Psycho-Babble Medication Thread 381490

Shown: posts 1 to 25 of 39. This is the beginning of the thread.

 

Ambien or Ativan?

Posted by Minnie-Haha on August 23, 2004, at 19:19:13

Info out there on whether or not Ambien or Ativan is the lesser of two evils for someone who is suffering from long-term anxiety and depression with insomnia (or insomnia with anxiety and depression? Sometimes this seems like one of those chicken-or-egg problems.)

 

Re: Ambien or Ativan? » Minnie-Haha

Posted by partlycloudy on August 23, 2004, at 19:32:24

In reply to Ambien or Ativan?, posted by Minnie-Haha on August 23, 2004, at 19:19:13

I think that Ambien is the lesser of two evils. I can't sleep without an aid of some kind. My p-doc prescribed Ambien and told me it is not a benzo like Ativan is and so does not have the same possibility for addiction.

 

Re: Ambien or Ativan?

Posted by Bela on August 24, 2004, at 11:39:30

In reply to Ambien or Ativan?, posted by Minnie-Haha on August 23, 2004, at 19:19:13

I am a middle-of-the-night insomniac and addicted to Ambien. I would like to break the habit and get back to sleep naturally. Suggestions?

Please direct me to a more relevant thread if this is not the appropriate one.

 

Re: Ambien or Ativan?

Posted by Bill LL on August 25, 2004, at 9:05:53

In reply to Re: Ambien or Ativan?, posted by Bela on August 24, 2004, at 11:39:30

Non-prescription remedies include Tylenol PM, melatonin, valerian, and ashwaghanda.

I know that when people discontinue Ambien, they have a hard time sleeping. But on the other hand, they also had a hard time sleeping just prior to starting Ambien. So it's hard to tell if it's "addictive". I think that it is technically non-addictive.

If Ambien is working for you and you find that nothing else works, keep taking it. It's suppose to be safe even for long term users. And its far better than going sleep deprived.

> I am a middle-of-the-night insomniac and addicted to Ambien. I would like to break the habit and get back to sleep naturally. Suggestions?
>
> Please direct me to a more relevant thread if this is not the appropriate one.

 

Re: Ambien or Ativan?

Posted by sobstory on August 25, 2004, at 13:33:55

In reply to Re: Ambien or Ativan?, posted by Bela on August 24, 2004, at 11:39:30

Serax is non-addictive. It gives you a nice smooth sleep. Maybe you could switch to that, and gradually reduce your dosage.

> I am a middle-of-the-night insomniac and addicted to Ambien. I would like to break the habit and get back to sleep naturally. Suggestions?
>
> Please direct me to a more relevant thread if this is not the appropriate one.

 

Re: Ambien or Ativan?

Posted by Minnie-Haha on August 25, 2004, at 16:49:34

In reply to Re: Ambien or Ativan?, posted by sobstory on August 25, 2004, at 13:33:55

> Serax is non-addictive. It gives you a nice smooth sleep. Maybe you could switch to that, and gradually reduce your dosage.

I started this thread because I wanted to compare the pros and cons of Ambien (sleep medication) to Ativan (anti-anxiety med). I am ALWAYS looking for safe alternatives to these, as both are potentially habit forming, so this suggestion really caught my eye.

However, when I check it (Serax) out at HealthSquare.com it says it is a benzodiazepine, like Ativan, which means it can be addicting.

My main question still stands: Is one the lesser of two evils? (Is one more likely to be addicting or to cause a dependence? Is one more likely to cause cognitive or mood problems with long-term use? etc...)

 

Re: Ambien or Ativan?

Posted by Bela on August 25, 2004, at 18:45:07

In reply to Re: Ambien or Ativan?, posted by Minnie-Haha on August 25, 2004, at 16:49:34

> > Serax is non-addictive. It gives you a nice smooth sleep. Maybe you could switch to that, and gradually reduce your dosage.
>
> I started this thread because I wanted to compare the pros and cons of Ambien (sleep medication) to Ativan (anti-anxiety med). I am ALWAYS looking for safe alternatives to these, as both are potentially habit forming, so this suggestion really caught my eye.
>
> However, when I check it (Serax) out at HealthSquare.com it says it is a benzodiazepine, like Ativan, which means it can be addicting.
>
> My main question still stands: Is one the lesser of two evils? (Is one more likely to be addicting or to cause a dependence? Is one more likely to cause cognitive or mood problems with long-term use? etc...)
>

I also looked up Serax on the web and it basically sounded like a trade-name for Ambien. I have taken Ativan on two occasions over the past few years when I could not break a string (2-3 weeks) of sleepless nights. It knocked me out both times. Recommended doses (5-20 mg.) of Ambien never did that. In my experience, I would not recommend long-term use of Ativan. It broke the cycle, alright, but I was a zombie for about 2 days afterward.

