Psycho-Babble Medication Thread 16983

Shown: posts 1 to 25 of 33. This is the beginning of the thread.

 

Marplan and insomnia (or something)

Posted by Elizabeth on December 15, 1999, at 21:47:11

I'm having something really odd going on. I'm taking Marplan 40mg, lithium 300mg b.i.d. (now trying to d/c it - switching to 300 q.d. tomorrow), and pindolol 5mg b.i.d. I have the worst insomnia-or-something I've ever had when not depressed! I've been alternating between sleeping maybe 2-4 hours one night and not sleeping at all the next. Also it's initial as well as terminal/late insomnia, which is not typical for me either (while depressed or not).

It gets weirder. I'm getting food cravings starting at night and through the middle of the night. (Not overeating or gaining weight, but they are usually cravings for sweets.) I feel more awake and alert in the middle of the night than in the day...I feel like I should be asleep in the daytime, and sometimes I do sleep in the day, but I've been trying not to do this and I still have lots of trouble getting to sleep at night (often can't at all). Has anyone experienced this (especially the day-night reversal thing), and if so do you have any idea what causes it?

My pdoc wrote me a script for some more Ambien (20mg/night) today; I hope it works again this time (I used it the whole time I was on Nardil, but the insomnia wasn't as bad that time).

 

Re: Marplan and insomnia (or something)

Posted by Adam on December 15, 1999, at 23:35:09

In reply to Marplan and insomnia (or something), posted by Elizabeth on December 15, 1999, at 21:47:11

I'm afraid it's the pindolol. I'm sorry I didn't mention this earlier. In my travels through the wonderful world of potential drug augmentation strategies for OCD I came across this side effect and guessed that if I wanted to stay on selegiline or switch to tranylcypromine pindolol was NOT the thing to try (and anyway, it wouldn't do what I want). To wit...


J Pharmacokinet Biopharm 1995 Apr;23(2):131-45

Prediction of sleep disorders induced by beta-adrenergic receptor blocking agents based on receptor occupancy.

Yamada Y, Shibuya F, Hamada J, Sawada Y, Iga T
Department of Pharmacy, University of Tokyo, Japan.


As for the munchies, I'm baffled. I thought pindolol would help prevent that, no? (antagonizing presynaptic 5-HT1A, helping to stimulate postynaptic 5-HTeverything)

I'm essentially a notcturnal creature these days too. It was fun at first, but now it just sucks. I probably need some zolpidem as well, but I can't really have any right now.

Meanwhile my roomates are thinking of hanging some garlic over my bed and spritzing me with holy water to see what would happen.


> I'm having something really odd going on. I'm taking Marplan 40mg, lithium 300mg b.i.d. (now trying to d/c it - switching to 300 q.d. tomorrow), and pindolol 5mg b.i.d. I have the worst insomnia-or-something I've ever had when not depressed! I've been alternating between sleeping maybe 2-4 hours one night and not sleeping at all the next. Also it's initial as well as terminal/late insomnia, which is not typical for me either (while depressed or not).
>
> It gets weirder. I'm getting food cravings starting at night and through the middle of the night. (Not overeating or gaining weight, but they are usually cravings for sweets.) I feel more awake and alert in the middle of the night than in the day...I feel like I should be asleep in the daytime, and sometimes I do sleep in the day, but I've been trying not to do this and I still have lots of trouble getting to sleep at night (often can't at all). Has anyone experienced this (especially the day-night reversal thing), and if so do you have any idea what causes it?
>
> My pdoc wrote me a script for some more Ambien (20mg/night) today; I hope it works again this time (I used it the whole time I was on Nardil, but the insomnia wasn't as bad that time).

 

Re: Marplan and insomnia (or something)

Posted by Elizabeth on December 16, 1999, at 0:01:30

In reply to Re: Marplan and insomnia (or something), posted by Adam on December 15, 1999, at 23:35:09

> I'm afraid it's the pindolol. I'm sorry I didn't mention this earlier. In my travels through the wonderful world of potential drug augmentation strategies for OCD I came across this side effect and guessed that if I wanted to stay on selegiline or switch to tranylcypromine pindolol was NOT the thing to try

What do you mean by "this side effect?" Insomnia? Can you characterize it? Did you do the dramatic day-night flip that I've done? The no-sleep-whatsoever-on-some-nights thing?

> (and anyway, it wouldn't do what I want).

What is it that you want?

> As for the munchies, I'm baffled. I thought pindolol would help prevent that, no?

No. But I don't think the pindolol is *causing* it, either. I get the impression it might be caused by the same thing that's causing the sleep disorder, because of the obvious circadian cycle my appetite is on.

> I'm essentially a notcturnal creature these days too. It was fun at first, but now it just sucks. I probably need some zolpidem as well, but I can't really have any right now.

The clinical trial thing?

> Meanwhile my roomates are thinking of hanging some garlic over my bed and spritzing me with holy water to see what would happen.

