Diazepam - should I just ignore the prescription and avoid it ?

[MrWorldwide]

Went to Pattaya Memorial with a persistent cough this morning and after the blood and nasal drip (!) results came back the doctor confirmed what he knew from sticking the tongue depressor down my gob - infection requiring an antibiotic. Fine, but having mentioned that the coughing was disrupting my sleep patterns, he prescribed Diazepam. Yup, the housewife's friend, Valium ...

http://en.wikipedia.org/wiki/Diazepam#Adverse_effects

I'm loathe to take anything that leaves you feeling as bad - if not worse - when you regain consciousness than you did when you finally nodded off. Diazepam also has an unfortunate track record for figuring prominently in the pharmaceutical lab found in many autopsies post suicide / death by misadventure, but after a week on 4 hours of disjointed sleep per night I'm on the verge of just taking the damned pills. As of this morning, having just ingested a handful of the other pills, I still have phlegm to contend with and the prospect of not regaining consciousness when I need to clear my throat doesnt thrill me.

Happy to hear any and all sane feedback - am I just being a big girl's blouse here ? They're 5mg tabs, I'm 55 years old and in reasonably good health - non-smoker but a fairly heavy drinker, FWIW, although that's a relative term in central Pattaya on any given night. I know you cant second guess a doctor based on a post like this, but i'm keen to hear from those who have firsthand experience with this particular drug.

Thanks,

MrWW

FWIW, these are the other drugs I was prescribed, none of which seem to be even remotely in the same class as Diazepam - happy to hear otherwise :

Flumicil aka soluble aspirin

Prednisolone, an anti-inflammatory

Aller-tab, an anti-histamine

Klacid, an antibiotic : http://en.wikipedia.org/wiki/Clarithromycin

[h90]

I wouldn't eat them......unless the it is really very bad.

[harrry]

Why didn't you ask the doctor what you needed of those.

The one I would be most worried about is the prednisalone but you may need it.

Flumicll is not soluble asprin. It is a medicine to make the mucous in your lungs less sticky.

Edited December 24, 2014 by harrry

[MrWorldwide]

harry, all he said to me was 'I'll give you an antibiotic for your infection' - communication in English was tougher with this doctor than the one who treated my shoulder, so I left it at that. Is it really my place to question the doctors on the medication they prescribe ? From his POV, Diazepam may well be the right drug regardless of my concerns - I'm less concerned about an anti-inflammatory as I've taken lots of those for my shoulder and back. I guess its easy to become complacent when drugs the job they're supposed to and forget the longterm effects of prolonged usage.

[harrry]

harry, all he said to me was 'I'll give you an antibiotic for your infection' - communication in English was tougher with this doctor than the one who treated my shoulder, so I left it at that. Is it really my place to question the doctors on the medication they prescribe ? From his POV, Diazepam may well be the right drug regardless of my concerns - I'm less concerned about an anti-inflammatory as I've taken lots of those for my shoulder and back. I guess its easy to become complacent when drugs the job they're supposed to and forget the longterm effects of prolonged usage.

Yes it is your place to question the doctor on medicine he prescribes.

[Sheryl]

You should ignore, not only the valium but also the prednisolone. Neither are remotely indicatedf for this condition. For which reason I would also avoid this doctor in the future, what you describe is not good medical practice by any standard.

The soluble aspirin is intended to relieve throat pain (though it may do so at the price of gastric upset). If your throat is so painful that it really bothers you you could take it (always on a full stomach), otherwise don't.

The antihistamine is in case there is an allergic process contributing to the congestion. Won't hurt, may help.

What would have made sense for the night-time coughing would have been an anti-inflammatory nasal spray to decrease the post-nasal drip and perhaps, for a short-time, a cough preparation containing a low dose of codeine, which is an excellent cough suppressent.

In summary: take only the antibiotic and antihistamine (and, if throat is really raw and painful, the aspirin), ignore the rest.

Don't see this doctor again

If you do not improve -- and you might not with this regimen - come back online and I'll suggest a good ENT.

Taking supplemental zinc may also help. Redoxan brand (Vit C + zinc) can be found at Bots, watsons etc.

[MrWorldwide]

Thanks Sheryl - you've neatly zeroed in one the key problem and that's the coughing, particularly at night time. Its a shame I got lumped with this guy - his English was abysmal but he seemed to the only doctor on duty at 6:30am. The doctor who treated my shoulder was much better, but after years of enduring the Australian system its still a novelty to be in and out in under 2 hours. I'll chase up the other medication you've recommended - its surprising what some of the pharmacies are prepared to give you over the counter here.

