Posted by SLS on January 17, 2001, at 10:48:12
In reply to Re: SLS, JohnL, stjames, Cam W, Judy1, allisonm, JahL » Ron Hill, posted by Cam W. on January 17, 2001, at 10:27:08
Listen to Cam. But...
Since I spent some time putting together a post that Cam beat me to posting, I will include it anyway. It will give Cam an opportunity to critique it and serve to comment on each suggestion.
Looking forward to it.
One sleep algorithm has not yet been mentioned. Before going to bed, try reading some of Cam's brilliant and learned posts. I don't know what the hell he is talking about.
:-)
- Scott
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Thankfully, there are quite a few options. As has been mentioned, you can add one of the sedating antidepressants to be taken at bedtime. These would include Remeron (mirtazapine), Serzone (nefazodone), Desyrel (trazodone), Elavil (amitriptyline), and Sinequan (doxepin). Generally speaking, the dosages of these drugs that are effective to produce sleep are much lower than those used for depression. Another option is to use a longer-acting hypnotic such as Ambien or Ativan that will help you get to sleep and stay asleep..You have two aspects to your insomnia:
- Falling asleep
- Staying asleep
You can take one of the potent short-acting drugs to initially get you to sleep.
- Halcion (triazolam)
- Sonata (Zaleplon)
- Ambien (zolpidem)
- Imovane (zopiclone)To stay asleep, you can either use low dosages of one of the previously listed soporific antidepressants or a longer-acting hypnotic.
- Ativan ( lorazepam)
- Restoril (temazepam)
- Klonopin (clonazepam)
- Ambien (zolpidem)
- Dalmane (flurazepam)* With the exception of Restoril, each of these longer-acting drugs is capable of helping you get to sleep. You may want to try Ambien or Ativan first to see if they are also capable of getting you to sleep. I have had trouble staying asleep. I use Ativan. I try to take it every second or third day. It prevents me from becoming unacceptably sleep-deprived. It is my hope that this kind of dosing will help prevent tolerance and perhaps even entrain my sleeping pattern. This is only an experiment. I just started taking Ativan this past week. I’ll let you know how it goes.
Perhaps you can find a way of optimizing a single drug by discovering the best way to utilize melatonin. I think Dove had mentioned that it is not advisable to take melatonin beyond 3:00am. I think that is even too late based upon what I know about the natural course of melatonin secretion. I think you are better off not taking it any later than 1:00am
I used to have success with a Halcion / Ativan combination when I could not get to sleep at all for days. (Parnate + desipramine combination)
I would be curious to know what you decide. I have a hunch that your doctor already has a good idea as to how to handle the situation.
Good luck.
- Scott
poster:SLS
thread:51834
URL: http://www.dr-bob.org/babble/20010111/msgs/51860.html