My roommate says: "hey, what a great idea!" :)

 

Re: Marplan and insomnia (or something)

Posted by jen on December 16, 1999, at 0:56:45

In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 16, 1999, at 0:01:30

i have nothing of use to add--except that i smiled when i saw that your prior reply was made today, the 16th, though there have only been 2 hours of this day proper.

wishing you some dreams,
jen

 

Re: Marplan and insomnia (or something)

Posted by Adam on December 16, 1999, at 0:57:12

In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 16, 1999, at 0:01:30

> What do you mean by "this side effect?" Insomnia? Can you characterize it? Did you do the dramatic day-night flip that I've done? The no-sleep-whatsoever-on-some-nights thing?
>
> > (and anyway, it wouldn't do what I want).
>
> What is it that you want?
>
I'm sorry for the misunderstanding. I've found some issues with OCD to be troublesome while on selegiline. I've tried to find any way I could to augment selegiline in an efficacious way without sending my doctors into fits. Just literature searches. No personal experience with the drug. What I found were, among other things, risk of sleep disturbances and lack of efficacy as an augmentation strategy for OCD.

> > As for the munchies, I'm baffled. I thought pindolol would help prevent that, no?
>
> No. But I don't think the pindolol is *causing* it, either. I get the impression it might be caused by the same thing that's causing the sleep disorder, because of the obvious circadian cycle my appetite is on.

Oh. I thought I read someplace that pindolol could help with appetite, something about 5-HT1A agonists causing hyperphagia or something. Maybe I'm wrong.

>
> > I'm essentially a notcturnal creature these days too. It was fun at first, but now it just sucks. I probably need some zolpidem as well, but I can't really have any right now.
>
> The clinical trial thing?

Yup. I'm thinking of starting a seriously strenuous exercise regimen. I used to swim, run, and play soccer competatively. I never slept better (without meds, of course). I don't know what else to do.

>
> > Meanwhile my roomates are thinking of hanging some garlic over my bed and spritzing me with holy water to see what would happen.
>
> My roommate says: "hey, what a great idea!" :)

Should I ask someone if they're on Prozac before I bite 'em in the neck?

 

Re: Marplan and insomnia (or something)

Posted by anita on December 16, 1999, at 21:02:03

In reply to Marplan and insomnia (or something), posted by Elizabeth on December 15, 1999, at 21:47:11

Hey Elizabeth,

This probably won't apply, but when I was on both Nardil and Parnate, I had a period of time when I only slept 4-6 hours per night. Usually, tho, I awoke early. I also didn't feel bad or sleep-deprived the next day. I read that what I experienced isn't uncommon for MAOIs, but I don't know about your situation.

Hope things even out.

anita

 

Re: Marplan and insomnia (or something)

Posted by Elizabeth on December 16, 1999, at 21:51:54

In reply to Re: Marplan and insomnia (or something), posted by anita on December 16, 1999, at 21:02:03

> This probably won't apply, but when I was on both Nardil and Parnate, I had a period of time when I only slept 4-6 hours per night. Usually, tho, I awoke early. I also didn't feel bad or sleep-deprived the next day. I read that what I experienced isn't uncommon for MAOIs, but I don't know about your situation.

Hi Anita. How's it going?

What you describe sounds like what happened to me on Nardil once I started taking Ambien. I hope the Ambien will do the same here too.

 

Re: Marplan and insomnia (or something)

Posted by Adam on December 17, 1999, at 3:27:56

In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 16, 1999, at 21:51:54

Well, of possible relevance to this thread (and my own obvious problems with
insomnia, given that it's about 4:00 AM EST and I'm wide awake)...

I've been reading up on beta-adrenergic receptor mediated control of melatonin
production. I was aware that the pineal gland was involved in regulating circadean
rhythms, but I was not aware of diurnal changes is norepinepherine levels, and
how this periodic increase and decrease in NE controled melatonin production,
and hence, rhythmic sleep patterns.

Research has shown that beta-blockers can interfere with this process by inhibiting
NE signalling (beta-adrenoreceptors on the pineal gland regulate the expression of
5-HT-N-acetyltransferase). Both 1 and 2 beta-ad. receptors are likely involved.

Perhaps this is a partial explanation for this shift in sleep patterns and food
cravings: your body can't tell night from day as well as before. Could well-timed
use of melatonin plus Ambien help reset your clock and get at least some sleep while
on pindolol and Marplan? Is such an approach safe? It seems for people who have
had sleep distrubances related to shifts in sleep patterns, melatonin can help at
least with the timing, if dosed properly.

I'm kind of interested in what you think of melatonin, Elizabeth, if it's not too
much trouble.

Also, a paper on the molecular mechanisms of NE-regulated melatonin production in
the pineal gland is here, if you are interested...

http://www.biomednet.com/library/fulltext/JNRB.nb8523

I had no problem reading it from home.

 

Re: Marplan and insomnia (or something)

Posted by Noa on December 17, 1999, at 6:40:10

In reply to Re: Marplan and insomnia (or something), posted by Adam on December 17, 1999, at 3:27:56

A psychiatrist who specializes in biological rhythms, sleep, jet lag, depression, etc. is Dan Oren, at Yale University. When he was at NIH, his research focused on melatonin. He has also done work on light therapy. You can look him up at the Yale University site or the Yale-New Haven Hospital site.

 

Re: Marplan and insomnia (or something)

Posted by Adam on December 17, 1999, at 14:53:36

In reply to Re: Marplan and insomnia (or something), posted by Noa on December 17, 1999, at 6:40:10

Thank you, Noa.

I don't want to dilute or detract from this thread (I do that all the time eslewhere and am trying to quit), so I think I will take questions about melatonin to the INSOMNIA thread.

> A psychiatrist who specializes in biological rhythms, sleep, jet lag, depression, etc. is Dan Oren, at Yale University. When he was at NIH, his research focused on melatonin. He has also done work on light therapy. You can look him up at the Yale University site or the Yale-New Haven Hospital site.

