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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by starfox on November 28, 2005, at 11:58:19
Hi everyone,
I suffer with chronic insomnia, the main complaint being that I awake to early in the morning.
I have tried a whole host of sleep meds ranging from herbal, hypnotic and sedating antidepressants not with any real help.
Heres my list:
Cipralex: 30mg(no help with sleep at all)Trazodone:(weird dreams and several wake-ups thru night)
Remeron:(helps slightly but does,nt keep me asleep past 4-5 hours even at low doses of 15,7.5)
Ambien:(same as above)
Zopiclone:(same as above)
Lunesta: does the job for about 5 hours then wake up feeling like I have had worst unrefreshing sleep ever!)
Amitriptyline:(I only took this drug for about 3 days, it didnt even sedate me whatsoever-tried dosage from 50 then 75 then 100-nothing)
As you can probably imagine Im now feeling like a f*!@ing walking chemist and am still strugling with sleep maintenance.
Im interested in Benzo's but am scared Ill get addicted to them and tolerance issues ect, ect.
Is it possible I can mix tricyclics together like doxepin(which ive heard is very good for sleep probs) with say, remeron or trimipramine or all 3 together or is this dangerous?.
God Im really pissed off with this its driving me nuts!!!
Anyone with any advise on this problem or what things helped you out would be greatly appreciated
as im feeling really down in the dumps at the moment.
Thankx in advance
P.S
Im Male, 27
Posted by Muad' Dib on November 28, 2005, at 13:29:39
In reply to Best meds for sleep disorders?, posted by starfox on November 28, 2005, at 11:58:19
Xyrem/GHB is the best sleep med, hands down.
Posted by ed_uk on November 28, 2005, at 13:50:59
In reply to Best meds for sleep disorders?, posted by starfox on November 28, 2005, at 11:58:19
Hi Starfox
How long do you actually *need* to sleep in order to feel ok the next day? Is 5 hours enough - it is for some people. I need 8 hours though, we're all different.
Do you get distressed when you wake up during the night or is it more of an annoyance?
Say you were taking Remeron and got 5 hours sleep. What time would you generally fall asleep and what time would you wake up?
Have Ambien and Remeron been the best sleep meds you've tried so far?
Regards
Ed
PS. What country do you live in?
Posted by spriggy on November 28, 2005, at 13:58:06
In reply to Re: Best meds for sleep disorders? » starfox, posted by ed_uk on November 28, 2005, at 13:50:59
What about Restoril?
when I can't sleep, that's what I take.
30 mg's knocks me out for 9 hours and it's a very restful sleep.
Posted by starfox on November 28, 2005, at 14:43:27
In reply to Re: Best meds for sleep disorders? » starfox, posted by ed_uk on November 28, 2005, at 13:50:59
> Hi Starfox
>
> How long do you actually *need* to sleep in order to feel ok the next day? Is 5 hours enough - it is for some people. I need 8 hours though, we're all different.
>
> Do you get distressed when you wake up during the night or is it more of an annoyance?
>
> Say you were taking Remeron and got 5 hours sleep. What time would you generally fall asleep and what time would you wake up?
>
> Have Ambien and Remeron been the best sleep meds you've tried so far?
>
> Regards
>
> Ed
>
> PS. What country do you live in?--------------------------------------------------
Hi ed,Im in the uk too,
I would generally say I need about min 7 hours of solid sleep to feel refreshed and In a generally happy mood ready for the day ahead. Anything less and I become very aggitated, aggresive and moody normally all day, also very depressed but only when I had bad sleep and woke up early. When I sleep for 7 hours or more I kinda feel euphoric, like a natural buzz.
When I wake up to early I feel distressed and annoyed.
I would probably say that ambien is maybe the best one ive tried, but like I said its good for knocking you out but no good for a long uninterupted sleep.
I take 7.5mg remeron about 10.30pm asleep about 11.30-12.00 then wake up about 4a'mish.
