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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by FrequentFryer on June 20, 2006, at 23:09:23
Hi.
I have pretty bad Insomnia. (Benzo's, Zolpidem {Stilnox & Lunesta} OTC meds dont help)
Mirtazapine helped but weight gain is a major problem. I have been taking Seroquel - (quietapine) for about a year, it works well but I started on 50mg and now Im on 100mg and now 100mg is becoming inefective due to tollerance & the more I take the fatter, weaker, sweatier I get.
Im thinking of importing some Trazodone but have a few questions Im hoping you might be able to answer.Trazodone is less toxic on the liver then Nefazodone yeah?
Assuming you dont get liver failure from Trazodone is it still quite hard on the liver?
If I changed Antipsychotics for my Insomnia would I have just as high a tollerance for the new agent. (ie would my tolerance carry on from the Seroquel)? And are there any other good Anti-Psychs for Insomnia, preferably with less weight gain?
Posted by ace on June 20, 2006, at 23:42:23
In reply to Help with my chronic Insomnia if ya could please?, posted by FrequentFryer on June 20, 2006, at 23:09:23
Stay with Seroquel...you can titrate to a maximum of 800mg, although for the relief of insomnia use lowest dose possible.
Try Clonidine also.
Also, old antipsychotics, Like Largactil and haldol are excellent, but be careful for symptoms of TD and TA...but Largactil is preety benign in this aspect....
Posted by UgottaHaveHOPE on June 21, 2006, at 1:00:13
In reply to Help with my chronic Insomnia if ya could please?, posted by FrequentFryer on June 20, 2006, at 23:09:23
My pdoc said you could go as high as 400mg of Seroquel with no problem. Anything over that, you may need to check blood levels.
Posted by bipolarspectrum on June 21, 2006, at 1:14:15
In reply to Help with my chronic Insomnia if ya could please?, posted by FrequentFryer on June 20, 2006, at 23:09:23
Hello,
Seroquel is a great bet.. I've been on 600 mg and I know that it can be pushed up to 900 even... Trazodone is a great backup plan, its highly effective from family members of mine with little side effects...What country do u live in taht u cant get trazodone?? i remember reading that it was developed in italy, so i assume its available in euope?? mabye im wrong about this...
your 50 to 100 mg seroquel is quite a low dose, so u have lots of room to move...
bps
Posted by jedi on June 21, 2006, at 4:00:59
In reply to Help with my chronic Insomnia if ya could please?, posted by FrequentFryer on June 20, 2006, at 23:09:23
> Hi.
> I have pretty bad Insomnia. (Benzo's, Zolpidem {Stilnox & Lunesta} OTC meds dont help)
...Hi,
I used to take trazodone for insomnia induced by Nardil. It really gave me a drugged out feeling that I didn't like. Sometimes I would still feel drugged in the morning from Traz. Seroquel always made me really sleepy, but antipsychotics seem a little like overkill for insomnia. But than again, if we can't get a decent nights sleep, it is really difficult to recover from our illness. I would probably stick with the Seroquel and up the dosage a little.
Be Well,
Jedi
Posted by ace on June 21, 2006, at 5:28:29
In reply to Seroquel, posted by UgottaHaveHOPE on June 21, 2006, at 1:00:13
> My pdoc said you could go as high as 400mg of Seroquel with no problem. Anything over that, you may need to check blood levels.
That's not true. No need to check blood levels while on Seroquel. Did you mean have Full Blood Count (FBC)?
Posted by ed_uk on June 21, 2006, at 13:13:39
In reply to Help with my chronic Insomnia if ya could please?, posted by FrequentFryer on June 20, 2006, at 23:09:23
Hi
What country do you live in?
Although liver damage has been reported with trazodone, it appears to be extremely rare - only a handful of cases have ever been reported.
Have you ever tried a sedating TCA for insomnia?
Ed
Posted by ikikass on June 21, 2006, at 13:36:02
In reply to Help with my chronic Insomnia if ya could please?, posted by FrequentFryer on June 20, 2006, at 23:09:23
Hi there - I too suffer from an incurable life-long sleeping disorder and have tried many things over the years, all of the natural and healthy stuff (exercising, chamomile tea, routine setting etc.) as well as a few meds.