 

Re: Marplan and insomnia (or something)

Posted by Scott L. Schofield on December 18, 1999, at 19:13:19

In reply to Marplan and insomnia (or something), posted by Elizabeth on December 15, 1999, at 21:47:11


> I'm having something really odd going on. I'm taking Marplan 40mg, lithium 300mg b.i.d. (now trying to d/c it - switching to 300 q.d. tomorrow), and pindolol 5mg b.i.d. I have the worst insomnia-or-something I've ever had when not depressed!

Did the insomnia begin immediately after adding pindolol?

> It gets weirder. I'm getting food cravings starting at night and through the middle of the night. (Not overeating or gaining weight, but they are usually cravings for sweets.) I feel more awake and alert in the middle of the night than in the day...I feel like I should be asleep in the daytime, and sometimes I do sleep in the day, but I've been trying not to do this and I still have lots of trouble getting to sleep at night (often can't at all). Has anyone experienced this (especially the day-night reversal thing), and if so do you have any idea what causes it?

Insomnia has seemed to be a good-prognosis side-effect for me.
If an MAO-inhibitor is going to work for me, I develop insomnia early on.

I have had this type of insomnia along with the day-night reversal with three different MAOIs. It was very frustrating, and the lack of sleep really affected cognition. I used benzo sleeping pills a few times (Ativan and Halcion combination), but found that it can be counterproductive in the long run. I felt like I would go through some sort of mini-withdrawal syndrome every day. I guess this could have been due to the short half-life of the Halcion. I found that Ambien wasn't strong enough to do the job.

I did try to keep my behavioral day-night cycle even though my biological cycle was out of whack. I went to bed at 11:00 PM and remained in bed until 7:00 AM, regardless of how wide-awake I was. I found that short naps during the day were O.K., but definitely not for more than 45 minutes. I remember hearing something about 20 minutes being ideal.

> My pdoc wrote me a script for some more Ambien (20mg/night) today; I hope it works again this time (I used it the whole time I was on Nardil, but the insomnia wasn't as bad that time).

I'm sure you thought of using trazodone. Is there some reason you are avoiding using it?


- Scott

 

Re: Marplan and insomnia (or something)

Posted by Elizabeth on December 19, 1999, at 10:26:31

In reply to Re: Marplan and insomnia (or something), posted by Scott L. Schofield on December 18, 1999, at 19:13:19

> Did the insomnia begin immediately after adding pindolol?

No, I've had insomnia for a long time. It got worse when I started Marplan and pindolol (I started them simultaneously).

> Insomnia has seemed to be a good-prognosis side-effect for me.
> If an MAO-inhibitor is going to work for me, I develop insomnia early on.

It is working. All the MAOIs have caused increased insomnia for me, and all that I have tried except selegiline have worked.

> I have had this type of insomnia along with the day-night reversal with three different MAOIs. It was very frustrating, and the lack of sleep really affected cognition. I used benzo sleeping pills a few times (Ativan and Halcion combination), but found that it can be counterproductive in the long run. I felt like I would go through some sort of mini-withdrawal syndrome every day. I guess this could have been due to the short half-life of the Halcion. I found that Ambien wasn't strong enough to do the job.

I need 20mg (2 pills) of Ambien. It seems to be working okay.

> I did try to keep my behavioral day-night cycle even though my biological cycle was out of whack.

This has been a long-term problem for me. I have tried a lot of behavioral and sleep-hygeine methods.

> I went to bed at 11:00 PM and remained in bed until 7:00 AM, regardless of how wide-awake I was.

I don't think you're "supposed" to do this (CW is that you should get up and go in another room and do something relaxing if you're awake more than 20 minutes or so), but hey, whatever works for you.

> I found that short naps during the day were O.K., but definitely not for more than 45 minutes. I remember hearing something about 20 minutes being ideal.

I don't nap during the day. Mostly I'm just not sleeping.

> I'm sure you thought of using trazodone. Is there some reason you are avoiding using it?

Yeah, 'cause it didn't do anything for me even when I took it (up to 400mg at h.s.) without an MAOI!

 

Re: Marplan and insomnia (or something)

Posted by Scott L. Schofield on December 23, 1999, at 21:26:28

In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 19, 1999, at 10:26:31

> > Did the insomnia begin immediately after adding pindolol?

> No, I've had insomnia for a long time. It got worse when I started Marplan and pindolol (I started them simultaneously).

> > Insomnia has seemed to be a good-prognosis side-effect for me.
> > If an MAO-inhibitor is going to work for me, I develop insomnia early on.

> It is working. All the MAOIs have caused increased insomnia for me, and all that I have tried except selegiline have worked.


Did you say it *is* working?

Alright! :)

Would you mind telling me about it?


Sincerely,
Scott


P.S. Why did you discontinue the other MAOIs?

 

Re: Marplan and insomnia (or something)

Posted by Elizabeth on December 24, 1999, at 0:28:58

In reply to Re: Marplan and insomnia (or something), posted by Scott L. Schofield on December 23, 1999, at 21:26:28

> Did you say it *is* working?

Yuppers.

> Alright! :)
>
> Would you mind telling me about it?

Sure thing, what would you like to know?

> P.S. Why did you discontinue the other MAOIs?

Nardil: poop-out - also massive weight gain (unfortunately, weight gain looks like it's becoming a problem with Marplan too).
Parnate: it causes spontaneous hypertensive crises (i.e., not drug-drug or food-drug interactions) at relatively low doses, so I couldn't get past 30mg/day, which really wasn't enough.

