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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by ed_uk2010 on February 18, 2012, at 13:56:01
For those who have taken Depakote...
Did it affect your sleep? If so, in what way?
Posted by SLS on February 18, 2012, at 15:06:37
In reply to Depakote and sleep, posted by ed_uk2010 on February 18, 2012, at 13:56:01
> For those who have taken Depakote...
>
> Did it affect your sleep? If so, in what way?I found Depokote to be neutral with respect to the number of hours of uninterrupted sleep I got. Of course, I wouldn't know how it affected sleep architecture. I did not have nightmares or otherwise vivid dreams. I was really surprised when you mentioned in another thread how Depakote can produce insomnia or disturbed sleep. You are right, of course. I had no idea.
- Scott
Posted by ed_uk2010 on February 18, 2012, at 15:38:48
In reply to Re: Depakote and sleep » ed_uk2010, posted by SLS on February 18, 2012, at 15:06:37
Thanks Scott, I found this in the Depakote monograph...
(Adverse effects in epilepsy)
Insomnia on low dose Depakote - 9%
Insomnia on high dose Depakote - 15%Somnolence on low dose Depakote - 18%
Somnolence on high dose Depakote - 30%
Posted by Phillipa on February 18, 2012, at 17:57:36
In reply to Re: Depakote and sleep, posted by ed_uk2010 on February 18, 2012, at 15:38:48
Ed are you going to take depakote? PJ
Posted by ed_uk2010 on February 19, 2012, at 5:43:53
In reply to Re: Depakote and sleep » ed_uk2010, posted by Phillipa on February 18, 2012, at 17:57:36
> Ed are you going to take depakote? PJ
No PJ.
Posted by g_g_g_unit on February 19, 2012, at 6:11:02
In reply to Re: Depakote and sleep, posted by ed_uk2010 on February 18, 2012, at 15:38:48
Low doses definitely disturb mine, as I pointed out in the other thread. I experience delayed sleep onset as well as more vivid dreaming, resulting in an overall tattered sleep experience.
I increased to 500mg last night, though was still not tired 2 hours later, which is unusual, since my diary from my last trial indicates that this is an expected effect.
Posted by ed_uk2010 on February 19, 2012, at 12:38:08
In reply to Re: Depakote and sleep, posted by g_g_g_unit on February 19, 2012, at 6:11:02
> Low doses definitely disturb mine, as I pointed out in the other thread. I experience delayed sleep onset as well as more vivid dreaming, resulting in an overall tattered sleep experience.
>
> I increased to 500mg last night, though was still not tired 2 hours later, which is unusual, since my diary from my last trial indicates that this is an expected effect.Thanks, so you actually didn't feel tired? Not that you were tired but still unable to sleep?
Posted by Phillipa on February 19, 2012, at 18:40:05
In reply to Re: Depakote and sleep, posted by ed_uk2010 on February 19, 2012, at 5:43:53
Ed that's what I though Info gathering assuming PJx
Posted by g_g_g_unit on February 20, 2012, at 1:30:19
In reply to Re: Depakote and sleep » g_g_g_unit, posted by ed_uk2010 on February 19, 2012, at 12:38:08
> > Low doses definitely disturb mine, as I pointed out in the other thread. I experience delayed sleep onset as well as more vivid dreaming, resulting in an overall tattered sleep experience.
> >
> > I increased to 500mg last night, though was still not tired 2 hours later, which is unusual, since my diary from my last trial indicates that this is an expected effect.
>
> Thanks, so you actually didn't feel tired? Not that you were tired but still unable to sleep?
>Well, it's hard to say. The first night I increased to 500mg, there were some potential complications (I'd taken Vit D, which always seems to give me insomnia).
Last night I took 500mg and was feeling a little tired 2 hours later, but not nearly enough to sleep, so I added in melatonin and an anti-histamine and fell asleep relatively quickly, but my sleep quality was poor once again.
