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Is It Safe To Take Lozapine And Activan To Treat Sleeping Problem?

Posted on Tue, 24 Dec 2013

Question: I have sleeping problem. I take lozapine (25 mg)+ activan (2 mg) at the middle of the night as PRN. It gives me just enough sleep. But can I use it every night? Does it have side effects like constipation? I also tried Zopiclone (7.5 mg), but not as effective. I need a heavy one. Thanks for helping me to fix my lack of sleep issue. Best regards! XXXXX

Answered by Dr. Rakesh Madhyastha (2 hours later)

Brief Answer: Addictive properties Detailed Answer: Hello Thanks for the query The combination you are on is known to be addictive and you will end up not getting sleep without using it. In order to help you better I need a little more info from you 1. What do you think is the reason behind your lack of sleep? for example stress? irregular sleep habits, etx 2. Do you have a shift job ? 3. is the room you sleep in noisy ? 4. Do you smoke ? how often ? do you consume alcohol? how often ? 5. Please mention your coffee/ tea habits 6. how long have you been on medications for sleep? Please get back to me, I am awaiting your reply Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Rakesh Madhyastha (2 days later)

Dr. XXXXXXX Madhyastha: I don't have any of the conditions or bad habits you mentioned. I have been taking a lot of sleeping pills for ~2 years. Please check my profile, I included my medication list. Following Dr. XXXXXXX Reddy's suggestion, my family doctor added the Zopiclone (7.5 mg) to help my sleep. I took one in the middle of the night to make my sleep last longer. It costs me $1 for one, but I feel I still need more. Here are my questions: 1. Can I double Zopiclone to 15 mg a night? What's the maximum for this pill? 2. In order not to be addicted by one sleeping pill, is it better to alternate between two different kinds of pills, say one night on Zopiclone and another night on Lozapine + Activan? 3. What do you think would be the best for me? I am already taking a lot of sleeping pills, but their effects don't last long enough. Can I move some to the middle of the night? My doctor suggested to increase Clonazepam. I am taking 2mg, how far can I stretch it? It would solve my problem if you could help me to sleep 1 or 2 more hours. Please tell me what I should suggest to my doctors next time. Thanks! XXXXX

Answered by Dr. Rakesh Madhyastha (1 hour later)

Brief Answer: Insomnia Detailed Answer: Hello Thanks for the reply I understand your concern and I have gone through your treatment profile. Here are my suggestions to you 1. You cannot double the Zoplicone dose to 15mg, 7.5 mg is the maximum. Even if you do increase it will not be of help as you will start developing tolerance 2. What I usually do in my practice is I alternate sleeping pills once in 3-4 weeks, this prevents drug tolerance and the since the patient is off one drug for several weeks they tend to act better at lower doses. 3. I agree with your doctor, clonazepam is a good drug, long acting with lesser dependency profile. Do not take more than 2 mg as of now, we give up to 3mg. 4. Another good drug is Zolpidem. It is a good drug in induction and maintenance of sleep.It has helped a lot of my patients, you can also approach your doctor with my suggestion. It is not expensive as well. I also suggest 1. You exercise everyday for at least 30 min. Yoga is the perfect for you 2. Sometimes what we allopathy doctors cant solve alternate medicines like ayuveda and homeopathy have done very well with. There is no harm giving it a try 3. I always advice my patients to read a book in dim light just before going to bed, it is the best sleep inducer. I hope I was of help to you Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Rakesh Madhyastha (8 days later)

Dr XXXXXXX Madhyastha: Thanks for all you suggestions, I will present them to my family doctor and my psychiatrist. One more question: Every time I take Lozapine(25mg)+Activan(2mg) at the middle of the night to prolonge sleep, I feel terrific. If I could taken it every day, I will be fine. What are the side-effects apart from habit forming? I am hooked to a lot of sleeping pills already, so it's not a major concern. Is it bad for the liver, relatively speaking? I had to change medication because of liver dammage before. My friend is taking Lozapine(50mg) for sleeping, and he seems fine. How about me taking half of the dose? Best Regards! XXXXX

Answered by Dr. Rakesh Madhyastha (4 hours later)

Brief Answer: Not at these doses Detailed Answer: Hello Thanks for the query At the doses you are taking we dont see any complications, I havent seen any till now in my practice, but please check your liver function and renal function test every once in 6 to 8 months since you are already have a history of liver damage. Relatively speaking every drug we take is bad either for the liver or kidney because these are the two major excretory organs but the dosage of the drugs are adjusted so as to not cause any harm. I hope I was of help Regards

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Rakesh Madhyastha (2 days later)

I like your stradegy of alternating sleeping pills. I intend to alternate between Zopiclone and Zolpidem every month. The question is: They sound similar, are they the same family? Can I alternate between two pills of the same family? Best regards! XXXXX

Answered by Dr. Rakesh Madhyastha (6 hours later)

Brief Answer: Same family of drugs Detailed Answer: Hello Thanks for the reply, I am glad you are finding my suggestion useful Zopiclone and zolpidem belong to the same family of drugs called nonbenzodiazapine, they are used in the treatment of insomnia. You might not find it very useful to alternate between these two class of drugs. Please approach your doctor with a better alternative than these two drugs. For example between clonazepam and zolpidem. I hope i was of help regards

Above answer was peer-reviewed by : Dr. Prasad