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Re: **INSOMNIA FROM HELL** med_empowered

Posted by jerrympls on March 25, 2005, at 18:53:40

In reply to **INSOMNIA FROM HELL**, posted by med_empowered on March 24, 2005, at 23:26:41

> Hey! Insomnia sucks--no doubt about it. There are lots of reasons you may be having sleep med "issues". Obviously, there's tolerance. On the other hand, a lot of shrinks under-utilize benzos/sleep aids...you gave an example of Ativan; when I had my all-purpose ativan RX, it was 2mgs for a panic attack, 4-5mgs for night time use..I think your shrink may be under-prescribing in an effort to "err on the side of safety". Of course, there are non-benzo alternatives. You've done the Ambien thing already (Ambien, BTW, is very benzo-ish; that's why it+sonata are schedule IV drugs, just like benzos)...like the others mentioned, there's chloral hydrate, a schedule III old-school drug that's still used by many shrinks...as Phillipa said, please be careful about alcohol (or any sedatives) w/ chloral hydrate...in addition to the "mickey finn" effect, this was one of the sedatives that killed Marilyn Monroe. Seroquel is overkill for me, too; personally, I found the solution was to rotate meds. So...I tried to go med-free, if I couldn't, I'd first try 5-10mgs Ambien OR 1-2 Sonata capsules. If that failed, it was time for 600-900 mgs Neurontin (Neur. works, but has a noticeable hangover effect). I personally HATE trazadone, but lots of people swear by Remeron (watch out for the weight problem and drug-drug interactions). For a while, mood-stabilizers (in my case, Trileptal) helped with my insomnia a good bit...if you're bipolar or have a more "complicated" depressive disorder, this might be worth trying. For non-drug alternatives, there's always exercise (helped me a lot), meditation, and good "sleep hygiene". Alternative remedies are plentiful...I personally have found that 5-HTP, 50-100mgs right before bed, helps out a whole lot, though there may be some stomach issues. Lots of people swear by melatonin, and valerian root is popular as well...supposedly, it works in a benzo-ish manner, but no one seems TOTALLY sure about that. The usual meds of last resort are the barbiturates...some shrinks are more free with them than others, some don't use them at all, and sometimes they're inappropriate for a given patient, no matter how severe the insomnia. Nonetheless, its a possibility...it seems that the most popular one still used is Phenobarbital; its a less scary barbiturate, and its a schedule IV just like benzos. But..there are lots of problems with it. It has lots of drug-drug interaction problems, it lasts FOREVER, and there are cognitive side-effects. And of course, it still leads to those mysterious "accident or suicide?" deaths, like Muriel Hemingway, so its got some lethal-potential. Less popular, but still available are Seconal (the *OFFICIAL* suicide sedative), Tuinal (amytal+seconal), Alurate, and Amytal.

Hey there-

Thanks for your post. I have to be honest and say I've tried all of the drugs and NON-drug remedies you listed above. Ambien was a miracle drug for me for many years. Sonata doesn't do a thing for me. I HATE trazadone. My previous family doc. finally put me on Nembutal (a barbituate) years ago. It was THEE BEST sleep I have EVER gotten. I felt more energized during the day I slept very well - no hangover. However, it was only for 2 months that he wanted me on it - so afterwards we went back to Ambien. Nov. 2004 my doctor (my pdoc) agreed to try Nembutal - and gave me a script for it. I was so relieved....except only to find out that they've stopped making it as of Nov. 1 2004!!!

So I can understand my pdoc's frustration - but I'm frustrated with him for not being more aggressive with my insomnia.

Anyway, thanks for your reply
Jerry


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poster:jerrympls thread:475165
URL: http://www.dr-bob.org/babble/20050322/msgs/475611.html