Posted by SLS on February 20, 2012, at 6:59:31
In reply to Re: Depakote and sleep » ed_uk2010, posted by g_g_g_unit on February 20, 2012, at 1:30:19
> > > Low doses definitely disturb mine, as I pointed out in the other thread. I experience delayed sleep onset as well as more vivid dreaming, resulting in an overall tattered sleep experience.
> > >
> > > I increased to 500mg last night, though was still not tired 2 hours later, which is unusual, since my diary from my last trial indicates that this is an expected effect.
> >
> > Thanks, so you actually didn't feel tired? Not that you were tired but still unable to sleep?
> >
>
> Well, it's hard to say. The first night I increased to 500mg, there were some potential complications (I'd taken Vit D, which always seems to give me insomnia).
>
> Last night I took 500mg and was feeling a little tired 2 hours later, but not nearly enough to sleep, so I added in melatonin and an anti-histamine and fell asleep relatively quickly, but my sleep quality was poor once again.
I mentioned in another thread that valproate can make depression somewhat worse with continued usage. Unfortunately, this is not uncommon. Melatonin can also make depression worse, although this seems to occur in a minority of cases.If Parnate is to be your miracle drug, you might have to deal with severe insomnia. This is something that must be dealt with aggressively and should not be the reason to discontinue treatment if at all possible.
- Scott
Posted by g_g_g_unit on February 21, 2012, at 4:15:33
In reply to Re: Depakote and sleep » g_g_g_unit, posted by SLS on February 20, 2012, at 6:59:31
> If Parnate is to be your miracle drug, you might have to deal with severe insomnia. This is something that must be dealt with aggressively and should not be the reason to discontinue treatment if at all possible.
>Thanks Scott. I'm actually getting a little worried thinking about the whole sleep issue.
I can't tolerate benzos (rebound depression), Gabapentin (increased depression), or Seroquel (restless leg syndrome) and I grow tolerant to anti-histamines very quickly (within a matter of days), so that doesn't seem to leave too many options .. unless I look into a long-acting benzo like Klonopin (the half-life of which might help mitigate next-day withdrawal issues), or, as I've mentioned, clonidine, though the reports in the archive don't seem too favorable.
Do you find that Prazosin helps with sleep-onset at all?
Posted by SLS on February 21, 2012, at 5:38:42
In reply to Re: Depakote and sleep » SLS, posted by g_g_g_unit on February 21, 2012, at 4:15:33
> > If Parnate is to be your miracle drug, you might have to deal with severe insomnia. This is something that must be dealt with aggressively and should not be the reason to discontinue treatment if at all possible.
> Thanks Scott. I'm actually getting a little worried thinking about the whole sleep issue.
>
> I can't tolerate benzos (rebound depression), Gabapentin (increased depression), or Seroquel (restless leg syndrome) and I grow tolerant to anti-histamines very quickly (within a matter of days), so that doesn't seem to leave too many options .. unless I look into a long-acting benzo like Klonopin (the half-life of which might help mitigate next-day withdrawal issues), or, as I've mentioned, clonidine, though the reports in the archive don't seem too favorable.Are you currently employed? If not, then you might have the luxury of time in performing the experimentation necessary to titrate Parnate and find a treatment for the insomnia.
You sure are a challenge. Yes, Klonopin was the first drug that came to mind. I did well with it years ago when my Parnate insomnia was very bad. Trazodone should be considered also. I wouldn't worry too much about hangover effects right now, which you might get from trazodone. You can mitigate this through dosage adjustments as the body accomodates to it. Linkadge has found the combination of melatonin, cyproheptadine, and Ativan effective.
Can you list which hypnotics you have tried already? Can you describe the withdrawal effects you get?
> Do you find that Prazosin helps with sleep-onset at all?I really can't say for sure. I didn't have a problem with sleep initiation to begin with with. I believe prazosin has smoothed out my sleep with fewer awakenings. I also fall asleep faster after an awakening. Sigismund might try prazosin for his sleep issues. I'll be curious to see what happens with him.
