and then stop it?I am very much interested in stopping the medicine.Can you give me your telephone number so that I can talk to you.I can pay you separately.My name is XXXXXXX from Mumbai .One last question.What is the right time to take it in the night and should it be taken on an empty stomach?
 
 
Answered by Dr. Sudhir Kumar 2 hours later
Hi,
Thank you for getting back.

I am sorry if my answer confused you.
What I meant is that since zolpidem improves sleep, people will have sleep problem when they stop it. It is not the effect of zolpidem, but that is the underlying problem of the patient. This is similar to a patient of, say for ex- knee pain due to arthritis- his pain will be relieved with a pain killer such as ibuprofen is taken, but when he stops ibuprofen, his knee pain will return. Hope my point is clear to you now!

The tapering schedule of zolpidem you suggested is correct.

The best time to take it is at night, preferably after dinner at home. One should not take it when outdoors, as the effect may start very soon after taking it.
Regarding telephone consultation, please contact XXXXXXX

Best wishes,
Dr Sudhir Kumar MD (Medicine) DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Takin zolpidem tartarate, alprax and larpose. Suggest some way to stop these medicine 4 hours later
Hi Doc.Thanks.Does the sleep quality improve after a certain period after stopping Zolpidem?
 
 
Answered by Dr. Sudhir Kumar 8 minutes later
The sleep quality after stopping zolpidem depends on the underlying cause of sleep problem. However, in most cases, sleep quality does improve over time.

Best wishes,
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by
 
Follow-up: Takin zolpidem tartarate, alprax and larpose. Suggest some way to stop these medicine 38 hours later
Hi Doc,I am having weight loss problems and loss of appetite .Is it due to Zolpidem?What is the remedy.Now I am taking 7.5mg Zolpidem.Is it common to have such problems.Or is it possible that it is due to digestion problems.I ahve pain in the stomach(not heavy).Perhaps it is all psychological.
 
 
Answered by Dr. Sudhir Kumar 3 hours later
Hi,
Thank you for getting back.

Weight loss and loss of appetite are most likely not due to zolpidem. It may be psychological or related to digestion.

You could consult a physician or gastroenterologist for further evaluation, if symptoms persist.

Best wishes,
Dr Sudhir Kumar MD (Medicine) DM (Neurology)
Above answer was peer-reviewed by
 
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