![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 27. This is the beginning of the thread.
Posted by CtrlAlt n Del on April 24, 2002, at 17:28:03
Can they be used indefinitely?
Do they lose effectivness?thanks.
Posted by Krazy Kat on April 24, 2002, at 19:14:22
In reply to anyone use sleeping pills long term?, posted by CtrlAlt n Del on April 24, 2002, at 17:28:03
heh, there. i was using sleeping pills a lot last year. i did not like ambien - hung over the next day - though i've seen many posts in its praise. so i was taking otc stuff - whatever is in tylenol/exedrin pm.
i did notice a tolerance building up with the otc, which is partly why i stopped. but maybe the prescription sleeping pills are better in that respect.
also, and i know this is not a concern for you, the prescriptions are safer in that it's more difficult to instantly have enough to overdose on when things get too rough (just thinking aloud). i think i have 4 sleeping pills in my med cab now.
- kk
Posted by CtrlAlt n Del on April 24, 2002, at 19:29:44
In reply to Re: anyone use sleeping pills long term?, posted by Krazy Kat on April 24, 2002, at 19:14:22
Hi KK
I was offered them from doc.
I don't seem to sleep deeply(even worse without AD's/meds...alcohol worked best)..shame the lamictal was good for sleep.
Benzo's make me depressed so I'm thinking no scary crazy dreams , deep sleep may make me 50% better.One day I'll find the coctail.....
xxxxxxxxx
Posted by James on April 24, 2002, at 20:25:17
In reply to Re: anyone use sleeping pills long term? » Krazy Kat, posted by CtrlAlt n Del on April 24, 2002, at 19:29:44
I have been using Tylenol/Excedrin PM as a sleeping pill on and off for the past 3 or 4 years, with varying results. Its interesting you mentioned it, but I have been feeling that the Excedrin PM was effecting me less and less lately. BTW the active sleep agent in it isDiphenhydramine Cytrate, and Excedrin has 38 mgs, whereas tylenol has 25 I think. But lately I went on Gabitril as mood stabilizer and it has been helping me get to sleep very well, maybe even tooo well. But, I don't know what your diagnosis is, so whatever.
--James
Posted by Willow on April 24, 2002, at 20:27:43
In reply to Re: anyone use sleeping pills long term?, posted by Krazy Kat on April 24, 2002, at 19:14:22
Dreamer (and Kat)
Funny, I never know who I'll bump into around the corner or in this case on another board.
Dreamer, as Kazoo would say, be specific and you if you can't yadaa yadaa. What drug are you talking about? And what are you using it for? To fall asleep? To stay asleep?
Are you still on the effexor? Sleep doc added clonazepam to my "cocktail" to help with the twitching, which the effexor had worsened, and I won't consider giving up the effexor because it helps me with the cognitive issues so much. So I guess I'm using the clonazepam to help improve my sleep and if it works I'll be on it for quite some time. Now I've also been given lorazepam by my gp to help with anxiety during my last bout with depression. When I asked for this rx to be refilled (this was before the clonazepam) over the phone the receptionist made me make an appointment to discuss my usage of the med. More yada yada! Sleep doc said the lorazepam doesn't help with the twitches, hence the other med. So in my opinion, some sleep meds can be used for a longtime.
Kat regarding keeping meds in the house, I think this is a good idea. With rx's that have large quantities you can ask for smaller ones with repeats. (I guess the good Wise Owl has had some depressive episodes with anxiety?)
Whispering Willow
Posted by CtrlAlt n Del on April 24, 2002, at 21:11:46
In reply to Re: anyone use sleeping pills long term?, posted by Willow on April 24, 2002, at 20:27:43
Sorry Willow/Kat/James..my mood is awful ...specific ain't my strong point at the momentI'm looking for a pill to reduce dreaming so I can sleep deeper...I had a couple once (off friend)and woke up refreshed and not disturbed ...
James I'll hunt the internet to see whats available in uk..my diagnosis is 'unspecified' mood disorder but I also feel I'm in perpetual post traumatic stress...especially after dreams in sleep.
