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On chlordiazepoxide and naltrexone for alcohol detox. Safe to take tylenol pm to sleep?

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My brother is taking Chlordiazepoxide, and naltrexone for alcohol detox. Can he take a tylenol pm to sleep?
Posted Tue, 11 Dec 2012 in Smoking and Alcohol Addiction
Answered by Dr. Jonas Sundarakumar 33 minutes later
Hello and welcome to Healthcare Magic. Thanks for your query.

Tylenol PM is a combination medication containing acetaminophen (an analgesic) and diphenhydramine (an antihistamine, with sedative properties). I would advise you to double check the ingredients of the medication, because cetain other compositions of Tylenol (like Tylenol 3) contain codeine - which is an opioid medication. Naltrexone is an opiod antagonist and hence can cause a bad reaction if codeine or other opioid containing medication are taken concurrently. So, please be extra-careful in taking any over-the counter sleep formulas or cough medication, since many of them contain codeine.

Disturbed sleep is a common symptom of alcohol withdrawal, but it usually settles down in about 2 to 3 weeks. It is a better idea not to get used to taking additional non-prescription medication for sleep, since some of them can be habit-forming and can have withdrawal symptoms when attempting to stop them after a prolonged period. You can advise your brother to follow strict sleep hygiene techniques which will help him regularize his sleep pattern soon:
- Fix a specific bedtime and an awakening time. Do not allow bedtime and awakening time to drift.
- Avoid napping during the day.
- Avoid coffee, tea or any caffeinated drinks or alcohol 4 hours before bedtime.
- Avoid heavy, spicy, or sugary foods for dinner. Have a gap of at least 1 hour between dinner and bedtime.
- Exercise regularly, preferably in the early evening, at least 4 hours before bedtime.
- Set up a comfortable environment which is dark, quiet and disturbance-free. Block out all distracting noise, and eliminate as much light as possible.
- Reserve the bed for sleep only. Don't use the bed for studying, working or for other rectreational activities.
- Try a light snack before bed. Warm milk and foods high in the amino acid tryptophan, such as bananas, may help you to sleep.
- Practice relaxation techniques before bed. Relaxation techniques such as yoga, XXXXXXX breathing and others may help relieve anxiety and reduce muscle tension.
- Don't take your worries to bed. Leave your worries about studies, work, daily life, etc., behind when you go to bed. Some people find it useful to assign a "worry period" during the evening or late afternoon to deal with these issues.
- Establish a pre-sleep ritual. Pre-sleep rituals, such as a warm bath or a few minutes of reading, can help you sleep.

I hope this advise is both informative and beneficial to you.

Best wishes,
Dr. Jonas Sundarakumar
Consultant Psychiatrist
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