gp

Hi Julie.  I had been taking zimovane sleeping tablets for many years. Now my gp decided i cant have them anymore. Apparently they have become a class c drug, you cant even buy them anymore from the states.  I was given one months supply and had to taper them off. After that she prescribed Mitarzapine which are supposed to help you sleep, but dont do a lot for me.  She just wasnt interested in how i am doing.  I went back because i was having side effects,eg; grogginess and restless legs, but she refused to give me anything else and has referred me to a sleep clinic. Meanwhile, i have to soldier on and try to get some sleep with the aid of antihistamines and Melatonin tablets.  So the answer to your question is `no, they dont care` and they dont understand about insomnia either.

Hi They are hay fever tablets, easily bought over the counter. Phenergan i have been trying.  Melatonin you cannot buy here. I send of to the states for them. I can give you the name of the company if you want. Its perfectly legal for them to import over here...

I was on both zopiclone and zolpidem. I'm in the states.  On line, i was searching for a doctor who will help you get off these medications and i found one near me who i went to. By the time i went to him, i had tapered off the zopiclone--not hard to do because i had PLENTY of zolpidem to take for sleep, what i got from my doctor along with what i bought overseas.  But then, i still needed to get off the zolpidem.  I went to this doctor, i think the specialty is called addiction medicine and my guy apparently works with a lot of people on Z drug sleep meds like us, and with people on  benzos.  He said the usual method is to swtch people from a short acting medication like the Z drugs to a long acting medication, usually diazapam.  He switched me to to Diazapam. I went from 27mg zolpidem to 10mg diazapam overnight, just like that, 20 years of taking zolpidem, off, just like that. The diazapam is stronger and different but it sure did make me sleep at that dose. Then, the proces is to wait until you stabilize on the diazapam and then start tapering off it.  I managed to taper down to 8mg but then i got stuck there. It's because of another health problem i have, somewhat serious, severe hypoglycemia,  not diabetic, some scary symptoms, today i'm seeing an endocrinologist and am expecting to get a diagnosis of insulinoma, which in most cases is benign and the hypoglycemia it causes is curable by surgery in those cases. My addiction doctor was pushing me to try another medication to help me keep tapering off the diazapam, but i told him because of the hypoglycemia, i was not wanting to change anything until i can get that sorted out and he said he agreed, so i am just staying on diazapam 8mg for now. I don't always sleep on that but usually. When i don't. sometimes i will take about 10mg of zolpidem--that's a lot less than i was taking before. My doctor doesn't want me to take it at all, but i am. Not every night, and way less than before, but i take it to get sleep. The hypoglycemia already causes pretty bad tiredness. That's why i'm wanting sleep. But once i get this condition cured, hopefully, then i will taper off the diazapam, i will go without sleep when needed in order to do that. I am coming to a couple of points here related to what you guys have commented about.  One of the medications my doctor wanted me to use to help taper off the diazapam is trazodone. I had looked into it and saw that sometimes it can cause cardiac arrhythmia. i got that from a different medication a long time ago and it finally cleared up and i dont' want to take a chance of that again, so i told him no on that. So then he started pressing me to try gabapentin.  That's when i told him i'm too confused and worried about the hypoglycemia (it has made me pass out) and i don't want to mix any more chemicals in. But you might look into these two medications, trazodone and gabapentin. He said they work for some people and that i could at least try it.  I asked what it's like going off it and he said it's easy to taper off of, easier than diazapam.  One other thing--i am actually inclined to go cold turkey off the diazapam when i'm ready, when i get my other thing straightened out, because i don't think of 8 mg as a very big dose, or maybe i would taper down to 7mg or 5mg, but then go cold turkey. i have a hard time with tapering--what bothers me is, when i taper, i don't sleep and yet i'm still putting the sleeping medication in my body--to me, that's the worst of both worlds. i would rather just get off the meds and not sleep and just ride out the process of adjusting to that, and i know that eventually, gradually, i will sleep better.  Most people i have discussed this with (on line, there are a lot of people struggling with trying to get off benzos and Z drugs) do not think cold turkey is a good idea and they are comfortable with tapering. I have never been comfortable with the idea of tapering. It's just the way people differ, what works for one person may be diferent than what works best for another. But i just want to say that my doctor shares the thinking of most medical professionals who have any expertise in this field and he is strongly against cold turkey. I have tried to talk with him about it and he won't even talk about it. He insists that i taper and would rather see me take other medications like trazodone or gabapentin than go off diazapam cold turkey.  Frankly, i will probably end up going off cold turkey after the hypoglycemia is cleared up. I did go cold turkey off of diazapam, 20 years ago, i was up to 30mg a night, though only for a couple of weeks or less, i  had been on about 15mg and then i got a tolerance for it and it didn't work at all, so i just stopped taking it. I had 4 days of withdrawal symptoms, mostly the worst was on two days and for me at least, it wasn't that bad, knowing it wold be over soon (pharmacicst told me average is two weeks but for me it was only 4 days for the worst of it). After the withdrawal symptoms that were neurological wore off, i still did not sleep normally for a long time. but it did gradually improve. i started taking it in the first place beceause  i couldn't sleep, so i can't say not sleeping was caused by stopping the diazapam. Anyway, back then, going off it cold turkey was not that bad and didn't last long, and i am on a lot less of it now.  But if i do go off it cold turkey, i think  my doctor will terminate our relationship, i think he feels that strongly about it. So compared to your doctors who are cutting you off suddenly, that is a big difference.  You might try asking your doctor for a referral to an addiction medicine specialist. What they do is work with your medications in order to taper you off. They may recommend you take another medication like mirtazapine but if you tell them it's not working. they will want to try other things.  I am not recommending any of these things to anyone else, just telling you my experience and how i feel about these things. I do not want to be on sleep meds every night and i want to get off them, and the way i think about it, i will continue to have zolpidem on hand for the occasional night when i have not been able to sleep for two or three nights very much and i will take zolpidem to help me have a good night's sleep.  But i have been addicted to these medications and i know what i would do different if i had it to do over again.  I am also interested in neurofeedback which is a specialized kind of  biofeedback that trains the brain to be conditioned to go to the state where it generates the kind of brain waves that transition you to sleep, the alpha waves, and other sleep related brain waves. i do want to try that.  It won't be paid for by insurance but it will be worth money i have to pay if it helps.  Julie, if you are going to a sleep clinic, ask them if they can give you a referral to a doctor who specializes in helping people get safely off of these kinds of meds.  The website where i found a long list of doctors who will do this, in countries all over the world, names submitted by patients and former patients, is at www dot benzodocs dot com  .  The referrals are mostly in the US but there are a couple in the UK, Australia, several in Canada. One in Poland. 

