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Re: Xanax XR tolerance problem » Ddog

Posted by yxibow on April 20, 2006, at 0:42:46

In reply to Re: Xanax XR tolerance problem » yxibow, posted by Ddog on April 19, 2006, at 8:38:29


> I was taking the soma for back problems and didn't taper from it properly.

I wasn't trying to imply anything, just some people take Soma..mm offlabel. It has some taper issues, yes, I'm sorry you had that.

>
> The Remeron 15mg is not working for sleep the way it did for about 2 weeks now I am lucky if I get 3 hours from it.
>
> What can I do for the sleep.
>
> Any other advice what is the valium switch over dose.

http://www.dr-bob.org/tips/bzd.html

30mg Valium at night for your 3mg alprazolam or some people may find twice daily more effective initially, 15mg twice daily.

As far as your doctor's reluctance... with regards to sleep he will probably be equally reluctant, but...

I believe that sleep medications are for sleep, and antidepressants are for antidepression activity. With the possible exception of Remeron, which may provide some REM capabilities. However it causes weight gain quite tremendously (I know) in many people. All these other yucky stuff like Trazodone and off-label tricyclics... grr.. I don't like their use and in fact Trazodone, while being an old line antidepressant, exhibits tolerance for sleep purposes. I kept getting into an actual "adult dose" and had to back off and back on to a "sleep dose." It also carries a definately non-zero risk of priapism (sustained unwanted erections in the male. I dont know what it does to females.)


You are least likely to run into a barrier if you request Ramelteon from your doctor as it is unscheduled (C-nothing). However he may make the case that it is similar to melatonin, a hormone, and I don't know if you have a history of depression.

Otherwise, Lunesta, C-IV, would be the next medication I would suggest for long term sleep. You have to be prepared for a nickel mouth taste that may or may not last through the morning. I didn't find it all that bad, I dont know why I went back to regular Ambien, its fuzzy in my mind. I had to take the 3mg level -- I have a fair level of insomnia. But it comes in 1, 2 and 3mg.

Followed by that, AmbienCR (C-IV) (regular Ambien is perfectly fine too, but people like to observe the studies that say that AmbienCR is for long term when I find its just more of a patent extension for most people -- it may provide some additional "through the night" sleep that regular Ambien doesn't but its probably more expensive.)

And then there's regular Ambien (C-IV), which can and has been dosed successfully up to 20mg, which by the tone of your doctor wouldn't do. Normal dose 10mg.

Sonata, the final one, is rather weak so I put it as an afternote.

So there are four true sleep medications: Ambien/AmbienCR, Lunesta, Ramelteon, and Sonata. At least for the US market.

 

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URL: http://www.dr-bob.org/babble/20060417/msgs/635079.html