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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Insomnia Be Managed While Switching From Naproxen To Tramadol For Arthritis Pain?

I ve been taking .25 Xanax to sleep for years. MY new primary care refuses to give it to me. She also will not write me my prescription Naproxen ER that I ve been taking for arthritis. She is allowing me 60 pills of .5 of the Xanax for one year. She will not wrote any more. So, I ve no choice but to wean off. I am trying to take an 1/8th, but i can t sleep with that dose. even on an 1/8th, the 60 won t last me for a year. She wrote me Tramadol for the pain to replace the Naproxen. I m confused. Isn t Tramadol bad too? She claims it s not bad for the stomach. I think I made a mistake chaning my primary care. All I want to do is sleep at night.
Tue, 25 Sep 2018
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General & Family Physician 's  Response
Hi there
I can understand that you are frustrated.
Lets start with the Naproxen vs the Tramadol. Naproxen is indeed not good for you stomach and can causes stomach ulcer if taken for too long. Tramadol is an effective pain treatment but the downside is that it can also be addictive.
Therefore you have to weigh up the risk vs benefit
Regarding the Xanax. People who have been on it for years have developed an dependency for it, and might possibly get withdrawal symptoms if the dose is lowered or the drug is stopped.
It is recommended that it be stopped at a very low rate to avoid withdrawal symptoms. If you reduce it gradually over months you should be able to wean of it sucsessfully.
There are other treatment available for insomnia that are not addictive/cause dependency. Amitryptiline works very well and is readily available. Maybe consult your doctor again regarding this.
It is also worthwhile to read up on sleep hygiene and to look if you can not implement some of the principles to help in insomnia
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How Can Insomnia Be Managed While Switching From Naproxen To Tramadol For Arthritis Pain?

Hi there I can understand that you are frustrated. Lets start with the Naproxen vs the Tramadol. Naproxen is indeed not good for you stomach and can causes stomach ulcer if taken for too long. Tramadol is an effective pain treatment but the downside is that it can also be addictive. Therefore you have to weigh up the risk vs benefit Regarding the Xanax. People who have been on it for years have developed an dependency for it, and might possibly get withdrawal symptoms if the dose is lowered or the drug is stopped. It is recommended that it be stopped at a very low rate to avoid withdrawal symptoms. If you reduce it gradually over months you should be able to wean of it sucsessfully. There are other treatment available for insomnia that are not addictive/cause dependency. Amitryptiline works very well and is readily available. Maybe consult your doctor again regarding this. It is also worthwhile to read up on sleep hygiene and to look if you can not implement some of the principles to help in insomnia