I wouldn't switch to alprazolam from clonazepam completely. I think high dose diazepam could help, but it would have to be HIGH dose, because you've been taking 1 mg to 3 mg clonazepam and that is quite potent a benzo with quite a half-life too. Mixing strong barbs even at hypnotic doses with higher doses of benzos sounds dangerous to me, but I don't know how dangerous, probably very, very risky.
I'd probably ask for an increase in the k-pin script, along with a triazolam script as needed. For bad nights I would take the triazolam along with promethazine if is easily available, that or diphenhydramine. I know you say promethazine has never worked, but throw triazolam into the mix and it might be a success, that and maybe ONE drink OR 50 mg butalbital. Just some thoughts. That would have me asleep fast. That is a sort of as needed cocktail though, and that is why I'd request my k-pin script to be upped at bedtime.
I'd probably ask for an increase in the k-pin script, along with a triazolam script as needed. For bad nights I would take the triazolam along with promethazine if is easily available, that or diphenhydramine. I know you say promethazine has never worked, but throw triazolam into the mix and it might be a success, that and maybe ONE drink OR 50 mg butalbital. Just some thoughts. That would have me asleep fast. That is a sort of as needed cocktail though, and that is why I'd request my k-pin script to be upped at bedtime.