Posted by dcruik518 on August 4, 2008, at 15:02:42
In reply to Re: beginning to hate remeron, posted by ricker on August 2, 2008, at 13:41:11
It seems as if many in this thread are of the opinion that no really satisfactory sleep agents are available. Apparently, Remeron makes many here feel lethargic in the morning. Trazodone and Seroquel also can cause bad morning lethargy. (Seroquel is particularly bad in this regard--made me feel like a zombie.) And of course the problem with most of the benzo-type sleep aids, including the newer ones, is that one quickly develops a tolerance to them and they therefore are not particularly effective for long-term use.
Recently, however, I have discovered a few drugs that not only help sleep without too much morning grogginess but also improve the quality of sleep. They mainly do this by increasing slow wave or delta sleep, which is the most restorative, and which stimulants, antidepressants, and benzos can interfere with.
In terms of sedating capacacity, I have found the new drugs for restless leg syndrome: Requip and Mirapex to be excellent sleep inducers. The same can be said for Bromocriptine. None of these produces the degree of morning grogginess that the sedating ADs do.
Two drugs that increase slow wave sleep are gabapentin/neurontin and cyproheptadine. Lyrica, of course, has the same effect as gabapentin. It's true that Neurontin and Lyrica are not sedating enough on their own for people with moderate to severe insomnia, but they are worth taking at night to improve the quality of one's sleep. Cyproheptadine is a benign antihistamine often used to treat anorgasmia, but it also fairly sedating and increases slow wave sleep.
I don't believe there is a single drug that can solve insomnia and poor sleep. After years of the most intractable insomnia, I am now able fall asleep easily and wake up with hardly any hangover effects. Here's my current cocktail:
1. Trazodone 50-100 mg
2. Requip 1-2 mg
3. Gabapentin 600 mg
I should say that I have tried all of the standard sleep meds and none of them were potent enough for me. High dose trazodone and seroquel both worked but left me feeling too drowzy the next day. The above works much better and I also know I'm getting deeper, better quality sleep than before. Most people, with less severe insomnia than I, would probably find the trazodone in the above cocktail unnecessary.
~DRC
poster:dcruik518
thread:841442
URL: http://www.dr-bob.org/babble/20080727/msgs/844138.html