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Dr. Bob is Robert Hsiung, MD,
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Posted by Phillipa on April 21, 2005, at 0:05:37
In reply to Re: Lunesta v. Ambien, not a clean swap, posted by Dkscully on April 21, 2005, at 0:00:38
That's great! And so encouraging to us who are thinking of trying it. Please all of you don't quit posting your responses to this hopefully great new medication! Sleep well. Fondly, Phillipa
Posted by jerrympls on April 21, 2005, at 1:11:03
In reply to Re: Lunesta v. Ambien, not a clean swap, posted by musil on April 18, 2005, at 4:51:23
> NO. Maybe. As long as Lunesta isn't a substitute for an existing med like Ambien or triazolem (Halcyon). If you are taking Ambien, I do NOT recommend replacing your Ambien with Lunesta, nor do I recommend combining Ambien with Lunesta. Perhaps this is a personal and one-time experience, but I could only think of thalidomide when I finally came out of the dream state I relate below.
Sorry to hear of your experience - and I do empathize. However, this is not the case for every as you stated - this is your personal experience. Ambien swap to Lunesta is safe and can be an excellent alternative. From reading your post - you certainly didn't have an easy transition. However, I find it odd that after taking the Lunesta you eventually woek up and took valium and halcion = potentially dangerous combination. I wouldn't think the addition of those meds while on a sedative like Lunesta would help in your dream-like state. One fact to note is that caffeine removes benzoz from their post synaptic state - basically reversing the effects. (just an FYI)
Again, from reading your post - it seems more likely - in MY opinion that the odd dream state were most likely a result from use of valium and halcion (valium has a very long half life) along with "ambien discontinuation." Let's hope it's a one-time occurrence.
I'm all for use of benzos and they used to get me right to sleep - but tolerance over the years has lessened that. I still take 4mg of Klonopin a day - even on top of Lunesta.
I too notice some odd dreaming with Lunesta- but nothing to the extreme you went through. In contrast, I find it easy to wake up to go to the bathroom, etc. if I need to in the middle of the night.
I've used Ambien 20mg since it first came out years ago. Of course I haven't been on it EVERYDAY since - but it's always been the sleep med my docs come back to due to my chronic insomnia. I had no problems switching from Ambien 20mg to Lunesta 3mg.
Well, I hope that you are better and that you find a peaceful sleep.
Jerry :-)
Posted by fachad on April 21, 2005, at 1:11:18
In reply to Re: Lunesta v. Ambien, not a clean swap » Dkscully, posted by Phillipa on April 21, 2005, at 0:05:37
My pdoc only had two of the 3mg and two of the 2mg samples left so that's what I got.
I took a 2mg last night and I went to bed 90min later and fell asleep with no trouble. I did not wake up, but I did have lots of dreams.
Tonight I took a 3mg tablet.
I'm interested to see what people find as far as:
- time to onset (Ambien was REALLY FAST)
- duration of action (Ambien wore off in 4 hrs and left me awake at 2 AM)
- subjective quality (Ambien just put me out, lorazapam made me fell dull and sullen)
- sleep quality
- other weird side effects (bad taste, headaches, itchiness, or ??)
Hope others post their experiences with this promising new sleep med.
Posted by jerrympls on April 21, 2005, at 1:12:55
In reply to Re: Lunesta v. Ambien, not a clean swap » musil, posted by Phillipa on April 17, 2005, at 21:20:42
> I sleep with l0mg of valium. Do you think lunesta would help me to sleep without waking during the night. I've been having bad dreams also, but I've also just had surgery [cosmetic] with complications. Thanks, Phillipa
I think Lunesta is worth a try. I'd talk to your doctor about the combination of valium and Lunesta. Perhaps you mean to stop the valium and start Lunesta? If Valium is not helping, talk to your doctor about it.
