Question to general practitioner Maarten: Tied to sleeping pills to get a healthy night's sleep
Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand.
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Dear Martin,
Unfortunately, I am tied to sleeping pills to get a healthy night's sleep. In the more than 25 years that I lived in Spain, I was able to buy Stilnox 10 mg (zolpidem) sleeping tablets at the local pharmacy, which charged 30 euros for 4 pieces and were even reimbursed by my health insurance.
Now after more than 4 years Dimenine 50 mg. in Thailand, my body is now so used to it that I have a sleep pattern of:
Go to bed at 23.30:01 PM, wake up around 00:07 AM, walk around the house and watch TV until 00:09 AM and try to start the day around 00:XNUMX AM.
This of course does not work and so yesterday I fell back on Stilnox sleeping tablets that are only sold through hospitals. Cost,……. 70 euros!
My question, is there a good alternative to Stilnox here in Thailand that has a normal price.
Regards,
T.
*****
Dear T,
Unfortunately, I rarely know what the price of medicines is and I can't help with that. The tablet is probably much cheaper in a state hospital.
Deminime is actually a tablet for sea and motion sickness, which indeed induces sleep.
It is extremely annoying not being able to sleep without a sleeping tablet. We are talking about addiction here. It's easier to kick heroin than stilnox, or benzodiazepines, but it's worth trying.
One method is to take half a tablet less once a week and then slowly reduce it. That takes about 1 months.
In the meantime, you can try to learn a form of meditation where you stop your thoughts for a while. It doesn't have to be through a religion or sect. There are techniques for that. Many methods can be found on Google. Search under meditate, or meditate without religion. To be honest, I don't know very much about it.
If you don't want that, you can try a benzodiazepine such as Lorazepam, which is also addictive. Also only through a hospital.
CBD (Cannabis) oil also sometimes works. You can obtain this via a state hospital, or via 1 of these clinics: www.thaicbd.info/full-list-of-cbd-thc-oil-clinics-in-thailand/
This is probably also offered elsewhere, but then you have no certainty about quality.
Undoubtedly, the readers also have some tips.
Yours faithfully,
Dr. Maarten
give Codiphen a try. Available from pharmacies without a prescription. 10 tablets 100 Bt.
I'm not a doctor. But it is clear that you are addicted and have come to see medication as a savior to your problem, with all the consequences that entails. But here are my tips for solving this: - Obviously you have to get rid of those medications. Medicines are called drugs in the US for a reason. – So taper off slowly. Take one pill less every week until you reach zero. - Stop looking at TV, mobile phone and PC an hour before going to sleep. – If you are going to look at screens in the evening, use glasses that filter the blue light. That blue light signals to your body that it is day, while your body has to prepare for the night. – In any case, do not do activities that require a lot of your brain late at night. – Stop drinking caffeine. At Starbucks you can simply ask for decaffeinated cappuccinos. Most types of tea and chocolate also contain caffeine. – Do not drink energy drinks such as Red Bull or cola – Set the alarm at the same time every day and then take action immediately, for example 7:30 in the morning. – Do not take naps during the day. – Stop drinking alcohol. This also has a bad effect on your night's sleep. – Meditation is probably good before going to sleep to relax the body and mind. – Provide a clean and low-noise sleeping environment (use ear plugs if necessary). – Ensure a clean bed and good ventilation. – It is important to plan activities during the day (outside) that can make you tired. > Fatigue is the best pillow – Benjamin Franklin. Good luck with the withdrawal.
I was once prescribed Amitriptyline 25mg after the death of my wife, and I slept very well on it.
Buy this every now and then in Thailand, available without a prescription from most pharmacies.
Half a tablet is enough for yourself.
I have always benefited from antihistamines (including vivinox, related?), but the sleep was not really good. Still superficial, lots of dreams and a hangover well into the morning. Discovered phenibut a year ago. Freely available in webshops (at least in NL). Will be different for everyone, but for me a world opened up. For the first time in decades I know sleep as it should be: refreshing, no hangover and without continuous thoughts/dreams. Although also addictive (what isn't?), variety may help with withdrawal (although I do think meditation is the best way). Good luck.
Kratom no solution? Read that Thailand is finally lifting the ban.
However, the sale will be arranged. So now they want to earn money with it.
Probably a select wealthy company and the state.
https://www.nationthailand.com/news/30396122?utm_source=homepage&utm_medium=internal_referral
It is a tree whose many parts can be consumed, especially the leaves
Thailand has made a lot of efforts to remove this national tree. However, they are still there and are kept secret.
