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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Cseagraves on January 21, 2009, at 21:33:00
Hi to all!!
Need to find something to help me sleep. Any ideas you might have would be greatly appreciated.
Here's what I have already tried:
Everything homeopathic including melatonin and other combination of sleep herbs. Doesn't put a dent in insomnia.
Ambien - had bad side effects. Haven't tried Lunesta, but if its anything like what I experienced with Ambien, then no. If you have had good experiences with Lunesta, please let me know.
Klonopin - doesn't work unless I take alot.
Seroquel - makes me sick with awful dreams. Gave me the worst headache for three days.
Trazodone - doesn't work. Same effects as Seroquel.
Remeron - doesn't knock me out, just makes me tired and I am using small doses to get me through the days until I get back into seeing pdoc.
Right now I have to take 200 mgs. of zanax for sleep. Seems like alot to me and don't want to become tolerant to it, as it has always been a good back up when I get anxietal. So I have quit taking it during the day (would only take .50 if needed).Will be starting Marplan in about two weeks and would still like to be able to use the zanax to tweak anxieties while on Marplan in hopes of gradually dropping the zanax at some point.
Ideas????
Courtney
Posted by Phillipa on January 21, 2009, at 23:57:28
In reply to Something to sleep??, posted by Cseagraves on January 21, 2009, at 21:33:00
If the xanax works stick to it or try valium or ativan. Love Phillipa As my pdoc says if it ain't broken don't try to fix it.
Posted by yxibow on January 22, 2009, at 1:45:36
In reply to Something to sleep??, posted by Cseagraves on January 21, 2009, at 21:33:00
> Hi to all!!
>
> Need to find something to help me sleep. Any ideas you might have would be greatly appreciated.
>
> Here's what I have already tried:
>
> Everything homeopathic including melatonin and other combination of sleep herbs. Doesn't put a dent in insomnia.
>
> Ambien - had bad side effects. Haven't tried Lunesta, but if its anything like what I experienced with Ambien, then no. If you have had good experiences with Lunesta, please let me know.Lunesta is a bit different in that its approved for longer term use, but if you're used to benzodiazepines you wont get a lot out of these "pseudobenzodiazepines" because of cross-pollination. At least some wont. It can leave some with a metallic taste as they go to sleep, some claim longer, I don't know -- just my experience. It didn't really bother me that much but it wasn't all that useful at its normal dose and I had to pay for a 4mg dose.
> Klonopin - doesn't work unless I take alot.
> Seroquel - makes me sick with awful dreams. Gave me the worst headache for three days.
> Trazodone - doesn't work. Same effects as Seroquel.It isn't my favorite, I can understand
> Remeron - doesn't knock me out, just makes me tired and I am using small doses to get me through the days until I get back into seeing pdoc.
It may be dose dependent.
> Right now I have to take 200 mgs. of zanax for sleep. Seems like alot to me and don't want to become tolerant to it, as it has always been a good back up when I get anxietal. So I have quit taking it during the day (would only take .50 if needed).
Two hundred ???? Is this a typo, because you would be in a coma if not off this earth ?
> Will be starting Marplan in about two weeks and would still like to be able to use the zanax to tweak anxieties while on Marplan in hopes of gradually dropping the zanax at some point.
>Well there is amitryptiline at 10mgs which is an average sleep dose. That's what I reached when other things didn't work.
However you're going on the journey of an MAOI so that is probably contraindicated. In fact the next thing, I don't know if it is or not contraindicated. MAOI polypharmacy is really out of my league I'm afraid.
Doxylamine succinate formulation of Unisom at its prescribed or slightly higher dose, depending on what your doctor says.
I have a bad sleep disorder, probably, so I take 75, but the normal dose is 25. I don't like the diphenhydramine (Benadryl) formulation, it leaves a depressive feeling.
-- just some thoughts-- Jay
Posted by X-ray on January 22, 2009, at 3:15:48
In reply to Something to sleep??, posted by Cseagraves on January 21, 2009, at 21:33:00
Hi,
I think that Elavil is one of the most effective sleep-aids.
I have been on this drug for 37 years, so I'm very familiar with it.You will probably need 50 mg to get a good night's sleep.
