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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 Agomelatinehope on November 24, 2011, at 17:55:00
Hi. I suffer from depression and chronic insomnia.
Insomnia has destroyed mi life and no med seems to make me sleep.
I'm trying to avoid antidepressants since I had not a good experiencie with them (lots of side effects)
I have almost tried anything...
Which med do you think would help with my insomnia?
Last one I tried was trazodone but caused me uncomfortable erections during night. I also tried Mirtazapine but made me become a zombie and couldn't even leave the house in that state.
Thank you in advance from Spain
Posted by Phillipa on November 24, 2011, at 22:54:23
In reply to Depression related insomnia. żBest med?, posted by Agomelatinehope on November 24, 2011, at 17:55:00
Benzodiazapines, tamazeapam, ambien, lunesta? Tried any of these may have differents names in Spain? Phillipa
Posted by jono_in_adelaide on November 24, 2011, at 23:07:08
In reply to Depression related insomnia. żBest med?, posted by Agomelatinehope on November 24, 2011, at 17:55:00
Given that your insomnia is a chronic problem, I would try rotating your sleep meds so you dont become tolorant/dependant.
I'd suggest taking say temazepam 20mg one night, and say quietipine 25-50mg the next night, and so on.
Your insomnia would probably improve if you managed to hit on the right treatment for your depression... what have you tried in the past?
Posted by Agomelatinehope on November 25, 2011, at 2:56:57
In reply to Depression related insomnia. żBest med?, posted by Agomelatinehope on November 24, 2011, at 17:55:00
Tkanks for the replies
Antidepressants I've tried:
-Prozac (Worsens Insomnia. Sexual side effects)
-Cymbalta (Helps with insomnia but too many side effects and brainzaps when withdrawing even gradually)
-Paroxetine (I feel like a robot, with no feelings. Plus, anorgasmia)
-Agomelatine (Had high hopes on this one but didn't work. Caused me dangerous mood swings and abdominal pain)
-Trazodone (Helps with insomnia but every night I had uncomfortable penis erections for hours that could have easily led to pripapism)
-Mirtazapine (The brain fog/dizzines was too much for me, I couldn't drive nor function in any sense)
Benzodiacepines:
-Alplazolam (I got addicted to this one in the past and had a tough time withdrawing with car accidents, whole weeks without sleep, etc. Works like charm but tolerance is built too fast. Plus, anhedonia increased after a few weeks of use)
-Diazepam (It helps me to relax but does nothing as far as sleeping is concerned. Plus, sexual side effects)
-Lorazepam (Worked great at first, then built dependence and had terrible time withdrawing. Pretty much as with alplazolam)
-Zolpidem (I've tried so many times since it's so famous among insomniacs but although I sleep well on it, next day is a real nightmare, I feel as if I hadn't slept for weeks)
I've tried some others but these three are the ones I have more experience with.
Any advice? Would it be better to look for another antidepressant instead?
Thank you very much
Posted by sigismund on November 25, 2011, at 3:40:30
In reply to Depression related insomnia. żBest med?, posted by Agomelatinehope on November 24, 2011, at 17:55:00
>Last one I tried was trazodone but caused me uncomfortable erections during night.
What was your dose. I wouldn't mind a bit of that. Did it feel awful as well?
>I also tried Mirtazapine but made me become a zombie and couldn't even leave the house in that state.Yes, I know.
Posted by sigismund on November 25, 2011, at 3:45:05
In reply to Re: Depression related insomnia. żBest med?, posted by Agomelatinehope on November 25, 2011, at 2:56:57
>Agomelatine (Had high hopes on this one but didn't work. Caused me dangerous mood swings and abdominal pain)
Some people report gastric irritation. I have had heartburn. Have you ever tasted it? Can't be good for you. Even though I like it.
Interested in Chinese herbs? I buy this online after having had it Rxd.......An Shen Ding Zhi Wan....it's as good as anything.
