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Suggest Treatment For Insomnia
Question: I took generic alprazolam .25 mg (occasionally .5mg) for sleep when I had sleep problems. Only for a month. Otherwise I am healthy. Some family tensions gave sleepless nights. I do yoga, pranayam, and 30 min on treadmill. Eat lots of fruits and take good supplements...B-compleax, multi vitamin, calcium and mag. . Generally people think I am health conscious, never went to Doctor in last 20 years. But without any knowledge I took alprazolam and slept well all the month. But I hear lot of stories about it that it gets addicted and what not. Now I want to stop it and switch to Aswagandha for sleep as one Ayurvedic Doctor suggested. One of my friends who is a Doctor (MD, Gynecologist, not a family practice medicine) suggested that I should slowly wean out of Alprazolam . So I should try alternate days alprazolam .25 mg and Benedryl (which makes sleep). After a week then I should try Ashwagandha in the night half a tea spoon in warm milk before sleep. What is u r suggestion?
Brief Answer:
His suggestion is valuable
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
As you have history of only one month it is likely that you are not addicted with Alprazolam. In your case it can be tapered down lowly. Alternate day strategy is not useful and you need to break the tablet to reduce dosage in progressive way. Continue breaking on every other day to minimum possible dose and later on discontinue it all together.
I do not think you will need sleep medicine if you can practice principles of sleep hygiene.
For the principles of sleep hygiene you are requested to follow following link-
https://www.icliniq.com/health-articles/health-topics/emotional-and-mental-health/how-to-sleep-better-tips-for-getting-a-good-nights-sleep
In case you are already following all these things than you can consider taking Melatonin or aswagandha which are natural remedies.
'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks
His suggestion is valuable
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
As you have history of only one month it is likely that you are not addicted with Alprazolam. In your case it can be tapered down lowly. Alternate day strategy is not useful and you need to break the tablet to reduce dosage in progressive way. Continue breaking on every other day to minimum possible dose and later on discontinue it all together.
I do not think you will need sleep medicine if you can practice principles of sleep hygiene.
For the principles of sleep hygiene you are requested to follow following link-
https://www.icliniq.com/health-articles/health-topics/emotional-and-mental-health/how-to-sleep-better-tips-for-getting-a-good-nights-sleep
In case you are already following all these things than you can consider taking Melatonin or aswagandha which are natural remedies.
'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks
Above answer was peer-reviewed by :
Dr. Raju A.T
In the beginning when I started having sleep problems I took melatonin even up to 10 mg by Natrol but it did not make any difference. I could not sleep. Then I tried Childrens allergy medicine (started with lowest dose, generic...like Benedryl) and started sleeping Then one day when I heard Alprazolam I got the lowest dose (.25mg) and took I sept like a baby. But now after a month on it people are telling me though I am sleeping well, my eyes look tired. My close friend who is a Ayurveda doctor suggested that I should switch to Half tea spoon Aswagandha in warm milk at bed time by not taking alprazolam. I am worried if this causes any withdrawal symptoms just switching like that and leo may to be able to sleep. Previously I never put medication unless some antibiotics for dental problems(wisdom teeth removed, doctor gave me anti biopics). That is why I asked, should I try first children’s medicine again (allergy...like benedryl) with adult dose of 50 mg and wean off slowly and start Aswagandha at bed time. Today just to introduce to my body I took One fourth tea spoon aswagandha in milk in the morning. Did not feel much difference. Once I take like this for a while then I felt it would be appropriate to switch to Aswahandha in the night. I hope aswagandha makes me sleep at that point. Am I right in my view? Please let me know. Thanks.
Brief Answer:
yes you are right
Detailed Answer:
Hello,
Thanks for reverting back to me.
Ayurvedic medicine like aswagandha is widely used for sleep problem and it can be used by you too. Only thing that need to be taken care of, its side effects with proper discussion with ayurvedic practitioner. I am of the opinion that anything taken beyond a certain limit have side effects and they should be closely watched for.
Same thing is applicable to benadryl like alprazolam. It has half life of 6-12 hours, means it remains in your body for this time duration leading to feeling drowsy in the next morning.
Having said this at this stage I like to assure you that what ever you are planning is in line of therapeutic principles but it is advised to seek consultation with your friend about dosage and duration of treatment.
'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks
yes you are right
Detailed Answer:
Hello,
Thanks for reverting back to me.
Ayurvedic medicine like aswagandha is widely used for sleep problem and it can be used by you too. Only thing that need to be taken care of, its side effects with proper discussion with ayurvedic practitioner. I am of the opinion that anything taken beyond a certain limit have side effects and they should be closely watched for.
Same thing is applicable to benadryl like alprazolam. It has half life of 6-12 hours, means it remains in your body for this time duration leading to feeling drowsy in the next morning.
Having said this at this stage I like to assure you that what ever you are planning is in line of therapeutic principles but it is advised to seek consultation with your friend about dosage and duration of treatment.
