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Re: Marplan and insomnia (or something)

Posted by Scott L. Schofield on December 18, 1999, at 19:13:19

In reply to Marplan and insomnia (or something), posted by Elizabeth on December 15, 1999, at 21:47:11

> I'm having something really odd going on. I'm taking Marplan 40mg, lithium 300mg b.i.d. (now trying to d/c it - switching to 300 q.d. tomorrow), and pindolol 5mg b.i.d. I have the worst insomnia-or-something I've ever had when not depressed!

Did the insomnia begin immediately after adding pindolol?

> It gets weirder. I'm getting food cravings starting at night and through the middle of the night. (Not overeating or gaining weight, but they are usually cravings for sweets.) I feel more awake and alert in the middle of the night than in the day...I feel like I should be asleep in the daytime, and sometimes I do sleep in the day, but I've been trying not to do this and I still have lots of trouble getting to sleep at night (often can't at all). Has anyone experienced this (especially the day-night reversal thing), and if so do you have any idea what causes it?

Insomnia has seemed to be a good-prognosis side-effect for me.
If an MAO-inhibitor is going to work for me, I develop insomnia early on.

I have had this type of insomnia along with the day-night reversal with three different MAOIs. It was very frustrating, and the lack of sleep really affected cognition. I used benzo sleeping pills a few times (Ativan and Halcion combination), but found that it can be counterproductive in the long run. I felt like I would go through some sort of mini-withdrawal syndrome every day. I guess this could have been due to the short half-life of the Halcion. I found that Ambien wasn't strong enough to do the job.

I did try to keep my behavioral day-night cycle even though my biological cycle was out of whack. I went to bed at 11:00 PM and remained in bed until 7:00 AM, regardless of how wide-awake I was. I found that short naps during the day were O.K., but definitely not for more than 45 minutes. I remember hearing something about 20 minutes being ideal.

> My pdoc wrote me a script for some more Ambien (20mg/night) today; I hope it works again this time (I used it the whole time I was on Nardil, but the insomnia wasn't as bad that time).

I'm sure you thought of using trazodone. Is there some reason you are avoiding using it?

- Scott




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