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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by owensmar on September 1, 2004, at 15:09:37
Some of us were discussing insomnia issues under the thread Ambien vs. Ativan. We thought it's probably a pretty big issue for a lot of us on this board so wanted to broaden the discussion to insomnia in general.
What meds work for you (preferably without too many side effects or tolerance/dependence issues)?
Is your insomnia categorized by the inability to fall asleep or inability to stay asleep?
How do you avoid the tolerance issue?
Posted by King Vultan on September 1, 2004, at 16:46:45
In reply to Insomnia - what works for you?, posted by owensmar on September 1, 2004, at 15:09:37
> Some of us were discussing insomnia issues under the thread Ambien vs. Ativan. We thought it's probably a pretty big issue for a lot of us on this board so wanted to broaden the discussion to insomnia in general.
>
> What meds work for you (preferably without too many side effects or tolerance/dependence issues)?
>
> Is your insomnia categorized by the inability to fall asleep or inability to stay asleep?
>
> How do you avoid the tolerance issue?
>
>I take an MAOI and can fall asleep but have problems with waking up throughout the night. I avoid the tolerance issue by alternating sleeping meds. I take a sedating OTC antihistamine one night and Halcion (triazolam) the next. For the antihistamine, I was using 2 x 25 mg Benadryl (diphenhydramine), which works okay but not great, but am now trying Unisom tablets, which contain 25 mg doxylamine succinate. I took one pill the other night and was surprised to find that this med is apparently much more anxiolytic than is Benadryl; apparently, antihistamines can be skewed either towards being sedative/hypnotic or being anxiolytic, just as is the case with the benzodiazepines. Still, the Unisom tablets seemed to work for sleep also, as the very pronounced calming effect seemed to keep my thoughts from racing in the middle of the night, which seems to be my big problem as far as getting back to sleep. I must say I seemed a bit more hung over the next day than I do with the diphenhydramine and was only going to try half a pill tonight.
I have never had to use more than half of a 0.25 mg pill of the Halcion, which perhaps helps me to avoid tolerance also. I do think Restoril/temazepam is probably a superior sleep med based on what I've read, but I haven't tried it. Halcion's half life is so short it really isn't the best choice for people who have trouble maintaining sleep. I think it works for me because I also use a sleep/relaxation CD played all night on repeat; this helps to keep me in a relaxed state so that when I wake up it isn't so difficult to fall back asleep.
Todd
Posted by Colleen D. on September 1, 2004, at 16:59:04
In reply to Insomnia - what works for you?, posted by owensmar on September 1, 2004, at 15:09:37
> What meds work for you (preferably without too many side effects or tolerance/dependence issues)?
What's working for me is 50mg of Doxepin (Sinequan) about an hour before bedtime.
> Is your insomnia categorized by the inability to fall asleep or inability to stay asleep?Both.
>How do you avoid the tolerance issue?
From what I understand, tolerance and/or dependence is not usually an issue with this drug. (I could be wrong though.) It is a tricyclic antidepressant and I am taking it with Effexor XR.
Colleen
PPD, GAD and OCD
Posted by KaraS on September 1, 2004, at 17:34:11
In reply to Re: Insomnia - what works for you?, posted by Colleen D. on September 1, 2004, at 16:59:04
> > What meds work for you (preferably without too many side effects or tolerance/dependence issues)?
>
> What's working for me is 50mg of Doxepin (Sinequan) about an hour before bedtime.
>
> > Is your insomnia categorized by the inability to fall asleep or inability to stay asleep?
>
> Both.
>
> >How do you avoid the tolerance issue?
>
> From what I understand, tolerance and/or dependence is not usually an issue with this drug. (I could be wrong though.) It is a tricyclic antidepressant and I am taking it with Effexor XR.
>
> Colleen
> PPD, GAD and OCD
I took a small dosage of doxepin for many years for sleep. It's a TCA and there is no tolerance issue. I wasn't as lucky as Colleen, though, as doxepin made me quite groggy during the day and it increased my appetite quite a bit.-K
Posted by Wildflower on September 2, 2004, at 13:59:15
In reply to Insomnia - what works for you?, posted by owensmar on September 1, 2004, at 15:09:37
I've tried a few and had very little success. Right now, Trazodone seems to be working a bit but I still haven't found a fool-proof med. All that I've tried leave me groggy and feeling tired the next day.
