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Suggest Treatment For Chronic Insomnia
Question: For the past 10 years I have had chronic insomnia. I cannot initially fall asleep. When I finally do, I sleep like a baby for 7/8 hours and mostly stress free. First Dr. prescribed Seroquel, which has terrible side effects; i.e. uncontrollable weight gain, high blood pressure & cholesterol, and restless leg syndrome. I have been on/off this drug for a long time, but do not want to take it. Have been taking some prescribed drugs in between the Seroquel, but nothing else works. My Dr. said there are similar meds and we can try them. Do you know what these meds might be, or do you have any suggestions. I do not want to depend on Seroquel but will take it once in a while to sleep. Sometimes I am awake for days. Really stressed/panic attacks, a mess.
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Brief Answer:
Alternative medication are available...
Detailed Answer:
Hello and welcome to Healthcare Magic. Thanks for your query.
I understand that you have been suffering from early insomnia (difficulty in initiating sleep) for a long time. Seroquel (Quetiapine) is an anti-psychotic medication which has sedative properties and if sometimes used in the short-term management of insomnia. Unfortunately, you have been experiencing multiple side effects of that medication.
Now, there are several other medication which can be used to treat insomnia. Benzodiazepines are one such group, but the problem with this group of medication is the high risk for dependence.
One good alternative, especially for initial / early insomnia is Zolpidem. This is very effective in people who have trouble falling alseep. It is a relatively safe medication and unlike benzodiazepines, there is no risk for dependence.
Low doses of certain antidepressants with sedative properties are also often used effectively in the management of insomnia. Trazadone is one such medication which is used in low doses (25 - 50 mg) for treating insomnia. Since you also mention that you suffer from anxiety-related symptoms also, another good option would be Mirtazapine - which is an antidepressant with both sedative and anti-anxiety properties.
So, I would suggest that you discuss about the above mentioned options with your doctor, so that an appropriate choice of medication can be made.
Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist
Alternative medication are available...
Detailed Answer:
Hello and welcome to Healthcare Magic. Thanks for your query.
I understand that you have been suffering from early insomnia (difficulty in initiating sleep) for a long time. Seroquel (Quetiapine) is an anti-psychotic medication which has sedative properties and if sometimes used in the short-term management of insomnia. Unfortunately, you have been experiencing multiple side effects of that medication.
Now, there are several other medication which can be used to treat insomnia. Benzodiazepines are one such group, but the problem with this group of medication is the high risk for dependence.
One good alternative, especially for initial / early insomnia is Zolpidem. This is very effective in people who have trouble falling alseep. It is a relatively safe medication and unlike benzodiazepines, there is no risk for dependence.
Low doses of certain antidepressants with sedative properties are also often used effectively in the management of insomnia. Trazadone is one such medication which is used in low doses (25 - 50 mg) for treating insomnia. Since you also mention that you suffer from anxiety-related symptoms also, another good option would be Mirtazapine - which is an antidepressant with both sedative and anti-anxiety properties.
So, I would suggest that you discuss about the above mentioned options with your doctor, so that an appropriate choice of medication can be made.
Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Dr. Sundarakumar:
Thank you so much for answering my question. I will talk to my Dr. about the 2 suggestions you have made. I have tried Trazedone. It is useless, does nothing. Have even tried in high doses, doesn't work at all on me. I will do some research on Zolpidem and Mirtazapine for side-effects. Or if you can help me with that as well, I would appreciate it. Perhaps I should wait for my Dr. to talk to me about that.
If you have time, would like answer re side-effects, but that is up to you. Perhaps I should wait for my Dr. to talk about that question.
Thank you for answering so promptly; however, I was finally able to get to sleep at 8:30 am Sunday USA ET zone. Slept 6 hours, but very anxious about tonights sleep.
Thanks very much,
Sincerely, XXXXXXX Cincotta
Thank you so much for answering my question. I will talk to my Dr. about the 2 suggestions you have made. I have tried Trazedone. It is useless, does nothing. Have even tried in high doses, doesn't work at all on me. I will do some research on Zolpidem and Mirtazapine for side-effects. Or if you can help me with that as well, I would appreciate it. Perhaps I should wait for my Dr. to talk to me about that.
If you have time, would like answer re side-effects, but that is up to you. Perhaps I should wait for my Dr. to talk about that question.
Thank you for answering so promptly; however, I was finally able to get to sleep at 8:30 am Sunday USA ET zone. Slept 6 hours, but very anxious about tonights sleep.
Thanks very much,
Sincerely, XXXXXXX Cincotta
Brief Answer:
Side effects explained...
Detailed Answer:
Dear Ms. Cincotta,
Regarding the side effects of the medication, Zolpidem is generally well tolerated and most people do not experience any significant side effects. Among the list of side effects, the relatively commonly reported ones are headache, drowsiness, light-headedness, fatigue, muscle aches, nightmares, etc. Rare ones include confusion, memory difficulties, hallucinations, etc.
With regards to Mirtazapine, it can sometimes cause increased appetite, weight gain, drowsiness, dizziness, weakness, gastric irritation, etc.
Usually, the side effects of both medication, if any, are mild and self-resolving. However, if you experience any serious or distressing side effects, then you should report them to your doctor immediately and get appropriate medical attention.
Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist
Side effects explained...
Detailed Answer:
Dear Ms. Cincotta,
Regarding the side effects of the medication, Zolpidem is generally well tolerated and most people do not experience any significant side effects. Among the list of side effects, the relatively commonly reported ones are headache, drowsiness, light-headedness, fatigue, muscle aches, nightmares, etc. Rare ones include confusion, memory difficulties, hallucinations, etc.
With regards to Mirtazapine, it can sometimes cause increased appetite, weight gain, drowsiness, dizziness, weakness, gastric irritation, etc.
Usually, the side effects of both medication, if any, are mild and self-resolving. However, if you experience any serious or distressing side effects, then you should report them to your doctor immediately and get appropriate medical attention.
Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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