[WitawatWatawit]

Of course each individual will react differently to a certain drug, so if you have had anything similar to diazepine before, you might have some idea of just how deep the effect on you will be of just one pill. For example, it may put you into a deep sleep, or it may just facilitate a good night's sleep, but present no clear symptoms of drowsiness - I have recently tested this with hydroxyzine (antihistamine). A good night's sleep, which was very welcome, but no drowsiness (as many others report on various websites). I once spoke with a doctor about the benzodiazepine drugs - xanax, etc, which are related to the valium range. I was curious about the very concern you raise of a deep sleep, and he assured me the tranquilising effects should not be too significant. Actually, I wasn't terribly assured , but anyway took the drug for a few years without problems (until it came time to go through withdrawal, but that's a story for another day).

[h90]

You should ignore, not only the valium but also the prednisolone. Neither are remotely indicatedf for this condition. For which reason I would also avoid this doctor in the future, what you describe is not good medical practice by any standard.

The soluble aspirin is intended to relieve throat pain (though it may do so at the price of gastric upset). If your throat is so painful that it really bothers you you could take it (always on a full stomach), otherwise don't.

The antihistamine is in case there is an allergic process contributing to the congestion. Won't hurt, may help.

What would have made sense for the night-time coughing would have been an anti-inflammatory nasal spray to decrease the post-nasal drip and perhaps, for a short-time, a cough preparation containing a low dose of codeine, which is an excellent cough suppressent.

In summary: take only the antibiotic and antihistamine (and, if throat is really raw and painful, the aspirin), ignore the rest.

Don't see this doctor again

If you do not improve -- and you might not with this regimen - come back online and I'll suggest a good ENT.

Taking supplemental zinc may also help. Redoxan brand (Vit C + zinc) can be found at Bots, watsons etc.

some mouthwash may also help a little bit with the throat.

[Sheryl]

Thanks Sheryl - you've neatly zeroed in one the key problem and that's the coughing, particularly at night time. Its a shame I got lumped with this guy - his English was abysmal but he seemed to the only doctor on duty at 6:30am. The doctor who treated my shoulder was much better, but after years of enduring the Australian system its still a novelty to be in and out in under 2 hours. I'll chase up the other medication you've recommended - its surprising what some of the pharmacies are prepared to give you over the counter here.

In addition to various preparations with small amounts of codeine (small is all you need for cough- the cough suppressent effect is at much lower doses than the analgesic effectt) there is also something called "Brown Mixture" which contains very small amounts of tincture of opium & works well. Used to be sold everywhere, conflisting info as to whether it still is, but I think most pharamcies still have it

pix here https://www.google.com/search?q=Brown+Mixture&tbm=isch&imgil=lGlae9c7EHgIUM%253A%253BqHEFuwGvc8jerM%253Bhttp%25253A%25252F%25252Farchive.samanthaculp.com%25252F2009%25252F03%25252Fbkk01-leopard-medical-brand-brown-mixture-aka-leopard-5-star%25252F&source=iu&pf=m&fir=lGlae9c7EHgIUM%253A%252CqHEFuwGvc8jerM%252C_&usg=__g6qjWIsgsq82R1DCsDKTIY6e8C8%3D&biw=1160&bih=699&ved=0CEYQyjc&ei=nG6aVIHeK5aGuASW64KICQ#facrc=_&imgdii=_&imgrc=lGlae9c7EHgIUM%253A%3BqHEFuwGvc8jerM%3Bhttp%253A%252F%252Farchive.samanthaculp.com%252Fwp-content%252Fuploads%252F2009%252F03%252FIMG_3201.JPG%3Bhttp%253A%252F%252Farchive.samanthaculp.com%252F2009%252F03%252Fbkk01-leopard-medical-brand-brown-mixture-aka-leopard-5-star%252F%3B500%3B666

This is only a quick fix though and it is not unusual for this sort of thing to turn chronic. You don't want to be taking cough supressents long-term, need to address the udnerlying post nasal drip that causes the irritation.

If the abx & antihistamines don't do the trick, I highly recommend Prof, Songklot at St Louis Hosp in Bkk. He has successfully treated many people I know for this and related problems, is reasonable in price, US trained and fluent in English, and very kind and thorough.

