I apologize if this isn't in the right place. Just looking for some advice or best bets from others with experience.
I work 12-hour days at random times. I have been prescribed armodafinil 150 mg tablets daily for several years. In addition, I am prescribed 1 mg alprazolam daily for anxiety and I use it off-label occasionally to handle acute insomnia (this insomnia is occasionally exacerbated by the armodafinil). As I understand, armodafinil moderately induces CYP3A, and thus reduces the systemic exposure to midazolam in the study I read by over 30 percent. I have noticed that the effects of my Xanax are markedly tamed the closer I take it to the Nuvigil and remain relatively tame even 12-14 hours after taking the Nuvigil. So without seeking out a barbiturate (NEVER the right answer for sleep or anxiety issues from my perspective) and without drastically increasing the Xanax dose, is there a more effective sedative to take to achieve sleep? I would be willing to try a different benzo, maybe, or perhaps a slight increase in the Xanax from 1 mg to 1.5 mg, but more benzos are rarely the answer to anything in my experience. Just for further background, I have tried diphenhydramine up to 75mg and doxylamine up to 50 mg (not together), as well as promethazine or trazodone in varying low to moderate dosages; none of these medicines were effective more than a day or two. I was interested in possibly talking to my doctor about trying triazolam, zolpidem, or even a low dose of an atypical like quetiapine (last resort only on that one) but I'm kinda stumped. I have tried suvorexant and it's pretty effective generally, but I don't know what, if any impact it would have when administrated within 24-hours of armodafinil, and it is still prohibitively expensive. Any suggestions?
I work 12-hour days at random times. I have been prescribed armodafinil 150 mg tablets daily for several years. In addition, I am prescribed 1 mg alprazolam daily for anxiety and I use it off-label occasionally to handle acute insomnia (this insomnia is occasionally exacerbated by the armodafinil). As I understand, armodafinil moderately induces CYP3A, and thus reduces the systemic exposure to midazolam in the study I read by over 30 percent. I have noticed that the effects of my Xanax are markedly tamed the closer I take it to the Nuvigil and remain relatively tame even 12-14 hours after taking the Nuvigil. So without seeking out a barbiturate (NEVER the right answer for sleep or anxiety issues from my perspective) and without drastically increasing the Xanax dose, is there a more effective sedative to take to achieve sleep? I would be willing to try a different benzo, maybe, or perhaps a slight increase in the Xanax from 1 mg to 1.5 mg, but more benzos are rarely the answer to anything in my experience. Just for further background, I have tried diphenhydramine up to 75mg and doxylamine up to 50 mg (not together), as well as promethazine or trazodone in varying low to moderate dosages; none of these medicines were effective more than a day or two. I was interested in possibly talking to my doctor about trying triazolam, zolpidem, or even a low dose of an atypical like quetiapine (last resort only on that one) but I'm kinda stumped. I have tried suvorexant and it's pretty effective generally, but I don't know what, if any impact it would have when administrated within 24-hours of armodafinil, and it is still prohibitively expensive. Any suggestions?