I also have another irritating problem but that's a rare nothing can help thing...
thanks all xxxxxx
Posted by James on April 24, 2002, at 21:15:15
In reply to Re: thanks all, posted by CtrlAlt n Del on April 24, 2002, at 21:11:46
Good Luck searching. Why are you looking in the UK? I'm a little new to this stuff, so I apologize if this is a really stupid question. :)
--James
Posted by CtrlAlt n Del on April 24, 2002, at 21:28:08
In reply to Re: thanks all, posted by James on April 24, 2002, at 21:15:15
Posted by CtrlAlt n Del on April 24, 2002, at 21:39:08
In reply to Re: I live in uk James : ) (nm), posted by CtrlAlt n Del on April 24, 2002, at 21:28:08
If your a new poster..forgive my miserable mood and welcome : )
Posted by Cecilia on April 24, 2002, at 22:28:58
In reply to Re: anyone use sleeping pills long term?, posted by James on April 24, 2002, at 20:25:17
> I have been using Tylenol/Excedrin PM as a sleeping pill on and off for the past 3 or 4 years, with varying results. Its interesting you mentioned it, but I have been feeling that the Excedrin PM was effecting me less and less lately. BTW the active sleep agent in it isDiphenhydramine Cytrate, and Excedrin has 38 mgs, whereas tylenol has 25 I think. But lately I went on Gabitril as mood stabilizer and it has been helping me get to sleep very well, maybe even tooo well. But, I don't know what your diagnosis is, so whatever.
>
> --JamesYou can buy the diphrenhydramine (Benadryl) by itself-don`t use the ones with tylenol added unless you`re also in pain, too much tylenol is bad for your liver. Cecilia
Posted by Ritch on April 24, 2002, at 23:12:08
In reply to Re: thanks all, posted by CtrlAlt n Del on April 24, 2002, at 21:11:46
>
> Sorry Willow/Kat/James..my mood is awful ...specific ain't my strong point at the moment
>
> I'm looking for a pill to reduce dreaming so I can sleep deeper...I had a couple once (off friend)and woke up refreshed and not disturbed ...
>
> James I'll hunt the internet to see whats available in uk..my diagnosis is 'unspecified' mood disorder but I also feel I'm in perpetual post traumatic stress...especially after dreams in sleep.
>
> I also have another irritating problem but that's a rare nothing can help thing...
>
> thanks all xxxxxx
Dreamer, or should I say "excessive Dreamer"?, the one med class that cut-back on dreams the most that I have ever taken is TCA's. Desipramine the most of that bunch. Try 10-20mg at bedtime and see what happens.Mitch
Posted by CtrlAlt n Del on April 24, 2002, at 23:33:08
In reply to Re: thanks all » CtrlAlt n Del, posted by Ritch on April 24, 2002, at 23:12:08
Posted by Elizabeth on April 25, 2002, at 0:15:25
In reply to anyone use sleeping pills long term?, posted by CtrlAlt n Del on April 24, 2002, at 17:28:03
Hi. I use Ambien every night. It doesn't lose its effectiveness after at least a year, perhaps longer. However, some people say that they do become tolerant to Ambien. My only problem with it is that sometimes it wears off before I want to wake up, and I end up awakening in the middle of the night.
Tolerance is much more common with other types of sleeping pills, such as benzodiazepines and barbiturates, as well as certain similar drugs such as alcohol. (Unlike Ambien, these sedatives can also cause dangerous withdrawal symptoms.)
I'm not sure about the rate of tolerance to other kinds of drugs (antihistamines, tricylic antidepressants, trazodone, Remeron, clonidine, antipsychotic drugs, etc.) that are sometimes used to help people sleep. Personally, I've tried all of these and found that they lost effectiveness very rapidly, after at most a few days.
Over-the-counter pain medications, such as acetaminophen (Tylenol and others), ibuprofen (Advil, Nuprin, others), and the like, are not effective sleeping pills; some, like Excedrin, even have caffeine (useful for migraine, not so great if you want to get to sleep). Variations on these, such as "Tylenol PM" and "Excedrin PM," help people sleep because they contain an antihistamine (usually diphenhydramine, the same one in Benadryl, or similar ones like doxylamine and dimenhydrinate; sometimes these are marketed as sleeping pills (e.g., Unisom), sometimes as allergy pills (Benadryl, ChlorTrimeton (chlorpheniramine), Tavist (clemastine), etc.). You're probably better off taking only the stuff that you need, as Cecilia says. For example, if you want to get to sleep but don't have any pain, it doesn't make sense to take a pill that has a pain medicine in it as well as an antihistamine -- if you're choosing between Tylenol PM and Benadryl, then Benadryl would be the better choice in this case. (If you do have pain, it may make sense to take the Tylenol PM, of course.)
