Posted by fachad on June 18, 2002, at 19:26:29
In reply to Re: Doxepin, Sleep Duration, and Other Sleep Meds. » fachad, posted by Chloe on June 18, 2002, at 18:31:03
> I wonder if I spaced out the Dox to 10 mgs 7pm, then 20 mgs at 11 pm, that I could get some more pain relief and not have the afternoon sleepies. Do some people take Dox during the day? I think I read somewhere you can take it in divided doses...
Yes, I take my trimip around 7 or 8 PM, even though I don't go to bed until 10. I get two benefits from doing it that way: first, I am drowsy by bed time, and second it has had more time to wear off when it is time to wake up.
Taking the dox earlier will help reduce next day sedation. As far as divided doses goes, any of the TCAs can be given divided, but most people take them all at once, at night, to compress the worst of the side effects into the time when they are sleeping.
But my wife will take a little ami in the day if she has stomach pain, and I read a study where they compared dox to valium for anxiety, and gave study sujects multiple doses or either drug durning the day.
> I do have to report that last night was my best night on doxepin yet. I slept till 8 am! Very exciting for me. And was able to dream and rest for another hour or so...But I still am toying with increasing the dose, since the hair pain has come back.
Glad to hear that you are sleeping well! It may take either more time or a higher dose for the pain relief.
I don't see any reason why your pdoc would not be willing to titrate up the dose until you are satisfied or the side effects become troublesome.
> I did not like Remeron when I tried it about 6 years ago. All I wanted to do was sleep. I couldn't get out of bed...all I wanted to do was eat. I thought about food 24/7.
Yeah, I hated Remeron too. But I still think it is the most potent sleep med ever, period. If someone was really in misery because of insomnia, and nothing else worked, I'm sure Remeron would.
> I know what your mean about having such a short time with your pdoc. It's just not enough. Do you live in the US, or is this because of a NHS, if you don't mind me asking?
I live in the US, and have employer provided health insurance.
> I live in the US, but my insurance only covers psych appointments or hospitalization up to $10,000. I used that up long ago! At least I still get a little help with meds.
Is that $10K a yearly cap or a lifetime cap?
I don't know if I have a cap on my psych coverage. I think the reason for my limitation is based more on the way psychiatry is done nowadays than anything else.
I think even if I was 100% self-paying, most pdocs are just doing their thing in 15 min "med check" appointments these days. If they can classify you as "stable" by any stretch of definition, they put you into the quarterly (3month), bi-annual, or annual visit category.
I think the only reason I get to see my pdoc every three months instead of yearly is because dex is Schedule II and he knows he needs to see his CII patients more often to avoid scrutiny from the State Board of Medical Examiners or the DEA. Kind of a lame reason, but at least in gets me 4 appointments per year.
But I sometimes look back with nostalgic yearning to the old days when psychiatrists did insight psychotherapy, and were not solely focused on meds and med management. It was nice to be able to talk with your dr about how your life was going, and how you felt about life, rather than just how the meds were going, and how you were feeling from meds...(insert bitter irony emoticon here)