Kindly suggest a medicine for my sleep issue.

Hi,

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A number of issues need to be addressed here. Before we talk about medicines, it is important to give much attention to sleep hygiene as your medications. Regarding the medicines, Zolfresh (Zolpidem) is a medicine that has a short duration of action and starts working immediately. A key condition for Zolfresh to work well is that you lie down soon after you take it. In other words, you should take it no earlier than 5 to 10 minutes before your sleeping time. On the contrary, Mirtaz (Mirtazapine) acts after a time lag and has a relatively long duration of action. So, you need to take it a good two to three hours before your sleeping time. So, if all the above aspects have been taken care of, the next step would be to increase the dose of Mirtazapine. You are currently on the least available dose of Mirtazapine. You can try increasing it to 15 or 30. Remember that the maximum dose of Mirtaz is 60 mg per day. Consult your specialist doctor, discuss with him or her and get the dose altered. Your daytime sleepiness may be related to two things inadequate sleep at night, and continuing effects of Mirtazapine into the day. Since you are having problems with sleeping at night, I would assume that predominantly it is the scenario one. I would suggest you stop Armod (Armodafinil) 150 for the time being and get your sleep back on track with these measures. Pay special attention to the sleep hygiene points. You will also need to get a serum TSH and hemogram done. As far as erectile difficulties are concerned, with the above measures some improvement is expected because psychological well being is closely related to erectile function. Once the sleep and depression issues are sorted out and the erectile problem still persists, then we can look into it. Thank you.