Last but not least, there are a bunch of strategies collectively referred to by the unfortunate name "sleep hygeine" that help a lot of people. I think that this is always worth a try, even if you have a primary sleep disorder.
To reduce dreaming, a tricyclic antidepressant is a good bet, preferably one of the more sedating ones such as doxepin or amitriptyline (desipramine is a bad choice for a TCA to take before bed). MAOIs work great to virtually eliminate dreaming, but they tend to cause some insomnia too. Benzodiazepines should also be helpful. I'm not sure about the over-the-counter antihistamines.
Can I ask what problem you have that you think there's nothing you can do about? You're free not to discuss it if you'd rather not, but there might be someone here who's familiar with it and can make suggestions. Just a thought.
best,
-elizabeth
Posted by CtrlAlt n Del on April 25, 2002, at 1:18:16
In reply to Re: anyone use sleeping pills long term?, posted by Elizabeth on April 25, 2002, at 0:15:25
> Hi. I use Ambien every night. It doesn't lose its effectiveness after at least a year, perhaps longer. However, some people say that they do become tolerant to Ambien. My only problem with it is that sometimes it wears off before I want to wake up, and I end up awakening in the middle of the night.
>
> Tolerance is much more common with other types of sleeping pills, such as benzodiazepines and barbiturates, as well as certain similar drugs such as alcohol. (Unlike Ambien, these sedatives can also cause dangerous withdrawal symptoms.)
>
> I'm not sure about the rate of tolerance to other kinds of drugs (antihistamines, tricylic antidepressants, trazodone, Remeron, clonidine, antipsychotic drugs, etc.) that are sometimes used to help people sleep. Personally, I've tried all of these and found that they lost effectiveness very rapidly, after at most a few days.
>
> Over-the-counter pain medications, such as acetaminophen (Tylenol and others), ibuprofen (Advil, Nuprin, others), and the like, are not effective sleeping pills; some, like Excedrin, even have caffeine (useful for migraine, not so great if you want to get to sleep). Variations on these, such as "Tylenol PM" and "Excedrin PM," help people sleep because they contain an antihistamine (usually diphenhydramine, the same one in Benadryl, or similar ones like doxylamine and dimenhydrinate; sometimes these are marketed as sleeping pills (e.g., Unisom), sometimes as allergy pills (Benadryl, ChlorTrimeton (chlorpheniramine), Tavist (clemastine), etc.). You're probably better off taking only the stuff that you need, as Cecilia says. For example, if you want to get to sleep but don't have any pain, it doesn't make sense to take a pill that has a pain medicine in it as well as an antihistamine -- if you're choosing between Tylenol PM and Benadryl, then Benadryl would be the better choice in this case. (If you do have pain, it may make sense to take the Tylenol PM, of course.)
>
> Last but not least, there are a bunch of strategies collectively referred to by the unfortunate name "sleep hygeine" that help a lot of people. I think that this is always worth a try, even if you have a primary sleep disorder.
>
> To reduce dreaming, a tricyclic antidepressant is a good bet, preferably one of the more sedating ones such as doxepin or amitriptyline (desipramine is a bad choice for a TCA to take before bed). MAOIs work great to virtually eliminate dreaming, but they tend to cause some insomnia too. Benzodiazepines should also be helpful. I'm not sure about the over-the-counter antihistamines.
>
> Can I ask what problem you have that you think there's nothing you can do about? You're free not to discuss it if you'd rather not, but there might be someone here who's familiar with it and can make suggestions. Just a thought.
>
> best,
> -elizabethThanks for info Elizabeth...my other problem is for all the world to see on the social board it's a sexual problem .
Posted by cmcdougall on April 25, 2002, at 10:17:25
In reply to Re: anyone use sleeping pills long term? » Elizabeth, posted by CtrlAlt n Del on April 25, 2002, at 1:18:16
I have taken trazodone for years - 3 years as an antidepressant until the dose got so high I couldn't function in the morning. For the past 7 years or so, I have taken 50-100mg every night. I sleep very well, sometimes dream very vividly, and only rarely wake up too early.
Trazodone has very few side effects (none that I can think of), can be combined w/ most other meds, and best of all its CHEAP. One months supply is less than $5.
