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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by truman on October 6, 2003, at 20:34:27
Hi-
My pdoc has agreed that I need something for my insomnia. He has essentially told me to "pick a pill, any pill," and I am having a very difficult time deciding which to ask for.
I have never been able to fall asleep before 2 or 3am, even when I was a child. Once asleep, I stay asleep, never wake at night. But I do require lots of sleep, I function best when I sleep for 10-11 hours per night, although I now average about 5. I was only able to get the 10 hours regularly when I was in college.
He mentioned Ambien. I have been through ALL of the posts on it, and noticed that many people reported night waking with Ambien. I am wondering whether people who had Ambien-related night waking had night waking problems to begin with. Since I have never had problems with night waking, will I be immune to this effect? Or does the breakdown of the drug after 4 or 5 hours screw up the sleep cycle and cause night waking in some people regarless of sleep history?
Any other med suggestions? Again, I sleep like a rock once I go down, but it takes A LOT to knock me out!
I should add that I am on Wellbutrin SR 150mg bid and Ritalin 20 mg bid. Adjustments/discontinuation of these over the last several months have made no difference in my sleep, but did reinforce the fact that this is the absolute perfect combo for me to treat my *very* anergic depression.
Any input/comments/suggestions are extremely appreciated. Thanks so much!
Posted by jerrympls on October 6, 2003, at 22:44:19
In reply to Choosing Sleep Meds, posted by truman on October 6, 2003, at 20:34:27
If you want to get to sleep and stay asleep I would suggest Restoril. Some docs use Trazodone - but it's not safe especially for men plus it's an atidepressant and has HUGE hangover effects. If MY doc said to pick a pill I would choose Nembutal - because it always gets my sleep back on track (it's only for 4 weeks use or so). Some docs also use sedating antipsychotics like Seroquel - but again - they effect SO MANY neurotransmitters plus weight gain and hangover effects. Ambien is great - especially if you can get a doc to prescribe 20mg. Sonata is HORRIBLE- it has not worked for ANYONE I have know to take it. It may help get them to sleep - but then an hour later they're wide awake.
Good luck
Posted by Searchlight on October 7, 2003, at 1:13:38
In reply to Choosing Sleep Meds, posted by truman on October 6, 2003, at 20:34:27
Hi, sorry to hear about your sleep dilemna.
I take Celexa (one of many over the years) right now and don't have too much insomnia, but when I do I like Xanax and Ativan. I tried Ambien, and it made me feel absolutely terrible-almost sick- and irritable the next day. BTW- Ambien is used to help facilitate sleep; it usually doesn't help in staying asleep past about 4 hours.
good luck
Posted by Viridis on October 7, 2003, at 3:54:21
In reply to Choosing Sleep Meds, posted by truman on October 6, 2003, at 20:34:27
I haven't tried Ambien, but it's highly recommended by many people, even for long-term use.
I find Xanax (alprazolam) the best, but it's notorious for tolerance when used as as a sleep med, so seems best for short-term use. I still use 1 mg or so occasionally when I have trouble sleeping.
I pretty much stopped having problems with insomnia when I started taking Klonopin (clonazepam) daily for anxiety. The catch is that supposedly, tolerance builds to the anti-insomnia effects yet not the anti-anxiety effects. So, by using it for anxiety, I seem to have solved the sleep problem too, but my pdoc doesn't like to prescribe it as a sleep med although he's quite comfortable with using it long-term for anxiety. I also find that it has good antidepressant qualities (probably because my depression is mostly anxiety-based).
Maybe Klonopin would be worth a try, with the caveat that if tolerance to the anti-insomnia effects develops, you'd need to taper off it. This is definitely something to discuss with your doctor. It causes no side effects for me (although it took a week or two to get used to).
BTW, I really disliked Trazodone and wouldn't use it again.
Posted by Harvester of Eyes on October 7, 2003, at 9:10:40
In reply to Re: Choosing Sleep Meds » truman, posted by Viridis on October 7, 2003, at 3:54:21
It's important to remember that one person's super pill is another's "poison." We all react differently. For example, Trazadone worked well for me for years (I am male). I know many people who didn't care for it.
It sounds like you need a list of options, a straightforward look at the pros and cons, some comments from members, and then you can pick candidate #1. Give it a chance, and if it fails, don't be too concerned. Try the next med.
If you have a significant other, try getting a thorough massage at bed time. And by all means, try to keep to a regular sleep schedule.
Oversleep may be running in a loop with your depression, each one stoking the other. Note that a treatment of last resort for depressed people who respond to nothing else is sleep deprivation. Don't try that on your own of course, but consider it in context of your long sleeping hours.
If a person came up to me and said they can't sleep because they don't feel sleepy, I might suggest Trazadone. If they said it's because they feel wired, then Klonipin. If it's because they feel worried or nervous that they won't fall asleep, I'd say Ativan. I am not qualified to comment on the other proposals.
Posted by T_R_D on October 7, 2003, at 16:22:56
In reply to Choosing Sleep Meds, posted by truman on October 6, 2003, at 20:34:27
I don't know if Ambien is available in Canada--I've never tried it.
I take an "old school" benzidoazepine called Oxazepam/Serax. Works like a charm and I never have any hangovers. Not sure if docs are eager to prescribe it because there are a lot of newer (better?) drugs out there but I won't let this stuff go! No way uh-uh!
Good luck in your search!
Karen
Posted by truman on October 8, 2003, at 13:25:57
In reply to Re: Choosing Sleep Meds, posted by T_R_D on October 7, 2003, at 16:22:56
Thanks so much for the responses. I have requested Ambien, so we'll see how it goes. I will post with initial results if they may be helpful to the board. Thanks again!
Posted by cybercafe on October 8, 2003, at 13:29:09
In reply to Re: Choosing Sleep Meds, posted by Harvester of Eyes on October 7, 2003, at 9:10:40
> It's important to remember that one person's super pill is another's "poison." We all react differently. For example, Trazadone worked well for me for years (I am male). I know many people who didn't care for it.
i'm curious... why is trazadone not recommended for males? does it have to do with that rare priaprism thing, or something else?
>
> It sounds like you need a list of options, a straightforward look at the pros and cons, some comments from members, and then you can pick candidate #1. Give it a chance, and if it fails, don't be too concerned. Try the next med.
>
> If you have a significant other, try getting a thorough massage at bed time. And by all means, try to keep to a regular sleep schedule.
>
> Oversleep may be running in a loop with your depression, each one stoking the other. Note that a treatment of last resort for depressed people who respond to nothing else is sleep deprivation. Don't try that on your own of course, but consider it in context of your long sleeping hours.
>
> If a person came up to me and said they can't sleep because they don't feel sleepy, I might suggest Trazadone. If they said it's because they feel wired, then Klonipin. If it's because they feel worried or nervous that they won't fall asleep, I'd say Ativan. I am not qualified to comment on the other proposals.
Posted by Mimi on October 9, 2003, at 8:26:23
In reply to Choosing Sleep Meds, posted by truman on October 6, 2003, at 20:34:27
Ambien rocks!!!
I've tried all the others and Ambien is best for me by a long stretch. I had severe sleep disturbances for more than 10 years. I also sleep 9-10 hours a night--which I consider to be in the normal range.
Mimi
Posted by jane d on October 9, 2003, at 17:31:06
In reply to Re: Choosing Sleep Meds, posted by truman on October 8, 2003, at 13:25:57
Good luck with the ambien. I found both ambien and sonata worked very well for me. I am like you. I have a lot of trouble getting to sleep but once out I stay out. And stay out, and stay out.
Jane
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