Take things one step at a time, and start a new thread regarding treating your Parnate-induced insomnia.
- Scott
Posted by g_g_g_unit on February 21, 2012, at 6:01:34
In reply to Re: Depakote and sleep » g_g_g_unit, posted by SLS on February 21, 2012, at 5:38:42
> Are you currently employed? If not, then you might have the luxury of time in performing the experimentation necessary to titrate Parnate and find a treatment for the insomnia.
I work for my dad two days a week. I have to wake up at 8am, which I find to be a tremendous struggle, but other than that, I'm free to experiment. My problem is that I'm tremendously impatient and get freaked out when I'm left feeling out-of-control due to a side-effect like insomnia.
> You sure are a challenge. Yes, Klonopin was the first drug that came to mind. I did well with it years ago when my Parnate insomnia was very bad. Trazodone should be considered also. I wouldn't worry too much about hangover effects right now, which you might get from trazodone. You can mitigate this through dosage adjustments as the body accomodates to it. Linkadge has found the combination of melatonin, cyproheptadine, and Ativan effective.Maybe I'll talk to my psychiatrist about importing Trazodone. My only concern with klonopin is that it isn't ideal as far as sleep architecture goes and so probably wouldn't be a decent long-term solution.
>
> Can you list which hypnotics you have tried already? Can you describe the withdrawal effects you get?I've tried Xanax, Valium and Zolpidem (I believe it's roughly equivalent to Ambien?). All produce irritability, agitation and (worst of all) sincere suicidal ideation. I partly wonder if these side-effects would be mitigated by an anti-depressant response from Parnate.
>
> > Do you find that Prazosin helps with sleep-onset at all?
>
> I really can't say for sure. I didn't have a problem with sleep initiation to begin with with. I believe prazosin has smoothed out my sleep with fewer awakenings. I also fall asleep faster after an awakening. Sigismund might try prazosin for his sleep issues. I'll be curious to see what happens with him.
>
> Take things one step at a time, and start a new thread regarding treating your Parnate-induced insomnia.
>
>
> - Scott
>
Posted by SLS on February 21, 2012, at 7:00:56
In reply to Re: Depakote and sleep » SLS, posted by g_g_g_unit on February 21, 2012, at 6:01:34
> > Are you currently employed? If not, then you might have the luxury of time in performing the experimentation necessary to titrate Parnate and find a treatment for the insomnia.
>
> I work for my dad two days a week. I have to wake up at 8am, which I find to be a tremendous struggle, but other than that, I'm free to experiment. My problem is that I'm tremendously impatient and get freaked out when I'm left feeling out-of-control due to a side-effect like insomnia.Well, even if you decide to discontinue the Parnate, you will have my support.
I think too much attention is being payed to "sleep architecture". Regardless of EEG findings, if you sleep okay, that's all that matters. I was on BZDs for three years while taking Parnate and Nardil. I slept fine and felt no ill-effects during the day. Quite a few people take Klonopin every night for years without ill effect.
Personally, I like the idea of taking zaleplon (Sonata) for sleep initiation. It is rather gentle and has a short half-life. It is out of you well before your wake up. I don't know if it would produce the behavioral disinhibition that has been a problem for you with the other BZD receptor agonist drugs you have taken. Some people do well with tiagabine (Gabitril) for anxiety and sleep. However, some people become agitated. I am not a big fan of this drug, though. The only way to know how you will react to tiagabine is to try it. If you don't react well to it, just stop. Perhaps that is the attitude you should take with these drug trials. They are nothing more than experiments using educated guesses. You can always stop taking immediately any drug that fails to help you.
I can only present you with information and an occasional opinion. I can't really predict or guarantee how you will react to any drug that I mention.
- Scott
This is the end of the thread.
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