Posted by johnj on April 25, 2002, at 17:37:04
In reply to I've used trazodone for 10 years, posted by cmcdougall on April 25, 2002, at 10:17:25
Do you feel groggy in the morning with trazodone? I am on 15 mg of remeron and feel too groggy in the morning. Thanks!
johnj
Posted by turalizz on April 26, 2002, at 0:58:43
In reply to I've used trazodone for 10 years, posted by cmcdougall on April 25, 2002, at 10:17:25
> I have taken trazodone for years - 3 years as an antidepressant until the dose got so high I couldn't function in the morning. For the past 7 years or so, I have taken 50-100mg every night. I sleep very well, sometimes dream very vividly, and only rarely wake up too early.
>
> Trazodone has very few side effects (none that I can think of), can be combined w/ most other meds, and best of all its CHEAP. One months supply is less than $5.
I also use 50 mg trazodone to counteract the insomnia I get from moclobemide. It is very good for sleep. I get very good quality and deep 7 hours of sleep, and wake up just fine.cem
Posted by Elizabeth on April 26, 2002, at 20:15:53
In reply to Re: anyone use sleeping pills long term? » Elizabeth, posted by CtrlAlt n Del on April 25, 2002, at 1:18:16
> Thanks for info Elizabeth...my other problem is for all the world to see on the social board it's a sexual problem .
Ahh. Well, I know of a few things that seem to help some people with that kind of thing, although I'm sure you've tried most of them. Let me know if you'd like me to post about this, though.
-e
Posted by paxvox2000 on April 26, 2002, at 20:57:43
In reply to anyone use sleeping pills long term?, posted by CtrlAlt n Del on April 24, 2002, at 17:28:03
Yes, and yes. The key is NOT to increase the dose on your own, and to switch between benzos and non-benzos (e.g. Ambien, Sonata). You WILL develop tolerance to benzos, but that doesn't mean that they still don't help you. I have taken them for at least 4 years straight to date.
PAX
Posted by cmcdougall on April 27, 2002, at 13:23:38
In reply to trazodone question for (cmcdougall), posted by johnj on April 25, 2002, at 17:37:04
Posted by CtrlAlt n Del on April 27, 2002, at 16:22:30
In reply to Re: anyone use sleeping pills long term? » CtrlAlt n Del, posted by paxvox2000 on April 26, 2002, at 20:57:43
> Yes, and yes. The key is NOT to increase the dose on your own, and to switch between benzos and non-benzos (e.g. Ambien, Sonata). You WILL develop tolerance to benzos, but that doesn't mean that they still don't help you. I have taken them for at least 4 years straight to date.
>
>
> PAXDoc will only give me 20 ativan for 5/6 weeks (history of alcohol binging) already need to double the dose.
Can't change doc..
My brain so scattered ..Elizebeth it may be hypomania..don't know anymore : )just incase anyone has idea I take
225mg efexor
100mg x2 daily neurontin (doc said will only go up to 500mg a day-so maybe not worth it)
and the ativan...supposed to be used outside for sedation so I don't get over stimulated...oh boy
I'm thinking of trying trileptal and quitting neurontin....I'm getting close to starting the drink to stop irritation.
many
thanksxxxxxx
Posted by Elizabeth on May 2, 2002, at 23:50:13
In reply to Re: anyone use ..Elizebeth pav..others, posted by CtrlAlt n Del on April 27, 2002, at 16:22:30
> Doc will only give me 20 ativan for 5/6 weeks (history of alcohol binging) already need to double the dose.
I really don't think that taking a benzo long-term for insomnia is a great strategy. It works for some people, but tolerance is very likely if you are taking the stuff every night.
If you think it might be hypomania, you should definitely tell your pdoc that. He might be willing to raise the Neurontin more (I don't get why your doc didn't want to go above 500). He might also want to add a different mood stabilizer. (Neurontin, BTW, can be a good sleep aid and anxiolytic.)
Another strategy would be to tell the doc that you're feeling so revved up that you've been craving alcohol. This is risky and may backfire on you. But if the doc is feeling sensitive and friendly that day, he may be willing to give you more Ativan, the idea being to relieve the symptoms that are making you want to drink. Make sure that the doc gets how serious you are; otherwise he's liable to blow it off. (Do you think that you ever abused benzos, BTW?) I don't think that Ativan is a good long-term sleeping pill, especially if you're already getting tolerant, but it should at least in the short term get rid of the hyperness and the cravings.
If you still have a long-term insomnia problem after you've done away with the hypomania-or-whatever, I really do think that Ambien would be worth a try.