 

Re: Marplan and insomnia (or something)

Posted by Phillip Marx on December 24, 1999, at 12:52:21

In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 24, 1999, at 0:28:58

Hi Elizabeth.
It is good that you are researching the chemistry in such detail. I did the same thing after I realized how easy it was to learn more than my HMO knew, their ratio of negative success to zero positive success should have tipped me off sooner, except they had turned me into a revenue patient who couldn't remember how to complain. That struggling to think while under sedation will strengthen your mind and it's determinations to the point that you will seem like a manic rocketship when the sedative restraints fall off for any reason. Just like a runner would even use resistance training to build muscles that run faster, you are inadvertently using chemical mental resistance training that is building you and your concentration up for some really fast and clear thinking that will likely look like something worse. See my other posts here as I have just recently discovered this forum. I have found that using 1/2 to a full 0.25mg halcion=triazolam WITH 50-150mg Serzone=nefazodone gets me to very restful sleep in just a couple of hours or less unless I take too little which then takes longer, and the drop-off to sleep point is mostly at my discretion so that I CAN finish watching the climax endings of some TV shows the first time now. Benefit, alarms do make me conscious, there is very little paralysis, and the wake up hangover is only a sluggish period of at most 1/2 hour and I am clear thinking all day afterwards. Sometimes I wake up before the sluggish period is over and sometimes it is completely gone by the time I wake up and I can go right to the treadmill and do a quarter mile at 10 miles an hour without stumble, this treadmill won't go any faster. Not bad, it amazes me, I am 51 years old. The Physicians' Desk Reference says that Serzone makes the Halcion 1.7 times stronger and last 2.8 times longer. This is a perfect profile for those like me who are immune to Halcion by itself. Dosage might be less for you if you aren't yet. Most other medications effects and side effects are dependent on timed out serum metabolic conversion and renal (kidney) clearance. This means the wear-off time is somewhat logarithmic. The binary combination I'm suggesting times out and clears quickly, more like the desperately desired [square - rectangular -trapezoidal] step function every one wants. It has been working so well for me for two years now that I am not fearful of getting the word out to those who sound like they are otherwise starting a long terrible journey through multiple depressing expirations of medical efficacies. The Rx profession tried a lot of things on me and only this one rates my thanks. Another benefit of Halcion that encourages hope is that tolerances reverse with as little as a week of medicine holiday, and can then work for another couple of years. I haven't regained efficacy on any of the others I've used.

I don't know what brought you to this forum first, but you sound not only very intelligent, but not driven yet to abandon hope. I lasted almost two years on increasing strength, increasingly crippling medications before they took me totally down. I was on state disability over a two-year period which www.DrJensen.com fixed in only his first week. The first medication got me through the next few months in a recovery mode that quit working when that brain chemistry system "healed" enough so that I had to work on the next most "not-yet-healed" brain chemistry exhaustions (workaholism does catch up, I've never heard of anyone who was working harder than I was in peacetime, I'd be afraid to meet her). I am now getting the 1st or 2nd top grades in some career transistion classes I'm taking into work that should be impossible to overwork in, which shows the medicine is working, though it makes people nervous how fast I finish the tests. Having gotten so sick and fat from the metabolic crippling of accumulated sleep medicines forced me to do as you are doing and re-learn from scratch how to take care on my normally self-negligent self. Now the weight is gone and skin shrinking back, though slower than I would wish. My body itself is a little afraid that it's not safe yet to get off emergency mode. I can now do more (sometimes twice) the weight and reps as the physical trainers at the gym half my age, I can't do free weights well at high weights because of my carpal tunnel issues since the tendons also grew in channels that didn't (oversize tendons are stronger and don't hurt as long as they aren't rubbed together until they swell even further under high loads, the weight machines "hold" alignments preventing such tendon sliding) as I got my strength back after a muscle-wasting three months stuck almost totally in bed from a desperately overdue, but temporary medication success. It's bizarre and baffling, but if I wouldn't have gotten so sick, and made even worse by the HMO, I wouldn't be alive today from the stress I was under back then. Now, I'm an otherwise very healthy looking person mistaken for 10-20 years younger than reality, I have to carry around transistion pictures to convince old friends that I am Me. Anyway, look up those two medications. They are synergistic and so are functional at doses so low that I haven't had any negative side effects. Dr. Jensen does telephone diagnosis and prescriptions world-wide.

Phillip Marx
PhilMarx@net999.com


> Did you say it *is* working?
>
> Yuppers.
>
> > Alright! :)
> >
> > Would you mind telling me about it?
>
> Sure thing, what would you like to know?
>
> > P.S. Why did you discontinue the other MAOIs?
>
> Nardil: poop-out - also massive weight gain (unfortunately, weight gain looks like it's becoming a problem with Marplan too).
> Parnate: it causes spontaneous hypertensive crises (i.e., not drug-drug or food-drug interactions) at relatively low doses, so I couldn't get past 30mg/day, which really wasn't enough.

 

Re: Marplan and insomnia (or something)

Posted by Scott L. Schofield on December 25, 1999, at 11:56:24

In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 24, 1999, at 0:28:58

In Re: Marplan

> > Did you say it *is* working?

> Yuppers.

> > Alright! :)
> >
> > Would you mind telling me about it?

> Sure thing, what would you like to know?

How does it feel?


