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MN Psychiatrist
MN Psychiatrist, Psychiatrist
Category: Mental Health
Satisfied Customers: 792
Experience:  Physician for 17 years, adult psychiatrist for 13 years working with a wide variety of patients.
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I take Ambien 10 mg nightly;however, thdosage wears off by

Resolved Question:

I take Ambien 10 mg nightly;however, thdosage wears off by 2:00 and the restless legs start up again. Can I safely take 10 at 9:;00 and increase the dosage to another 10 at 1:00?
Submitted: 4 years ago.
Category: Mental Health
Expert:  MN Psychiatrist replied 4 years ago.
Hello, I am a psychiatrist.

For me to best answer this question, I need to know all the doses of all the medications you are currently taking, and what time of day you take them.

Also, are you being treated for restless leg syndrome? If so, has you iron levels been checked?
Customer: replied 4 years ago.
Itake anbieim10 mg at night around 9:00, tylenol pm at 25 mg (2) at bedrime, Neurontin 1200 mg. bedtime, alprazolam 0.25 prn.when the legs get really bad. Iron levels have been check they are wnl. I am being treated for RLS and have been done so for over 40 years. Other medications I take are prozac, 20 mg. 1qd am, nexium dose unknown, abilify 5 mg. nightly.
Expert:  MN Psychiatrist replied 4 years ago.
I see. A few things to consider are that Abilify can absolutely worse restless leg syndrome, and I would consider it as quite likely doing so, until proven otherwise. I say this, because it opposes the action of the medications that are used to treat RLS: restless leg syndrome is often very well helped by either Mirapex (pramipexole) or Requip (ropinirole), usually to the point that people sleep through the night.

Even if your iron levels are in the "normal" range, they may have to be well up into the "normal" range (not just barely in it), for you to have a reduction of RLS symptoms.

To answer the question you asked, I would be concerned about going straight from 10mg to 20mg of Ambien nightly (even if you split the doses); it is possible that this could cause you to have trouble breathing during the night and or be at risk for falling. This isn't just a blanket concern; falls are certainly common in the elderly, and one study showed that for people over 65 who fell and broke a hip, 50% of them died within a year, due to all the complications that arise from hip fractures. If you were my patient, I might be open to you trying a total of 15mg of Ambien at nightly, but only after it was determined that Abilify wasn't worsening your RLS and that your RLS was thoroughly managed as well as possible by the usual RLS treatments and/or ensuring that your iron level was in the medium-high range.
Does this make sense?
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