Thanks for your query at DoctorSpring.com
I have gone through your question in detail and I can understand what you are going through.
It seems your insomnia is well controlled with imovane but unless you treat the underlying cause of insomnia, it will persist. You have mentioned that you have had PTSD and you will require treatment for PTSD. IT seems the anxiety symptoms are causing you sleep disturbances. Paroxetine is the most popular medicine and my drug of choice. I generally prescribe my patients 12.5 mg per day at night which takes care of anxiety symptoms. Also, certain medicines like propranolol and clonazepam can be given as required when there is a panic episode or expected situation where panic attack can appear.
Regarding the issue of shoulder pain, there has to be a cause behind this. If it has persisted since this long then it would be wise to get an MRI scan of the shoulder done. There could be a synovitis or a tendonitis or shoulder arthritis etc which will require some specific treatment. Unless you find the cause of the shoulder cramps, it will be difficult to treat it accordingly.
Meanwhile, painkillers like diclofenac and ibuprofen can help in reducing the pain. Also, physiotherapy exercises can help in making your shoulder free.
Hope this helps,
In case, if you have any further query, do let me know.
Dr. Srikanth Reddy
Patient replied :
Hello. Thank you for your very instructive reply.
I have now bought a series of Oxazepam, and I had in mind to replace the Zopiclone usage instead for this,
I was wondering if you believe it's safe to remove the 10 mg of zopiclone i use for 10 mg to Oxazepam and what dosage you would recommend and what time for this. (i could not get a hold of clonazepam -. but from what i understood this is very close and lighter version)
Please give your thoughts on this and I consider this case being excellently sorted out by you.
Thanks for the follow-up query.
Oxazepam is a good option. It is quite close to clonazepam and also shorter acting. It can be taken in the dose of 10mg at night for sleep and also occasionally during the day for anxiety. But as I said, it cannot cure the anxiety disorder and instead will just symptomatically cover it. You need to seek specialized treatment for anxiety disorder with the help of paroxetine or escitalopram or mirtazapine and if possible to combine these therapies with cognitive behavioural therapy.
Hope this helps you.
Dr. Srikanth Reddy MD