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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Effective And Safe Is Taking Surmontil For Insomnia ?

I have been on surmontil for 3 years now I am an insomniac and have tried a lot of meds which have had bad side affects. Surmontil has helped but still have really bad sleeps. I Also have half a zophiclone at night. About three months ago I took myself from 100mg of surmontil down to 50mg I did this very slowly and have had no side affects. I have just found out that surmontil has been stopped being made so I want to take myself off it completely. Would I start by taking one cap for two nights then miss a night then so miss one every third night then progress to one a night then miss a night. I have only 80 caps left. I would really love to get off the surmontil as I m sure they affect my memory and sick of taking meds. I would then just rely on my zophiclone for sleep I m hoping that will give me the sleep I need. I am 55 yrs and have had long term sleeping problems but try to keep my meds at a minamine thank you. For taking the time to read this.
Thu, 27 Oct 2016
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Neurologist 's  Response
Hello! Chronic insomnia, which i understand is in your case, can be difficult to treat in some cases. For the medical treatment tow types of drugs are usually used, short and intermediate acting benzodiazepines and sedating antidepressants. The mos frequent benzodiazepiens used for insomnia are Zolpidem, Zaleplon, Eszopiclone. The use of these drugs should have some precautious, they should be used the lowest effective dose, for a period 2 - 8 weeks, avoid nightly use, avoid using alcohol with these drugs. The antidepressants used more frequently in insomnia are amitriptyline, nortriptyline, mirtazapine, trazodone, doxepin. One group can't substitute the other. They in some cases for a short time can be used combined. So if you're not having any improvement from the use trimipramine, you can't use zopichlone as a substitute. I would suggest to use another antidepressant.
Regarding the stopping of trimipramine, as with all antidepressants, it should be slow and steady, the dose will decrease gradually allowing two to six weeks between dose reduction. I would highly suggest to consult your doctor and make the examinations and evaluations if there is something else underlying insomnia and eventually make a detaile plan of the treatment.
I hope i have been of help.
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How Effective And Safe Is Taking Surmontil For Insomnia ?

Hello! Chronic insomnia, which i understand is in your case, can be difficult to treat in some cases. For the medical treatment tow types of drugs are usually used, short and intermediate acting benzodiazepines and sedating antidepressants. The mos frequent benzodiazepiens used for insomnia are Zolpidem, Zaleplon, Eszopiclone. The use of these drugs should have some precautious, they should be used the lowest effective dose, for a period 2 - 8 weeks, avoid nightly use, avoid using alcohol with these drugs. The antidepressants used more frequently in insomnia are amitriptyline, nortriptyline, mirtazapine, trazodone, doxepin. One group can t substitute the other. They in some cases for a short time can be used combined. So if you re not having any improvement from the use trimipramine, you can t use zopichlone as a substitute. I would suggest to use another antidepressant. Regarding the stopping of trimipramine, as with all antidepressants, it should be slow and steady, the dose will decrease gradually allowing two to six weeks between dose reduction. I would highly suggest to consult your doctor and make the examinations and evaluations if there is something else underlying insomnia and eventually make a detaile plan of the treatment. I hope i have been of help.