Posted by crazyjoe on November 25, 2011, at 7:29:49
In reply to Re: Depression related insomnia. żBest med?, posted by sigismund on November 25, 2011, at 3:45:05
have you ever tried klonopin
Posted by SLS on November 25, 2011, at 8:14:50
In reply to Re: Depression related insomnia. żBest med?, posted by Agomelatinehope on November 25, 2011, at 2:56:57
Some people do well with doxepin. Doxepin is a sedating tricyclic antidepressant (TCA) that is good for sleep. You have not tried a TCA yet. It might help with depression also.
Espero que descubra una medicación que funciona muy pronto.
- Scott
Posted by bleauberry on November 25, 2011, at 11:26:45
In reply to Depression related insomnia. żBest med?, posted by Agomelatinehope on November 24, 2011, at 17:55:00
In terms of meds I would agree with SLS to take a look at tricyclics with focus on the more sedating ones. Ever tried amitriptyline? Nortriptyline? What about ultra low dose remeron (1mg-7.5mg)?
Anytime insomnia is an issue the first thing that comes to my mind is the word adrenaline. I simply make the assumption that for whatever reason we do not know, the adrenaline circuitry (norepinephrine, epinephrine, adrenaline, cortisol, pituitary gland, adrenal gland) is operating out of whack. Either there is too much stimulation going on, or there is not enough counteracting calming going on to balance out normal stimulation. Either way, we've got insomnia and probably depression because of those imbalances.
With that in mind, a totally different approach to treating and curing insomnia is to help the entire glandular and hormonal system find proper balance. There are a handful of adaptogen herbs that can do that and I've tried them. We're all different but my favorite is rhodiola rosea. The others were things like Eleuthero and Ashwaganda. Stay away from the ginsengs except for siberian ginseng. Good adaptogen herbs show their greatest benefits over time....weeks and months....so immediate results should not be expected.
Supplements to help the body make more of its own sleep chemicals would help lay a base foundation under everything else you do to help it all work better. I'm thinking gaba, niacinamide, glycine, magnesium, and maybe a tiny pinch of 5htp (5mg or so).
Herbs to use 2 or 3 at a time would include valerian root, lemon balm, skullcap, passionflower. These should help pretty fast if they are going to help. My experience with them is that they probably don't have the sedation to knock you out they have the calming and pre-sleep relaxation that allows sleep to come easy.
There is a lot of science behind each herb I've mentioned thus far.
Of them all however I can't say enough about rhodiola. Mileage varies and it isn't a super plant to everyone. But as long as this whole game is about trial and error and not really knowing much about why our disease is the way it is or how to fix it, rhodiola has the highest potential of anything else to help in the departments of depression, anxiety, and stress.
Posted by linkadge on November 25, 2011, at 18:45:31
In reply to Re: Depression related insomnia. żBest med?, posted by bleauberry on November 25, 2011, at 11:26:45
Try a little bit of the antihistamine chlorpheniramine plus lorazepam.
Linkadge
Posted by JONO_IN_ADELAIDE on November 27, 2011, at 17:04:07
In reply to Re: Depression related insomnia. żBest med?, posted by Agomelatinehope on November 25, 2011, at 2:56:57
I would consider trying reboxetine 4mg twice a day as an antidepressant (this shouldnt give you any of the side effects you've had in the past), and try using two sleep meds on alternate nights to avoid building up dependence - Temazepam 20mg one night, Quietipine 25-50mg the next night, then back to temazepam etc
Posted by Phidippus on November 30, 2011, at 20:29:14
In reply to Depression related insomnia. żBest med?, posted by Agomelatinehope on November 24, 2011, at 17:55:00
Here's a list of medications to try:
Gabitril
Cyproheptadine
Clonodine
Seroquel
Thorazine
Rozerem
Lunesta
Ambien
Vistaril
OxazepamYou may need to use a combination of medications to go to sleep.
Eric
This is the end of the thread.
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