The side effects are pretty bad.However, you can't mix TCAs and MAOIs.
So you'll have to give up the Marplan-idea.Keep Smiling,
X-ray
Posted by desolationrower on January 23, 2009, at 1:29:37
In reply to Something to sleep??, posted by Cseagraves on January 21, 2009, at 21:33:00
Well, for one thing, on an MAOI you don't really dream much so if thats the problem with a sleep drug, it might work while you're taking the MAOI. Also, some of those are just antihistamines, like amitryptiline. i'd suggest cyproheptadine for an antiH to try.
i don't know what your symptoms are like, do you perhaps expect too much from a hypnotic? its not unusual to need to spend some time late evening relaxing and doing slow rituals, and to lay in bed for a bit before you drift off. working on sleepy hygine in cbt can be helpful. i found meditation good, just because it made me much more skilled at turning my internal dialogue off.
-d/r
Posted by raisinb on January 24, 2009, at 0:30:24
In reply to Something to sleep??, posted by Cseagraves on January 21, 2009, at 21:33:00
I have been using Lunesta for 2+ years and it works very well for me. Puts me out and I usually stay asleep for at least seven hours, and I don't lose time and do things that I forget about the way I did when I first took Ambien. One downside for me is that it does not work very well if I take it shortly after eating a heavy meal. Another is that there is no generic and the insurance company doesn't like covering it, so it's a fifty dollar copay.
Posted by JadeKelly on January 27, 2009, at 12:19:51
In reply to Something to sleep??, posted by Cseagraves on January 21, 2009, at 21:33:00
Hey you,
I know you've tried these individually as have I, but on my worst nights I take 1-2mg Klonopin along with 6mg Melatonin. Always does the trick and I don't feel it at all in the morning.
Worth a shot if you're desperate!!!
~Jade
Posted by Vincent_QC on January 31, 2009, at 10:07:46
In reply to Something to sleep??, posted by Cseagraves on January 21, 2009, at 21:33:00
> Hi to all!!
>
> Need to find something to help me sleep. Any ideas you might have would be greatly appreciated.
>
> Here's what I have already tried:
>
> Everything homeopathic including melatonin and other combination of sleep herbs. Doesn't put a dent in insomnia.
>
> Ambien - had bad side effects. Haven't tried Lunesta, but if its anything like what I experienced with Ambien, then no. If you have had good experiences with Lunesta, please let me know.
>
> Klonopin - doesn't work unless I take alot.
> Seroquel - makes me sick with awful dreams. Gave me the worst headache for three days.
> Trazodone - doesn't work. Same effects as Seroquel.
> Remeron - doesn't knock me out, just makes me tired and I am using small doses to get me through the days until I get back into seeing pdoc.
> Right now I have to take 200 mgs. of zanax for sleep. Seems like alot to me and don't want to become tolerant to it, as it has always been a good back up when I get anxietal. So I have quit taking it during the day (would only take .50 if needed).
>
> Will be starting Marplan in about two weeks and would still like to be able to use the zanax to tweak anxieties while on Marplan in hopes of gradually dropping the zanax at some point.
>
> Ideas????
>
> CourtneyHi Courtney!
Hummm...did you know if the Seroquel you try is the regular version or the newer XR version...I had a bad experience with the Seroquel-XR you make me feel really dizness at daytime...even if I was taking the dose 6 hours before the bedtime, as my Doctor recommend it...Since, I switch on the regular generic Seroquel, 50mg before bed time and I sleep like a baby...I do severe migraine once a week at least and I always have a small headache everyday and the Seroquel never give me a stronger headache at daytime, but I feeled a little bit tired the morning after I take it for about 2 weeks...now it's ok... It'S the best drugs to put me asleep and STAY asleep....Before, I had no proble to fall asleep, but after 1-2 hours I Was already awake and I had the urge feeling to get up and move...now, I sleep 6-7 hours in a row, I wake up for the breakfast and sometimes I return in my bed and I Can sleep another 2 hours without any problems...
Since I discover the Seroquel (Generic and regular version), I can say that's the only efficiently drug I had to make me sleep more than 4 hours in a row...
