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Doctor insights on: Xyrem Cataplexy

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Sleep apnea provent?

Sleep apnea provent?

Provent: It's effective for certain situations but typically reserved when pap therapy and/or oral appliance therapy have failed. ...Read more

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Dr. Sewa Legha
52 doctors shared insights

Cataplexy (Definition)

The syndrome of narcolepsy, which causes daytime sleep attacks, may be associated with episodes of complete temporary loss of muscular tone, associated with intense emotions, such as crying or laughing. The pt may collapse to the ground, but does not go unconscious. This seems to be a ...Read more


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Trazodone (desyrel) is a sleep aid?

Trazodone (desyrel) is a sleep aid?

Technically not: But it is often used off label for sleep and works very well in many patients for sleep. It is fda approved as an antidepressant. ...Read more

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Is nuvigil effective for idiopathic hypersomnia?

Yes: Nuvigil is a central nervous system stimulant and can be effective for hypersomnia (sleepiness) of any origin including idiopathic hypersomnia. The response to Nuvigil is different in different individuals. ...Read more

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Will Suboxone worsen sleep apnea!

Will Suboxone worsen sleep apnea!

Yes: Suboxone , Buprenorphine plus Naltrexone , stimulate my receptors and can lead to respiratory depression, as such it can worsen sleep apnea. In combination with Xanax (alprazolam) and similar drugs, deaths have been reported. ...Read more

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Does provigil work for excessive daytime sleepiness?

Yes: Yes. It is an fda approved drug for eds (excessive daytime sleepiness). But i would try to determine why there is eds in the first place. A sleep study is a good start as well as an veal by a sleep specialist. ...Read more

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Does trazodone not work for geodon (ziprasidone) withdrawal insomnia?

Does trazodone not work for geodon (ziprasidone) withdrawal insomnia?

I have used it: Successfully for this, but if you have restless legs or periodic limb movements of sleep it may actually worsen rather than improve the situation. Trazodone dose also has to be high enough to correct the insomnia, somewhere between 50-200 mg at bedtime or more. Best wishes. ...Read more

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How is narcolepsy and REM sleep related?

How is narcolepsy and REM sleep related?

Closely: The symptoms of narcolepsy are those of parts of rem sleep intruding into wakefulness. These elements include sleepiness; hallucinations (dream imagery) while falling asleep or waking up; and cataplexy and sleep paralysis (both from the normal muscle paralysis that occurs during rem sleep). ...Read more

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Bipolar 2 disorder. Extreme anxiety bad sleep cycles. On wellbutrin, topamax, abilify, (aripiprazole) clozazepam , temazepam , zopliclone ? What now?

Bipolar 2 disorder. Extreme anxiety bad sleep cycles. On wellbutrin, topamax, abilify, (aripiprazole) clozazepam , temazepam , zopliclone ? What now?

Options: There are other options for your bipolar 2 condition. Wellbutrin won't help anxiety, and may stimulate it in some. Topomax is not a particularly robust mood stabilizer, but does work for some (apparently not you?). Seroquel may help this, anxiety, and your sleep issues. Latuda (lurasidone) is another option. Hoping you're working with a psychiatrist as you try these various medications -- psychotherapy too! ...Read more

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Is clozapine (clozaril) benzodiazepine?

Is clozapine (clozaril)  benzodiazepine?

Dibenzodiazepine: Clozaril/clozapine is not a benzodiazepine like lorazepam/ativan or alprazolam/xanax. Its chemical structure is a dibenzodiazepine and it is a 2nd generation antipsychotic. ...Read more

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Is Xanax (alprazolam) effective at treating sleep apnea?

Is Xanax (alprazolam) effective at treating sleep apnea?

Benzodiazepines as a: Trratment for sleep apnea are contraindicated because they all, including xanax, (alprazolam) tend to depress our respiratory centers and can be even more depressing and even dangerous in sleep apnea. There are other medications that a physician can use to help sleep problems safely. Over the counter sleep aids when one is on prescription meds should be discussed with the prescribing physician or practitioner. ...Read more

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Can sleep apnea induce seizures in a non epileptic patient?

Can sleep apnea induce seizures in a non epileptic patient?

Unlikely: Highly unlikely but in a patient with known seizure activity.. Sleep apnea can make the seizure activity worse. ...Read more

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Is provigil [modafinil] associated with depression?

Is provigil [modafinil] associated with depression?

Provigil: It is a stimulant associated more with anxiety & jitteriness instead of depression. It is however possible to experience some depression when Provigil is coming out of your system by the end of the day, although mild. ...Read more

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Klonopin (clonazepam) and trazodone for sleep safe?

Klonopin (clonazepam) and trazodone for sleep safe?

Yes: It is a safe combination. I can think of a number of clinical scenarios where this would be very appropriate and I have quite a few patients on this combination. ...Read more

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Does Effexor (venlafaxine) effect REM sleep?

Does Effexor (venlafaxine) effect REM sleep?

Yes: All the ssri antidepressants have an impact on rem sleep. Though Effexor (venlafaxine) is not technically an ssri, it is a dual action agent (snri) that has ssri activity in addition to norepinephrine reuptake inhibition. Most patients complain of increased dreaming, or more vivid dreaming, which suggests an impact on rem sleep, since dreaming occurs during rem sleep. ...Read more

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Is Rozerem (ramelteon) an effective sleep medication?

Is Rozerem (ramelteon) an effective sleep medication?

For some, yes: A frequent answer to questions on the Internet, and one which I think applies here, is "YMMV" ("your mileage may vary"). As with many medicines, which are helpful for some and not helpful for others, it often comes down to a "therapeutic trial" to see how it might help, and also to see what kind of side effects it might cause. Melatonin, similar in action to Rozerem, (ramelteon) might be worth a try. ...Read more

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Bipolar(controlled -lamictal, carbamazepine), anxiety-semi-under control (lorazepam, temazepam, cymbalta) and ADD problematic- considering Vyvanse (lisdexamfetamine) ?

Bipolar(controlled -lamictal, carbamazepine), anxiety-semi-under control (lorazepam, temazepam, cymbalta)  and ADD problematic- considering Vyvanse (lisdexamfetamine) ?

So much medication: It might be necessary to take some drugs but I question the risks already and adding the new one is especially bad w/ cymbalta (duloxetine). It can cause severe anxiety! Also serotonin syndrome. Almost all of your meds combine to cause a host of symptoms like dizziness, confusion and general impairment. Please consider a good psych eval and adding good psychotherapy to lower need for Rx and help them work! ...Read more

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27y/o f narcolepsy/sle/anxiety/add benzodiazepines paradoxically increase anxiety any suggestions for nonbenzo anxiolytic? Pt takes Adderall (dextroamphetamine and racemic amphetamine) and apri.

27y/o f narcolepsy/sle/anxiety/add benzodiazepines paradoxically increase anxiety any suggestions for nonbenzo anxiolytic? Pt takes Adderall (dextroamphetamine and racemic amphetamine) and apri.

Tough question: Switch to another psychostimulant or reduce the dose to start. Sometimes selective beta blockers can be added (naldolol, metoprolol). Low dose trazadone can be added (low antichiolinergic profile) it has some anxiolyt. I suggest making only one change at a time if possible. Buspar (buspirone) can be tried but BP has to be watched. I'm assuming the diagnosis of narcolepsy and add have been carefully worked up. ...Read more

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