Sincerely,
Scott


P.S. I'm sorry that I keep forgetting about your experiences with Parnate. It must be my hippocampus fighting mental health again.

Keep going.

 

Re: Marplan and insomnia (or something)

Posted by Elizabeth on December 25, 1999, at 22:31:35

In reply to Re: Marplan and insomnia (or something), posted by Scott L. Schofield on December 25, 1999, at 11:56:24

> How does it feel?

Can you be a little bit more specific? I'm not sure how to answer this one.

> P.S. I'm sorry that I keep forgetting about your experiences with Parnate. It must be my hippocampus fighting mental health again.

It's okay, mine does that too. :)

 

Re: Marplan and insomnia (or something)

Posted by Elizabeth on December 25, 1999, at 22:45:16

In reply to Re: Marplan and insomnia (or something), posted by Phillip Marx on December 24, 1999, at 12:52:21

Phillip,

Serzone is contraindicated with MAOIs. I can't use it. I tried it for depression a while back with no success -- and furthermore it caused multiple nighttime awakenings (where without Serzone, at the time, I had just been waking up early in the morning.

I've tried a number of benzodiazepines for insomnia; I develop tolerance to them rapidly, so they aren't terribly useful to me. I've also tried trazodone, atypical antipsychotics, thioridazine (Mellaril), clonidine, tricyclics, diphenhydramine, hydroxyzine, gabapentin, chloral hydrate, and probably some I'm forgetting.

I started using Ambien 20mg this week had used it before with Nardil, with some success). It's not perfect (wears off in a few hours -- not enough), but it's better than nothing.

Take it easy.

 

Re: Marplan and insomnia (or something)

Posted by Phillip Marx on December 26, 1999, at 1:16:27

In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 25, 1999, at 22:45:16

Hi Elizabeth

The Serzone didn't do anything the tiniest bit noticeable on me by itself. "Only" concurrent with Halcion did the miracles start (synergy). I think I'll only be able to use binary medications in the future since all the single medications were used until they timed out. My curing doctor is world famous, look at his site @ www.DRJENSEN.com where he explains how he has taken people who have been to 50-100 doctors and has 30%-60% of them much better in less than two weeks. He did it for me twice. He will characterize the 10 main brain chemistry systems and see if the failure to cure is due to the failure to fix more than one imbalance simultaneously. That ambien will be as useless to you as it is now to me if you keep using it consistently for long due to tolerance increase up to virtual immunity (futility point). You have to think ahead now before the deficits build back up as they will soon when that ambien efficacy times out in known unavoidable ways. If you find an alternate before you are totally immune to ambien, you will still be able to use ambien later as a backup. Ambien is a crutch, not a fix for whatever is really causing the insomnia. I have no short half-life meds left still usable to me. Ativan still works a little because I talked the early doctors out of it early on since it so destroyed my memory, especially my short-term memory, so my tolerance to it hasn't been all used up yet. I wish I had jumped meds earlier so that I would have a short one available if I wasn't very tired and a long one for when I did need more sleep or one that I could add if I needed a couple of more hours sleep after an early wake-up. These meds are not tied into the sleep regulation systems, they replace them and over-ride them, they don't work with the regulation and feedback systems. Now I have to regulate (limit) how tired I get to match how much sleep I get per per med night, even the best medications in the world won't let me get back to how hard I was working, and I've lost most of the years of driven acquired endurance that enabled me then. Oh, also, I had a neck injury back in '79 that made me mostly numb. I acquired about a ten degree tilt in my atlas at the skull joint. MRI wasn't good enough for anything back then and I was forced to take a year of biofeedback (eventually worked well, now I can walk and run around in cold snow barefoot without freezing, though before that I could waterski in February) to control/ignore pain. The skull deformities, bone spurs and tendon deformations now show quite well when I had a skull x-ray taken to look for premature pineal calcification, none though. I think that is why I could work so much without feeling hardly tired, I think fatigue sensations need functioning Schwann cells to report fatigue level to the brain as well as pain levels. About three years ago the neck started to heal (maybe from so much bedridden immobility) and now I feel more naturally tired much more like before I hurt my neck. Meds regulate kind of like a heart pacemaker that doesn't have a blood Ox sensor built in. If you don't have a backup ready as soon as a known drug fails, you will have to experiment till you find one, and experiments hurt the most when they are started too late, especially if it's one that takes long to try (trial period). A second trial drug has an even tougher time since more systems are exhausted. It feels like multiple systems failures as the persisting problem failure causes many other dependent systems to exhaust and crawl along with crippled functions. If I would have rotated through that whole series of benzodiazepines instead of sticking each one out until there weren't any "work"able medications that could keep me working, I wouldn't have been forced to divorce my job. I just read somewhere that these can actually "cause" the insomnia.

Merry Christmas and God bless you
Phillip Marx
PhilMarx@net999.com

> Phillip,
>
> Serzone is contraindicated with MAOIs. I can't use it. I tried it for depression a while back with no success -- and furthermore it caused multiple nighttime awakenings (where without Serzone, at the time, I had just been waking up early in the morning.
>
> I've tried a number of benzodiazepines for insomnia; I develop tolerance to them rapidly, so they aren't terribly useful to me. I've also tried trazodone, atypical antipsychotics, thioridazine (Mellaril), clonidine, tricyclics, diphenhydramine, hydroxyzine, gabapentin, chloral hydrate, and probably some I'm forgetting.
>
> I started using Ambien 20mg this week had used it before with Nardil, with some success). It's not perfect (wears off in a few hours -- not enough), but it's better than nothing.
>
> Take it easy.