Posted by ed_uk on November 28, 2005, at 15:42:57
In reply to Re: Best meds for sleep disorders?, posted by starfox on November 28, 2005, at 14:43:27
Hi Starfox
Did you buy Lunesta on the internet?
>Im in the uk
OK, some UK docs are happy to prescribe short courses of benzos to treat insomnia. Long term use is pretty much restricted to those who are already physically dependent on benzodiazepines.
You could try doxepin or trimipramine next. If all else fails, sedating antipsychotics such as Seroquel are sometimes prescribed.
How do you react to antihistamine like Nytol?
Ed
Posted by Bill LL on November 28, 2005, at 17:16:22
In reply to Best meds for sleep disorders?, posted by starfox on November 28, 2005, at 11:58:19
I have used Ambien and Lunesta. A couple of weeks ago I started taking pregabalin (Lyrica) for anxiety. Even the first night on it I could sleep very well without taking Lunesta. I started Lyrica at 300 mg, and now take 600 mg which has been a great improvement in my anxiety.
Posted by linkadge on November 28, 2005, at 21:21:16
In reply to Re: Best meds for sleep disorders?, posted by Bill LL on November 28, 2005, at 17:16:22
I would try a combination approach.
I would start in the evening with say 100mg of magnesium, 10mg zinc, 500mg of vitamin C 100mg of Niacine, 500 mg of Taurine.
Then, at bedtime I would take a low dose of doxapine, perhaps with 1mg of melatonin.
The alternatives listed are relatively inexpensive, but I would take them early in the evening.
Linkadge
Posted by Phillipa on November 28, 2005, at 22:12:06
In reply to Re: Best meds for sleep disorders?, posted by linkadge on November 28, 2005, at 21:21:16
Nickengland just suggeted I take Omega 3, Gaba, Taurine,Magnesium citrate. Oh course I still take the valium. I find I'm not falling asleep very easily and waking up at around 8-9. That's the best I've done. What I don't understand is why since I've moved I've not excercised and am able to sleep better. Doesn't make sense does it unless I'm getting very lazy. Fondly, Phillipa
Posted by Bill LL on November 29, 2005, at 13:37:41
In reply to Re: Best meds for sleep disorders?, posted by Phillipa on November 28, 2005, at 22:12:06
A new prescription sleep drug, Rozerem, is another alternative. It is similar to melatonin, but not the same thing. It is supposed to be more effective than melatonin.
It has no known side effects except that it makes one tired during the day time. This is transient and generally goes away before 4 weeks.
Posted by Paulbwell on November 30, 2005, at 16:06:25
In reply to Best meds for sleep disorders?, posted by starfox on November 28, 2005, at 11:58:19
> Hi everyone,
>
> I suffer with chronic insomnia, the main complaint being that I awake to early in the morning.
> I have tried a whole host of sleep meds ranging from herbal, hypnotic and sedating antidepressants not with any real help.
> Heres my list:
> Cipralex: 30mg(no help with sleep at all)
>
> Trazodone:(weird dreams and several wake-ups thru night)
>
> Remeron:(helps slightly but does,nt keep me asleep past 4-5 hours even at low doses of 15,7.5)
>
> Ambien:(same as above)
>
> Zopiclone:(same as above)
>
> Lunesta: does the job for about 5 hours then wake up feeling like I have had worst unrefreshing sleep ever!)
>
> Amitriptyline:(I only took this drug for about 3 days, it didnt even sedate me whatsoever-tried dosage from 50 then 75 then 100-nothing)
>
> As you can probably imagine Im now feeling like a f*!@ing walking chemist and am still strugling with sleep maintenance.
> Im interested in Benzo's but am scared Ill get addicted to them and tolerance issues ect, ect.
> Is it possible I can mix tricyclics together like doxepin(which ive heard is very good for sleep probs) with say, remeron or trimipramine or all 3 together or is this dangerous?.
> God Im really pissed off with this its driving me nuts!!!
