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    Suggest treatment for sleep disorder despite taking Quetiapine

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Posted on Wed, 25 May 2016 in Mental Health
Question: Sir I m taking 50mg Librium and quetiapine 150 mg plain for my cyclonic bipolar disorder. but still my sleep disorder is there. please guide me.
doctor
Answered by Dr. Chintan Solanki 9 minutes later
Brief Answer:
olanzapine or nitrazepam

Detailed Answer:
Hello,

Welcome back.


Either nitrazepam can be added as it is potent benzodiazpeine or olanzapine can be added as it is good anti bipolar drug with sedation.

Follow sleep hygiene also.

Hope this answer will help, I will be happy to help further.
Regards,
Dr.Chintan Solanki.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki 14 minutes later
Sir quetiapine SR can be added? I was on clonazepam 2 mg since 1998 so I may be tolerant to it but Sir 200mg plain quetiapine with 2 mg clonazepam give 6to7 hours sleep.but Sir I want to quit clonazepam groups' tranquillisers. so please Sir guide me accordingly. my self psychological test on Psych centre on Internet. ...6 for bipolar and 26 for depression out of 100. Except above disorder I m totally physically fit having no BP nor DIABETES.
doctor
Answered by Dr. Chintan Solanki 9 minutes later
Brief Answer:
quetiapine sr will not help

Detailed Answer:
Hi,

Thanks for follow up.

Clonazpeam, librium and nitrazepam are from the same group. If you want to quit benzodiazepine group, non benzodiazepine drug for sleep like zolpidem can be added.

Quetiapine sr will not help in sleep, rather you can increase plain quetiapine to 200 mg. Alternative is olanzapine.

Let me know your duration of sleep at present with timing of going for sleep, waking up and in between awakening.

Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki 24 minutes later
my duration of sleeping is 6 to 8 hours if I take clonazepam 2mg with 200mg quetiapine plain. Can nitrazepapam10mg or 5mg in addition or should I take Librium 5mg with quetiapine 200mg plain +nitrazepapam10mg or 5mg
doctor
Answered by Dr. Chintan Solanki 1 hour later
Brief Answer:
reduce clonazepam slowly

Detailed Answer:
Hello,

Thanks you for information.

Normal adult person in generla requires 6-8 hours of sleep per day.
With quetiapine 200 mg either of clonazepam, librium or nitrazepam can be used as they belong the same group of drugs with same mechanism of the action. Among them clonazepam is better from long term point of use. If you get good sleep of 6-8 hours with clonazepam, I think you should continue with 2 mg. Later on you can reduce 0.25 mg dose from clonazepam every 10 days and gradually stop it and can get sleep with 200 mg quetiapine only.

Hope this answer will help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki 1 hour later
Sir i have been taking clonazepam 2mg since 1998.so Sir should I continue it?
doctor
Answered by Dr. Chintan Solanki 1 hour later
Brief Answer:
I recommend continuing clonazepam

Detailed Answer:
Hello,

If I were your treating doctor I would surely continue clonazpeam with quetiapine. Later on (probably after 8-10 weeks) of course I would like to gradually reduce and stop it.

Hope this helps.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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