I have taken Ambien off and on since 1997, usually 5-10 mg every night. The only time I have ever been off it for any prolonged period was when I was taking antidepressants like Remeron and Serzone, that help sleep. I think it affects short-term memory. I don't think it gives you a great sleep and it tends to lose it's effectiveness but I agree with an earlier post, it is one helluva lot sweeter than sleep deprivation!

Getting back to your question: in my mind, Ambien is by far the lesser evil; as I recall it is not a benzodiazepine but still habituating. I don't think it affects my mood one way or the other unless it acts to depress me because I am so damned dependent on it!

Now, I am waiting for Estorra to come out.

 

Re: Ambien or Ativan?

Posted by Minnie-Haha on August 25, 2004, at 18:50:29

In reply to Re: Ambien or Ativan?, posted by Bela on August 25, 2004, at 18:45:07

> I also looked up Serax on the web and it basically sounded like a trade-name for Ambien.

Not to start an argument, but just to get things clear, Serax is a benzo, so it can't be a trade name for Ambien. It (Serax) would be more like Ativan (a benzo), right?

 

Re: Ambien or Ativan?

Posted by Bela on August 25, 2004, at 18:56:36

In reply to Re: Ambien or Ativan?, posted by Minnie-Haha on August 25, 2004, at 18:50:29

> > I also looked up Serax on the web and it basically sounded like a trade-name for Ambien.
>
> Not to start an argument, but just to get things clear, Serax is a benzo, so it can't be a trade name for Ambien. It (Serax) would be more like Ativan (a benzo), right?
>

You're right. Sorry for the confusion.
Bela

 

Re: Ambien or Ativan?

Posted by sobstory on August 26, 2004, at 17:30:49

In reply to Re: Ambien or Ativan?, posted by Bela on August 25, 2004, at 18:56:36

Yeah, Serax is the brand name for oxazepam and Ativan is the brand name for Lorazepam, and they are both benzodiazepines. But personally, I found that Serax is non-addicting. I was having sleep trouble for weeks, and took the serax for only two nights, and the third night onwards I was able to sleep independently. Now I only take it as needed when I can't sleep or have anxiety, and I only end up taking it the one time. I maybe take it now once a month, sometimes every two months, depending.

> > > I also looked up Serax on the web and it basically sounded like a trade-name for Ambien.
> >
> > Not to start an argument, but just to get things clear, Serax is a benzo, so it can't be a trade name for Ambien. It (Serax) would be more like Ativan (a benzo), right?
> >
>
> You're right. Sorry for the confusion.
> Bela
>

 

Re: Ambien or Ativan?

Posted by Bela on August 27, 2004, at 9:33:25

In reply to Re: Ambien or Ativan?, posted by Bill LL on August 25, 2004, at 9:05:53

> Non-prescription remedies include Tylenol PM, melatonin, valerian, and ashwaghanda.
>
> I know that when people discontinue Ambien, they have a hard time sleeping. But on the other hand, they also had a hard time sleeping just prior to starting Ambien. So it's hard to tell if it's "addictive". I think that it is technically non-addictive.
>
> If Ambien is working for you and you find that nothing else works, keep taking it. It's suppose to be safe even for long term users. And its far better than going sleep deprived.
>
> > I am a middle-of-the-night insomniac and addicted to Ambien. I would like to break the habit and get back to sleep naturally. Suggestions?
> >
> > Please direct me to a more relevant thread if this is not the appropriate one.
>

> Thanks for your great advice. Actually, I have tried every non-prescription sleep aid known to man to return to sleep at 3 a.m. and none do a thing for me---valerian, melatonin, Tylenol PM, etc. I agree that I may be stuck with Ambien for life and it is DEFINITELY better than sleep deprivation, as you say, but I am still curious as to whether anyone has discovered any behavioral mechanisms for returning to sleep after awakening at 3 a.m. Thanks....
Bela

 

Re: Ambien or Ativan?

Posted by sobstory on August 27, 2004, at 13:00:11

In reply to Re: Ambien or Ativan?, posted by Bela on August 27, 2004, at 9:33:25

If I wake up in the middle of the night and can't get back to sleep, I cover my clock so I can't see the time. Then I don't worry about what time it is, how much longer till I have to wake up etc. It also reduces the light source. Some other tips are getting up to do something that will make you sleepy such as reading or watching tv. If you stay in bed while awake and unable to sleep, you might start associating your bed with being awake.