-elizabeth
Posted by CtrlAlt n Del on May 3, 2002, at 5:30:22
In reply to sleep stuff » CtrlAlt n Del, posted by Elizabeth on May 2, 2002, at 23:50:13
Good mourning Elizabeth...: ) thanks for reply
> If you think it might be hypomania, you should definitely tell your pdoc that. He might be willing to raise the Neurontin more (I don't get why your doc didn't want to go above 500). He might also want to add a different mood stabilizer. (Neurontin, BTW, can be a good sleep aid and anxiolytic.)
He knows about my (mild?)hypomania episodes...
Only has prescribed neurontin for patients who suffer from pain -500mg a day ..(ukdoc)..I am his first patient to be treated with new anti-convulsants for mood disorder(rapid)--I suggested trying it. Sometimes he thinks he knows what's best , can be difficult sometimes to enlighten> Another strategy would be to tell the doc that you're feeling so revved up that you've been craving alcohol. This is risky and may backfire on you. But if the doc is feeling sensitive and friendly that day, he may be willing to give you more Ativan, the idea being to relieve the symptoms that are making you want to drink. Make sure that the doc gets how serious you are; otherwise he's liable to blow it off. (Do you think that you ever abused benzos, BTW?)
Abuse of benzo's a no no I find them too dull but helps with irritation and 'trapped' feeling
Yesterday I took extra neurontin and felt really good , although it was a short lived initial drunk feeling- WoW!... maybe the neurontin increase is the answer.I need to get the level right to reduce irritation that leads to craving and other problems but not too flat as to interfere with creative impulses ..unfortunately it's taking long time .
> If you still have a long-term insomnia problem after you've done away with the hypomania-or-whatever, I really do think that Ambien would be worth a try.Thanks , I'm thinking of replacing the ativan with it..
ali ......
Posted by katekite on May 3, 2002, at 18:39:36
In reply to sleep stuff » CtrlAlt n Del, posted by Elizabeth on May 2, 2002, at 23:50:13
I'm currently using neurontin to sleep as I'm tapering off my klonopin which I'm dependent on/addicted to, and don't want to be -- having rebound insomnia now. I have weird side effects from neurontin if I take it 3 times a day but can tolerate it as a once a day med no problem. Helps a lot for sleep for me.
When I was on it 3 times a day I also had a nice antidepressant response feeling almost dopey/giddy for a few hours when it first started. The mood effect lasted pretty well over the weeks I was on it.
kate
Posted by Elizabeth on May 6, 2002, at 15:05:16
In reply to Re: sleep stuff » Elizabeth, posted by CtrlAlt n Del on May 3, 2002, at 5:30:22
Hi ctl-alt-del.
> He knows about my (mild?)hypomania episodes...
> Only has prescribed neurontin for patients who suffer from pain -500mg a day ..(ukdoc)..I am his first patient to be treated with new anti-convulsants for mood disorder(rapid)--I suggested trying it. Sometimes he thinks he knows what's best, can be difficult sometimes to enlightenGoodness. He needs to keep up with the research if he thinks using the newer AEDs for mood disorders is such a radical idea.
> Abuse of benzo's a no no I find them too dull but helps with irritation and 'trapped' feeling
I can't understand why anybody would abuse benzos. I think they're helpful for slowing things down (racing/intrusive thoughts, jitters, etc.), but I definitely wouldn't consider them party drugs (even the much-maligned Xanax).
> Yesterday I took extra neurontin and felt really good , although it was a short lived initial drunk feeling- WoW!... maybe the neurontin increase is the answer.
That's *weird*. I thought Neurontin sort of felt like Xanax or Klonopin, not like alcohol! The "drunk" feeling should go away after you've been on the higher dose of Neurontin for a few days, so I hope that's not the only thing you're getting from it. (I leave to you the question of whether increasing the Neurontin is really the right thing for you, and if so, how you can convince your pdoc to increase the dose.)
> I need to get the level right to reduce irritation that leads to craving and other problems but not too flat as to interfere with creative impulses ..unfortunately it's taking long time.
Patience! When you're testing a particular dose, stay on it for several days so that you can really get a sense for how it affects you.
> > If you still have a long-term insomnia problem after you've done away with the hypomania-or-whatever, I really do think that Ambien would be worth a try.
>
> Thanks , I'm thinking of replacing the ativan with it..I should note that if you're "physically dependent" on the Ativan, Ambien won't eliminate all withdrawal symptoms. I think that Ambien is probably a better thing to be on long-term, though.
-elizabeth
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.