My daughter was on zolpidem, up to 20mg, last year, she'd been on it for a few years. She tapered off of it, slowly, over a couple of months.  She has used anti-histamines/allergy pills  to help with sleep since then.  The main one she uses is Benadryl, generic name diphenhydramine.  This works for her pretty well, she says, though not like regular sleep meds.  She wanted to give those up because she was trying to get pregnant, and also because she developed a tolerance for zolpidem and the writing was on the wall--the dose was just going to keep going up with less effect.  She tried tapering off fast at first and had a very bad time with it.  Personally, for me, i think tapering is harder than cold turkey, i am not alone, there are others who feel that way, but we are in the minority.  Once i get off the sleep meds, the diazapam, i will try pheneragan and benadryl and other things like that.  Melatonin scares me because it's a hormone, but that's just me. A lot of people take it, find it helpful with sleep and do not have any ill effects. There is now a prescription medication that has come out recently that is a synthetic melatonin.  I wish i could remember the name of it.  I might have it bookmarked somewhere.  it was in wikipedia.  i think it was designed to take whatever works in melatonin and make it stronger. 

I just found the prescription synthetic melatonin, it's been out for a while now, the generic name is Ramelteon.  The brand name at least in the US is Rozerem.  You can google it and read the wikipedia article.  The psychologist i have been seeing for help with sleep/meds has said that he has heard a number of patients say that this works pretty well for them.  

I am not recommending the following idea, just sharing it.  You might ask your doctor if she would substitute zolpidem for zopiclone.  It's the same kind of medication, but it's much shorter acting, the elimination half life is only 2-3 hours. It's not designed to keep you asleep, it's designed to just get you to sleep, and it does do that in my experience, but it wears off in a couple of hours or so, and then it's up to your natural ability to sleep if you continue to sleep after it wears off.  Unlike benzos, it only acts on the hypnotic brain transmitter, which is the one for sleep. Benzos act on that one and also 4 others, one for anxiety, one for seizures, i can't remember the other two right now, but zolpidem is a pretty simple short acting and in that sense mild medication which does put you to sleep. As i said before, it was zolpidem which i used to get through tapering off zopiclone. I cut one quarter pill at a time, and looking back, i now know it was easier to do than i thought it would be, because of the zolpidem, and i would've done it in a month instead of two months.  As far as i know, the new restrictions that have been placed on prescribing zopicloone haven't been placed on zolpidem. Again, i don't recommend it, i became addicted to it, but i think i am more addicted to sleep than i am to the medication.  In my case, i have just started seeing a therapist who is trained and has a certificate in cognitive behavior therapy (CBT) which has been helpful to a lot of people who have sleep issues.  I have used it on my own to deal with other issues and i know how it works, it gives you ways of contesting beliefs you have about things, beliefs that are distorted and which keep you from doing things you want to do, keep you stuck in patterns. i know that i have distorted beliefs about the need for sleep and how bad it is going to be if i don't, and other things.  So i'm going to try working with the new therapist to see if this can help me taper off the diazapam.  But first i need to clear up the hypoglycemia thing. 