Surmontil sucked *ss, took hours to kick in then left me with a hangover so bad I had to call in sick to work many times.
Last year while on stress leave I tried Restoril (Temazepam) and it knocked me out, literally. I actually had bruises on my body from taking it in the bathroom and they trying to walk through the house and getting into bed. The sedative effects were doubly compounded if I had even had one glass of wine with in 4 hours of taking it, so it's pretty strong. That being said, it still left me with same "body encased in concrete" hangover, so it was hard to function taking it once I started going back to work as far as getting ready in the morning and driving safely. Because of it's strength, it could be also quite habit forming, so I only took it when I was mega stressed an knew I would not sleep a wink or if the sun was comming up and I still hadn't slept.
Hope this helps, I know how much sleeping disorders suck!
A
Posted by Racer on June 21, 2006, at 13:40:19
In reply to Help with my chronic Insomnia if ya could please?, posted by FrequentFryer on June 20, 2006, at 23:09:23
Posted by Phillipa on June 21, 2006, at 14:11:01
In reply to Re: Help with my chronic Insomnia if ya could please?, posted by ikikass on June 21, 2006, at 13:36:02
Pamelar flattened me out til 2pm. It will definitely let you sleep Love Phillipa
Posted by Declan on June 21, 2006, at 15:40:15
In reply to Re: Help with my chronic Insomnia if ya could please?, posted by ikikass on June 21, 2006, at 13:36:02
My nutritional dr and I are exploring the possiblity that my midnight awakening (last 10 years) is part of a dysregulation of the feedback mechanisms between bloodsugar, insulin and cortisol (That's the only words I have for it)......like a learner driver overcorrecting, leading to hypoglycemia and then high cortisol levels and then adrenaline. We spent an hour or two on it yeaterday, and I will redo the glucose tolerance test, but this time it will be a 4 hour one.
Alcohol (ahem) is involved in this.
Declan
Posted by FrequentFryer on June 21, 2006, at 17:58:53
In reply to Re: Help with my chronic Insomnia if ya could please? » FrequentFryer, posted by ace on June 20, 2006, at 23:42:23
> Stay with Seroquel...you can titrate to a maximum of 800mg, although for the relief of insomnia use lowest dose possible.
>
> Try Clonidine also.
>
> Also, old antipsychotics, Like Largactil and haldol are excellent, but be careful for symptoms of TD and TA...but Largactil is preety benign in this aspect....Ok Chears.
Im actually Taking Clonidine at the moment to reduce Hyperhydrosis, but it aint helping @ 200 micrograms :/
Posted by FrequentFryer on June 21, 2006, at 18:02:06
In reply to Re: Help with my chronic Insomnia if ya could please?, posted by bipolarspectrum on June 21, 2006, at 1:14:15
Im In Australia, they took Nefaz & Traz off the market because of the liver thing I think.
> Hello,
> Seroquel is a great bet.. I've been on 600 mg and I know that it can be pushed up to 900 even... Trazodone is a great backup plan, its highly effective from family members of mine with little side effects...
>
> What country do u live in taht u cant get trazodone?? i remember reading that it was developed in italy, so i assume its available in euope?? mabye im wrong about this...
>
> your 50 to 100 mg seroquel is quite a low dose, so u have lots of room to move...
>
> bps
Posted by FrequentFryer on June 21, 2006, at 18:07:23
In reply to Re: Help with my chronic Insomnia if ya could please? » FrequentFryer, posted by ed_uk on June 21, 2006, at 13:13:39
Australia.
Nope, very little experience with TCA's & Im trying to loose weight, but once I loose some weight I might try a TCA.
Do some people reckon they work better then the SSRI's?> Hi
>
> What country do you live in?
>
> Although liver damage has been reported with trazodone, it appears to be extremely rare - only a handful of cases have ever been reported.
>
> Have you ever tried a sedating TCA for insomnia?
