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Re: Marplan and insomnia (or something)

Posted by Scott L. Schofield on December 26, 1999, at 14:39:13

In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 25, 1999, at 22:45:16

> I've tried a number of benzodiazepines for insomnia; I develop tolerance to them rapidly, so they aren't terribly useful to me. I've also tried trazodone, atypical antipsychotics, thioridazine (Mellaril), clonidine, tricyclics, diphenhydramine, hydroxyzine, gabapentin, chloral hydrate, and probably some I'm forgetting.

> I started using Ambien 20mg this week had used it before with Nardil, with some success). It's not perfect (wears off in a few hours -- not enough), but it's better than nothing.

The first time I tried a combination of tranylcypromine (Parnate) and desipramine (Norpramin), I was unable to sleep at all for the first week or so. At this point, my doctor decided it was time to intervene using sleeping medications. He chose Halcion (triazolam) and Ativan (lorazepam) to be taken in combination at bedtime. The strategy was to take advantage of the potent effects of the Halcion to initially induce sleep, and then have the Ativan carry me over until morning. The dosages were tweaked a bit and resulted in little, if any, hangover the next morning.

If Ambien (generic name?) works well enough to put you to sleep, perhaps you can find something else to carry you the rest of the way through the night (trazadone, clonazepam, lorazepam). I found chloral hydrate to be hell on the stomach.

For some reason, I find myself waking up at 2:00 AM and then at 5:00 AM when using either Nardil or Parnate. I was told by WZ Potter that this was a function of time after the initiation of sleep. I guess this is possible since I have pretty much gone to bed around the same time for years (10:30 - 11:00 PM). As far as the 5:00 AM awakening, I get the feeling that this might be more a function of circadian rhythm. I have never bothered to look into it.

Does the fact that you experience early-morning awakenings indicate that you suffer from typical (melancholic) unipolar depression?

- Scott




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