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Effects of NORSPAN on sleep. ENDEP, TEMAZEPAM.

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Not sure you can see my previous questions. I had been given 20mg Norspan last Monday and couldnt sleep, Saw my normal Dr on Friday who reduced it to 10mg and gave me Endone for breakthrough pain (I havent taken of this yet). I'm still having no sleep, causing me anxiety, stress and very emotional. I went to the Dr again today and he advised it's the 20mg patch in my system still, and in a couple days it should be gone. He said I could take 3 Endep (I normally take 1 1/2 tabs every night for anxiety which normally knocks me out in an hour) or I could take Temazepam 10mg-20mg to help me sleep.
What I want to know is do you suggest the 3 endep or the 1 (or 2) Temazepam. I'm concerned 3 endep wont do much since 2 hasnt been since I tried that the last 2 nights, and I've read online that 1 Temazepam doesnt do much either... after 7 nights of no sleep... I need to sleep. Can you suggest which option is best?


Category: Family Physician-GP

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Category: Sexually Transmitted Diseases(STD)Specialist
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Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Hello.
Thank you for your query at DoctorSpring.com
I remember your case since i was the doctor who replied to you.
I will advise you to take Temazepam, because even clinically it has good results and normally improves the patient's sleep cycle to a large extent. Once the Norspan clears up, your sleep will be normal again, but till then you can take Temazepam. One other good thing about temazepam is that it does not produce much tolerance compared to endep.
To have its full action, you need to give it 2-3 days time. I understand a week without sleep is distressing but any sedative for that matter, but it will take 2-3 doses for its full effect. Normally after consuming Temazepam, sleep will be induced immediately. Best results, that is a complete 7-8 hours of undisturbed sleep will be seen after 2-3 doses as i mentioned. So you take a dose and let me know if it is working for you.
Regards.


Patient replied :

Thanks. I took one tremazapan and have had 4 hours then 3 hours unbroken sleep. Mind feels clearer and not so scattered or anxious. Guessing tonight I take another 1 tremazapan?


Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

Hello.
I am glad that you finally got some sleep at least.
Yes you can take 1 more tonight. As i told you, within the next 2-3 days your sleep cycle will imporve gradually, and it will also reduce your anxiety levels.
Regards.


Patient replied :

Me again... yep still not sleeping. So tomorrow will be a week since I took the 20mg patch off and replaced with 10mg.
The last 2 nights I've taken 1 1/2 tablets of temazepam, as the first nigh i just took 1 and slep for a few hours and that was it. The next nigh i slept for 3 hours then was up every 1-2 hours. Tonight (it's 4.30am here) I went to sleep around 9pm when I felt the temazepam was starting to work. well I've been up every hour since. I moved to the lounge and have been dozing on and off for 10-20 minute sessions.
I'm feeling anxious, my heart rate is at 118bpm. I'm hot and cold, and I know it's because I'm anxious. I'm meant to work in 4 hours but with so little sleep I worry about my performance. o i sit here wondering whether to go in or not.
. Do you recommend going back to my GP now or trying tremazepam again tonight ...maybe 2 tablets? I'm aware of the risks of addiction to these so don't want to be reliant on them. Should i switch and try 3 endep tomorrow night instead?
Thanks


Expert:  Dr. Deepu Sebin Sebastian replied 2 Days.

Hello.
Thank you for the follow up.
Endep is actually a form of medicine which is used to treat a variety of causes such as tension headaches, reducing anxiety levels, and helping with the sleep cycles. I did not recommend it to you before since you mentioned that 2 did not work either. You can take 3 endep tonight. IT works very welll for most patients who actually complain of being drowsy the entire next day, hence be careful if you're about to drive or something.
I will also advise a psychiatrist follow up. Because he is the best judge of a combination of possible medicines that cn be given to you, which will help reducing your anxiety levels and also help you in your sleep cycle. If your HR is going up to 118 per minute, it definitely is causing a lot of stress to your body. Hence i believe you need a combination of drugs to help your case.
Hope this was helpful,
Regards.


Patient replied :

Thanks for that info...again tonight...not much sleep. I went to the pharmacy on my way home from work who gave me restavit and ensured me it would help me sleep. Took half a tablet as directed at 730 pm. By 10pm..awake. At midnight Itook the other half of the tablet...again. Couple hours and then nothing. Its now 5am. I'm wide awake, feeling hot and cold and also a big sense of insomnia. I feel alone and dont know what to do to fix it... seems ju relaxing doesn't work.
I know youprobably have no other advise and I will ring my GP to make another appointment to see him.

Do you have any further sgggestions?


Expert:  Dr. Deepu Sebin Sebastian replied 1 Day.

Hello.
Restavit won't be helpful in your case when Temazepam and endep has not been that useful.
Moreover it is used to treat very short lived episodes of insomnia and also the sleep induced by the drug is for a very short period.
I genuinely feel you can consult a psychiatrist, who can recommend you the correct dose after assessing your condition and put you on a combination of these medicines. Since single drug therapy has not been helpful.
You can also discuss the possibility of using Zopiclone/ Secobarbital, since the other drugs have not been helpful. They have been used to relieve chronic episodes of insomnia.
Regards.


Dr. Deepu Sebin Sebastian
Category: Sexually Transmitted Diseases(STD)Specialist
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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