Posted by jerrympls on April 21, 2005, at 1:18:12
In reply to Lunesta v. Ambien, not a clean swap, posted by musil on April 17, 2005, at 21:08:14
> I have been trying 2Mg Lunesta for the past 6 nights after about 18 months on 10mg Ambien, which ALWAYS seemed to work for me to relax, get me to sleep and keep me asleep from 9:30PM to at least until 12:30AM especially when combined with nightly 10mg diazepam. The early waking is worsened when I am in a major depressive state, so that I might wake up after 2.5 hours when depressed.
>
> My doc asked me to switch directly over from Ambien to Lunesta as he said he "did not want me on more than one sedative at any time" apparently forgetting the 20mg diazepam daily. Regarding Lunesta with 10mg diazepam before bed at 9:30PM, I found the sleep to be much less relaxed and full of inescapable dreams, almost like I had forgotten to take my Ambien and very much like my sleep profile without medication at all.
>
> I concur that there must be some cross tolerance /if not interference/ at the benzo sites hit by Ambien, and that Lunesta will probably be great for those who have never taken Ambien. But for those who are expecting that relaxed feeling before nodding off, Lunesta didn't replace Ambien for me 1 to 1 at all -- in fact, I might suggest that I suffered from Ambien discontinuance...I don't think an even swap is fair to most folks who have been long term successful Ambien patients.
> Your p-doc should know from these experiences that it's not an even exchange and that if anything Lunesta should be ADDED to the regimen if it's so harmless and even a little helpful.
>
> OK with you, all you benzophobes? We just want to sleep, is all. I've been to two funerals of friends who died from lack of sleep. Addict shmaddict -- hold your breath for a while and see what you're really addicted to. (sorry, cranky from lack of sleep...)
>
> My sleep profile without medication is simply not to sleep -- except of course, when driving, or trying to work, or eat, or romantic moments. Yawn.I agree that Lunesta doesn't "feel" like Ambien - ie: the relaxed state - however I do feel a more normal sleepiness on Lunesta. It certainly helps more with racing throughts than Ambien at 20mg (which I've been on and off for years). Ambien always "worked like a dream" but eventually tolerance developed.
So yeah - this isn't a feel-good-before-you-go-to-sleep med like Ambien - but it still works very well - for me - and as long as I can get to sleep and stay asleep without hangover in the morning - I'm ok.
Posted by jerrympls on April 21, 2005, at 1:25:28
In reply to 2nd night of Lunestra, posted by fachad on April 21, 2005, at 1:11:18
> My pdoc only had two of the 3mg and two of the 2mg samples left so that's what I got.
>
> I took a 2mg last night and I went to bed 90min later and fell asleep with no trouble. I did not wake up, but I did have lots of dreams.
>
> Tonight I took a 3mg tablet.
>
> I'm interested to see what people find as far as:
>
> - time to onset (Ambien was REALLY FAST)When Ambien worked really well for me - it got me to sleep very fast whereas Lunesta 3mg takes an hour or so
>
> - duration of action (Ambien wore off in 4 hrs and left me awake at 2 AM)Duration is MUCH longer = better than Ambien.
>
> - subjective quality (Ambien just put me out, lorazapam made me fell dull and sullen)Ambien gave me a more relaxed "falling asleep" whereas Lunesta seems to just make me somewhat "normally" tired (yawn, etc). I don't feel knocked out - but it seems to put me in a deeper sleep than Ambien.
Also - I have NONE of the amnesia effects that Ambien has been known to cause.
>
> - sleep qualityStill deciding on the sleep quality. I generally think it's very good overall - but I may have sleep apnea (I have a sleep study later this month) so that may be interfering.
>
> - other weird side effects (bad taste, headaches, itchiness, or ??)No bad taste as some others have reported. I did have a headache for the first 3 days of taking it - nothing really bad - but annoying. No other side effects.
>
> Hope others post their experiences with this promising new sleep med.
