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Re: Ambien or Ativan?

Posted by Minnie-Haha on August 31, 2004, at 13:27:53

In reply to Re: Ambien or Ativan?, posted by owensmar on August 29, 2004, at 17:36:16

> Hi. You're not pestering me. I have deep sympathy for insomnia sufferers.
> After d/cing the Ativan I was put on imipramine (a tricyclic a/d). I continued to have insomnia. (I don't know if it was from the drug or if it was just taking me a year or more to recover from the ativan abuse. I know it took many, many months before I recovered otherwise from it). Then I was on Prozac for nine years and continued with horrible, horrible insomnia on that - it generally took me about two hours to fall asleep -terrible racing thoughts. If I was away from home it might take me 5-6 hours to fall asleep if I could at all.
For a while I treated it with benadryl and beer but then decided that wasn't a great idea. So I just suffered through it. At least once I was asleep I could sleep fine.

Well, here is one area where we are different. I rarely have trouble falling asleep, it's that I usually wake up between 2 a.m. and 4 a.m. and have trouble getting back to sleep. I frequently wake with specific anxieties -- sometimes even panic -- but often it's just a lot of noise in my head, snippets of songs, counting... kind of like random processing with some low-level intrusive thoughts thrown in for good measure (though not like of death or disease or anything like that). What the Ativan does for me -- and once again, I rarely take more than 0.5mg, frequently only 0.25mg -- is push out the wake-up hour from say 2 a.m. to 4 a.m. I do not tend to get addicted to substances or abuse them. I rarely drink and always take the lowest doses possible of drugs to help me. Over the past year, it's been me expressing concerns repeatedly to my psychiatrist about not wanting to get addicted to Ativan, but she said it was better for me to be taking the small dose I'm taking and sleeping, than getting sleep deprived and anxious and falling into catastrophic thinking and panic.

When I switched to Ambien (10mg) I had a couple of OK nights (I'd still wake, but I was too groggy to stay awake and worry, so I'd fall back to sleep), but then started having daytime anxiety and depression. When I asked my new psychiatrist (old one is closing her practice) if I could be having withdrawal symptoms, he said that he thought it unlikely considering what a small dose I was on, and that I'd recently been able to go 3-4 days without it with OK results. He said I could try discontinuing the Ambien, or cut the dose in half, or return to the Ativan, which I've done, and once again, I am sleeping a little better.

My PCP wants me to get on a low dose of a tricyclic (like 10mg Elavil) at night to help me sleep, but since my DX is Bipolar II, my psychiatrist seems reluctant to start me on any anti-depressant, even such a small dose. (I am taking 150mg Trileptal -- mood stabilizer -- in the a.m. and 300mg in the p.m.) He wants to address my sleep disorder first and see if that clears up my depression. My daytime affect runs from so-so (brief spurts of being able to smile or laugh) to flat or downright sad or tearful.

> Then Prozac quit working and I went on Effexor. Within about two weeks, I could fall asleep within 45 minutes, sometimes within 30. That's where I am now. For several years now I have had only occasional insomnia while on Effexor. (Many other a/ds actually caused insomnia for me. That's one reason I've stayed on Effexor even though it's not very effective for my depression. I don't know if the Effexor actually treats the insomnia or if I just no longer have insomnia as badly now that I am off Prozac.

When I was first DXd BP2 I was put on Depakote and Effexor, which was fairly effective for a year or two, but I gained 30 pounds, my menstrual cycle and my metabolism changed, and I started getting depressed again. I don't know if I'm ready to get back on it (Effexor) or any other SSRI at this time. Since my original DX of BP2, I have reason to question it, went to a psychologist just to discuss the possibility that it could be wrong (since I'd come to believe that my anxiety had been mistaken for manic agitation), and then walked away with an OCD DX! Yikes! I really feel like what I have is depression and anxiety, but what ya gonna do?...

Finally, FWIW, my PCP had me try Zyprexa once. I took like 2.5mg and it knocked me out: no chatter in my head and I slept like a rock, but I also felt like a zombie the next day... physically and mentally clumsy. Yikes!

Thanks again for your feedback. It has given me some things to consider.




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