[harrry]

Thanks Sheryl - you've neatly zeroed in one the key problem and that's the coughing, particularly at night time. Its a shame I got lumped with this guy - his English was abysmal but he seemed to the only doctor on duty at 6:30am. The doctor who treated my shoulder was much better, but after years of enduring the Australian system its still a novelty to be in and out in under 2 hours. I'll chase up the other medication you've recommended - its surprising what some of the pharmacies are prepared to give you over the counter here.

In addition to various preparations with small amounts of codeine (small is all you need for cough- the cough suppressent effect is at much lower doses than the analgesic effectt) there is also something called "Brown Mixture" which contains very small amounts of tincture of opium & works well. Used to be sold everywhere, conflisting info as to whether it still is, but I think most pharamcies still have it

pix here https://www.google.com/search?q=Brown+Mixture&tbm=isch&imgil=lGlae9c7EHgIUM%253A%253BqHEFuwGvc8jerM%253Bhttp%25253A%25252F%25252Farchive.samanthaculp.com%25252F2009%25252F03%25252Fbkk01-leopard-medical-brand-brown-mixture-aka-leopard-5-star%25252F&source=iu&pf=m&fir=lGlae9c7EHgIUM%253A%252CqHEFuwGvc8jerM%252C_&usg=__g6qjWIsgsq82R1DCsDKTIY6e8C8%3D&biw=1160&bih=699&ved=0CEYQyjc&ei=nG6aVIHeK5aGuASW64KICQ#facrc=_&imgdii=_&imgrc=lGlae9c7EHgIUM%253A%3BqHEFuwGvc8jerM%3Bhttp%253A%252F%252Farchive.samanthaculp.com%252Fwp-content%252Fuploads%252F2009%252F03%252FIMG_3201.JPG%3Bhttp%253A%252F%252Farchive.samanthaculp.com%252F2009%252F03%252Fbkk01-leopard-medical-brand-brown-mixture-aka-leopard-5-star%252F%3B500%3B666

This is only a quick fix though and it is not unusual for this sort of thing to turn chronic. You don't want to be taking cough supressents long-term, need to address the udnerlying post nasal drip that causes the irritation.

If the abx & antihistamines don't do the trick, I highly recommend Prof, Songklot at St Louis Hosp in Bkk. He has successfully treated many people I know for this and related problems, is reasonable in price, US trained and fluent in English, and very kind and thorough.

Sheryl, the Flumicil http://pharmacybook.net/acetylcysteine-fluimucil/ he was prescribed was not soluble asprin.

[timmyp]

Valium is not the best sleep aid, but it isn't something to fear either. You are being responsible about being concerned, you are clearly the type of person that will use such medication responsibly. Sleep is important when you are sick, and if you are having trouble falling asleep naturally, it is not at all a bad decision to take something that will help you rest so that you can get better.

Just like Sheryl said, diphenhydramine is an antihistamine that also doubles as a sleep aid. It's the active chemical in Benadryl (but Benadryl in Thailand tends to be a sugary syrup, so I ask for it by the chemical name).

Back to the mother's little helper: Valium can work as a sleep aid. I find it works well on flights (I really can't sleep on airplanes without something to knock me out). Drinking booze isn't a good idea with valium, I'm sure you read. If you're not feeling well, I would recommend laying off the booze until you're body heals. That's probably a bigger concern than taking a couple of 5 mg tabs of valium.

[humqdpf]

The best cough suppressor is Codeine but even relatively small doses will make you sleep all day. And it carries the same danger of other such tablets if they are around people with suicide on their mind.

But I had something called cough syncope which in itself has its dangers and this is what I used. I slept for most of 2 days on the stuff but at the end my terrible cough was gone.

[welshchris]

Having got asthma I tend to pick up a lot of chest infections.

Quick trip to boots and 7 days supply of doxycycline. Within a couple of days on the mend and sleep back to normal.

[smileydude]

I agree with Sheryl's advice. It seems this doctor was overzealous in trying to stop your coughing and insomnia with a quick fix.

Prednisolone is usually reserved as a last resort for post-viral allergic cough, that is the actual infection is gone but there is an allergic reaction.

