Brief Answer:
You can try medicines as below or Change duty

Detailed Answer:
Hi XXXXXXX

Thanks for wriritng to us.

I read your this question as well as question answered by Dr.Mazumdar before.

You are aware about circadian rhythm.It is a body clock. Sun rays enters in to retina of eyes and stimulates a hormone melatonin from pituitary and by this other hormone secretions are managed in body. When someone has frequent job shift changes like people working in airport, railway, electricity company etc have some problem to adjust it and difficulty in sleeping and secondary stress and fatigue because of unsatisfactory sleep.

Sleep Hygiene suggested by Dr.mazumdar is a good approach but it is not going to effective for sleep disturbance due to shift changes.

You can take medicine called Zolpidem 10 mg on first day after change in shift just before half an hour of going to sleep to induce sleep.This medicine will make you to sleep fast and you can wake up even after 3 hours if needed without sedation.No much side effects or dependence potential.You may have headache(2-3% chances).Second day you can take 5 mg and 3rd day 5 mg and not needed from 4th day.If not satisfied with 5 mg continue 10 mg for 3 days and then stop.
Restart in next shift cycle if you feel that there will be sleep disturbance in that shift cycle also.

If for one month you continue the same and feeling better,next month take medicine for 2 days in shift cycle.

Another medicine is agomelatine (25 mg) which you can take daily before 2 hours of starting to sleep according to shift.It is not sleeping pill but it tries to regulate circadian rhythm as it is an active metabolite of melatonin. If you feel better with it continue for at least 3 months.

With medicines continue sleep hygiene as before.
Note: One important thing I used to say my patient,"Drink a cup or half cup of warm milk with one spoon of GHEE or honey before 15 minutes to going to bed for sleep." It helps in 30-40% patients for sleep and they do not need medicines.

If above trial of medicines under psychiatrist's prescription done and by chance problem not solved, you can get medical certificate for unfit for shift work. And according to company's law you can get continuous one shift or you may need to change the job.

Hope I have answered your query, I will be happy to help further if any.

Regards,
Dr.Chintan Solanki.

---

Brief Answer:
You need to consult doctor physically

Detailed Answer:
Hello XXXXXXX

Thanks for follow up query.
Normally according to ethics and current laws you need to have physical prescription of the medicines as online medical prescription may not work. But if you can get medicines, its ok.

However ultimately if you need medical certificate by chance in future, personal physical consultation is must. So better to consult physician/ psychiatrist to start the treatment and if not able to succeed with treatment, same doctor can write certificate in future considering past records.

All the best for efforts , wish you early stability.Late me know progress if feasible.
Regards,
Dr.Chintan Solanki.

---

Brief Answer:
find below but certificate purpose doctor must

Detailed Answer:
Hello,

I can understand your concern. Even I am writing prescription below for you. But as I suggested before, by chance if you will be in need of medical certificate, physical examination and treatment under the same doctor is needed. No doctor generally consider treatment or prescription of other doctors for certificate purpose and particularly in cases where diagnosis is based on history of the patient.Now choice is yours.

If you can share your exact place , I may refer to someone for treatment.

It is not feasible to send attachement of prescreption on this forum. So I am writing below. Else you can fHello,

I can understand your concern. Even I am writing prescription below for you. But as I suggested before, by chance if you will be in need of medical certificate, physical examination and treatment under the same doctor is needed. No doctor generally consider treatment or prescription of other doctors for certificate purpose and particularly in cases where diagnosis is based on history of the patient.Now choice is yours.

If you can share your exact place , I may refer to someone for treatment.

It is not feasible to send attachement of prescription on this forum. So I am writing below. Else you can find my email address and send me email.

For Mr XXXXXXX
Rx,
T.Zolpidem 10 mg - 1 before sleep as instructed.
T.Agomelatine 25 mg- 1 daily before sleep.

10 tablets of each to be given to Mr. XXXXXXX

Regards
Dr.Chintan Solanki.

---

Brief Answer:
all the best, NIMHANS will be good choice

Detailed Answer:
Hello XXXXXXX

Hope you will find medicines helpful.In banglore National Institute of Mental Health and Neuroscience (NIMHANS) is there.It is apex institute in XXXXXXX You can consult there and if any certificate needed in future,it will be quite valid certificate.

Late me know your progress.

All the best.

Dr.Chintan Solanki.

---