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Re: Wicked insomnia - what should I take? dreamboat_annie

Posted by yxibow on October 15, 2006, at 2:58:34

In reply to Wicked insomnia - what should I take?, posted by dreamboat_annie on October 14, 2006, at 0:03:01

> It takes me about 2 hours or more to actually fall asleep and then I wake up two or three time a night. I've always had mild insomnia, but it is getting worse. I tried Trazadone about 2 years ago and, 1/2 of a 25mg pill worked, but I was a total zombie the following day. It took until noon the next day for it to wear off. And, it made me feel very depressed after a few days of use. I figure if I can just get 2 or 3 nights of good sleep, then I will be fine for awhile again.
>
> Any suggestions?
>
> Thanks a bunch!

Trazodone takes getting used to, just like the off-label use of Sinequan (doxepine). Doxepine especially requires a weekend to devote to getting used to, its heavily sedating to start with.

The trouble is eventually you do get used to Trazodone though it is not a scheduled drug -- surprised about depression as an adult dose (which would put anyone to sleep and isn't used any more) was an antidepressant. At any rate eventually 25 becomes 125, etc, and you're starting to get into the serotonergic range and you have to drop and go back if you dont want hangover effects.


I'm not a particular fan of off label medications, but some doctors are benzophobes or feel their patients with depression shouldn't be taking them.


Personally though I would still recommend the pseudobenzodiazepine class, which depending where you live, includes either Lunesta (the active metabolite of Zopiclone, sold generic elsewhere but the US), Ambien, and Sonata.


If you have depression, I would probably not take Rozerem. It is just an expensive target for the same melatonin receptors that OTC melatonin targets, albeit probably a little cleaner. It can cause hormonal changes which is not good for affective disorders. Melatonin is good for resetting jet lag, but not really for a long term basis especially with those with affective disorders.


If you're already used to benzodiazepines, you may have to take more than the recommended dosage for pseudobenzodiazepines, e.g. 4mg of Lunesta or 15-25mg of Ambien. That's up to your doctor though.

Hope you get some pleasant dreams.

There is one off label, I think I've posted this before, Remeron, which at its lowest dose 7.5mg is a good REM medication. Unfortunately, unless you're among the small percentage of people who don't gain weight on it, you'll gain quite quickly if you don't restrict a diet firmly.

-- tidings


Jay

 

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