Q. I am a 53-year-old male. Early this year, I suffered from respiratory arrest and stoppage of heart beat during an episode of Status Asthamaticus. Due to prolonged deprivation of oxygen, the CT scan of the brain indicated hypodensities in bilatral basal ganglia and posterior internal capsule infarct, and patchy hypodensities in frontal white matter. Now I am having a problem in sleeping. Immediately after getting discharged from the hospital, I was able to sleep well. However, on the third night, there was a flush in my head, and I woke up not to sleep again. I had sweating as soon I woke up. I was given Placida. It did not work. Then I was given Ativan, which worked for two weeks. This was replaced with another medicine, which worked for another three weeks. In between I was given Fulnite, which did not work at all. I developed a burning sensation on my hands when I slept or sat. I was asked to take Feeliz S plus, but this also did not put me to sleep. Now I am on Nitrosun 10 mg for more than a month. I feel groggy all through the day. So, the doctor has reduced the dose to Nitrosun 5 mg. I am not able to get a sound sleep of 7-8 hours. I get sleep from 11:00 p.m. to 5:00 a.m., whereas earlier I used to sleep up to 7:00 a.m. Am I on right medication?
If the oxygen supply to brain is impaired for any significant length of time, it leads to infarction and signs and symptoms are just like those of stroke. In such cases, sleep disturbances are not uncommon.
Ativan (lorazepam) is actually an agent to reduce anxiety and thus help patients sleep. When used over prolonged periods, patients become resistant to its action.
I cannot find Placida on the national and international data bank of quality products. There is a brand called Placid, but it contains an anti-cancer drug called etoposide, which has no relevance in your case. I hope it was not given to you since it has a huge number of side effects. Fulnite also does not appear on the list of quality brands. Please see general note on selection of brands.
Feeliz S is the brand name of an anti-psychotic medicine called escitalopram. It is indicated in the treatment of major depression and panic disorders. Its side effects include worsening of depression, suicidal tendency, nausea, sweating, dizziness, gastro-intestinal upset, fatigue and yawning. It also leads to severe agitation-type events including agitation, disinhibition, emotional lability, hostility, aggression and depersonalisation.
Nitrosun is the brand name of a medicine called nitrazepam. It can adversely affect alertness, precipitate nervous system disturbances and ataxia (difficulty in walking) apart from drowsiness and dizziness. It should not be used for more than seven days since it can cause dependence and addiction and lead to withdrawal symptoms on discontinuation. Other side effects include memory loss and drop in blood pressure. Great caution should be exercised while prescribing it to patients of respiratory disorders, particularly in elderly patients.
In general, sound sleep for 6-8 hours is adequate. Instead of taking medicines with all their side effects, non-drug methods such as Yoga are preferable.
General statement on selection of brands: There are scores, sometimes hundreds, of brands of the same medicine. Against about 300 pharmaceutical manufacturers in western countries like Britain, there are over 20,000 producers in India that market more than 40,000 brands. Most manufacturers do not have quality testing laboratories. Hence, the selection of brands is important. Many companies give incentives to prescribers to patronise their products. Patients should check the reputation of manufacturers before consuming medicines.