Great post! I hope others respond as well.Jerry
Posted by musil on April 21, 2005, at 6:58:45
In reply to Re: Lunesta v. Ambien, not a clean swap » musil, posted by jerrympls on April 21, 2005, at 1:11:03
I took the valium as prescribed and the halcyon as prescribed. What am I missing regarding the dangers of taking both together? I have been Rx'ed 10mg diazepam 2X daily (AM & PM) plus Ambien plus Halcyon if early wakeup around 2AM. The idea is that triazolem is short lived enough to take at 2AM so that there is no extreme hangover in the AM.
The Lunesta was intended to replace the Ambien and hopefully relieve the early waking so that Halcyon wasn't necessary for early waking.
What is my pdoc missing besides the benefit of youth and 3 feet of colon?
Posted by vivi on April 21, 2005, at 18:10:23
In reply to Valium + Halcyon dangerous? Re: Lunesta v. Ambien, posted by musil on April 21, 2005, at 6:58:45
> I took the valium as prescribed and the halcyon as prescribed. What am I missing regarding the dangers of taking both together? I have been Rx'ed 10mg diazepam 2X daily (AM & PM) plus Ambien plus Halcyon if early wakeup around 2AM. The idea is that triazolem is short lived enough to take at 2AM so that there is no extreme hangover in the AM.
>
> The Lunesta was intended to replace the Ambien and hopefully relieve the early waking so that Halcyon wasn't necessary for early waking.
>
> What is my pdoc missing besides the benefit of youth and 3 feet of colon?Is Halcyon used for sleep? I have never heard about it.
Posted by musil on April 21, 2005, at 18:34:22
In reply to Re: Valium + Halcyon dangerous? Re: Lunesta v. Ambien, posted by vivi on April 21, 2005, at 18:10:23
>
> Is Halcyon used for sleep? I have never heard about it.
>
>
http://www.parpharm.com/downloads/triazolam_po.pdf
Triazolam is a hypnotic with a short mean plasma half-life reported to be in the range of 1.5 to 5.5
hours. In normal subjects treated for seven days with four times the recommended dosage, there was
no evidence of altered systemic bioavailability, rate of elimination, or accumulation. Peak plasma levels
are reached within 2 hours following oral administration. Following recommended doses of triazolam,
triazolam peak plasma levels in the range of 1 to 6 ng/mL are seen. The plasma levels
achieved are proportional to the dose given.
Triazolam and its metabolites, principally as conjugated glucuronides which are presumably inactive,
are excreted primarily in the urine. Only small amounts of unmetabolized triazolam appear in the
urine. The two primary metabolites accounted for 79.9% of urinary excretion. Urinary excretion appeared
to be biphasic in its time course.
.....In sleep laboratory studies, triazolam significantly decreased sleep latency, increased the duration of
sleep and decreased the number of nocturnal awakenings. After two weeks of consecutive nightly
administration, the drug’s effect on total wake time is decreased, and the values recorded in the last
third of the night approach baseline levels. On the first and/or second night after drug discontinuance
(first or second post-drug night), total time asleep, percentage of time spent sleeping, and rapidity of
falling asleep frequently were significantly less than on baseline (predrug) nights. This effect is often called “rebound” insomnia.
Posted by lois on April 21, 2005, at 20:36:12
In reply to Lunesta, Has Anyone Tried It?, posted by Phillipa on April 10, 2005, at 13:06:33
I took 2 mgs for a week and so-so. Now on 3mgs,and a little better. Headache during the day.
Has anyone tried 4mgs? I know it's not suggested, just wondering.
Lois
Posted by betternow on April 22, 2005, at 22:54:26
In reply to Re: Lunesta, Has Anyone Tried It?, posted by lois on April 21, 2005, at 20:36:12
I took 4mg about 3 hrs ago. I'm still here, awake. This is my fourth night of no sllep on 4mgs. Tomorrow I will goto 6mgs. The science behind this drug is too good for this drug to respond so poorly at indicated dosages. My guess is that Sepracor studied the drug on relatively healthy participants, not us. Us being this little population of folks who just can't seem to feel right. I think we need higher doses of everything.
