Question: I am a 66 year-old male. I've had Night Terrors since age 10. I could not sleep normally - especially at night. I could not find treatment until the age of 25 I began at age 15. In 1977, My physician, at Presbyterian Hospital, in XXXXXXX TX. Prescribed me Ativan – that quickly - my 15 years of nightmares disappeared immediately! However, Ativan did not help me go to sleep. Finally, my doctor added another Benzodiazepine, Halcion. A drug that would become famously abused and misused by the public – but I always followed my doctor’s instruction – as prescribed, and never have had any issues for over 4 decades! I have been successfully taking this cocktail for over 41 years - until recently. My last of 5 prescribing physicians, since 1977, retired recently & now everyone freaks out I have taken this regiment 41 years, & fear to continue prescribing me. I’ve been cut off Halicon, but continued on Ativan – since no alternative has been found, first, for the Halicon. Only using Ativan – I sleep in 45 minute periods, and where I use to only be in bed 6 to 9 hours – now I am in bed for 15 hours a day & have had to quit making art – for lack of sleep – suffering mild to moderate, but well-defined Sleep-deprivation. I contacted Pfizer as to whether they had, or were conducting current studies over, "Long-term Use," of their Benzodiazepines. They haven't, and aren't expecting to anytime soon. All data published that I find say I should have quit Benzodiazepines 40 years ago, but I didn't, and they have been responsible for me living a, "Near-to-normal," Lifetime during which, in these past 25 years - I have experienced increased cognitive function - allowing me to make advancements in the area of Digital Art - specifically since after 2000. I am the exception to the rule it would seem - but no one will believe me - or try to help me. It seems I am now suffering ageism, where doctors just ignore my pleas and try to find replacement therapy. Anyone who would study me could determine for themselves I am not suffering cognitive dysfunction. If I am to continue my career as a Digital Artist, I must continue my 41-year-old regiment. I even offer to sign waivers to release my doctors of any responsibilities that might result from my continuing my course. I am not a, “Patient Seeking Medication from Doctors,” an Architype as currently defined since the, “Opioid Crisis.” We all know that not everyone can be fit into the same cookie-cutter - as most everyone else. Some people are just different - physiologically. Ask any Centurion what vices they have that should have taken their life decades earlier - some things just cannot be explained that fall outside conventional wisdom. I am in that quandary...

Dear Dr. Bishnoi,
Thank you for your reply. I have exhibited no signs of cognitive failure. I have tried Trazodone - to no effect. Other options I have tried to no effect were XXXXXXX Amitriptyline, and Hydroxzyine. I had negative, ill-side effects trying both Seroquel, and Chlorpromazine - which made me very ill for days - after taking one on the 1st night - to no effect I could tell - then two on the 2nd night, which - after 12+ hours created some sort of hangover that really disturbed my body, and changed my bedtime rhythm from 5:30 am to 8:30 am. This is the time I become most tired - thus allowing the Ativan the maximum opportunity to be effective. Without the Halcion - to put me to sleep... With Ativan - I may get 6 to 8 hours of steady sleep. Without the Halcion, I get two hours of sleep, then I'll dose off for near 40 minutes every hour for as long as I can go without either becoming unable to sleep, or beginning to have unsettled dreams. My unsettled dreams today - versus 41 years ago, are more sophisticated and eerie - where as a child, onto becoming a young adult - my nightmares back in the old days were more like 'horror movies' - where monsters would hunt me, and eat me alive. Nowadays, I'm more often confronted by devious people, with evil intentions. I am often gutted with a sword, or large blade - my guts spill out upon my feet, and I awake. It makes my next few early waking hours unsettled, as I go on and take care of my daily duties. I think that watching adult movies {not Porn}, in recent decades, fare with more sophistication, plots, and thought-provoking plots - have changed the landscape of all of my dreams - the good and the bad!...
I have not taken Mirtazapine, or low doses of Olanzapine or Risperidone. I will offer these as suggestions to my doctor when we next meet, on, or just before the 13th of Sept. - when my Ativan Prescription needs renewal... The drugs I mentioned above - were attempts by my PCP, and now, my Psychiatrist - to replace the Halcion. I suspect, if he [the Psychiatrist] can find a substitute for the Halcion - then he will likely try to replace the Ativan as well. I feel like my life has been stolen. My career was rising - I was getting interviews over my special work, and people were becoming more interested in involving my work in their venues, or their shows, publications, etc. However, I now, cannot work, since 6/30/18, and I seriously wonder if my career has be stolen from me - all was fine for 41 years - then my last doctor of 17 years, my age, decided to retire, and replacing him has been impossible. I am not even sure how much longer my current Psychiatrist will continue to offer me Ativan… I feel like the world has let me down... This all caught me totally off guard - I had no idea there was going to be an issue with my medication before there was a problem with my medications! So I'm older - they told my mother the same thing - & she stayed or her life's med regiment until her death of natural causes, at 84, in 2015. I was her Caregiver for her last 11 years. I cannot give up yet - my work is too important -and, I have spent 49 years developing it - hate to see all of my effort go to waste - I sacrificed so much for my career along the way - including not having children - so depressing for me now - there is no one who will care for me...
Sincerely, Brad XXXXXXX Moore
www.alphasight.com

Dr. Seikhoo Bishnoi,

Thank you for your time, and work. I will call my doctor today & make my next apt... I will write him a note over my recent observations, and give him a list of Meds to investigate - if he is not familiar with any of them in his practice - then we will see what the next step will be. I do feel, the last several days like I might be coming into a, 'new normal,' , I agree that an increase of Ativan might be a good path. Medicare says they can allow me up to 5 per 24 hours. I presently am taking 3 per 24 hours. I will close our discussion & do my review in the next 24 hours. Thank you, again, for your suggestions and insights - they have been helpful in helping me feel more confident that this issue can be resolved.
Sincerely, Brad XXXXXXX Moore