I try also in the past some Desyrel(Trazodone), who was horrible, I was sick the morning after...nausea and worst headache of my life...and daytime sedation who was untolerable for me. I also try the Remeron, it was so so..I mean very good at first but stop working after a while...and I Was not sleeping a long time on it...and I gain weight...I Try also some regular Unisom...Gravol...at high dose...they don't work on me...The Melatonin (6mg and more) never help me...I just get a bigger headache on it.
One advise...don't take any benzo drugs to help you to sleep...addiction is not really the goal you want to reach i'm sure... This is why I ask for the Seroquel...I know that if I take a 20mg of Valium before bedtime I will sleep a little bit more long time...but that's not helping with my benzo addiction problem...
The main problem with the Xanax is the short half-life in the blood...around 4 hours...mean that after that, you have a great chance to have early wake up and you will need to take anoter pill again to fall asleep...
Rivotril is not really good for the sleep...You get used very fast of the sedation he give at first...The same apply to the Valium...when I switch from the Rivotril to the Valium, I was really tired at first, Valium has a more pronounced effect on the sedation, but you get used fast of it also...Now I Take sometimes 15 mg in one shoot at daytime and I Feel nothing at all...
Insomnia is a major issue and we have to find effective solution against it...but the goal to reach is to find the right level of drug to help you yo sleep at least 6h...and have no sedation or daytime sedation the day after...
I read somewhere that the Unisom 2 (Pzifer) is the best thing to help to sleep...not the regular Unisom...it's made with Doxylamine succinate ...but i'm not lucky, in the Canada, I have to order it and it's expensive...so I never try it...so I don'T know...but in the states it's avaible i'm sure...you have nothing to loose by trying it...
So that's it...take care of you and have a nice weekend ;-)
Bye!
Vincent ;-)
Posted by myco on January 31, 2009, at 13:16:42
In reply to Re: Something to sleep?? » Cseagraves, posted by Vincent_QC on January 31, 2009, at 10:07:46
> I read somewhere that the Unisom 2 (Pzifer) is the best thing to help to sleep...not the regular Unisom...it's made with Doxylamine succinate ...but i'm not lucky, in the Canada, I have to order it and it's expensive...so I never try it...so I don'T know...but in the states it's avaible i'm sure...you have nothing to loose by trying it...Hey Vince,
Unisom-2 (Doxylamine succinate) is available in Canada to buy but difficult to find as diphenhydramine (regular unisom, nite-ol, sleepeeze etc...) has the market cornered. You just have to know where to look. I'm in Alberta. I can mail you a box if you like to try. It's a decent knock out with my nardil but I still often awake in the night...although I am only taking the 1 pill (minimum dose - recommended dose on the box).
keep smilin,
myco
Posted by Vincent_QC on February 1, 2009, at 8:38:10
In reply to Unisom-2 (DOXYLAMINE) in CANADA (VINCE), posted by myco on January 31, 2009, at 13:16:42
> Hey Vince,
>
> Unisom-2 (Doxylamine succinate) is available in Canada to buy but difficult to find as diphenhydramine (regular unisom, nite-ol, sleepeeze etc...) has the market cornered. You just have to know where to look. I'm in Alberta. I can mail you a box if you like to try. It's a decent knock out with my nardil but I still often awake in the night...although I am only taking the 1 pill (minimum dose - recommended dose on the box).
>
> keep smilin,
> myco
>
>Hummmm thanks ;-) Well, for now it's ok, I finally succeed to talk to my Pharmacist and he said yes about refilling my prescription 7 days before...He will fax an order to my family Doctor about the new dosage I need to take of the Seroquel regular version...
For the Unisom 2, I was award about the avaibility in the Canada...but in the Quebec province, we have to order it...the only place where the Pharmacist wanted to help me to order it was to the WallMart shop...I never go there normally...anyway...
