Patient: 10 month old with difficulty falling and staying asleep was prescribed methotrimeprazine/Levomepromazine (Nozinan) by a neurologist. The doctor said to take it every night, for a whole year. Before prescribing this medication the neurologist did an EEG and said the results were normal, that the baby was a light sleeper and had difficulty falling asleep, which he called a “sleep disorder”. He is now 23 months and is still on this medication (and still does not sleep through the night). Should this advice be trusted? Can this medication harm such a young child, specially with such long term use?
Symptoms: Toddler on Nozinan due to sleep difficulties, still does not sleep through the night
Doctor: Hello,Thanks for the query to askthedoctor.com for an opinion.It is understood that your child was diagnosed as w ith sleep disorder even though the EEG was normal and was prescribed NOZINAN which is a phenothiazine and has been usually prescribed to patients with neuroleptic disorders like schizophrenia, mania, bipolar disorder or ADHD where depression of hyperactivity or increased sleep is desired to depress the symptoms. Your baby was advised the same and for a year long now. A phenothiazine should not be continued for long for toddlers. If there was no difference or result seen in the sleep activity of the child within a month, then the medication should have been reconsidered.I suggest if there as been no improvement in the sleep activity, you may stop the drug and review with your physician for a re-evaluation whether the child actually requires medication or with growth and activity the sleep pattern shall naturally get regulated. Ideally it does. Please review with your treating physician.I hope i have been able to address your concerns here,Wishing good health to your family,Regards
Comments / Follow Ups
Patient: Thank you for your help. I asked this question because I was concerned about my friend’s child. We are not in the US so this medication is not difficult for her to get and no one keeps track of how long and how much you use it. I passed on your suggestions but unfortunately she does not want to stop giving him the medication and is not willing to put her son in a regular schedule. Hopefully taking it for yet another year or however long it takes, won’t cause any irreversible harm to the child.
There is no irreversible harm that we are looking at but there are chances of toddler becoming resistant to the drug and hence the response can be sub dued and not as desired. It is again completely the decision of the parents with regards to toddlers, we as medical service providers can just guide and ultimately to follow or not relies on the compliance of the patients. Nevertheless, it would be in favour of the toddler to get his medication reviewed by his physician for a more effective alternative.