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Dr. Andrew Rynne

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What causes excessive sleeping while on Ambien?

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Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 3222 Questions

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Posted on Tue, 20 Oct 2015 in Bones, Muscles and Joints
Question: I have had severe Neuropothy for 7 years in feet and hands. I have attended a pain center and after 2 years was prescribed 60 mg oxycontin 3 times daily and oxycodone 10-325 4 times daily as well as Methodone 10 mg 4 times daily. .
About 4 months ago while visiting my primary care for a annual physical, I am a male, I mentioned sleeping was an issue. My doctor cave me a prescription for Ambien 10 mg at bedtime. . After a month I had an incident where I fell and had some kind of reaction where I fell asleep for 2 days and lost 4 oxycontin and some oxycodone 10-325 about 8. I always hide some of my medicine as I am totally disabled and have workers in my apt from time to time. I called my pharmacy believing I needed a refill on my meds. I had never did this before in 7 years. I was not aware I was missing meds. I found my prescription was not due for 5 more days on a monthly refills. I called my pain dr. Who has been handling me for 7 months at that time and she saw me as a possible suicide potential and took me off all my meds and put me on bupre norphine patch. After 2 weeks with no withdrawal symptoms on my next visit told me to double the paycheck as it was not helping my pain. The next 2 months she put me back on meds that were oxycontin 1 3 times a day 10 mg and 4 oxycodone 10-325 4 times a day. After a month on next visit I told her it was not helping much. I thought maybe she should go yo 30 mg oxycontin 3 times a day. She prescribed me 20 mg 3 times a day. In last year my health pain increased drastically and I did not ask for any increase from my severe Neuropothy meds mentioned already. The pain was from Bone on bone Hip pain in need of total replacement in left hip. 9 months ago my right knee which was replaced 10 years ago slipped on ice and knee went out and needs total replacement of the partial I had previously had. Then 7 months ago I had 3 breaks in my foot which were treated with cast and top specialist for New England Patriots and my foot is repaired.
Here is last part. I moved my residence from second floor unit at beach because I could not walk up stairs any longer. I moved to a hotel for 2 months because my condo , which I own and was rented was on Forst floor and tenant could not vacate till this past week.
While at hotel my x wife had not heard from me for 3 days and called Police for a well check. When police came I was in a lot of pain as my meds still 1 20 mg oxycontin 3x daily and 4 oxycodone 10-325 4 times daily were not working well. I ended up in hospital because I didn't remember much and was judged overdose because pill bottles were empty because I had some hidden because of cleaning people coming in my unit and worry about loss. . The hospital took me off meds except 10 mg oxycontin 6 times or every 4 hours for pain. My bp was and still is in the range of 170-190 over 125-150 while in Hosp and when released I brought into my pain dr. Meds I had found of all but 2 days of balance of prescription, and I forgot to mention, that on my fall in May I had not run out of my meds but I was short 4 days of oxy done 10-325 and 3 days oxycontin 60 mg 3 times per day ( so 9 of those pills. )
I never took all my meds and showed my pain Doctor what i had which they destroyed as the cut my meds prior to hospitalization.
'Y pain doctor, who is still worried about me overdosing had not realized that I had been taking Ambien during both problem periods. When I was at hospital and my bottles were given back to me , my Nurse stated that with or without pain meds the Ambien could have caused my problems, which I never had in 7 years previously.
After the nurse mentioned this it dawned on me that I also had a strange event at my beach home where my girlfriend found me walking around the house at 5am naked, which shocked her.
I had been trying to make sense of why I had these issues in last 5 months when I had been on pain meds over 7 years with no problems. Now it made sense, the Ambien, which I have not taken since I was hospitalized in mid August. My pain doctor, who kept me as a patient, she is a PA not a doctor but reviews with a doctor. She now has me on first 2 weeks 1-2 mg Buprenorphine tablet sl 3 times daily, which did very little for pain and second 2 weeks which is at 3rd week total on this medication 2 tabs under young 3 times daily, which has not helped my pain at all since increased last week.

I go back there next week and don't know why these meds haven't helped me and what might work. Remember my initial pain issue wasn't cleared but I could live with it at 60 mg oxycontin 3 times daily and 4 10-325 oxycodone 4 times daily and had been taken off methadone a. I was at a level of what I described as 4-4 1/2 pain level but now I would call my level a 7. 1/2 - 8-1/2 pain level.
I am just asking why my current pain meds don't work and what might work for me when I go back.

I have been prescribed, Tens units, an operation where they put probes on my nerves at base or skull and run wires to stimulate my nerves, didn't work, morphine, phentenyl patch does not work, Lyrica, neuro tin and 3 other nerve pain meds did not work. My severe Neuropothy is not from diabetes. I have had 14 tests for different items that cause severe Neuropothy and they still don't know what's causing it.

I am just asking your opinion as to what might help me with pain relief that I could look into. Thank You, XXXXXXX XXXX
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Answered by Dr. Matt Wachsman 4 hours later
Brief Answer:
wow... where to begin....

Detailed Answer:
I'm beginning at the end.
Buprenorphine recommendations on raising the dose are as you describe.
but.
while the drug is potent in a milligram basis, it's overall maximum effect does not go up to the full amount that you were on. 60 mg oxycontin x 3 + 40 mg oxycodone four times a day ? that seems to be 180 + 160 or over 300 mg a day. That is quite a high dose. You cannot get to that level of narcotic effect with buprenorphine--not even 1/3rd of that level. over 100 mg a day is a concerning amount.
Nevertheless, buprenorphine generally is given at about 16 to 24 mg per day, so the final dose is going to be double to triple the amount you are on. 6 mg a day is not a sufficient dose to be able to judge whether buprenorphine is going to be a reasonable choice; 16 mg is.

Next. Neuropathic pain is generally treated with some drugs that effect nerves. These include and are not limited to antiepileptics (gabapentin), nerve blockers (pregabalin), lidocaine like drugs (lidocaine or amitryptiline) and spinal blockers (amitryptiline or actual spinal blockade or TENS). Then there can also be procedures that affect the nerves like surgery, and implanted tens units.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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