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What causes persistent sleeplessness at night despite taking medication?

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Posted on Tue, 24 Apr 2018
Question: SIR I HAVE BEEN TAKING CLONAZEPAM 2MG SINCE 1998.WITH OTHER DRUGS LIKE TRIKA ,PROTHEIDIN MIRTAZE QUTIAPIN SR RESPECTIVELY WITH NITROZEPAM REMITEX ZOLFIDEM AND GABAPIN 600MG SR TILL2013.IN 2013 MY PSYCHIATRIST PUT ME ON 2MG CLONAZEPAM +400MG QUETIAPIN PLAIN+600MG GABANEURON SR WITH 10MG ZOLFRESH TILL TODAY. THOUGH I M TAKING THIS DOSE MY SLEEP DISURBEDAT MIDNIGHT AND I HAVE TO TAKE ADDITIONAL 0.5MG CLONAZEPAM. SIR I HAVE BEEN TAKING CLONAZEPAM 2MG SINCE SINCE LAST 20 YEARS. I THINK THAT THE 2.5MG DOSE OF CLONAZEPAM IS HIGH DOSE. SIR I WANT TO BE OUT OF THIS NEXSES. WHAT SHOULD I DO? SHOUID I CONTINUE THE 2.5MG CLONAZEPAM OR WHAT IS OTHER THERAPY?SIR I HAVE BEEN TAKING CLONAZEPAM 2MG SLEEP HIGINE LIKE COW MILK WITH COW GHEE.SIR AM I SUFFERING FOR BIPOLAR OR BY INSOMNIA OR ANXIETY DISORDER?SIR PL. GUIDE ME.EARLIER I WAS PUT ON LITHIUM WHICH SET ME BUT IT BADLY AFFECTED MY THYROID PROFILE AND I HAD TO STOP LITHIUM.
doctor
Answered by Dr. Seikhoo Bishnoi (25 minutes later)
Brief Answer:
Zolpidem SR can be used.

Detailed Answer:
Hello thanks for asking

I can understand your concern. Your current therapy consists of Clonazepam 2+0.5 mg, Quetiapine 400 mg sustained release, Gabaneuron 600 mg and 10 mg Zolfresh.

Even with 2 mg of Clonazepam and other medicines your sleep is getting disturbed in night and there is awakening in midnight. You have tried improving sleep hygiene.

In that case considering your symptoms and history one thing that can be done is to take Zolpidem ER or SR tablet. The tablet is available in 12.5 mg SR form and this usually helps in sleep onset as well as maintenance. This will surely help to solve your problem. Once you are better then you can reduce the dose of SR tablet to 6.25 mg and then on SOS basis. Avoid increasing the dose of Clonazepam to 2.5 mg when you take SR Zolpidem. Take to your doctor for this.

Thanks and Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Seikhoo Bishnoi (13 hours later)
SIR I M TAKING 400MG QUTIAPN PLAIN NOT SR. I THINK GABANEURON 600MG MAINTAIN MY DAILY ACTIVITIES BY BETTERING MY CONCENTRATION AND AVOID FATIGUE AND NUMBNESS. SO SIR AS I M TAKING 400MG QUTIAPN PLAIN WHAT SHOULD MY DOSE? NOW I M TAKING ZOLFRESH. SHOULD THE ZOLFRESH BE SUBSTITUTED WITH ZOLFIDEM 12.5MG? PLEASE SIR EXPLAIN ME NOW WHAT SHOULD I DO?
doctor
Answered by Dr. Seikhoo Bishnoi (19 hours later)
Brief Answer:
Take 12.5 mg ER or SR form of Zolpidem.

Detailed Answer:
Hello again

If possible take Zolfresh or Zolpidem ER 12.5 mg tablet for sustained sleep. Continue to take Quetiapine plain and other drugs as per your prescription. The tablet will help in sound sleep.

Thanks
Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5181 Questions

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What causes persistent sleeplessness at night despite taking medication?

Brief Answer: Zolpidem SR can be used. Detailed Answer: Hello thanks for asking I can understand your concern. Your current therapy consists of Clonazepam 2+0.5 mg, Quetiapine 400 mg sustained release, Gabaneuron 600 mg and 10 mg Zolfresh. Even with 2 mg of Clonazepam and other medicines your sleep is getting disturbed in night and there is awakening in midnight. You have tried improving sleep hygiene. In that case considering your symptoms and history one thing that can be done is to take Zolpidem ER or SR tablet. The tablet is available in 12.5 mg SR form and this usually helps in sleep onset as well as maintenance. This will surely help to solve your problem. Once you are better then you can reduce the dose of SR tablet to 6.25 mg and then on SOS basis. Avoid increasing the dose of Clonazepam to 2.5 mg when you take SR Zolpidem. Take to your doctor for this. Thanks and Take care