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Q. I am unable to sleep even with a high dose of Zolcalm. Please help.

Answered by
Dr. Vishal Anilkumar Gandhi
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 10, 2020

Hello doctor,

I am 24 years old and diagnosed with generalized anxiety disorder, OCD, and IBS(digestive issues). Due to my exam stress and terrible insomnia, my psychiatrist prescribed my Etilaam, Sobrium, and Zolcalm. But due to prolonged use of Zolcalm, I have reached a point where even 20 mg is not enough to make me feel asleep. Then I approach for 5 or 10 mg more. Although my current prescription prescribes only Nexito and Petril 0.5, I cannot sleep without Zolcalm no matter what. I want to know ways to reduce this dosage to standard 5/10 mg and finally to let go of it. I cannot discuss it with my psychiatrist as I will be scolded for taking Zolfresh even though not prescribed. Sleeping at night has become a real challenge for me. I want to go back to times when half Zolfresh or mere Etilaam .5 will put me to sleep.

#

Hello,

Welcome to icliniq.com.

I can understand your situation. You must continue tablet Nexito and Petril. If you are taking tablet Zolfresh 20 mg then you must continue tablet zolfresh 15 mg for four weeks then take 10 mg for another foue weeks. Now you are stable on tablet zolfresh 10 mg. Then you should take 7.5 mg zolfresh for another four weeks then 5 mg for another four weeks. You must continue 5 mg for four weeks then take it an alternate day for another four weeks. Now you can take it as per required once a week. So basically you need to gradually taper off your medication.

You should also follow below lifestyle to deal with your problem. It will help you.

1. Do exercises daily for 30 - 45 minutes like at least going for a walk.

2. Do meditation for 20 minutes daily, just sit at one place in a comfortable position and try to concentrate on your normal breathing. Do not stop or force yourself to stop your thoughts, just let it be.

3. Eat healthy home-cooked foods, avoid junk foods.

4. Drink enough water.

5. Spend quality time with friends and family daily or do video calls if you are living away from your family.

6. Spend time on creative hobbies like reading good books, writing journals, painting, drawing, learning new skills or language or musical instruments.

7. Take enough 7 - 8 hours of sleep daily.

Fix your time for sleep, which means you must fix the time to sleep and awake. You must not do any other activities in bed. Do not just lie down on the bed without any reason, bed is just meant for sleep. Wear loose and comfortable clothes for sleep. Take light food at night or dinner at least three hours before sleep.

You can take a maximum of 20 minutes of nap a day. Do not use mobile or TV or laptop at least half an hour before sleep. Try to maintain the adequate temperature of your room, means not so cold not so hot. Have a proper bed and pillow. Make sure there is no noise or disturbance at night. You can drink warm milk with turmeric before sleep. Avoid tobacco or alcohol or any substance abuse. Be bold and confident.

I hope this helps.

Thank you doctor,

Can you send a prescription so that I can buy and follow your tablet regime?

#

Hello,

Welcome back to icliniq.com.

I am sorry to say that I cannot prescribe you medication. I can only suggest to you.


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