Posted by Piquet on September 2, 2004, at 15:35:45
In reply to Insomnia - what works for you?, posted by owensmar on September 1, 2004, at 15:09:37
> Some of us were discussing insomnia issues under the thread Ambien vs. Ativan. We thought it's probably a pretty big issue for a lot of us on this board so wanted to broaden the discussion to insomnia in general.
>
> What meds work for you (preferably without too many side effects or tolerance/dependence issues)?
>
> Is your insomnia categorized by the inability to fall asleep or inability to stay asleep?
>
> How do you avoid the tolerance issue?
>
I take Parnate (60 mg/6 weeks) and although I'm finding it a little easier to get to sleep these days, I only sleep for 2-3 hrs max without assistance. Therefore I alternate with Ambien (5 mg), Benadryl (10 ml = 25 mg of active ingred.), temazepam (10 mg) or diazepam (10-15 mg). I try not to take a benzo two nights in a row (not always possible) and believe that alternating the meds has kept me from having to increase their respective dosages. Rarely, I get a 4 or 5 hours natural sleep, and sometimes Johnny Walker gives me a hand. The 'cleanest' drug for me, insofar as nil next day hangover is concerned, is Ambien. I also resist sleeping during the day, especially during the afternoon 'Parnate sedation' period.
Posted by thinkfast on September 3, 2004, at 11:09:19
In reply to Insomnia - what works for you?, posted by owensmar on September 1, 2004, at 15:09:37
I've been on 100mg of seroquel for about a month and it's working great. Falling asleep and staying asleep have been problems for me for quite some time. My pdoc says that a lot of people on this med complain of tiredness the next day, but I havn't really experienced that at all. The seroquel is much easier on me the next day compared to Remeron. That stuff made me feel like crap!
peace
Posted by Sad Panda on September 3, 2004, at 12:03:55
In reply to Insomnia - what works for you?, posted by owensmar on September 1, 2004, at 15:09:37
The sedating TCA's are very good & have no tolerance/dependance issues. From weakest to strongest: Nortriptyline, Amitriptyline, Trimipramine & Doxepin. Remeron is also good, especially if you are suffering from SSRI induced nausea. What all these meds are firstly are antihistamines. Remeron being the most powerful on the market. Of the OTC antihistamines, Benadryl & Phenergan are probably the most sedating.
Cheers,
Panda.
Posted by Mariposa on September 3, 2004, at 19:48:58
In reply to Re: Insomnia - what works for you - Sedating TCA's, posted by Sad Panda on September 3, 2004, at 12:03:55
Lexapro..... Was a terrible insomniac until I was rx'd Lex for PMDD. Now sleep soundly through nite, do NOT wake at 3AM to stare at the clock until it's time to get up like I used to.~~~8|8
Posted by 4WD on September 3, 2004, at 22:02:04
In reply to Re: Insomnia - what works for you - Sedating TCA's, posted by Sad Panda on September 3, 2004, at 12:03:55
> The sedating TCA's are very good & have no tolerance/dependance issues. From weakest to strongest: Nortriptyline, Amitriptyline, Trimipramine & Doxepin. Remeron is also good, especially if you are suffering from SSRI induced nausea. What all these meds are firstly are antihistamines. Remeron being the most powerful on the market. Of the OTC antihistamines, Benadryl & Phenergan are probably the most sedating.
>
> Cheers,
> Panda.
>
I've taken Phenergan for nausea before but I didn't know you could get it OTC? What's the brand name?Marsha
Posted by 4WD on September 3, 2004, at 22:04:15
In reply to Re: Insomnia - what works for you -, posted by Mariposa on September 3, 2004, at 19:48:58
> Lexapro..... Was a terrible insomniac until I was rx'd Lex for PMDD. Now sleep soundly through nite, do NOT wake at 3AM to stare at the clock until it's time to get up like I used to.~~~8|8
That is so weird. When I took Lexapro, one of the problems I had with it was that it made me wake up about two hours too early everyday.
This is the end of the thread.
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