'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks
Above answer was peer-reviewed by :
Dr. Yogesh D
I did not take alprazolam .25 mg on Sunday night. I took only on Saturday night. I took n Sunday night 20ml antihistamine (that too children’s) and I could sleep only for 4 hours. Yesterday I took that same antihistamine (did not take alprazomal) but to my XXXXXXX I could not sleep at all. In the early hours I took another 20 ml, but still could not sleep. Today whole day I am feeling groggy and unsettling because of lack of sleep. I should not have done tow days in a row not taking alprazomal, I believe. However I was taking Ashwagandha since Sunday morning hours after breakfast with milk. First day, on Sunday whole day I felt good. In fact too good. Previous night took alprazomal .5mg and slept well, and morning this Ashwagandha....it was good feeling. Yesterday and today I took Ashwagandha, I wanted to sleep in the afternoon but sleep did not come. I felt sleepy but could not sleep. I guess in spite of the lowest dose I took for a month (.25mg) it looks like my body addicted to it. So withdrawal symptoms were rebound insomnia I guess. Please help me what I should do tonight? Should I take alprazomal or should I take Ashwagandha 2g powder? Or first take with meal Ashwagandha and if sleep does not come in two to three hours can I take alprazomal? Please help e and guide me. Your answer as u quirky as u give will be highly appreciated. Thank you. Namste.
Brief Answer:
You need to take alprazolam and reduce it slowly
Detailed Answer:
Dear XXXXXXX
Welcome back to Healthcaremagic.
First of all I feel sorry for not answering your query immediately as it was the sleeping time, at the time of posting this query in my part of world.
Now regard to your question I think you need the alprazolam more than anything else. It is not advisable to stop it all together as rebound insomnia is very common withdrawal side effect of it. Presence of rebound insomnia do not indicate addiction as it may occur even after single dose of alprazolam. This happens because alprazolam have half life of 8-15 hours. After around 20 hours or less there is excitation of particular neurons which leads to difficulty in onset of sleep.
Because of this reason, it is advised to reduce the dose slowly so the brain gets adapted to lower dose of alprazolam with time. What you have done, is just increase in the interval between the two dosage. It is not going to work as I already informed in last answer to decrease the dose rather than going for alternative day.
Regarding aswagandha you can follow as per instructions of your ayurvedic practitioner.
I hope this clarifies the situation.
"If you do not have any clarifications, you can close the discussion and rate the answer.
Wish you good health".
You need to take alprazolam and reduce it slowly
Detailed Answer:
Dear XXXXXXX
Welcome back to Healthcaremagic.
First of all I feel sorry for not answering your query immediately as it was the sleeping time, at the time of posting this query in my part of world.
Now regard to your question I think you need the alprazolam more than anything else. It is not advisable to stop it all together as rebound insomnia is very common withdrawal side effect of it. Presence of rebound insomnia do not indicate addiction as it may occur even after single dose of alprazolam. This happens because alprazolam have half life of 8-15 hours. After around 20 hours or less there is excitation of particular neurons which leads to difficulty in onset of sleep.
Because of this reason, it is advised to reduce the dose slowly so the brain gets adapted to lower dose of alprazolam with time. What you have done, is just increase in the interval between the two dosage. It is not going to work as I already informed in last answer to decrease the dose rather than going for alternative day.
Regarding aswagandha you can follow as per instructions of your ayurvedic practitioner.
I hope this clarifies the situation.
"If you do not have any clarifications, you can close the discussion and rate the answer.
Wish you good health".
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Thank u so much for your clear answer. I have read many reviews too that only slow and steady wins the race with Alprazomal. I did wrong thing.
I will do according to your instructions but it is already small tablet and small dose. How much low I can go per day?. Can u give me suggestions Please? How to taper slowly? How long do I have do it? It looks like a challenging task but I hope I can do it with u r guidance. As I told u I am otherwise healthy. No health issues.
I could not do my daily regimen of treadmill brisk walk for 30 min, and yoga last whole week because of poojas of Navarathri times. I will resume again. I take aloevera juice twice a day because my Ayurveda doctor thought that my vata dosha must have been aggravated in order to have sleep problems in the first place. So I am trying to calm down vata aggravation last whole month while I was on Alprazolam. I think my vata dosha is coming down I can feel. Though I am pitta dosha basically, but sleeplessness is only because of Vata aggravation.For any one who belongs to any dosha , it is it. So I never cared much of Alprazolam at that time, happily taking and sleeping without any issues. Now this challenge of coming down from .25 mg looks like is very difficult but not impossible I guess. So please guide me in this. How low can I go on a daily basis and how long I need to do? Thank you. Namste.
I will do according to your instructions but it is already small tablet and small dose. How much low I can go per day?. Can u give me suggestions Please? How to taper slowly? How long do I have do it? It looks like a challenging task but I hope I can do it with u r guidance. As I told u I am otherwise healthy. No health issues.