Julie--for CBT, i asked my addiction doctor if he had any referrals for that and he emphatically said yes, and gave me this one.  He said she was "the best."   I hope you can get some support medically for this medical problem.  Regardless, i beleive you will get through it and you will be OK, but it is no way to go about it, to just cut a person off like that. It adds to the psychological and emotional anxiety and only makes it harder to sleep.  i know that mirtazapine is a common prescription to help patients with going off sleeping medications, and for that reason your doctor probably feels like her butt is covered because she has done the thing that doctors are supposed to do, but it doesn't sound like she is looking at you as a person who needs her help, as a unique individual. On this forum or the the different zopiclone discussions on these forumes, i've noticed some people have supportive doctors and some don't.  And maybe you can change to someone who is more flexible and will work with you instead of standing over you and treating you like a passive person with nothing worthwhile to contribute to decision making. But i also have gotten the impression that there has been new policy that's come out about zopiclone, because of some research findings about dangers connected with it, that it sounds like this has freaked doctors out, or maybe they have been given orders not to prescribe it.  i don't know.  it sounds like overseas pharmacies can't ship it to the UK anymore.  You might try getting zolpidem. If i had it to do over, i never would've started zopiclone, i would've just stayed with zolpidem (instead of combining them, thigns got more complicated and worse after that), whereas in retrospect, i can see that the zolpidem still got me to sleep, although the dose was almost three times the prescribed dose--the reason it got that high is because of how short acting zolpidem is  and so, i would go to sleep at bed time and then wake up a couple of hours later, first it was 4 hours, then it got shorter and shorter, so then, i got so i would always take a second dose around 4am and then i would get some more sleep.  That made it frustrating and confusing about how to start stopping it.  And then i got the addiction doctor. i had big misgivings about being switched onto diazapam. i had gone off it back in 1993 and was never going to take it again, and getting off it was a bit of an ordeal, and i knew that the Z drugs, especially zolpidem, were milder and less complicated and easier to get off. But thte addiction fo having that control over being able to go to sleep was the main problem i have had, psychologically, and that's why i went to the addiction doctor and ended up doing what he recommended. But i have mixed feeligns about it, because diazapam is very long acting, at 10mg it gave me such a hang over that i was far more tired than i would've been without sleep, and because it lasts so long in the body, it accumulates, the body doesn't get rid of it by the time you take more so it just accumulates, and i don't know how to estimate when it will all be out of me. So i don't know, in retrospect, i probably should've gone cold turkey off the zolpidem.  i don't think it would've been a very big deal. My GP doctor was prescribing the sleep meds and did not seem to have any worries about it, he asked me at different times if i wanted to stop the zopiclone (when i told him i thought it was making me groggy in the day time) but i told him i was going to taper off it and was working on that. So i felt like we were a team and we were collaborating and he respected me and stuff like that.  Not all doctors i've had have been that supportive. He's an osteopath, maybe that has something to do with it. But at one time, he was prescribing Zopiclone 7.5, zolpidem 10g and zolpidem extended release, and i was using all of that, plus i was buying more zolpidem 10mg from overseas.  All just for sleep.  I never had any withdrawal symptoms during the day, though some people do because they are so short acting, but that's why i have thought in my case at least, it would not have been that hard to just stop taking them. But i never got to that point. I now think that's because of the hypoglycemia.  

I think that doctors like to feel that they are implementing a plan to do the right thing, so if your doctor has switched you to mirtazapine (i read up on it when i considered it after hearing about it on these forums and i think it sounds scary, no way for that), she now thnks that no one can question her clinical judgement sicne she has done what is considered to be a reasonable substitution for the zopiclone.  Maybe if you tell her clearly and make sure she writes it down that the mirtazapine is not helping you sleep and is causing other side effects, and ask her if she will give you a referral to an addiction medcine specialist, she will consider that another reasonable plan to exerxise good clinical judgement in helping you to get off the zopiclone. If youc an get a referral, a specialist will have more flexible ways of working with you, hopefully.  Another idea might be to ask her if she can give you zolpidem to help you to get off the zopiclone, if there have been no policy changes on that one, she might be ok with it, but maybe not. There are research findings that zolpidem has some bad outcomes associated with it.