Inclusion Criteria:  - Body mass index > 35 and < 60 kg/m2 Either medically free or with well controlled hypertension and/or diabetes.  Exclusion Criteria:  - Patient's refusal to participate in the study BMI > 60 kg/m2. Age less than 21 years. Patients with severe systemic disease which is not life-threatening. Patients on antipsychotics, antidepressants and/or corticosteroids. Patients with history of obstructive sleep apnea. Allergic reaction to any of the study medications.