A Post-viral cough can sometimes last for months after infection resulting in prolonged bronchial hyperreactivity. This type of cough, which can be thought of as "temporary asthma," can usually be managed with inhaled steroids and/or a bronchodilator. For chronic cough a short burst of prednisone (40mg qD x 5d) may also be used when antibiotics are initiated. I wouldn't diagnose your case as either chronic cough or post viral, yet.

It would be better practice for the doctor to try to use a codeine-based cough suppressant first plus maybe a mild bronchodilator such as meptin before jumping straight to steroids.

He should have also advised you to avoid prolonged exposure to cold air eg. sleeping with the A/C on and also the use of a humidifier to alleviate your cough/bronchospasms which are triggered by both dryness and cold temperatures.

Avoiding dusty areas and any kind of allergens would also help.

As for Valium, I don't know how serious your insomnia is but I believe we should always use medication as a last resort.

First we have to determine whether your sleep cycle is disturbed because of your sleeping habits and correct those first.

Do you sleep and wake up at the same time regularly?

Do you tend to oversleep on the weekends to compensate for lost sleep?

Do you exercise late into the evening?

Do you drink alot of caffeine, coca cola or alcohol late into the evening?

(Contrary to popular belief even though alcoholic drinks tend to make us drowsy you often end up with poor quality REM prolonged sleep).

Its normal for us to sleep less as we age and to also wake up in the middle of the night more often.

Having the occasional difficulty sleeping and true insomnia require different approaches.

Of course coughing will disrupt your sleep but it shouldn't warrant the immediate use of sleep medication.

Edited December 24, 2014 by smileydude

[inbangkok]

Thanks Sheryl - you've neatly zeroed in one the key problem and that's the coughing, particularly at night time. Its a shame I got lumped with this guy - his English was abysmal but he seemed to the only doctor on duty at 6:30am. The doctor who treated my shoulder was much better, but after years of enduring the Australian system its still a novelty to be in and out in under 2 hours. I'll chase up the other medication you've recommended - its surprising what some of the pharmacies are prepared to give you over the counter here.

In addition to various preparations with small amounts of codeine (small is all you need for cough- the cough suppressent effect is at much lower doses than the analgesic effectt) there is also something called "Brown Mixture" which contains very small amounts of tincture of opium & works well. Used to be sold everywhere, conflisting info as to whether it still is, but I think most pharamcies still have it

pix here https://www.google.com/search?q=Brown+Mixture&tbm=isch&imgil=lGlae9c7EHgIUM%253A%253BqHEFuwGvc8jerM%253Bhttp%25253A%25252F%25252Farchive.samanthaculp.com%25252F2009%25252F03%25252Fbkk01-leopard-medical-brand-brown-mixture-aka-leopard-5-star%25252F&source=iu&pf=m&fir=lGlae9c7EHgIUM%253A%252CqHEFuwGvc8jerM%252C_&usg=__g6qjWIsgsq82R1DCsDKTIY6e8C8%3D&biw=1160&bih=699&ved=0CEYQyjc&ei=nG6aVIHeK5aGuASW64KICQ#facrc=_&imgdii=_&imgrc=lGlae9c7EHgIUM%253A%3BqHEFuwGvc8jerM%3Bhttp%253A%252F%252Farchive.samanthaculp.com%252Fwp-content%252Fuploads%252F2009%252F03%252FIMG_3201.JPG%3Bhttp%253A%252F%252Farchive.samanthaculp.com%252F2009%252F03%252Fbkk01-leopard-medical-brand-brown-mixture-aka-leopard-5-star%252F%3B500%3B666

This is only a quick fix though and it is not unusual for this sort of thing to turn chronic. You don't want to be taking cough supressents long-term, need to address the udnerlying post nasal drip that causes the irritation.

If the abx & antihistamines don't do the trick, I highly recommend Prof, Songklot at St Louis Hosp in Bkk. He has successfully treated many people I know for this and related problems, is reasonable in price, US trained and fluent in English, and very kind and thorough.

I have seen this many times and always wondered what it was. How is something with tincture of opium legal for sale at pharmacies?

[kamahele]

I don't suppose one could get Nyquil in Thailand. This noxious liquid available over the counter in the US will put me down for 8 hours even during the worst cold.

[circusman]

The best medical advice you can get on Tvisa. Don't take advice from Tvisa.

[monk213]

I have been on diazepam for 4 years, if you really want sleep then temazepam would be a better short term option. Diazepam is actually pretty much suicide proof unless combined with other substances. I have taken 400mg in a day before back when I had a full blown out of control addiction. But I use it medically these days, still it is a crutch and a horrible one at that.

