Need sleep-aid guidance. I've been diagnosed for 12 years, on the same combo for five with great success: Viracept, DDI and 3TC. Early on my diagnosis, I used 5 mg diazepam to help me sleep. It worked for three years. When I found out about temazapam, specifically formulated for sleep, I switched. Disaster! Within a few days I had an alergic reaction - intense itching - and tried to default back to the diazepam. I was alergic to that, too! My doc found a formulation of hydroxyzine, PAM, that was supposed to rescue me. 10 mg per night was effective, but the hangover was terrible. I've endured the hydroxyzine PAM for six years, but a few months ago I decided to see if I could return to diazepam (without consulting my doc) and resurrected some pills from an old cache in the medicine cabinet. There was a month-long adjustment of slight itching and strange nightmares when I went back on 5 mg of diaz, but it seemed to be working fine in the sleep department and the hangover hasn't been bad.

Yesterday, after telling my HIV doc about my adventure, I filled my first perscription for 5 mg diaz. With it came the "advisor" sheet which stated emphatically: DO NOT TAKE THIS MEDICINE IF YOU ARE ALSO TAKING HIV PROTEASE INHIBITORS. I called the pharmacist to find out what the specific problem was in mixing the meds. He explained in some depth that the Viracept's effectiveness would be inhibited, which was my big worry, but that the diazepam is not metabolized properly and remains in my system for longer than it should, hence the warning. He tell me to stop, but to recoginize that the adjustment may be necessary relative to the diazepam.

My questions: should I discontinue diazepam completely? Are there more risks than his database provided? I don't want to mess with my cocktail because of some unknown problem just to use the diaz since I've had five years of great success. To return to hydroxyzine would be like revisiting hell, so I'd like to avoid it.

Do you have any suggestions on sleep-aids that aren't as heavy-handed in the hangover department but are effective? Without sleep, of course, I cannot function. I'm willing to accept that any sleeping pill is going to have morning-after problems. I think I'm particularly sensitive to the hydroxyzine realm and need some alternatives.

Many thanks for enduring my long-winded plea!

BB

The benzodiazapams (i.e. Valium) are quite addictive and often help a person seemingly fall asleep without actually getting good (REM) sleep. If benzos are used long-term U often work with an HIV experienced psychiatrist.

Trazadone or low dose amitrypiline is often effective (and non-addicting ) for sleep. Often a 3mg melatonin + 25 mg diphenhydramine (Benadryl) +/- a mild analgesic such as Alka-Seltzer or Tylenol is a safe and effective nighttime sedative. Getting into a sleep routine without caffeine/alcohol after late afternoon, soft music, and reading (may I suggest the history of the English Kings)can be included in the routine. KH