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Re: Why not benzos for sleep?

Posted by zeugma on May 15, 2004, at 15:11:52

In reply to Why not benzos for sleep?, posted by Guy on May 15, 2004, at 14:37:45

Benzos are not ideal for sleep, as they tend to lose their effectiveness for this indication over time. But benzos are BETTER drugs (in terms of disruption of sleep architecture) than the SSRI's and other serotonergetic drugs that have acquired no 'phobes' among doctors yet :). Benzodiazepines cause less shift to stage 1 sleep, which results in frequent awakening and chronic fatigue, than Prozac, and can actually be used as an 'antidote' to the REM behavior disorder that is beginning to be pinned on SSRI's as a cause. (Of course, if someone develops any signs of REM behavior disorder while on an SSRI, *I* would think termination of the SSRI ASAP would be the indication.)

If you have social phobia AND chronic insomnia, I would recommend clonazepam and a sedating AD (the TCA's are great in this respect). As the SSRI era comes to a close studies are beginning to be done that reveal some neglected virtues of these old drugs. If you don't mind wading or skimming through technical material in order to get to the 'good part,' I recommend perusing the following article:

tricyclic antidepressants have been shown to down-regualte the HPA axis.




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