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Re: clomipramine insomnia - does it ever go away? SLS

Posted by undopaminergic on January 29, 2023, at 4:21:26

In reply to Re: clomipramine insomnia - does it ever go away? TriedEveryMedication, posted by SLS on January 28, 2023, at 11:28:14

>
> 2. If insomnia is the problem you are addressing, there are several medications that would probably give favorable results.
>
> zolpidem (Ambien) - Z-drug
> lorazepam (Ativan) - benzodiazepine
> temazepam (Restoril) - benzodiazepine
> clonazepam (Klonopin) - benzodiazepine
> quetiapine (Seroquel) - antipsychotic
> mirtazepine (Remeron) - antidepressant
> doxepin (Sinequan) - antidepressant (TCA) - Extremely antihistaminergic
> amitriptyline (Elavil) - antidepressant (TCA)
> trimipramine (Surmontil) - antidepressant (TCA)
> prazosin (Minipress) - Specific for PTSD nightmares.
>

What about cyproheptadine (Periactin)? It's an antihistamine but also blocks serotonin 5-HT2A, which may improve sleep quality.

> I prefer Z-drugs. If you ever need to discontinue Ambien, you can do so abruptly without having typical benzodiazepine withdrawal reactions. Insomnia can be a withdrawal reaction. For me, I had only partial insomnia as a withdrawal reaction to Ambien discontinuation. This might not be true of everyone. Zolpidem and triazolam (Halcion) are good for initial-insomnia while temazepam is good for sleep-maintenance. Many people like low-dosage quetiapine for both types of insomnia.
>

Midazolam (Dormicum) is another short-acting benzodiazepine suitable for sleep initiation, but it seems to be available (as Versed) only for injection in the US.

> About melatonin:
>
> 1. Melatonin can make depression somewhat worse.
>

Yet there is an antidepressant (agomelatine -- Valdoxan) that is a melatonin agonist.

> 2. The optimum timing of melantonin dosing varies between individuals. Most people find that 1 hour before bedtime works well. Yet, there are people who sleep much better when melatonin is given in the afternoon.
>

Dose is also important. There are people who insist that 300 mcg (micrograms) is better than higher doses.

> 3. Herbal teas. Valerian is mentioned often. Chamomile, lemon grass, and eleuthero are others with reputations as being sleep-aids.
>

Eleutherococcus is also called Siberian Ginseng.

I got angry from Valerian. It was very unusual in how it started and in its qualities. But it has only happened once.

-undopaminergic


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