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Suggest treatment for sleep talking, sleep walking and nightmares

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Posted on Sat, 13 Dec 2014
Question: Hello Doctor, I am XXXX, 29 Year old IT employee, Completed B.E. I am suffering from somnambulism from childhood, self talking at sleep, sed anxiety and difficulty in communication, disturbed sleep , not get freshness after the awakening. H/O high sex desire since young age, More interested in masturbation, appetite normal,
Two Years before I consulted a doctor and they recommended medicine (Cap Prodep 20mg/Flunil) one at night , (Lonazep 1 mg /melzap -md/Lonaceen) one at night (Amival/amigold/solphitac 50mg) one at night , This medicine recommended for a six month, I did not recover after six month course, I am suffered by same after stopped the medicine , My sleep become very dangerous I was walking in at sleep, Bad dreams, some of the day I am started to cry at sleep, Some time I tried to jump from house in my sleep because of bad dreams, so I started to have a same medicine without consulting doctor,
I meet a doctor after one year He is recommended to have (Pari-CR Plus/Ponazed 12.5/Zaptra 12.5) one tap at night for one year.
I heared Zaptra 12.5 may affect spams count. I am married 6 month before, I stopped medicine because of marriage , My Wife is conceived she is 4 month perganent, Some time I am suffering by dreams, talking, Walking @ sleep.
I want to start the treatment (Pari-CR Plus/Ponazed 12.5/Zaptra 12.5) one tap at night for one year.
Please recommended the What may be the best treatment for this, I am suffering by bad dreams after stopping the medicine. I want to know the side effect of this treatment. I am having a plan of another child after two years. This treatment should not affect my next child plan.
Please share your thought on this treatment.
doctor
Answered by Dr. Seikhoo Bishnoi (2 hours later)
Brief Answer:
Paroxetine is good and safe

Detailed Answer:
Hello thanks for asking from HCM

Somnambulism, sleep taking result in disturbed sleep which causes anxiety, depression and day time drowsiness. Sleep talking and walking occur in NREM (type of sleep) sleep and cause significant distress to individual. Initially you were given Fluoxetine and recently prescribed Paroxetine and Clonazepam combination.

Depression itself cause reduced latency of REM sleep, vivid nightmares and other sleep disorders. Paroxetine is a SSRI medicine and result in improvement of sleep architecture (altered sleep rhythm may be a reason for nightmares) and improve the condition. Over all ther drug is safe and side effects like nausea, vomiting, dizziness, sedation, dry mouth, blurred vision, constipation (especially with Paroxetine) etc can be seen. The drug on long term use may cause delayed ejaculation and decreased orgasm. These side effects are reversible on stopping the drug. It don't cause reduced sperm count, so no need to fear for that.

You can go with this drug with consultation with your psychiatrist, there is no need to fear for that drug for any effect on childbirth.

Paroxetine and clonazepam will improve your sleep as well as depression and will improve the condition. Try yoga and light exercises in evening for better sleep. Acoid alcohol, tea, coffee in evening. Warm water bath in evening will also help.

If condition don't improve then drugs like Ramelteon can be used. The drug corrects abnormal sleep cycle and hence improve the condition.

Thanks, hope this helps you. Ask again for any uncleared doubts.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Seikhoo Bishnoi (10 hours later)
Thank you Doctor,
your answer is much more helpful to me, Thank you .
I have the another question, Is it this abnormal diseases (Sleeping disorder and high sex feelings) is curable? . Do I want to medicine for a life long?.

I am suffering from Sleeping disorder and high sex feelings from childhood.
Do we have another medical test to find the behavior of this diseases?
I like to know about the origin of this diseases, Mean It is started because of the stress or any other issue in body/brain.
Please let me know If I want to go through medical examination.

Thanks and Regards,
doctor
Answered by Dr. Seikhoo Bishnoi (1 hour later)
Brief Answer:
Yes its treatable

Detailed Answer:
Hello again

The disease is treatable provided proper medicines are given. Most of individuals respond to short term use of anti-depressants or low dose benzodiazepines. No need to take medicines for life long. Usually individuals respond in 8-12 weeks treatment though there is risk of relapse but over all no need for life long treatment.

Polysomnography can prove useful in your case but that investigation is not specific and depends upon observer interpretation. EEG (electro encephalography), EOC (electro oculography) and EMG (electro myography). Change in sleep pattern in NREM sleep are observed. The test requires complete study in sleep and it doesnt have any therapeutic advantage.

Detailed history and clinical examination is sufficient to make diagnosis.


Thanks, hope this helps you. You can ask again if you have more doubts.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Answered by
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Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5187 Questions

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Suggest treatment for sleep talking, sleep walking and nightmares

Brief Answer: Paroxetine is good and safe Detailed Answer: Hello thanks for asking from HCM Somnambulism, sleep taking result in disturbed sleep which causes anxiety, depression and day time drowsiness. Sleep talking and walking occur in NREM (type of sleep) sleep and cause significant distress to individual. Initially you were given Fluoxetine and recently prescribed Paroxetine and Clonazepam combination. Depression itself cause reduced latency of REM sleep, vivid nightmares and other sleep disorders. Paroxetine is a SSRI medicine and result in improvement of sleep architecture (altered sleep rhythm may be a reason for nightmares) and improve the condition. Over all ther drug is safe and side effects like nausea, vomiting, dizziness, sedation, dry mouth, blurred vision, constipation (especially with Paroxetine) etc can be seen. The drug on long term use may cause delayed ejaculation and decreased orgasm. These side effects are reversible on stopping the drug. It don't cause reduced sperm count, so no need to fear for that. You can go with this drug with consultation with your psychiatrist, there is no need to fear for that drug for any effect on childbirth. Paroxetine and clonazepam will improve your sleep as well as depression and will improve the condition. Try yoga and light exercises in evening for better sleep. Acoid alcohol, tea, coffee in evening. Warm water bath in evening will also help. If condition don't improve then drugs like Ramelteon can be used. The drug corrects abnormal sleep cycle and hence improve the condition. Thanks, hope this helps you. Ask again for any uncleared doubts.