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Have chronic Insomnia. Taking Mirtazapine with no effect. Started Stilnox. Unable to sleep. Recommendations?

I have chronic insomnia . I have been using mirtazapine but it has not been effective yet. I also take Circadin. I have been using benzopdiazipines but my doctor recently prescribed Stilnox . The first night I slept well eanough after taking 12.5 mg. But last night I did not go to sleep at all, I took 12.5 mg about 9pm , then a further 12,5 during the night. I am feelign desperate. Please advise me. Michele
Asked On : Mon, 25 Mar 2013
Answers:  2 Views:  210
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Psychiatrist 's  Response
Dec 2014
Welcome to HCM

Insomnia occurs in individuals due to a number of causes like physical illness, stress, some mental illnesses, due to effect of some psychoactive drug or it may occur due to behavioral modification. You have been using mirtzapine but its not effective. Recently you have been started on Stilnox or Zolpidem long acting 12.5 mgs. As you have mentioned you slept for one day but next day you were not able to sleep and you took two medicines.
I would like to tell you that zolpidem is a drug that help to induce sleep, it is given for early insomnia. But in stilnox its long acting formulation is there and it help in sleeping as well as it also help to maintain sleep. Dose of 12.5 is sufficient and if you will take double the dose it will not help and it will increase the restlessness only.
The reason of insomnia in you may be poor sleep hygiene also.
Try to fix your time to go for sleep. Use bed only for sleeping, don't watch TV or read books from bed. Don't take tea/coffee or alcohol inn evening. Have light meals in night. Don't think again and again about not getting enough sleep as it will further increase stress and consequent insomnia. Do light exercises in evening.
If you don't get relief from these symptoms visit your Psychiatrist.

Dr. Seikhoo Bishnoi
Answered: Tue, 26 Mar 2013
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Psychiatrist Dr. Payman Hajiazim's  Response
hi Michelle, thanks for asking. People who have insomnia, should avoid poly pharmacy for their insomnia. It will lead to resistance to therapy. People who take melatonin every night will find problem since melatonin in a hormone which is regulatory. It means that it should be used in jet lag, shift work or people who have documented melatonin secretion problem. It is good that you take advantage of sleep hygiene point (just search it in the internet), relaxation methods, bed restriction (voiding staying too much in bed) and cognitive therapy. You can ask your doctor about these issues. Best wishes.
Answered: Tue, 26 Mar 2013
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