 

Re: Marplan and insomnia (or something)

Posted by Phillip Marx on December 26, 1999, at 2:48:33

In reply to Re: Marplan and insomnia (or something), posted by Phillip Marx on December 26, 1999, at 1:16:27

I just found an online interview transcript, check it out.

http://www.concernedcounseling.com/ccijournal/conference/jensendepression.htm
pm

> Hi Elizabeth
>
> The Serzone didn't do anything the tiniest bit noticeable on me by itself. "Only" concurrent with Halcion did the miracles start (synergy). I think I'll only be able to use binary medications in the future since all the single medications were used until they timed out. My curing doctor is world famous, look at his site @ www.DRJENSEN.com where he explains how he has taken people who have been to 50-100 doctors and has 30%-60% of them much better in less than two weeks. He did it for me twice. He will characterize the 10 main brain chemistry systems and see if the failure to cure is due to the failure to fix more than one imbalance simultaneously. That ambien will be as useless to you as it is now to me if you keep using it consistently for long due to tolerance increase up to virtual immunity (futility point). You have to think ahead now before the deficits build back up as they will soon when that ambien efficacy times out in known unavoidable ways. If you find an alternate before you are totally immune to ambien, you will still be able to use ambien later as a backup. Ambien is a crutch, not a fix for whatever is really causing the insomnia. I have no short half-life meds left still usable to me. Ativan still works a little because I talked the early doctors out of it early on since it so destroyed my memory, especially my short-term memory, so my tolerance to it hasn't been all used up yet. I wish I had jumped meds earlier so that I would have a short one available if I wasn't very tired and a long one for when I did need more sleep or one that I could add if I needed a couple of more hours sleep after an early wake-up. These meds are not tied into the sleep regulation systems, they replace them and over-ride them, they don't work with the regulation and feedback systems. Now I have to regulate (limit) how tired I get to match how much sleep I get per per med night, even the best medications in the world won't let me get back to how hard I was working, and I've lost most of the years of driven acquired endurance that enabled me then. Oh, also, I had a neck injury back in '79 that made me mostly numb. I acquired about a ten degree tilt in my atlas at the skull joint. MRI wasn't good enough for anything back then and I was forced to take a year of biofeedback (eventually worked well, now I can walk and run around in cold snow barefoot without freezing, though before that I could waterski in February) to control/ignore pain. The skull deformities, bone spurs and tendon deformations now show quite well when I had a skull x-ray taken to look for premature pineal calcification, none though. I think that is why I could work so much without feeling hardly tired, I think fatigue sensations need functioning Schwann cells to report fatigue level to the brain as well as pain levels. About three years ago the neck started to heal (maybe from so much bedridden immobility) and now I feel more naturally tired much more like before I hurt my neck. Meds regulate kind of like a heart pacemaker that doesn't have a blood Ox sensor built in. If you don't have a backup ready as soon as a known drug fails, you will have to experiment till you find one, and experiments hurt the most when they are started too late, especially if it's one that takes long to try (trial period). A second trial drug has an even tougher time since more systems are exhausted. It feels like multiple systems failures as the persisting problem failure causes many other dependent systems to exhaust and crawl along with crippled functions. If I would have rotated through that whole series of benzodiazepines instead of sticking each one out until there weren't any "work"able medications that could keep me working, I wouldn't have been forced to divorce my job. I just read somewhere that these can actually "cause" the insomnia.
>
> Merry Christmas and God bless you
> Phillip Marx
> PhilMarx@net999.com
>
> > Phillip,
> >
> > Serzone is contraindicated with MAOIs. I can't use it. I tried it for depression a while back with no success -- and furthermore it caused multiple nighttime awakenings (where without Serzone, at the time, I had just been waking up early in the morning.
> >
> > I've tried a number of benzodiazepines for insomnia; I develop tolerance to them rapidly, so they aren't terribly useful to me. I've also tried trazodone, atypical antipsychotics, thioridazine (Mellaril), clonidine, tricyclics, diphenhydramine, hydroxyzine, gabapentin, chloral hydrate, and probably some I'm forgetting.
> >
> > I started using Ambien 20mg this week had used it before with Nardil, with some success). It's not perfect (wears off in a few hours -- not enough), but it's better than nothing.
> >
> > Take it easy.

 

Re: Marplan and insomnia (or something)

Posted by Scott L. Schofield on December 26, 1999, at 14:16:16

In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 25, 1999, at 22:31:35

In Re: Elizabeth's responding to Marplan

> > How does it feel?

> Can you be a little bit more specific? I'm not sure how to answer this one.


The question was designed specifically to be anything but specific. Please feel free to answer it whichever way you like. You can, of course, decline to answer it at all. It is sort of personal.

Oh yeah - Happy Belated Holidays!


Sincerely,
Scott

 

Re: Marplan and insomnia (or something)

Posted by Scott L. Schofield on December 26, 1999, at 14:39:13

In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 25, 1999, at 22:45:16

> I've tried a number of benzodiazepines for insomnia; I develop tolerance to them rapidly, so they aren't terribly useful to me. I've also tried trazodone, atypical antipsychotics, thioridazine (Mellaril), clonidine, tricyclics, diphenhydramine, hydroxyzine, gabapentin, chloral hydrate, and probably some I'm forgetting.