> Anyone with any advise on this problem or what things helped you out would be greatly appreciated
> as im feeling really down in the dumps at the moment.
> Thankx in advance
> P.S
> Im Male, 27
>
>Best sleep?-in a word 'Nembutal"-(pentalbarbital) i have read of more than one person here on these boards, getting the best, sleep, ever after taking 1-2 100mg caps of Nembutal!!
Unfortunately for you (I'm guesssing you are a USA citizen)? it was removed from the market in Nov-2004.
Have a look at what meds you are taking, Stimulants, AD, AP, review the situation.
Halcion, (Triazolam) is VERY effective, BUT only lasts a short while-and produceces a hangover.
If Insomnia is really f*cking with your life, get some effective meds!!-Ambian, Zoplicone, Eszoplicone, or even if these fail, there is Seconal-(red bullets)-and Tuinal-(Rainbows, due to their colour)=seconal+Amobarbitone-combined-Barbiturates, almost guaranteed to put you to sleep! available.
Good luck.
Cheers
Posted by vbAgent on December 1, 2005, at 23:00:09
In reply to Re: Best meds for sleep disorders? » starfox, posted by Paulbwell on November 30, 2005, at 16:06:25
Hi there, don't despair even though you've tried the more commonly prescribed psychotropic drugs used to treat insomnia.
1) Like you stated: There are the benzos, but as you realize, the benefits of the benzodiazepines are compromised by their abuse potential. This is something you and the doctor need to discuss. Ativan is a strong benzo worth considering.
2) Ambien: Have you tried the new extended release formulation now available? It's called AmbienCR and supposedly works for 7-8 hours.
3) Seroquel: This is one of the newer generation atypical antipsychotics. Better side-effects profile compared to other antipsychotics. This medication will do the job when nothing else will. Psychiatrists normally prescribe 25-100mg (or more if necessary) taken at bedtime. I can vouch for Seroquel's efficacy in treating hopeless insomniacs.
4) I wouldn't suggest mixing tricyclics together to treat insomnia. The level of polypharmacy that you're seeking there seems almost dangerous. Keep it simple.
5) Avoid supplements and herbal products, except maybe St. John's Wort and Kava Kava. For example, don't take high doses of supplemental magnesium, taurine or melatonin unless you have a bona fide deficiency!! Also, essential fatty acids (i.e. omega-3,6 & 9) will not alleviate (chronic) insomnia.
6) Besides the benzodiazepines, you do have the barbiturates at your disposal. The problem is finding a doctor who's willing to prescribe one.
Based on your post, I think you could be challanged again with Ambien but ask for the "CR" version - maybe the extended release feature will make a positive difference. Then there's Ativan, a potent benzo, which you could try. I would suggest Seroquel in your case based on your history.
You definitely want to talk to your doctor about anything that "stands out" in your mind which was discussed in this thread.
Best of luck resolving your problem. ;-]
Posted by starfox on December 2, 2005, at 6:35:49
In reply to Re: Best meds for sleep disorders, posted by vbAgent on December 1, 2005, at 23:00:09
Wow I never thought I'd get that much responce to my post!!!.
Thankyou all so much especially vb agent for your informative post.
Ill talk to my Doc about small doses of seroquel for sure.
Once again thanks to all of you for your helpful and kind replys.
God Bless,
Starfox
Posted by Paulbwell on December 3, 2005, at 0:31:49
In reply to Re: Best meds for sleep disorders, posted by starfox on December 2, 2005, at 6:35:49
> Wow I never thought I'd get that much responce to my post!!!.
> Thankyou all so much especially vb agent for your informative post.
> Ill talk to my Doc about small doses of seroquel for sure.
> Once again thanks to all of you for your helpful and kind replys.
> God Bless,
> StarfoxYou REALLY wanna avoid APs if possible.
Both my Grans took barbiturates and lived through till yheir 80's-insist on Seconal ETC if insomnia is f*cking up your life-they are VERY effective, and proven, or perhaps ahigh dose of Zopliclone, sehoe you go.
