Managing Sleep Disorders: Medication Side Effects and Concerns

At night, when lying in bed with my eyes closed, I tend to think about various random things, which leads to insomnia?

Hello, Doctor.
I would like to ask Dr.
Zhong about the medications I received at the clinic.
I take my morning medication along with my antihypertensive medication.
In February, I switched to this medication, N-acetylcysteine 0.5 mg (Mecobalamin) "Shengda" Yulishupan tablets 0.25 mg, which I take before bedtime (previously, I was taking Lipeizhen tablets 0.5 mg).
In February, I switched to Jingdeke Xianping tablets 0.5 mg, along with calcium carbonate tablets 500 mg, and a self-paid supplement called Xinboning.

I have been taking insomnia medication for almost four years, and recently I have experienced drowsiness, dizziness, blurred vision, and memory decline.
I went to an ophthalmologist, and the doctor said my eyes are fine.
I mentioned these issues to the doctor at the insomnia clinic, and he said that the medications I was prescribed should not cause such symptoms.

I would like to ask Dr.
Zhong if it is okay for me to only take the bedtime medication.
Additionally, I would like to know if taking N-acetylcysteine 0.5 mg could be causing a tingling sensation in my head, as if blood is rushing out.
Recently, my heart rate has also slowed down, and my blood pressure has decreased, with diastolic pressure often between 60 and 70, and my heart rate ranging from a low of 53 to a high of 68.

I would like to know if these symptoms are related to the neurological medications I am currently taking.
Is it possible that only taking the bedtime medication is causing these symptoms? The tingling sensation in my head feels like blood is rushing out.
This seems to be a medication issue, as I did not have these symptoms before.

I initially went to the clinic because of insomnia.
Should I consider going to the hospital for these symptoms? My family hopes that I can consolidate my chronic illness medications and the medications I mentioned above at Chang Gung Memorial Hospital (most of the medications are from the clinic).

Cai Xiansheng, 30~39 year old female. Ask Date: 2016/05/15

Dr. Zhong Mingxun reply Psychiatry

If medication consolidation is possible, it is best to avoid drug interactions.
Generally, sedative-hypnotics do not have a significant impact on blood pressure, and only a very small number of individuals with specific sensitivities may experience such effects.
It may be beneficial to consult a patient and understanding psychiatrist to thoroughly discuss and share experiences, which may help identify a medication treatment that is suitable for your individual constitution.

Reply Date: 2016/05/15

More Info

Managing sleep disorders can be a complex issue, especially when medications are involved. Based on your description, it seems you are experiencing several concerning side effects, including drowsiness, dizziness, blurred vision, and memory issues, which you suspect may be related to the medications you are taking. Let's break down your situation and address your concerns.

Firstly, it is essential to understand that many medications prescribed for sleep disorders, such as the ones you mentioned (e.g., the sleep aids and the nerve medication), can have side effects that impact your daily functioning. Common side effects of sleep medications include drowsiness, dizziness, and cognitive impairments, which can manifest as memory issues or confusion. The fact that you have been on these medications for nearly four years may also contribute to the development of tolerance or dependence, which can complicate your sleep issues further.

Regarding your specific medications, the "拿保膠囊" (likely referring to a form of vitamin B12 or similar) and the other medications you mentioned, it is crucial to consider their interactions. Some medications can lower blood pressure or slow the heart rate, which might explain your symptoms of a slow heartbeat and low blood pressure readings. The sensations you describe, such as a tingling or "prickling" feeling in your head, could be related to changes in blood flow or nerve sensitivity, which can be influenced by your medications.

It is also worth noting that the combination of multiple medications, especially those affecting the central nervous system, can lead to compounded side effects. For instance, taking both a sedative and a medication for anxiety or depression can enhance drowsiness and impair cognitive function. If you are experiencing significant side effects, it is advisable to discuss these with your prescribing physician. They can evaluate whether your current medication regimen is appropriate or if adjustments are necessary.

As for your question about whether you can stop taking the sleep medications, it is crucial to consult with your doctor before making any changes. Abruptly stopping certain medications can lead to withdrawal symptoms or a rebound effect, where your sleep issues may worsen. A gradual tapering of the medication under medical supervision is often the safest approach.

Given your symptoms and the duration of your treatment, it may be beneficial to seek a second opinion or to have your medications reviewed by a specialist, such as a psychiatrist or a sleep medicine expert. They can provide a comprehensive evaluation of your sleep disorder and the medications you are taking, considering both your mental health and any underlying medical conditions.

In summary, your symptoms could indeed be related to your current medication regimen, and it is essential to address these concerns with your healthcare provider. They can help determine the best course of action, which may include adjusting your medications, exploring alternative treatments, or implementing lifestyle changes to improve your sleep quality. Additionally, if you feel that your current treatment is not adequately addressing your needs, seeking care at a hospital or a specialized clinic may provide you with more comprehensive support.

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