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I have been taking Alprazolam since 5 years.I am unable to sleep without the medicine.Please help.

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Patient's Query

Hello doctor,

  • I am taking Alprazolam 3mg since 5 years.
  • I am also taking Carbamazepine 30mg since 3 years.
  • Now I am unable to sleep without the medicine.

Please help.
Answered by Dr. Nidhi Jain

Education:

MBBS

Professional Bio:

Dr. Nidhi Jain is a General Practitioner specializing in Psychiatry and Sexology with 13 years of clinical experience. She completed her MBBS at the Gajra Raja Medical College and DPM at the Central Institute of Psychiatry. She specializes in diagnosing, preventing, studying, and treating mental disorders and can determine whether their symptoms result from a physical illness, a combination of physical and mental ailments, or strictly mental issues. Currently, she is practicing in Bukharia Skin and Mind clinic, Indore, Madhya Pradesh, India.

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Hello,

Welcome to icliniq.com.

  • You have been taking such a high dose of tablet Alprazolam 3mg since 5 years (long duration) and now you are dependent on it.
  • My treatment plan is to shift you to tablet Valium, a long acting benzodiazepine (in place of Alprazolam) and then gradually taper off tablet Valium.
  • So, stop the tablet Alprazolam and start with tablet Valium (Diazepam) 20mg per day.
  • Decrease the dose by 2.5 mg in every 15 days, which means 20mg for 15 days, then 17.5mg for the next 15 days and then 15 mg for the following 15 days and so on. Continue this method till zero dose.
  • Continue tablet Carbamazepine as it is.
  • If you encounter problem with sleep in this regimen, the dosage has to be altered.

Consult a psychiatrist online for further follow up --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist

Patient's Query

Thank you doctor,

  • For how long can I take Carbamazepine? 
  • Is this dose enough for chronic psychosis?
Answered by Dr. Nidhi Jain

Education:

MBBS

Professional Bio:

Dr. Nidhi Jain is a General Practitioner specializing in Psychiatry and Sexology with 13 years of clinical experience. She completed her MBBS at the Gajra Raja Medical College and DPM at the Central Institute of Psychiatry. She specializes in diagnosing, preventing, studying, and treating mental disorders and can determine whether their symptoms result from a physical illness, a combination of physical and mental ailments, or strictly mental issues. Currently, she is practicing in Bukharia Skin and Mind clinic, Indore, Madhya Pradesh, India.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality

Hi,

Welcome to icliniq.com.

  • Tablet Carbamazepine is an antiepileptic as well as a mood stabilizer.
  • It is effective for mood disorders like mania, bipolar disorder and epilepsy.
  • For psychosis antipsychotics are effective and not mood stabilizers.
  • Even for mood disorders Carbamazepine 30mg dose is not sufficient.
  • It is effective in at least 10mg/kg body weight dose which means, a minimum of 600mg for 60kg body weight.

I can suggest if you should continue or stop Carbamazepine, after knowing your illness in detail. I would like to know the answers for the following:

  • For how long have you had the symptoms?
  • How severe are the symptoms?
  • How was the response to this medication?
  • Is there any family history of the same symptoms?
  • How are you now?
  • Do you have any mood fluctuation now?
  • For how long have you been symptom free?

Revert back with the answers to a psychiatrist online for further follow up --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist

Answered by Dr. Nidhi Jain
Medically reviewed by iCliniq medical review team
Published At May 24, 2015
Reviewed At September 18, 2024

Education:

MBBS

Professional Bio:

Dr. Nidhi Jain is a General Practitioner specializing in Psychiatry and Sexology with 13 years of clinical experience. She completed her MBBS at the Gajra Raja Medical College and DPM at the Central Institute of Psychiatry. She specializes in diagnosing, preventing, studying, and treating mental disorders and can determine whether their symptoms result from a physical illness, a combination of physical and mental ailments, or strictly mental issues. Currently, she is practicing in Bukharia Skin and Mind clinic, Indore, Madhya Pradesh, India.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality

Same symptoms don't mean you have the same problem. Consult a doctor now!

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Alprazolam and Carbamazepine Drug Interaction and Dependence Decision Helper

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Dr. Nidhi Jain
Dr. Nidhi Jain

Psychiatry

Consult this doctor

Education:

MBBS

Professional Bio:

Dr. Nidhi Jain is a General Practitioner specializing in Psychiatry and Sexology with 13 years of clinical experience. She completed her MBBS at the Gajra Raja Medical College and DPM at the Central Institute of Psychiatry. She specializes in diagnosing, preventing, studying, and treating mental disorders and can determine whether their symptoms result from a physical illness, a combination of physical and mental ailments, or strictly mental issues. Currently, she is practicing in Bukharia Skin and Mind clinic, Indore, Madhya Pradesh, India.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality
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