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Issues with medicine
Hello Doctors,
On divalproex sodium 500 bid and Qutiepiane 100 mg SR.Facing multiple cases of sleep awakening and getting up too early (4-4.30 am) .Pls guide what is to be done .Regards
Answers (8)
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Actually these two medications are known to cause sleep overall. But again it may alter the sleep architecture and quality. Please consult the Psychiatrist for further management in terms of optimization of medications, of required short course of new medication to bring sleep or sleep hygiene and other cognitive and behavioral measures for sleep disturbances.
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Try taking Divalproex 500 mg both tablets or one tablet 1 g between dinner. You may increase the dose of Quetiapine to 100 mg + 50 mg or 200 mg at around 9 to 10 pm. Quetiapine preferably sustained release
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Most side effects improve in 2–4 days after stopping
Some mild residual tiredness or disturbed sleep can linger up to 5–7 days
Full recovery is expected without any long-term effects
Next Steps
Drink 2.5–3 L of water daily; helps your liver and kidneys clear the drug.
You can start a vitamin B-complex
Health Tips
Persistent head heaviness or concentration problems beyond 5–7 days
Tremors, nausea, vomiting, or vision problems
Sleep disturbance lasting more than a week
then your psychiatrist should re-evaluate
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Your medications can be modified and changed according to your symptoms and history of your illness.
Kindly consult online for the same
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Focus on box breathing and 4-7-8 method of breathing.
Along with this go for confidence enhancing guided imagery before you sleep. This should help.
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Okay I can understand your concern
Along with medications you have to follow certain life style modifications
Medications -you can take 1000 mg divalproex at night
Clonazepam 0.25 mg SOS, 1-2 week when you had response with recently added divalproex, irritability and sleep will improve
Along with it follow sleep hygiene, you can read on the net regarding it
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Dr. Chitra Jain
Psychiatrist
6 yrs exp
Mumbai
Try taking all the tablets at night. Taking tablets close to bedtime will also help.
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