But I could be wrong about all that. This could just be one of the many new products that get FDA approval and are worthless.I wll give an update on my 6mg adventure. If no efficacy I will the try 8mg. If that works, then my pdoc will need to prescribe 120 tabs/month. I guarentee no coverage at that dose point.
Bottom line: We can dose adjust and experiment all day long. But at the end of the day, this is just not a good product. Ambien, which will be generic soon, blows it away.
Posted by fachad on April 23, 2005, at 0:05:22
In reply to Re: Lunesta, Has Anyone Tried It? » lois, posted by betternow on April 22, 2005, at 22:54:26
Ambien is going to be generic soon? How soon? Have they filed all manner of legal BS to preserve the patent protection?
Is there a date for patent expiration? Have any generic manufactureres applied?
I agree that Ambien seems to be a better product than Lunesta. My insurance will not cover more than 30 3mg tablets a month (they will not cover more than 30 10 mg Ambien per month) and either med carries a $50/month copay.
If Ambien goes generic, the copay will drop to $10/month and in some cases they will cover more than the prescribing limit if the med is generic.
Posted by fachad on April 23, 2005, at 2:30:00
In reply to Ambien generic soon? I agree Ambien is better, posted by fachad on April 23, 2005, at 0:05:22
Now unless they have their lawyers do the patent protecting dance, that means we will see generic Ambien in about April of 2007 - still two years away.
Posted by ed_uk on April 23, 2005, at 12:41:23
In reply to Ambien Patent Expires Oct 21, 2006, posted by fachad on April 23, 2005, at 2:30:00
Hi,
>Generic Ambien (zolpidem).........
In the UK we've had a generic zolpidem for a while now.
Regards,
Ed.
Posted by vivi on April 23, 2005, at 19:13:33
In reply to Ambien generic soon? I agree Ambien is better, posted by fachad on April 23, 2005, at 0:05:22
> Ambien is going to be generic soon? How soon? Have they filed all manner of legal BS to preserve the patent protection?
>
> Is there a date for patent expiration? Have any generic manufactureres applied?
>
> I agree that Ambien seems to be a better product than Lunesta. My insurance will not cover more than 30 3mg tablets a month (they will not cover more than 30 10 mg Ambien per month) and either med carries a $50/month copay.
>
> If Ambien goes generic, the copay will drop to $10/month and in some cases they will cover more than the prescribing limit if the med is generic.I have to pay $25/month for Ambien, but if you come in 1 day before the 30 days, they will not cover the prescription. Insurance companies are so funny about sleep aids. At least it seems that way with mine. I just switched to lunesta 3 mgs and so far the results have been good. I do like that ambien works faster.
Posted by mugsy on April 24, 2005, at 0:30:58
In reply to Re: Ambien generic soon? I agree Ambien is better » fachad, posted by vivi on April 23, 2005, at 19:13:33
I just tried lunesta desperately hoping to find a gentler but effective alternative to the seroquel I've been taking (was taking 300-400 mg seroquel but tapered to less than 50mg for past couple of months).
The first night (two nights ago) I took 2mg of lunesta and about 25 mg of seroquel. Went to sleep easily but woke up early (maybe got 4 hours or so of sleep) and could not get back to sleep after that. Did not seem to have the munchies as much as with seroquel but felt ok except for this really weird taste in my mouth which lasted through half of the next day. The taste is most noticable when I drink water, lingering bitter taste. The second night on Lunesta I took 2mg lunesta and no seroquel, I slept for a bit and woke up, I took another 2mg of Lunesta and went back to bed, slept a few hours and woke up again not really able to get back to sleep.