> I started using Ambien 20mg this week had used it before with Nardil, with some success). It's not perfect (wears off in a few hours -- not enough), but it's better than nothing.

The first time I tried a combination of tranylcypromine (Parnate) and desipramine (Norpramin), I was unable to sleep at all for the first week or so. At this point, my doctor decided it was time to intervene using sleeping medications. He chose Halcion (triazolam) and Ativan (lorazepam) to be taken in combination at bedtime. The strategy was to take advantage of the potent effects of the Halcion to initially induce sleep, and then have the Ativan carry me over until morning. The dosages were tweaked a bit and resulted in little, if any, hangover the next morning.

If Ambien (generic name?) works well enough to put you to sleep, perhaps you can find something else to carry you the rest of the way through the night (trazadone, clonazepam, lorazepam). I found chloral hydrate to be hell on the stomach.

For some reason, I find myself waking up at 2:00 AM and then at 5:00 AM when using either Nardil or Parnate. I was told by WZ Potter that this was a function of time after the initiation of sleep. I guess this is possible since I have pretty much gone to bed around the same time for years (10:30 - 11:00 PM). As far as the 5:00 AM awakening, I get the feeling that this might be more a function of circadian rhythm. I have never bothered to look into it.

Does the fact that you experience early-morning awakenings indicate that you suffer from typical (melancholic) unipolar depression?


- Scott

 

Re: Marplan and insomnia (or something)

Posted by Elizabeth on December 26, 1999, at 20:13:28

In reply to Re: Marplan and insomnia (or something), posted by Phillip Marx on December 26, 1999, at 1:16:27

> My curing doctor is world famous, look at his site @ www.DRJENSEN.com where he explains how he has taken people who have been to 50-100 doctors and has 30%-60% of them much better in less than two weeks.

I've read his website; I think he tends to oversimplify people's problems in a way that I think is unlikely to work in many cases (though obviously because of nonspecific effects I don't doubt that he has good luck sometimes). I think perhaps his "method" relies a lot on expectation effects.

> That ambien will be as useless to you as it is now to me if you keep using it consistently for long due to tolerance increase up to virtual immunity (futility point).

Uh, no. Some people develop tolerance to Ambien (probably behavioral tolerance, as occurs with alcohol), but that isn't the rule. For example, I used it every day for a year or more without needing to increase the dose. Your experience doesn't generalize.

Also, benzodiazepines cause cross-tolerance; if you're tolerant to one, you will be at least somewhat tolerant to another.

BTW I wonder if perhaps your memory problems may be due to chronic sleep deprivation as well as overuse of high-dose benzodiazepines; your loss of motivation might be caused by partial remission from mania. (Why do you feel such a need to insist that you are not manic? Mania is defined by observed symptoms, which I think you know you have.)

 

Re: Marplan and insomnia (or something)

Posted by Elizabeth on December 26, 1999, at 20:19:59

In reply to Re: Marplan and insomnia (or something), posted by Scott L. Schofield on December 26, 1999, at 14:39:13

Scott....

> If Ambien (generic name?) works well enough to put you to sleep, perhaps you can find something else to carry you the rest of the way through the night (trazadone, clonazepam, lorazepam). I found chloral hydrate to be hell on the stomach.

(zolpidem)

My main problem has always been staying asleep, not getting to sleep, though now with the Marplan it's both, so I know that most other drugs don't help me to stay asleep. Something I'd thought of was perhaps using Sonata (a shorter-acting Ambien-like pill) when I wake up in the middle of the night when the Ambien wears off. Suboptimal, but could be worse.

> Does the fact that you experience early-morning awakenings indicate that you suffer from typical (melancholic) unipolar depression?

Well, that is the type of depression I have, but the insomnia is chronic, whereas the depression is episodic (it remits, then comes back). So, uh, I dunno!

About your question: I don't know how to answer it! But if you'll ask several specific q's instead of one broad one, I will try to answer those. :)

 

Re: Marplan and insomnia (or something)

Posted by Phillip Marx on December 27, 1999, at 0:08:44

In reply to Re: Marplan and insomnia (or something), posted by Elizabeth on December 26, 1999, at 20:13:28

Elizabeth

> > My curing doctor is world famous, look at his site @ www.DRJENSEN.com where he explains how he has taken people who have been to 50-100 doctors and has 30%-60% of them much better in less than two weeks.
>
> I've read his website; I think he tends to oversimplify people's problems in a way that I think is unlikely to work in many cases (though obviously because of nonspecific effects I don't doubt that he has good luck sometimes). I think perhaps his "method" relies a lot on expectation effects.

Logic is simpler than ill-logic. Would you prefer he chose his most complex cases? His protocols are designed to rule out non-specific effects. He gets treatment resistant failures from other doctors, mostly by referrals like mine and his television programs, which keep him saturated, he doesn’t have to advertise. He gets people with totally defeated expectations. I guess maybe defeated expectations can get people to follow protocols without rebellion sometimes, but I wouldn’t expect such to be reliable. He isn’t keeping his protocols to himself. He wants to help more people than he can help all by himself. He’s devoting a lot of time to making sure other doctors can imitate his success. His protocols clone! Why? Because they really do have better success statistics.

>
> That ambien will be as useless to you as it is now to me if you keep using it consistently for long due to tolerance increase up to virtual immunity (futility point).

> Uh, no. Some people develop tolerance to Ambien (probably behavioral tolerance, as occurs with alcohol), but that isn't the rule. For example, I used it every day for a year or more without needing to increase the dose. Your experience doesn't generalize.

