Posted by SLS on April 6, 2012, at 1:32:33
In reply to Re: Adding Parnate and prazosin., posted by uncouth on April 5, 2012, at 22:28:21
> hey scott, what is your dosing schedule for prazosin? my pdoc just prescribed it for me for refractory insomnia...both falling asleep and staying asleep...incicentally i also have high blood pressure. nothing else for sleep has worked...only thing that kinda works was saphris and i had to take it multiple times per night. hoping prazosin can help turn off my brain so i can fall and stay asleep.
What psychiatic conditions do you suffer from?
I hope the prazosin works to help you sleep. I take 6 mg/day in three divided doses of 2 mg. One can take 20 mg/day or more safely with this drug. Your doctor chose a good dosage for you to enhance sleep. Some people with PTSD go up to 12 mg or higher
I can't say that prazosin helps keep me asleep. Perhaps I am not taking enough at night to see a difference. My sleep is choppy, and I wake up a several times during the night. This disturbed sleep is the result of both adding Parnate and poor sleep hygiene. I allow myself to sleep too much during the day. I often fall asleep somewhere between 7:30 PM to 9:00 PM and wake at midnight. I have trouble going back to sleep after that. I just took some Ativan so that I can get through the rest of the night. I will use a sleep aid only occasionally.
What drugs have you already tried to treat insomnia? What were the dosages and outcomes? Do you have any trouble falling asleep initially? I once had complete insomnia when I first combined Parnate and desipramine. Combining two BZDs helped: triazolam (Halcion) to initiating sleep and lorazepam (Ativan) to maintain sleep. It worked like a charm, and I had very little hangover the next morning. A more modern combination might use zaleplon in place of the triazolam.
Would your doctor be willing to try GHB (Xyrem)?
Linkadge or Phiddipus might be of help to you. I have a list of treatments in mind, but I would rather know what you have tried first before describing alternatives. I believe Sigismund has already tried prazosin for sleep. Perhaps he will comment here.
I believe that it is justified to be as aggressive in the use of drugs to treat insomnia as it is for using drugs to treat MDD and BD.
This is not a comprehensive list. Each drug has it strength and weaknesses and treat different presentations of medical conditions.
If all else fails, one may elect to treat insomnia with the cautious and responsible use barbiturate:
> incidentally, i noticed today that my mood was very stable despite the extreme sleepiness. although it could have been from the zyprexa i popped last night to finally help me fall asleep.
Well, prazosin worked rather quickly for me to improve depression and reduce its variability during the day. Lithium has also helped with this also, but acts more so to stabilize my depression throughout the week.
By the way, I continue to improve gradually. The ride is not entirely smooth, though. This is to be expected in my case. Right now, my improvement ebbs and flows rather gently; the general direction of improvement still being upwards towards remission. Periodic worsenings now last for hours rather than days. I am gaining more and more confidence in my therapeutic response.
I am wondering if combining guanfacine and prazosin would yield somnolent effects without causing too much dizziness.
Some see things as they are and ask why.
I dream of things that never were and ask why not.
- George Bernard Shaw