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Re: Ambien or Ativan? Minnie-Haha

Posted by owensmar on August 31, 2004, at 19:58:19

In reply to Re: Ambien or Ativan?, posted by Minnie-Haha on August 31, 2004, at 13:27:53

> 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).

That's exactly the kind of thing that always kept me from falling asleep in the first place. I'd try to count sheep and they'd misbehave and not jump. I'd just lie there and cycle random thoughts, getting more and more worked up.

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.

But Ativan is a short acting drug. No wonder you wake up early. I think its main claim to fame is that it doesn't stay in your system long.

> 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.

You sound more depressed and anxious to me than BP.

(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.

When I'm on meds, (Effexor) I'm no longer sad and tearful. Just grim. Nothing is fun, nothing is worth doing. The only energy I have is if I get my stress hormones pumping - I can run on adrenaline for a while if I have to get something done. Then there's a big letdown and I need to calm/numb myself.
> > 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.

this was actually kind of misleading. I don't consider it insomnia if I can fall asleep within about an hour and a half these days. That's still not so great.

> 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!

Idiots! I truly think they are guessing and making stabs in the dark at diagnoses as well as meds.

Yikes! I really feel like what I have is depression and anxiety, but what ya gonna do?...

Memorize the DSM symptoms and trot them out on your next visit?

> 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!

I tried Zyprexa 2.5 mg once also - for one night. It worked great for insomnia, I felt fine the next day but was scared to take it since I'm in recovery from bulimia (another long hard fight) and don't want to lose that. Everyone says it makes you so very hungry.

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

You too. I think you're fine with that small dose of Ativan. Maybe if you gave yourself a drug holiday from time to time you wouldn't build up tolerance?





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