All the best, Merry Crimbo and a happy new years

To edit, things that are more natural are melatonin supplements, melatonin is a naturally occurring chemical that triggers sleeping patterns, but you can get supplements for sleep aides. Also, valerian root is a good one for sleep as well. Most sleeping pills leave you feeling drowsy and washed out the next day, try finding these 2 options I just noted, good luck.

Edited December 24, 2014 by monk213

[Gentmartin]

I AM NOT A DOCTOR

..but whilst the antibiotics take care of your throat, I usually gargle with diluted Dettol morning and night to soothe a bad throat.....obviously if youre coughing with a sore throat, youre not sleeping so hopefully this would stop the cough and pain and enable you to get a decent nights sleep with the aid of drugs to help you sleep. Get well soon mate :-)

[maidee]

thai doctors will give you AB for everything & nothing

[ehs818]

I have chronic Bronchitis and have a bout every year or so. I take AMK (Klacid) for it. It's mostly Amoxycillin and some Clavulanic Acid). It works GREAT. It's good for upper respiratory infections. I think this is what he gave you.

As for your question about the valium. If you can't sleep, take it. But a cough medicine that will knock you out will do just as well if not better. You'll get relief from the cough, and the sleep will help you heal inside. If you take anything that includes a Tussin, that will loosen up your phlegm so you can expel it. Also, at most 7-11 stores there's a cough medicine they sell that includes a bit of Camphorated Opium Tincture (00.6ml) for the entire bottle, so it's minimal-yet effective. It's called Brown Mixture and comes in a green box with a red spotted tiger on it. It's cheap and will help you sleep.

[micmichd]

Yes, avoid it, too many side effects. Try a couple of beers instead.

[Broeno]

Youve already said it; housewifes friend.

Millions of people use it aldo there is much to say against it.

Just make up you mind. If non sleep is bothering you that much, just take it for a few days, but not together with alcohol.

[Broeno]

Yes, avoid it, too many side effects. Try a couple of beers instead.

One bad option for the other.

[wgdanson]

Yes, avoid it, too many side effects. Try a couple of beers instead.

OR A LARGE SCOTCH WITH HONEY, LEMON JUICE AND HOT WATER WORKS A TREAT. HAPPY CHRISTMAS.

[KOZMO]

I wouldn't eat them......unless the it is really very bad.

Take the valium, it will relax your muscles and help your breathing. The 5 MG is not a large dose. I have been taking 5MG 3x a day for the past 12 years. no problems for me and I am 64. I am surprised that they did not give you Ambien for your sleep problems or even Xanax to help you sleep better. I take meds for high blood pressure, hypothyroid, type 2 diabetes and acid reflux with no problems between the meds. Just can't drink allot, lol. I forgot the PTSD, that is why I have the valium, Xanax, and ambien. Still kicking and no problems so far after 12 plus years.

[SOTIRIOS]

.....have some camomile tea with honey......

...this will soothe some of your symptoms........ and relax you....

[Vejo]

In the U.K. Diazepam is primarily prescribed as an anxiolytic, that is to reduce to symptoms of anxiety but it is also indicated for short term use in treating insomnia.

That it mind it is also highly addictive and a respiratory depressant meaning it has an adverse affect on your breathing.

Given your main concern is a breathing complaint it comes down to your judgement whether it is right for you.

My personal choice would be to skip it and if sleeping really is an issue, something like Zopiclone which is a hypnotic that can help you get to sleep but does not tranquilise and keep you asleep.

Coughing is goddamn annoying and painful but is your body's way of keeping the lungs clear and preventing anything nasty getting in to cause harm. I wouldn't personally risk suppressing its function.

[MrWorldwide]

Thanks for the feedback guys and I will definitely look for the 'brown mixture', even if the only green box I've seen with a tiger on it was Tiger Balm (from memory). I also take the point that it's time to lay off the booze - readily admit that I did try to 'anaesthatize' myself when the coughing drove me really crazy. I also feel for the others in my apartment block - nothing quite like having some poor sod coughing himself hoarse in the middle of the night. I'll only consider the Diazepam as a last resort - based on some of the dosages quoted here, it would appear that 5mg is the equivalent of Baby Panadol

Edit: aha ...

Edited December 24, 2014 by MrWorldwide