Sleeping Meds

[Bunny]

Hi Everyone,
I just have a question about my Mom's meds (she has bipolar, and takes an Antipsychotic, Sleeping meds, and Adavan). She recently went off of AD's and it was really good for her. She was feeling good, lost some weight, and didn't really have any trouble. My Mom and her psych then decided to try and decrease the sleeping meds (I think he decreased them by 25%), and she basically stopped sleeping, and although she didn't tell me so explicitly, I think she may have self-medicated by upping her Adavan because the lack of sleep was making her anxious. I know my Mom stockpiles Adavan in case of "emergency"...

I was wondering if any of you have some ideas for coping mechanisms when trying to go off of sleeping meds? If you think the extra Adavan is a good idea? If there's maybe another way that helped any of you? The overall goal as I understand it, is to lessen the total amount of medication my Mom has to take.

Thanks in advance!
Bunny

[AJ]

Bunny what is the name of the sleeping pill, and if you know the strength (mg) and dosage (how much she takes) a night, that would be helpful in answering your question.

[paul m]

Hello Bunny. I agree with AJ. However I will say that once one becomes dependant on sleeping pills or other sleep aids it can be a real nightmare to quit taking them.

Usually it takes a long time and sometimes a substitute is needed in the short run. Take Care. paul m

[Woody]

One of two things could be happening. One the decrease in sleeping aid could be too fast and the other is that she might need to take that much to help her sleep. If the first one does not work, then the second might have to apply

[Bunny]

Nozinan

Hi everyone,
The medication is called nozinan, and she went from 250mg down to 150mg. She has stuck with it though, but she says that it takes her 2 hours to fall asleep now. (so if she takes the meds at 9 and goes to bed, she's asleep by 11). She didn't sound so great when I just spoke with her, but it's hard to pinpoint if that's to do with the meds because she has some physical pain right now.
Anyways, if you have any experience with decreasing nozinan, please let me know. thanks!
Bunny

[Woody]

250 to 150!
I take the same medication but under a different name. My Pdoc prescribes me Nozinan and the pharmacy give me Methoprazine with Methotrimeprazine in brackets. The same medication has three different name with more online.

Right now I am taking 10 mg (19h). I just increased it from 5 to 10 because I am having problems with my sleep.
I never change it more than 5mg at the time.
This is important though. I also take 500mg of Seroquel at bedtime (22h).
The Seroquel allow me to fall asleep and the Methoprazine keep me asleep for the rest of the night.
The most I have ever taken of Methoprazine is 25mg

What is the source of pain, sorry if you have said this before. I cannot remember.

[paul m]

Hello Bunny. Nozinan is not really a sleeping pill, but rather an anti-psychotic that is sometimes used as a sleep aid. As far as I know Nozinan is not addictive(although it does have side affects) and can be taken for a long time.

If your mother has been on it for a long time there may be a psychological factor that may come into play, rather than a physical addiction. While she is being weaned down this may cause some lack of sleep due to her being used to taking it rather than any addictive properties.

If your mother was taking ativan regularily to help sleep at night that could be the problem. Ativan will cause problems when suddenly withdrawn including difficulty getting to sleep. If that was the case then the issue of ativan dependance may have to be addressed.

The biggest question in my mind would be why the doc is withdrawing her Nozinan. There are pros and cons to every med including this one. But this one has no bigger cons than any other anti-psychotic. It's a question you might ask. That and about the ativan. Take Care. paul m

[Woody]

Sorry Bunny,

When you said 250 and 150 I was kind of set back. Until they got my cocktail right, I had chronic insomnia and I do not take that much. Goes to prove that we are all different and react to the medications differently.

I found some information for you that might help...

Adults
Oral:
Minor conditions in which Nozinan may be given in low doses as a tranquilizer, anxiolytic, analgesic or sedative: begin treatment with 6 to 25 mg/day in 3 divided doses at mealtimes. Increase the dosage until the optimum level has been reached. As a sedative, a single night time
dose of 10 to 25 mg is usually sufficient.

Severe conditions: Such as psychoses or intense pain in which Nozinan is employed at higher doses: Begin treatment with 50 to 75 mg/day divided into 2 or 3 daily doses; increase the dosage until the desired effect is obtained. In certain psychotics, doses may reach 1 g or more/day. If it is necessary to start therapy with higher doses, i.e., 100 to 200 mg/day, administer the drug in divided daily doses and keep the patient in bed for the first few days.

You can read the spec sheet here if you like. In the second paragraph under severe condition, you will notice that it says that it can be use for intense pain. Perhaps that is why she is more in pain now than before?

From the looks of things, your mothers use of this medication is different than mine.

As a rule of thumb, if you start on a medication and they increase you by lets say 5mg/week, to get off that medication you would decrease by 5mg/week. But that is just a rule of thumb and will very.

As Paul mention Ativan is habit forming while Nozinan is not. And if I was to choose between the two evils, Nozinan would be my first choice.

I would still talk to her doctor and maybe suggest a slower rate of reduction.

[Bunny]

Confusing Meds

Hi Woody and Paulm,
Thanks for the really great information. When she said it was Nozinan, I was confused, because in my research it had said it was an anti-psychotic... I guess it has a dual use. Thanks for clearing that up. I'm pretty sure she takes Seroquel as well, which in the past she has described as her anti-psychotic -- and I remember when I was asking her about her med decreases, she told me they weren't touching that one at all. So as far as I can tell, it's nozinan, seroquel, ativan, and I'm pretty sure it's effexor that she was taken off of completely (anti-depressants).

The physical pain is an unrelated issue; from taking care of my Grandma for many years (lifting, moving, etc.) my Mom has developed really awful carpel tunnel in both arms -- and she's having surgery in a couple of months on one arm, and once that's all healed up, the other one will be operated on.

When I was a teenager, I remember talking to her psych at one point, and it was a really awful experience for me, (hard to explain, but I left not really understanding a lot, and feeling really awful/angry about my Mom) so I've never really considered doing it again. But she has a new psych, who is more "new school" -- the old psych was with her for about 20 yrs -- and the new one apparently feels that she is overmedicated. So, maybe I will ask her if it's okay to see him, or maybe we can see him together, so I can start to understand these meds. I just don't want my Mom to feel like I'm interfering or imposing my own opinions on the way she takes her medication; she knows a lot more about them than I ever will I'm sure.

Thanks again for the advice

[Woody]

I do not like taking more medications that I have to also.
It is good to re-evaluate from time to time. Our bodies are in constant flux, especially as we get older.

When you talk to your mom about all this, how is she... does she seem comfortable?

[paul m]

Hello Bunny. Nozain, seroquel, ativan and effexor can either be a horrible mix or a god send. Our bodies are weird in the fact that everybody reacts differently.

I'm guessing that her old shrink was a heavy medications guy and that combo would keep me very tranquil, but not necessarily happy. I know some people who take very heavy doses of antipyschotics and it works for them though. So unfortunately you will just have to wait and see on her reductions, but I'm with Woody, it seems a bit fast.

In regards to talking to her shrink. Teenagers should never have to talk to a shrink about their parents problems. Even if you understood it all it must have been a terrible experience.

If you do talk to her new shrink and you do not understand something try and think of it this way. He is getting paid to work for you for that time frame. In fact he is you and your mothers employee for a short time. You are entitled to an explanation in plain english because that is the language you speak. More or less do not be afraid to ask lots of questions, it's your and your Mom's right. Take Care. paul m