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Re: Marplan and insomnia (or something)

Posted by Phillip Marx on December 27, 1999, at 0:08:44

In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 26, 1999, at 20:13:28


> > My curing doctor is world famous, look at his site @ where he explains how he has taken people who have been to 50-100 doctors and has 30%-60% of them much better in less than two weeks.
> I've read his website; I think he tends to oversimplify people's problems in a way that I think is unlikely to work in many cases (though obviously because of nonspecific effects I don't doubt that he has good luck sometimes). I think perhaps his "method" relies a lot on expectation effects.

Logic is simpler than ill-logic. Would you prefer he chose his most complex cases? His protocols are designed to rule out non-specific effects. He gets treatment resistant failures from other doctors, mostly by referrals like mine and his television programs, which keep him saturated, he doesnít have to advertise. He gets people with totally defeated expectations. I guess maybe defeated expectations can get people to follow protocols without rebellion sometimes, but I wouldnít expect such to be reliable. He isnít keeping his protocols to himself. He wants to help more people than he can help all by himself. Heís devoting a lot of time to making sure other doctors can imitate his success. His protocols clone! Why? Because they really do have better success statistics.

> That ambien will be as useless to you as it is now to me if you keep using it consistently for long due to tolerance increase up to virtual immunity (futility point).

> Uh, no. Some people develop tolerance to Ambien (probably behavioral tolerance, as occurs with alcohol), but that isn't the rule. For example, I used it every day for a year or more without needing to increase the dose. Your experience doesn't generalize.

I know my experiences donít generalize, thatís why my first step into this forum was to ask if there were any atypicals like me around, since all other types of atypicals were begging for clues for help. I am philísanthropic enough to try to offer help to all those here medically stalled like I was for so long. How else could I respond to reading all this? I have a long history of trying to help people more than is good for me, I keep getting called co-dependent. I used to be reluctant to admit how much my own happiness depended on helping others, que sera. Trying to rescue everyone and everything on a sinking ship is not wise when the ship isnít really sinking. I probably shouldnít get my mission mixed up with my missionary inclinations again here or Iíll wear out again. Your experience expectations donít generalize well, which doesnít bode well for future depression avoidance. You are at least going to use up your endurance and get exhaustion tolerant (wouldnít that be interpreted (read) like depression, mental rather than physical) if you learn to settle for the short sleeps you get with Ambien. Your daily work output will decline and decay to the level you can recover nightly. Is your work output depressed? I couldnít work much on Ambien, and Iím the worst workaholic Iíve ever met, sort of. Maybe you are retired and donít need much sleep for your days.

Ambien (zolpidem tartrate), is a non-benzodiazepine hypnotic of the imidazpyrodine classÖGABAx subunit modulatorÖchemical structure unrelated to benzodiazepinesÖdeep sleep stages 3&4 factorsÖDuring nightly use for an extended period, pharmocodynamic tolerance or adaptation to some effects of hypnotics may develop. ÖíTransient and chronic insomnia useí clinical tests listed in the PDR are for 5 weeks max. Ö no objective insomnia rebound evidencedÖ. INDICATIONS AND USAGE: Ambien is indicated for the short-term treatment of insomnia. Hypnotics should generally be limited to 7 to 10 days of use, and re-evaluation of the patient is recommended if they are taken for more than 2 to 3 weeks. Ambien should not be prescribed in quantities exceeding a 1-month supplyÖ.The failure of insomnia to remit after 7 to 10 days of treatment may indicate the presence of a primary psychiatric/medical illness which should be evaluatedÖ. It is important to use the smallest possible effective doseÖ

Sounds like a professional warning of potential tolerance to me by the PDR. I wish you more than luck is usually statistically good for.
> Also, benzodiazepines cause cross-tolerance; if you're tolerant to one, you will be at least somewhat tolerant to another.

I donít know if tolerance ever wears off, but they put me on longer and longer half-life versions as time went on and sleep decreased to insufficient with each one. Iíll have to look up cross-tolerance somehow and see how wide itís definition is.
> BTW I wonder if perhaps your memory problems may be due to chronic sleep deprivation as well as overuse of high-dose benzodiazepines; your loss of motivation might be caused by partial remission from mania. (Why do you feel such a need to insist that you are not manic? Mania is defined by observed symptoms, which I think you know you have.)

Sleep deprivation hurt more than my memory, it hurt everything ever listed as effect from affect. Medicinal related memory problems were only significant for me on Ativan in therapeutic doses. Ativan is one of the anesthesiologistís choices to keep us from waking up and remembering surgery. Even Halcion can cause memory dysfunction, even amnesia, but I canít remember any??? Halcion is what made President Bush throw up on the Japanese ambassadors and what caused Sally Fieldís boyfriend in that bootlegger movie series look like he had AIDs. I never took an overdose of BDs that I know of, though I think they have been somewhat overused on me. I canít remember all the technical reasons why they chose original diagnoses that far back since I have overwritten it with much better information in the since-time, and I didnít like it then, but they promised me they wouldnít change to something else unless it didnít work, I would really have balked if I had know how long they would take to give up first diagnosis, but the earliest diagnoses were Insomnia (NOS) being not otherwise specified by professionals trained better than I ever want to be to call it mania if it is mania. My lo-pro call is manic-like but not manic-exact, conceding mania-standard too easily will put everyone back on a malevolent treadmill I donít think I should have been run on the first time. Suspicions of mania-standard cost me an extra couple of years of recovery. Mania-like, fine, lithium just wasted a lot (years) of my time. Mania-standard treatments failed which indicates non-mania-standard. Iím different in some ways, thanks, and Iím different in some other ways, sorry. Mania as cause/source and mania as result require different treatments. Lack of sleep is not always preceded by or indicative of mania-standard, if you have enough endurance you can sure test positive for increasing exhibited panic. If you split the mania definition right, you get more appropriate treatment, otherwise it will cost years by honest people who will never know they were wrong, even if you die. What you may be referring to as loss of motivation is really deferred motivation as I learned I had to put everything on hold until, if ever, promises of recovery ever came true. It would take years to complete all the projects I have preserved for such a time. Iím still reluctant to commit to much from the trauma of so much helpless powerlessness, I know how fast it overtook me completely against my will without any cooperation with convenient timing, there was no putting it off with a reschedule-please notice. My motivations are easiest to sustain for short, easy-to-complete quickly projects to this day still from sedative conditioning. I donít understand how loss of motivation can be caused by partial remission from mania, unless they were manic-only motivated projects, which I donít think any of mine are. The tree that kept filling my house downwind with its dirt I took down. Manic? I have to fix the garage fascia board it destroyed on the way down. Manic? I have to get the garden in the back yard replanted and the above-ground pool removed. Manic? Iíll have to mull over the rest. Iím willing to purge anything not belonging.

Phillip Marx




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