Question for GP Maarten: Sleep medication for sleep problems
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,
I have a question about my sleep medication. My name is P., I am 74 years old, I weigh 93 kg. I'm 1,90 m tall. I smoke moderately and drink a few beers once a week. My blood pressure is 1/111, my cholesterol is 63.
I've been a truck driver all my life. And much of that time was spent driving at night. My doctor at the time told me that I could suffer from this for a long time. And he was right. I used Dormicon during my working life and it worked well. Now this is no longer prescribed.
I have lived in Thailand for over 10 years now. My Thai doctor recently recommended a different medication to me. I have been taking them for almost a year now: Alpromazol 1 mg and Quetapine 25 mg. The latter medicine is mainly prescribed for people with psychosis and I am certainly not one of them. And I'm a little afraid that I'm going to suffer from that. I must say that I sleep well.
My question is whether there is an alternative to this combination of medications?
Thank you in advance for your response and advice.
Yours faithfully,
P.
******
Dear P,
It is indeed a difficult problem, but to immediately use quetiapine seems a bit overkill to me. It is important not to take afternoon naps for a longer period of time. Try to go to bed at the same time every day.
Oxazepam is a sleep aid and works for 8-12 hours. Alprazolam is more of a means of keeping calm. Start with Oxazepam 25 mg, possibly 50 mg 1 hour before you go to sleep. If it works, slowly reduce it by 5 mg per week after two months. If you feel that the starting dose is too high, take less. It won't be easy, but it is possible. Marijuana can also help sometimes.
There are also sleep laboratories, where you can learn to sleep.
Your blood pressure is a bit on the low side. Should be 10-15 cm higher.
Sincerely,
Dr. Maarten
Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information (see list at the top of the page).