It's your life, you either succeed or fail-it's up to you!!-OK!!
GOOD LUCK.
>
Posted by vbAgent on December 3, 2005, at 4:21:16
In reply to Re: Best meds for sleep disorders, posted by Paulbwell on December 3, 2005, at 0:31:49
Anytime, Starfox - I'm glad to offer my experience to help a fellow babbler.
Paulbwell, tell Starfox why he/she should avoid antipsychotics (APs). You owe him/her that one. :-)
1) I suggest doing your own research online with these questions in mind, and decide for yourself if a low dose of Seroquel may offer relief from the hell of insomnia. Otherwise, talk to your doctor about the pros and cons of using an antipsychotic (AP) to treat sleep disorders. That's their job!
2) Seconal, certainly an effective barbiturate, is actually a Schedule II controlled substance. Other Schedule II agents are Ritalin, Adderall, Dexedrine, morphine sulfate, methamphetamine, and OxyContin, among others. Paraphrasing one of Starfox's quotes: "I'm interested in benzos but scared that I may become addicted to them and develop tolerance issues, ect." Benzodiazepines are generally considered safer and equally effecacious compared to the older barbiturates. The non-benzodiazepines (Lunesta, Ambien, AmbienCR, Sonata, *Rozerem) are the best of the bunch in terms of low abuse potential and low potential for addiction.
* Rozerem, a benign melatonin agonist, is the newest FDA-approved drug used to treat insomnia.
Remember, what worked for Grans may not work for you. Still, you have nothing to lose by asking your doctor about Seconal.
Wow, time slips away from you when you're squandering (or babbling) the night away. So, gotta hit the sack. Hopefully, this post is coherent. I took two AmbienCR tablets about 45min ago (silly me).
Take care everyone... &:-?
Posted by ed_uk on December 3, 2005, at 12:59:56
In reply to Re: Best meds for sleep disorders » Paulbwell, posted by vbAgent on December 3, 2005, at 4:21:16
>Still, you have nothing to lose by asking your doctor about Seconal.
Take care. Asking for controlled drugs by name makes many doctors very suspicious!
Ed
Posted by Paulbwell on December 3, 2005, at 21:53:26
In reply to Re: Best meds for sleep disorders » Paulbwell, posted by vbAgent on December 3, 2005, at 4:21:16
> Anytime, Starfox - I'm glad to offer my experience to help a fellow babbler.
>
> Paulbwell, tell Starfox why he/she should avoid antipsychotics (APs). You owe him/her that one. :-)
--------------------------------------------------
Because i was in the ER the other night, and after a gallon of ineffective valium, 40-60mgs? was held down by 6 people (I weight 68kgs) and was shoot with haldol-not nice.I have read of MORE THAN 1 PERSON HERE WHO HAS SAID NEMBUTAL (PENTOBARBITAL)CAPS GAVE THE BEST SLEEP EVER. If you have ever been tortured with sleepness , then you will know what i mean.
Cheers
Posted by vbAgent on December 4, 2005, at 0:55:17
In reply to Re: Best meds for sleep disorders-BARBITURATES!!, posted by Paulbwell on December 3, 2005, at 21:53:26
Well, I hope you're doing better Paulbwell.
Starfox is concerned about taking a benzo and I'd be concerned about ever taking a barbiturate. Barbiturates ruined my mother's life. She committed suicide when I was 12. She was also an alcoholic.
I have this ongoing fear that I'm going to turn into my mother. I definitely have a predisposition to develop substance abuse. Fortunately, treatment today is much better then it was when my mom was alive. I also have hindsight to prevent myself from making her mistakes.
Anyway, I started with Lunesta 2mg but it started losing its effectiveness after about 2-3 weeks so we switched to Rozerem. What a mistake! My insomnia returned full-force. It really sucked. I'm taking 6.25 to 12.5 mg of AmbienCR now which is better, but I kinda feel drugged during the day. I'd probably be in trouble if I wasn't already prescribed Adderall.