I know my experiences don’t generalize, that’s why my first step into this forum was to ask if there were any atypicals like me around, since all other types of atypicals were begging for clues for help. I am phil’santhropic enough to try to offer help to all those here medically stalled like I was for so long. How else could I respond to reading all this? I have a long history of trying to help people more than is good for me, I keep getting called co-dependent. I used to be reluctant to admit how much my own happiness depended on helping others, que sera. Trying to rescue everyone and everything on a sinking ship is not wise when the ship isn’t really sinking. I probably shouldn’t get my mission mixed up with my missionary inclinations again here or I’ll wear out again. Your experience expectations don’t generalize well, which doesn’t bode well for future depression avoidance. You are at least going to use up your endurance and get exhaustion tolerant (wouldn’t that be interpreted (read) like depression, mental rather than physical) if you learn to settle for the short sleeps you get with Ambien. Your daily work output will decline and decay to the level you can recover nightly. Is your work output depressed? I couldn’t work much on Ambien, and I’m the worst workaholic I’ve ever met, sort of. Maybe you are retired and don’t need much sleep for your days.

Ambien (zolpidem tartrate), is a non-benzodiazepine hypnotic of the imidazpyrodine class…GABAx subunit modulator…chemical structure unrelated to benzodiazepines…deep sleep stages 3&4 factors…During nightly use for an extended period, pharmocodynamic tolerance or adaptation to some effects of hypnotics may develop. …’Transient and chronic insomnia use’ clinical tests listed in the PDR are for 5 weeks max. … no objective insomnia rebound evidenced…. INDICATIONS AND USAGE: Ambien is indicated for the short-term treatment of insomnia. Hypnotics should generally be limited to 7 to 10 days of use, and re-evaluation of the patient is recommended if they are taken for more than 2 to 3 weeks. Ambien should not be prescribed in quantities exceeding a 1-month supply….The failure of insomnia to remit after 7 to 10 days of treatment may indicate the presence of a primary psychiatric/medical illness which should be evaluated…. It is important to use the smallest possible effective dose…

Sounds like a professional warning of potential tolerance to me by the PDR. I wish you more than luck is usually statistically good for.
>
> Also, benzodiazepines cause cross-tolerance; if you're tolerant to one, you will be at least somewhat tolerant to another.

I don’t know if tolerance ever wears off, but they put me on longer and longer half-life versions as time went on and sleep decreased to insufficient with each one. I’ll have to look up cross-tolerance somehow and see how wide it’s definition is.
>
> BTW I wonder if perhaps your memory problems may be due to chronic sleep deprivation as well as overuse of high-dose benzodiazepines; your loss of motivation might be caused by partial remission from mania. (Why do you feel such a need to insist that you are not manic? Mania is defined by observed symptoms, which I think you know you have.)

Sleep deprivation hurt more than my memory, it hurt everything ever listed as effect from affect. Medicinal related memory problems were only significant for me on Ativan in therapeutic doses. Ativan is one of the anesthesiologist’s choices to keep us from waking up and remembering surgery. Even Halcion can cause memory dysfunction, even amnesia, but I can’t remember any??? Halcion is what made President Bush throw up on the Japanese ambassadors and what caused Sally Field’s boyfriend in that bootlegger movie series look like he had AIDs. I never took an overdose of BDs that I know of, though I think they have been somewhat overused on me. I can’t remember all the technical reasons why they chose original diagnoses that far back since I have overwritten it with much better information in the since-time, and I didn’t like it then, but they promised me they wouldn’t change to something else unless it didn’t work, I would really have balked if I had know how long they would take to give up first diagnosis, but the earliest diagnoses were Insomnia (NOS) being not otherwise specified by professionals trained better than I ever want to be to call it mania if it is mania. My lo-pro call is manic-like but not manic-exact, conceding mania-standard too easily will put everyone back on a malevolent treadmill I don’t think I should have been run on the first time. Suspicions of mania-standard cost me an extra couple of years of recovery. Mania-like, fine, lithium just wasted a lot (years) of my time. Mania-standard treatments failed which indicates non-mania-standard. I’m different in some ways, thanks, and I’m different in some other ways, sorry. Mania as cause/source and mania as result require different treatments. Lack of sleep is not always preceded by or indicative of mania-standard, if you have enough endurance you can sure test positive for increasing exhibited panic. If you split the mania definition right, you get more appropriate treatment, otherwise it will cost years by honest people who will never know they were wrong, even if you die. What you may be referring to as loss of motivation is really deferred motivation as I learned I had to put everything on hold until, if ever, promises of recovery ever came true. It would take years to complete all the projects I have preserved for such a time. I’m still reluctant to commit to much from the trauma of so much helpless powerlessness, I know how fast it overtook me completely against my will without any cooperation with convenient timing, there was no putting it off with a reschedule-please notice. My motivations are easiest to sustain for short, easy-to-complete quickly projects to this day still from sedative conditioning. I don’t understand how loss of motivation can be caused by partial remission from mania, unless they were manic-only motivated projects, which I don’t think any of mine are. The tree that kept filling my house downwind with its dirt I took down. Manic? I have to fix the garage fascia board it destroyed on the way down. Manic? I have to get the garden in the back yard replanted and the above-ground pool removed. Manic? I’ll have to mull over the rest. I’m willing to purge anything not belonging.

Phillip Marx
PhilMarx@net999.com



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