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Re: high dose zolpidem » dbc

Posted by Crotale on July 27, 2008, at 20:51:45

In reply to Re: high dose zolpidem, posted by dbc on July 27, 2008, at 18:14:17

> Something to keep in mind, any drug that relies on GABAa for its mechanism of action is impacted by any sort of stimulant. NRI/SNRI drugs included. This is such a big deal that even after ingesting caffeine you can see lower blood levels of valium than normal in patients.

I take Parnate...I have to take it at bedtime, because I take it not only for depression but also for a parasomnia (sleep disorder) called REM Sleep Behavior Disorder. It means I'm not paralyzed during REM sleep, so I act out my dreams. (My parents used to think I was sleepwalking, I only got diagnosed when I was 20 or so.) The MAOIs suppress REM sleep almost completely, which puts a stop to that. Other ADs suppress REM sleep to a degree but none of the other types did away with the "active dreaming" like the MAOIs.)

Yeah, MAOIs do interfere with sleep in my experience (regardless of what time of day I take them), but I can't find anything else that works as well both for the depression and the sleep d/o (desipramine was a good AD but it didn't solve the "active REM sleep" problem, plus I had a seizure on it).

I don't drink any caffeine, ever. Coffee, soda, anything. Even in the morning. Don't take any other stimulants either except very rarely, and only 1st thing in the AM, a modest dose of modafinil, 50-100mg.

Do you think Valium levels are affected by the pharmacodynamic action of caffeine (that seems weird), or is it a pharmacokinetic interaction? Have other bzds been found to be affected in this way too? I find the midazolam they give me along with the anesthesia during the ECT hits me plenty hard. Maybe if I have the confusion issues after I wake up from the next treatment - I'm pretty sure this is due to the Versed - I'll try taking some Parnate or something and see if that has any effect.

-Crotale


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