So that is my first two nights on Lunesta. Tonight I feel a little weird. I don't know what to take now... but I know I won't sleep without an effective sedative.
I'm bummed that lunesta isn't much better than it seems to me.
This chronic insomnia has been killing me for many years and seroquel is not really very gentle for me. None of my doctors will prescribe benzos on a regular basis but they have been effective and by far the gentlest of them all for for me. The benzo tolerance effect is a pain but with careful dosing I found could be manageable for a long time.
Seroquel makes me hungry and fat, affects my vision in a bad way, dries out and inflames my throat, irritates my sinuses and does other weird physical and mental stuff... but I either take that or friggin die of insomnia the way it is for me now.
I'm disappointed in lunesta. it's hard to believe we can put a man on the moon but can't have a gentle and effective medication for chronic insomnia.
Posted by vivi on April 24, 2005, at 0:46:57
In reply to seroquel to lunesta experience, posted by mugsy on April 24, 2005, at 0:30:58
> I just tried lunesta desperately hoping to find a gentler but effective alternative to the seroquel I've been taking (was taking 300-400 mg seroquel but tapered to less than 50mg for past couple of months).
>
> The first night (two nights ago) I took 2mg of lunesta and about 25 mg of seroquel. Went to sleep easily but woke up early (maybe got 4 hours or so of sleep) and could not get back to sleep after that. Did not seem to have the munchies as much as with seroquel but felt ok except for this really weird taste in my mouth which lasted through half of the next day. The taste is most noticable when I drink water, lingering bitter taste. The second night on Lunesta I took 2mg lunesta and no seroquel, I slept for a bit and woke up, I took another 2mg of Lunesta and went back to bed, slept a few hours and woke up again not really able to get back to sleep.
>
> So that is my first two nights on Lunesta. Tonight I feel a little weird. I don't know what to take now... but I know I won't sleep without an effective sedative.
>
> I'm bummed that lunesta isn't much better than it seems to me.
>
> This chronic insomnia has been killing me for many years and seroquel is not really very gentle for me. None of my doctors will prescribe benzos on a regular basis but they have been effective and by far the gentlest of them all for for me. The benzo tolerance effect is a pain but with careful dosing I found could be manageable for a long time.
>
> Seroquel makes me hungry and fat, affects my vision in a bad way, dries out and inflames my throat, irritates my sinuses and does other weird physical and mental stuff... but I either take that or friggin die of insomnia the way it is for me now.
>
> I'm disappointed in lunesta. it's hard to believe we can put a man on the moon but can't have a gentle and effective medication for chronic insomnia.
Have you tried Ambien? it works faster than Lunesta, but not as long. I liked ambien, but I needed something stronger. I have read some posts that mention Remeron?
Vivi
Posted by mugsy on April 24, 2005, at 0:55:42
In reply to Re: seroquel to lunesta experience » mugsy, posted by vivi on April 24, 2005, at 0:46:57
I tried a small amount of ambien a few times. It didn't seem to do much for me so I wrote it off pretty much. I might consider giving that another try sometime. I did try remeron once and it did not agree with me at all but I know a couple of people who found it helpful for them.
Posted by vivi on April 24, 2005, at 1:05:37
In reply to Re: seroquel to lunesta experience, posted by mugsy on April 24, 2005, at 0:55:42
> I tried a small amount of ambien a few times. It didn't seem to do much for me so I wrote it off pretty much. I might consider giving that another try sometime. I did try remeron once and it did not agree with me at all but I know a couple of people who found it helpful for them.
I took ambien 10mg and it would work right away, but if your problem is staying asleep, you might need to try something else like Klonopin. i have used that (not for sleep) but it did help me fall and stay asleep.