I could not do my daily regimen of treadmill brisk walk for 30 min, and yoga last whole week because of poojas of Navarathri times. I will resume again. I take aloevera juice twice a day because my Ayurveda doctor thought that my vata dosha must have been aggravated in order to have sleep problems in the first place. So I am trying to calm down vata aggravation last whole month while I was on Alprazolam. I think my vata dosha is coming down I can feel. Though I am pitta dosha basically, but sleeplessness is only because of Vata aggravation.For any one who belongs to any dosha , it is it. So I never cared much of Alprazolam at that time, happily taking and sleeping without any issues. Now this challenge of coming down from .25 mg looks like is very difficult but not impossible I guess. So please guide me in this. How low can I go on a daily basis and how long I need to do? Thank you. Namste.
Brief Answer:
Reduce 20% every week
Detailed Answer:
Dear XXXXXXX
Thanks for positive feedback and welcome again to HCM.
Basically the principle is 20% per week. You need to reduce about 20% of it every week.
To clarify it during first week 0.25 mg only. Strict no to 0.5 mg on any day.
Second week about 0.20 mg per night. This can be done just breaking part of it and throwing while the major portion to be taken.
Third week 0.15 mg per night. Break the 0.25 in two piece. Take the larger one and throw the smaller one.
Fourth week 0.10 mg. Break the 0.25 in two piece. Take the smaller one and throw the larger one.
Fifth week- 0.05 mg per night. Just half of smaller piece of 0.25 mg.
Sixth week- stop completely.
Having said this you need to take other things in consideration. The principles of sleep hygiene need to be followed strictly. Exercise should be carried ut as per plan. In nutshell about one hour of exercise per day.
I am not expert of Ayurveda and do not understand much about various dosha. I am sure your Ayurvedic doctor will be able to guide you thoroughly.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
Thanks and regards
Dr Ashok Kumar
Reduce 20% every week
Detailed Answer:
Dear XXXXXXX
Thanks for positive feedback and welcome again to HCM.
Basically the principle is 20% per week. You need to reduce about 20% of it every week.
To clarify it during first week 0.25 mg only. Strict no to 0.5 mg on any day.
Second week about 0.20 mg per night. This can be done just breaking part of it and throwing while the major portion to be taken.
Third week 0.15 mg per night. Break the 0.25 in two piece. Take the larger one and throw the smaller one.
Fourth week 0.10 mg. Break the 0.25 in two piece. Take the smaller one and throw the larger one.
Fifth week- 0.05 mg per night. Just half of smaller piece of 0.25 mg.
Sixth week- stop completely.
Having said this you need to take other things in consideration. The principles of sleep hygiene need to be followed strictly. Exercise should be carried ut as per plan. In nutshell about one hour of exercise per day.
I am not expert of Ayurveda and do not understand much about various dosha. I am sure your Ayurvedic doctor will be able to guide you thoroughly.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
Thanks and regards
Dr Ashok Kumar
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Thank u for your detailed analysis answer. I will do it. But fearing I will not get sleep yesterday night I took two tablets of .25mg. (meaning .5mg). And of course slept very well, knocked out feeling. I slept for 8 to 9 hours straight.
So first I will bring it down to .25mg then only I can do what you said. It may take longer period of time. Should I do from .5mg same way as you suggested for .25mg? Or take .25mg and half of .25 mg tonight? meaning, .25 + half of .25?
Please clarify. In the last whole month mainly I took .25 mg mostly only occasionally I took .5mg.
So first I will bring it down to .25mg then only I can do what you said. It may take longer period of time. Should I do from .5mg same way as you suggested for .25mg? Or take .25mg and half of .25 mg tonight? meaning, .25 + half of .25?
Please clarify. In the last whole month mainly I took .25 mg mostly only occasionally I took .5mg.
Brief Answer:
your day starts from the today
Detailed Answer:
Hello,
Welcome back to HCM.
I am aware of occasional 0.5 mg and that's the reason I started with 0.25 mg during the first week. During first week you need to avoid 0.5 mg at any cost. The success of first week will be determining factor for next four weeks.
As 0.5 mg was not regular, so there is no need to go at .37 mg or any other dosage. Your base dose during last one month was 0.25 mg and we need to decide as per the base dose not on basis of occasional high dosage.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
Thanks and regards
Dr Ashok Kumar
your day starts from the today
Detailed Answer:
Hello,
Welcome back to HCM.
I am aware of occasional 0.5 mg and that's the reason I started with 0.25 mg during the first week. During first week you need to avoid 0.5 mg at any cost. The success of first week will be determining factor for next four weeks.
As 0.5 mg was not regular, so there is no need to go at .37 mg or any other dosage. Your base dose during last one month was 0.25 mg and we need to decide as per the base dose not on basis of occasional high dosage.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
Thanks and regards
Dr Ashok Kumar
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you very much. You are a great help. I will do that. I will update it with you from time to time. How long I can do this with you? Please let me know. I only paid 15 dollars.
Best Regards.
Best Regards.
Brief Answer:
Thank you
Detailed Answer:
Brief Answer:
Thank you
Thank you
Detailed Answer:
Brief Answer:
Thank you
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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