>
> Ed
Posted by FrequentFryer on June 21, 2006, at 18:22:49
In reply to Re: Help with my chronic Insomnia if ya could please?, posted by Phillipa on June 21, 2006, at 14:11:01
Yep well Im still on an Anti-D holiday and to be honest with you I feel better in some ways.
Wanna try and stay Anti-D free for a few months to try & loose weight & get healthy.
But in a few months if Im depressed Ill probably give something like nortriptyline HCl a go.Do some People prefur TCA's over SSRI's Phillipa?
> Pamelar flattened me out til 2pm. It will definitely let you sleep Love Phillipa
Posted by FrequentFryer on June 21, 2006, at 18:28:36
In reply to Help with my chronic Insomnia if ya could please?, posted by FrequentFryer on June 20, 2006, at 23:09:23
Posted by Colleen D. on June 21, 2006, at 18:51:46
In reply to Help with my chronic Insomnia if ya could please?, posted by FrequentFryer on June 20, 2006, at 23:09:23
Trazadone isn't a very "clean" drug for insomnia. For a lot of people it has a lot of side effects, especially what I call "drug-induced hangover." My GP recommended trazadone, but I didn't care for it so she prescribed doxepin. It's a great drug for my wicked insomnia.
Good luck,
Colleen
MDD, GAD, OCD and SP
Posted by Colleen D. on June 21, 2006, at 19:02:49
In reply to Re: Help with my chronic Insomnia if ya could please? » FrequentFryer, posted by Colleen D. on June 21, 2006, at 18:51:46
I have lost weight while on it. 25mg 1/2 hr. before bed. No chance of tolerance, and less toxic to the liver than trazadone, if I'm not mistaken. Also very inexpensive. I don't know what I'd do without it. If I don't get enough unbroken sleep I am so irritable and have much trouble functioning like a somewhat normal human being. I can relate to your sleep problems so well. I used to self-medicate with alcohol to find sleep; the the quality of sleep just wasn't there, and I'm sure the alcohol wasn't doing much for my liver. Now I rarely have a drink. I've got my beloved doxepin. :-)
Colleen
p.p.s. - I hope to God my children don't have sleep problems.
Posted by FrequentFryer on June 22, 2006, at 20:51:15
In reply to p.s. - Doxepin is a TCA, FrequentFryer, and..., posted by Colleen D. on June 21, 2006, at 19:02:49
Sweet... Ill prolly give it a try...
Thanks!
> I have lost weight while on it. 25mg 1/2 hr. before bed. No chance of tolerance, and less toxic to the liver than trazadone, if I'm not mistaken. Also very inexpensive. I don't know what I'd do without it. If I don't get enough unbroken sleep I am so irritable and have much trouble functioning like a somewhat normal human being. I can relate to your sleep problems so well. I used to self-medicate with alcohol to find sleep; the the quality of sleep just wasn't there, and I'm sure the alcohol wasn't doing much for my liver. Now I rarely have a drink. I've got my beloved doxepin. :-)
>
> Colleen
>
> p.p.s. - I hope to God my children don't have sleep problems.
Posted by Declan on June 22, 2006, at 22:58:29
In reply to p.s. - Doxepin is a TCA, FrequentFryer, and..., posted by Colleen D. on June 21, 2006, at 19:02:49
Colleen, do you get a hangover from doxepin? You get deep sleep from doxepin? I liked the effect of low dose cyproheptadine and mirtazepine while I was asleep, and felt so rotten after that I haven't repeated them. How do they compare with doxepin? I took amitryptiline (25mg) and that wasn't much fun either. I want something to give me deep sleep and that has no hangover. I get 4 hours a night now, sometimes 5.
Declan
Posted by Dr. Bob on June 23, 2006, at 1:07:38
In reply to Have you tried behavior treatments? They work too (nm) » FrequentFryer, posted by Racer on June 21, 2006, at 13:40:19
> Have you tried behavior treatments? They work
Sorry to interrupt, but I'd like to redirect follow-ups regarding behavior treatments to Psycho-Babble Psychology. Here's a link:
http://www.dr-bob.org/babble/20060617/msgs/660452.html
Thanks,
Bob
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Dr. Bob is Robert Hsiung, MD,
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