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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Sleeplessness Due To Unknown Fear

SIR
I AM 60 YEARS OLD RETIRED EMPLOYEE. WHEN I GO FOR SLEEPING ON BED I FEEL VERY FEAR AND I CAN N0T SLEEP AGAIN TRY TO SLEEP BUT I CANNOT SLEEP DUE TO FEAR. THIS ACTION CONTINUE TILL 2&3 AM. AS PER DOCTOR ADVICE I START FEESIUM TABLET 1/2 WAS STARTED. LATER ON TAB FREESIUM OUT OF STOCK IN COUNTRY SUBSTITUTE TAB WAS GIVEN ATIVAN1/2 MG. AND I START ATIVAN BUT AFTER SOME PERIOD THE DOSE WAS INCREASED.NOW AND A DAYS I TAKE 4 MG ATIVAN.I WANT TO LEAVE TRANQUILIZER AND NATURAL SLEEP WITHOUT FEAR.OTHER. A DOCTOR ADVISE QUESEL 50 MG.BUT NO BUT NO EFFECT ON MY BRAIN LATER ON I TAKE TAB.ATIVAN BUT NO EFFECT DUE TO THESE TABLETS MY ATOMIC ALSO DEFECTED. I AM LIVING IN A VILLAGE ON LONG DISTANCE.
PLEASE HELP ME IN THIS MATTER.
SHAMAS
PAKISTAN
EMAIL YYYY@YYYY
Mon, 8 Dec 2014
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Neurologist 's  Response
I read your query and I am sorry for your concern.

Freesium and Ativan are benzodiazepines which are drugs which are not recommended any more to treat sleepnessness because as you have seen they develop tolerance (need an always bigger dose to get effect) and dependence. I don't know what Quesel, many drugs have different names in different countries.
Since you seem to have anxiety issues I would suggest the use of an antidepressant with antianxiety effect, because effect is stable in time, a drug of SSRI group like Citalopram. You have to wait at least a couple of weeks for effect. Don't interrupt Attivan right away, continue it for 2 more weeks, then lower the dose gradually until you interrupt it.
If Citalopram alone doesn't seem to work, then you add also a non-benzodiazepine sedative like Zolpidem in the evening, which causes much less tolerance dependance and tolerance then benzodiazepines.
I understand that you live in a distant village, but they are all prescription drugs and a visit to your doctor is recommended.

I hope to have been of help
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Suggest Treatment For Sleeplessness Due To Unknown Fear

I read your query and I am sorry for your concern. Freesium and Ativan are benzodiazepines which are drugs which are not recommended any more to treat sleepnessness because as you have seen they develop tolerance (need an always bigger dose to get effect) and dependence. I don t know what Quesel, many drugs have different names in different countries. Since you seem to have anxiety issues I would suggest the use of an antidepressant with antianxiety effect, because effect is stable in time, a drug of SSRI group like Citalopram. You have to wait at least a couple of weeks for effect. Don t interrupt Attivan right away, continue it for 2 more weeks, then lower the dose gradually until you interrupt it. If Citalopram alone doesn t seem to work, then you add also a non-benzodiazepine sedative like Zolpidem in the evening, which causes much less tolerance dependance and tolerance then benzodiazepines. I understand that you live in a distant village, but they are all prescription drugs and a visit to your doctor is recommended. I hope to have been of help