Got to read a story about a Thai who had this tree and protected it with open voltage wires to prevent wild picking. Well, it was over when a forager fell dead.
There are/were only 9 countries in the world where it was banned. If Thailand does indeed tack, then there are only 8 left. Thailand has banned it more because they could not make a profit and not so much because it is a drug. They labeled it as a drug.
However, it is sold worldwide, even Indonesia (Muslim country) sells kratom by the ton.
Dosage seems to be decisive, below 4 grams it would give a boost and above it a sleep intoxication.
No experience with it myself (yet), but can be googled.
No idea how fast Thailand will respond, because it was already a thought process last year.
However, according to the article, it seems to be through now.
In the state hospital I received a prescription (through various counters and the psychiatrist) but in the end I received alprazolam 0.5 mg
It cost so little that I paid for it myself. The service at the state hospital was superb. A woman approached me when I was looking around to find out who did what and where. She guided me through all the counters (a bit bureaucratic but efficient)
Thanks for the tip that cbd (also CBG and THC?) Can be obtained in Thailand that way. That surprises me a bit!
Tapering off with increasingly smaller doses is an option. But doctors also have to realize that a sleep disorder is a problem that needs to be investigated properly.
I went to Dr Smits hospital Ede and a specialist. I walked with electrodes on my head for two days to see if the melatoline production was normal. And that turned out to be the case. So taking melatonin is of no use…
I do not know if there are such centers in Thailand. I have not seen them..
And yes, most sleeping pills are just as bad as smoking..So..I don't use them for fun either..
The only solution is to go cold turkey. A difficult road, but well worth it. Could take a year or more.
good luck
John, excellent advice. Other drugs are of no use. The trick is to sleep without medication. This is sometimes very difficult and in exceptional circumstances impossible. For the latter case, there are sleeping pills.
Try drinking 1 tonic with lemon before going to sleep,
that will also work
I drink it myself sleep well.
I read this on Thaiblok
good luck Louis
There is an app "Insight timer" where many sleep meditations can be found. You have to do your best to find your way in it, but I know people who are very enthusiastic about it.
Dear people,
I have absorbed all the good advice and will certainly pay attention to it.
I have already tried the cold turkey advice in Spain, but after three weeks of not having enough sleep, my brain went into a sleep mode and I was no longer responsible for myself. The same effect occurred last week so that I drove against traffic on second road in Pattaya and no longer knew my debit card. So time for some medication!
Now half a Stilnox works fine and I'm going to try to skip this for once.
Once again my heartfelt thanks and I would like to try the CB oil.
Mvg, Theo (pseudonym)
As posted earlier, kratom is very suitable for a long night's sleep without proven harmful effects with normal use. The problem is that it's still not legal.
Another alternative is Sceletium tortuosum or kanna. http://southafrica.co.za/sceletium-tortuosum-traditional-mood-enhancer.html and also available in Thailand.
The name is Stilnoct and corresponds to Zolpidem and is 20 times as expensive as in the Netherlands - and sleeping pills have not been reimbursed by health insurance for many years.
What nonsense (Dr Maarten!) About that “addiction”: my GP always said: better sleep with a pill than lie awake without it.
Another advantage of Stilnoct is that, unlike other sleeping pills, you don't need more than 1 pill, and not more and more.
I usually bring Stilnoct from the Netherlands (or bring it with me, including pharmacist's statement in English), but due to Covid 19 I can't go back and forth - that also applies to others.
I have been using a combination of Codiphen (50 mg) and Desirel (50 mg) for several months, both available at my pharmacy without a prescription and/or reservation - very cheap (about 6 baht per pill) - and it works fine.
Good luck and don't worry about those people who call you 'addicted': sleeping is important.
Mvg Rene
Dear Rene, here in Thailand it is called Stilnox in Europe Stilnoct. Doesn't matter otherwise.
Going to sleep on an overly full stomach might also be good advice from a reader. I am completely back to my old self with half a Stilnox / Stilnoct and that is worth a lot to me.
Dear Rene,
Glad there's someone else like you who knows better.
Strange that I have always thought and read that Zolpidem is certainly as addictive as many benzodiazepines.
In addition, there are some serious psychiatric side effects, of which you, as an addiction expert, are of course aware.
I would therefore like to thank you very much for your contribution.
https://www.medscape.com/viewarticle/803495
Your doctor will be right that people sleep better with "a pill" than without. But I'd be surprised if he recommends this without follow-up or anything like take it up.
It is also typical of addicts that people always say that they are not addicted or cannot become addicted. Apparently you have been in that phase for some time.
Moreover, I think your reaction to Maarten is below par.