Thanks for the question!
As explained by my colleagues who have replied earlier – nope, we can’t get anti-depressants and sleeping pills (benzodiazepines and z-drugs) such as diazepam (Valium), lorazepam (Activan) or zopiclone (Imovane) off the shelves in Singapore.
But, don’t lose hope. I’ll elaborate a little more in a bit.
However, before we go into the treatment of depression/ anxiety/ sleep disorders, I think it is important to emphasize that you should always get assessed by an experienced psychiatrist to get the right diagnosis.
There are medical conditions which can present with what appears to be psychiatric symptoms, e.g. low mood, lethargy, poor sleep etc. These conditions can only be ruled out after a thorough examination of your condition.
That said, should anti-depressants be indicated, there are many different types of anti-depressants in the market, each with their different mechanism of action and side effect profile. Therefore, it is best to get an experienced psychiatrist to recommend the most appropriate agent for you.
Same goes for the sleeping aid, if needed.
Perhaps I should also take this opportunity to allay some anxieties regarding starting treatment for the above mentioned conditions. Anti-depressants are not only prescribed in severe cases.
In fact, we do prescribe anti-depressants in mild-moderate conditions as well, on a case-to-case basis. Some of these agents can help with sleep, which negates the need for sleeping pills. Some can even help with chronic pain!
Furthermore, anti-depressants have a faster therapeutic effect compared to therapy/counseling, which helps patients bounce back faster.
Contrary to popular belief, anti-depressants are actually very tolerable in the long term, with side effects most prominent in the first 1-2 weeks of initiating treatment.
Sleeping pills, examples of which I have listed above, are definitely helpful in the short term treatment of insomnia. These medications, if taken in the short term, at prescribed doses, are generally safe and not addictive.
However, the prescription of these medications should be closely monitored by a psychiatrist due to its abuse potential.
Even though benzodiazepines and z-drugs are not available off the counter, there are other commonly available agents we can use to help with sleep:
1. Melatonin is a hormone found naturally in the body, which plays an important role in our natural sleep-wake cycle. Melatonin supplements can be helpful in treating certain sleep disorders.
2. Anti-histamines e.g. chlorpheniramine (piriton), hydroxyzine (atarax) Due to their sedative effects, these agents can help with enhancing sleep in the short term.
However, do consult with your doctor about the use of these agents if you have other medical problems.
There are also commercially available supplements (e.g. 5-HTP, St John’s Wort, magnesium) that have been promoted to help with depression, anxiety and sleep. Unfortunately, we do not have sufficient evidence on the efficacy of these agents.
However, should you take such supplements, do remember to highlight this to your psychiatrist/ doctor as they may interact with certain medications.
Hope this helps!