Vivi
Posted by Phillipa on April 24, 2005, at 17:22:53
In reply to Re: seroquel to lunesta experience » mugsy, posted by vivi on April 24, 2005, at 1:05:37
I tried remeron l5mg and was afraid of wt gain. And since I was taking it with valium I really didn't think it helped. I'm still amazed at the posters who say remeron made them sleep for up to 20hours. Fondly,Phillipa
Posted by jerrympls on April 25, 2005, at 20:47:23
In reply to seroquel to lunesta experience, posted by mugsy on April 24, 2005, at 0:30:58
> I just tried lunesta desperately hoping to find a gentler but effective alternative to the seroquel I've been taking (was taking 300-400 mg seroquel but tapered to less than 50mg for past couple of months).
>
> The first night (two nights ago) I took 2mg of lunesta and about 25 mg of seroquel. Went to sleep easily but woke up early (maybe got 4 hours or so of sleep) and could not get back to sleep after that. Did not seem to have the munchies as much as with seroquel but felt ok except for this really weird taste in my mouth which lasted through half of the next day. The taste is most noticable when I drink water, lingering bitter taste. The second night on Lunesta I took 2mg lunesta and no seroquel, I slept for a bit and woke up, I took another 2mg of Lunesta and went back to bed, slept a few hours and woke up again not really able to get back to sleep.
>
> So that is my first two nights on Lunesta. Tonight I feel a little weird. I don't know what to take now... but I know I won't sleep without an effective sedative.
>
> I'm bummed that lunesta isn't much better than it seems to me.
>
> This chronic insomnia has been killing me for many years and seroquel is not really very gentle for me. None of my doctors will prescribe benzos on a regular basis but they have been effective and by far the gentlest of them all for for me. The benzo tolerance effect is a pain but with careful dosing I found could be manageable for a long time.
>
> Seroquel makes me hungry and fat, affects my vision in a bad way, dries out and inflames my throat, irritates my sinuses and does other weird physical and mental stuff... but I either take that or friggin die of insomnia the way it is for me now.
>
> I'm disappointed in lunesta. it's hard to believe we can put a man on the moon but can't have a gentle and effective medication for chronic insomnia.WOW - this is the exact stiuation I'm in! I'm finding that Lunesta isn't the great sleep med I'd hoped. I think my lack of response to it is because of too many years on benzos and Ambien....? The Seroquel is the only thing that will knock me out - but I can barely get out of bed in the morning which has caused many absences and tardiness to work = could very well get fired.
I see a sleep doc tomorrow - hopefully he'll have some good news?
Posted by jerrympls on April 25, 2005, at 20:49:29
In reply to Re: seroquel to lunesta experience, posted by mugsy on April 24, 2005, at 0:55:42
> I tried a small amount of ambien a few times. It didn't seem to do much for me so I wrote it off pretty much. I might consider giving that another try sometime. I did try remeron once and it did not agree with me at all but I know a couple of people who found it helpful for them.
Remeron does a great job of reducing my nighttime anxiety - but even at 15mg it makes my appetite OUT OF CONTROL.
Posted by jerrympls on April 25, 2005, at 20:59:57
In reply to Re: seroquel to lunesta experience, posted by Phillipa on April 24, 2005, at 17:22:53
> I tried remeron l5mg and was afraid of wt gain. And since I was taking it with valium I really didn't think it helped. I'm still amazed at the posters who say remeron made them sleep for up to 20hours. Fondly,Phillipa
I've had very similar experiences - it helped with anxiety and relaxed me but doesn't put me out light a light.
Posted by Phillipa on April 25, 2005, at 21:26:14
In reply to Re: seroquel to lunesta experience » Phillipa, posted by jerrympls on April 25, 2005, at 20:59:57
Corona with lime was my vice! Fondly, Phillipa
Posted by awatts on April 26, 2005, at 8:56:50
In reply to Re: seroquel to lunesta experience » jerrympls, posted by Phillipa on April 25, 2005, at 21:26:14
> Corona with lime was my vice! Fondly, Phillipa
Add some chloral hydrate to that and it WILL put you out like a light <grin>. However, I would not advise this.
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