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Discussion in 'Pharmacy' started by JerryPharmD, May 14, 2007.
Had a patient today (30-something male) on 90 mg temazepam QHS and 600mg trazodone QHS
did you guys check with the doctor just in case?
guy's been on it at least a year..crazier than the day is long
it would take a mucho dose of ativan, versed, or propofol to knock that guy out...
There is a max dose on the restoril at 60mg. Not sure on the other.
Info at http://meds.queensu.ca/~clpsych/orientation/Benzodiazepine%20comparison%20chart.pdf
My wife slept until 3:30PM on 1mg clonazepam. (I actually just checked to make sure she wasn't dead and accidently woke her up...she probably would have slept longer...)
It takes 3 mg of clonazepam just to get my wimpy butt on an airplane.
I know my father-in-law was on a serious dose of Requip for his RLS though they say most of the meds he takes are a lot less than what they dose for Parkinson's patients, just high for Restless leg syndrome patients. I don't know what his dose of Ambien was. The had to work him off Requip for an experimental study and then work his dose back up when he got kicked out. Totally sucks for him. He got 30 min sleep in 3 days when he was dosing down.
Trazodone dosed much higher than 300mg will actually keep you awake rather than put you to sleep. No wonder he needs so much temaz.
Who the hell lets a patient stay on sleep meds that long? Especially at that dose!
God help him if he attempts to stop cold turkey...that could be ugly...
I disagree with all of you - without the complete drug profile, pt hx, previous & concommitant medications, comorbid conditions....its hard to evaluate this regimen.
I have a pt who is on doses of somnotics, antipyschotics, atypicals which are far beyond recommended doses - but those are what is required.
Its difficult to take a pt out of context of his/her hx & previous exposure.
However, given the kinetics of temazepam & trazodone & how they work...I'd say perhaps an adjustment might be necessary.
True....is this guy 600 lbs? Does he have two livers?
For the average patient, I'd call that ridiculous, though.
But I agree that if it works, it works. I actually got into a brief argument with my primary care quack doc over my meds: "90 mg? That's too much." "No, it isn't." "Yes it is." "Um, no it isn't..." Am I on the floor in convulsions? No? Then stfu plz.