I wonder how common insomnia is among people with ADD? I think a problem with ADD is that it's often paired with co-morbid conditions, like anxiety and depression. I'm sure this presents a huge challenge to the doctor. You're unsure what's causing what...
Well I better stop here before I go off on another tangent. I hope everyone sleeps well tonight!
Posted by Paulbwell on December 4, 2005, at 3:44:07
In reply to Re: Best meds for sleep disorders-BARBITURATES!!, posted by vbAgent on December 4, 2005, at 0:55:17
> I wonder how common insomnia is among people with ADD? I think a problem with ADD is that it's often paired with co-morbid conditions, like anxiety and depression. I'm sure this presents a huge challenge to the doctor. You're unsure what's causing what...
>
> Well I better stop here before I go off on another tangent. I hope everyone sleeps well tonight!Hi
I have ADD/HD -apparently, and often find sucking on 20mgs Ritalin cleares my head, allowing sleep-weird i know.
Anything else you wanna know about me, i'd be ok to answer:)
Cheers
Posted by jamestheyonger on December 5, 2005, at 0:29:33
In reply to Re: Best meds for sleep disorders-BARBITURATES!! » vbAgent, posted by Paulbwell on December 4, 2005, at 3:44:07
Barbs are not used much anymore for good reasons:
1) Hard on liver, rather toxic
2) Suppress needed stages of sleep
3) Tolerance builds quickly, rebound anger quite common
4) Easy to kill yourself with them, accidental OD was quite common. Reckless to give them to many mentally ill persons & anyone who drinks or has a substance abuse problem
5) Some of the barbs cause an unsightly red face discoloration
Posted by tizza on December 5, 2005, at 1:49:15
In reply to Re: Best meds for sleep disorders, posted by ed_uk on December 3, 2005, at 12:59:56
I can't go past mogadon(benzo) but it's literally impossible to get barbs here so I have never tried them but I can tell you that seroquel and zyprexa knock you out cold and leave you feeling like crap the next day, very hungover but you will sleep like the dead, they are anti psych's and very powerful drugs so be careful
Posted by fires on December 7, 2005, at 22:37:40
In reply to New sleep drug, posted by Bill LL on November 29, 2005, at 13:37:41
> A new prescription sleep drug, Rozerem, is another alternative. It is similar to melatonin, but not the same thing. It is supposed to be more effective than melatonin.
>
> It has no known side effects except that it makes one tired during the day time. This is transient and generally goes away before 4 weeks.
>I've been using Rozerem for about one month. My experience has been like that described in the literature: it's much better at helping one fall asleep than it is for maintaining sleep.
Posted by fletch85712 on December 14, 2005, at 22:44:40
In reply to Best meds for sleep disorders?, posted by starfox on November 28, 2005, at 11:58:19
Hi, I just stumbled upon this forum and hope you all don't mind me joining. I am here for my father - he sounds just like starfox. We have tried everything and he still cannot sleep. We are just now trying Restoril but it doesn't look good. I’ll keep you all informed of our progress (or lack of) and hopefully one of us here can find something that will work. He remembers a long time ago using Placidyl, but that is not one that I would like to put him on if it can be avoided. Has anyone tried chloral hydrate recently? Thanks everyone.
Posted by Phillipa on December 14, 2005, at 23:34:10
In reply to Re: Best meds for sleep disorders? » starfox, posted by fletch85712 on December 14, 2005, at 22:44:40
Hey I took chloral hydrate for about 8 years. And yes 5cc let me sleep peacfully throughout the night. After that I had to raise the dose. But now I'm off of it and taking valium. And I do wake once at night and repeat the dose. But chloral hydrate is a thing of the past. And I took placidyl years ago when I was preganant. Do they even make it anymore? Fondly, Phillipa
This is the end of the thread.
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