The Seroquel put me asleep for a minimum of 6 to 8 hours in a row, something that nothing before succeed to do on me...even "hyptnotic" drugs like Zopiclone... So the only side-effect I get the morning after is the risidual sedation in the morning, if I have nothing plan in the morning I can return in my bed and sleep another 2 hours without any problems...sometimes I like just to watch TV on the Saturday morning and drink a good coffee...or just open my laptop like I do now, look the news, watch some TV show that I miss during the week time...so I have to drink something like 3 cups of coffee to have some mental energy...The Seroquel also cause some dizness, you really need to concentrate a lot when you get up because you feel a little bit in the fog but that's ok...I mean, I prefer to sleep 6-7 hours in a row and never wake up earlier like I Was doing before...at least, I know I sleep enought and probably the same time than a regular persone with no insomnia problem...I don't feel more energized in the day...but that's ok...I think the depression and anhedonia are the main problem for me now...the social phobia, panic disorder and general anxiety is relayed to the second line plan...
That's so complicated for nothing...Sometimes I wonder why some people, like one of my sister, answer very well to the first AD's they try and why some people like me, have to try everything, have to thinks about newer strategy to improve, follow CBT at the same time, do a lot of research on the internet about drugs, try to find combo of drugs who will help with social phobia and depression or the general anxiety or the panic disorder...
I mean, why in 2009, the medecine research is not more well evoluated and why they don't know exactly how the drugs they put on the market work on the people and witch neurons are implicated in the processus of anxiety and social phobia or depression...I mean I can't believe they don't involve more than this in 50 years... The first MAOI to hit the market as a anti-depressant drug was the Marplan ...who lost a lot of users for the newer TCA's they put on the market at the same time...so that's strange that for now, they do research on drugs who are already on the market but they just wanted to reduce their side-effects profile of them... We all see some example on this board...The Celexa was replaced by the Lexapro...but was not more effective in fact...the newer Pristiq his supposed to be a kind of Effexor more powerfull with a lesser side-effects profile but that's not seem to be the case... The Cymbalta is not very effecvite also...No wonder why people like me return on the old drugs...they work better and give more powerfull results...but that's frustrating a lot...I mean, in 50years, the psychiatricts field don't involve a lot...and all the strategy about drug market and concurency....I mean everything now is about money, they never think about the people who will take their drugs...That's suck..sorry for my poor language...
Anyway...at least, for now i'm off any AD and I can WRITE LONGGGGGGG text like these....lol that's a miracle ! hahaha
Well thanks again for you're offer...maybe one of these day I will ask to try it (Unisom-2)...for now the Seroquel do a good job...I just wonder for how many times he will do it...I just hope I Wll not get addicted of it (psychologic addiction)... lol
Have a nice sunday and take care of you !!!
Bye!
Vincent ;-)
Posted by raisinb on February 1, 2009, at 11:20:06
In reply to Unisom-2 (DOXYLAMINE) in CANADA (VINCE), posted by myco on January 31, 2009, at 13:16:42
What is the difference between the two? I'm not sure which one I've tried, but Sleepinal, Unisom, and other OTC meds made me very hung over and weepy the next day.
Posted by myco on February 1, 2009, at 13:15:54
In reply to Re: Unisom-2 (DOXYLAMINE) in CANADA (VINCE) » myco, posted by raisinb on February 1, 2009, at 11:20:06
Hey,
The most common OTC sleep med ingredient, at least in Canada, is diphenhydramine (unisom, nytol, sleepeeze - all same ingredient as benedryl) which is a sedating antihistamine. There is another type of unisom (unisom-2 and unisom 'sleep tabs') that uses doxylamine instead. This is also a sedating antihistamine. Just look on the front of the box of the sleep aid (or the side listing ingredients) to distinguish them. As far as im aware, from the literature, I believe diphenhydramine may have weak seratonin inhibiting abilities making it less desireable for MAOI users compared to doxylamine...although maois will potentiate anticholinergic effects (ie dry mouth) of them both. Ive found doxylamine to work better for sleep actually and less drying than diphenhydramine. Also ya, I agree, I feel abit "slower" the next day after taking diphenhydramine compared to doxylamine. Sleep onset is also faster for doxylamine from my perspective. Both suffer from wearoff in the middle of the night though resulting in my awaking after about 4-5h after dosing. Redosing helps and they are both cheap and OTC so thats fine.
keep smilin,
myco
atypical depression, gad, social anxiety
75mg nardil
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