Deep breathing will help you relax. Really concentrate on your breath, breath slowly and deeply from your diaphram. Hold your breath for a bit to slow down your breathing as you're doing this. Also, don't focus on how you can't sleep-just think you will be fine the next day even if you don't. Then before you know it you'll be asleep becuase you're not worrying about it. Just think of things that will relax you. All of these thinking patterns help you fall asleep.

> > Non-prescription remedies include Tylenol PM, melatonin, valerian, and ashwaghanda.
> >
> > I know that when people discontinue Ambien, they have a hard time sleeping. But on the other hand, they also had a hard time sleeping just prior to starting Ambien. So it's hard to tell if it's "addictive". I think that it is technically non-addictive.
> >
> > If Ambien is working for you and you find that nothing else works, keep taking it. It's suppose to be safe even for long term users. And its far better than going sleep deprived.
> >
> > > I am a middle-of-the-night insomniac and addicted to Ambien. I would like to break the habit and get back to sleep naturally. Suggestions?
> > >
> > > Please direct me to a more relevant thread if this is not the appropriate one.
> >
>
> > Thanks for your great advice. Actually, I have tried every non-prescription sleep aid known to man to return to sleep at 3 a.m. and none do a thing for me---valerian, melatonin, Tylenol PM, etc. I agree that I may be stuck with Ambien for life and it is DEFINITELY better than sleep deprivation, as you say, but I am still curious as to whether anyone has discovered any behavioral mechanisms for returning to sleep after awakening at 3 a.m. Thanks....
> Bela
>

 

Re: Ambien or Ativan?

Posted by Bela on August 27, 2004, at 14:16:32

In reply to Re: Ambien or Ativan?, posted by sobstory on August 27, 2004, at 13:00:11

> If I wake up in the middle of the night and can't get back to sleep, I cover my clock so I can't see the time. Then I don't worry about what time it is, how much longer till I have to wake up etc. It also reduces the light source. Some other tips are getting up to do something that will make you sleepy such as reading or watching tv. If you stay in bed while awake and unable to sleep, you might start associating your bed with being awake.
>
> Deep breathing will help you relax. Really concentrate on your breath, breath slowly and deeply from your diaphram. Hold your breath for a bit to slow down your breathing as you're doing this. Also, don't focus on how you can't sleep-just think you will be fine the next day even if you don't. Then before you know it you'll be asleep becuase you're not worrying about it. Just think of things that will relax you. All of these thinking patterns help you fall asleep.
>
> > > Non-prescription remedies include Tylenol PM, melatonin, valerian, and ashwaghanda.
> > >
> > > I know that when people discontinue Ambien, they have a hard time sleeping. But on the other hand, they also had a hard time sleeping just prior to starting Ambien. So it's hard to tell if it's "addictive". I think that it is technically non-addictive.
> > >
> > > If Ambien is working for you and you find that nothing else works, keep taking it. It's suppose to be safe even for long term users. And its far better than going sleep deprived.
> > >
> > > > I am a middle-of-the-night insomniac and addicted to Ambien. I would like to break the habit and get back to sleep naturally. Suggestions?
> > > >
> > > > Please direct me to a more relevant thread if this is not the appropriate one.
> > >
> >
> > > Thanks for your great advice. Actually, I have tried every non-prescription sleep aid known to man to return to sleep at 3 a.m. and none do a thing for me---valerian, melatonin, Tylenol PM, etc. I agree that I may be stuck with Ambien for life and it is DEFINITELY better than sleep deprivation, as you say, but I am still curious as to whether anyone has discovered any behavioral mechanisms for returning to sleep after awakening at 3 a.m. Thanks....
> > Bela
> >
>
> Sobstory,
Thanks again for your wisdom. I do try deep breathing, sort of a lying meditation, which does work at times, but at other times it doesn't. So be it. I would make a lousy Buddhist. However, if I get out of bed and watch TV or read, I can't remember ever getting sleepy, just fatigued as hell.

You are also right about the next day rarely being as bad as you anticipate it will be. Do you ever nap? If so, when and how long? Thanks....
Bela

 

Re: Ambien or Ativan? » Minnie-Haha

Posted by owensmar on August 27, 2004, at 20:35:43

In reply to Ambien or Ativan?, posted by Minnie-Haha on August 23, 2004, at 19:19:13

> Info out there on whether or not Ambien or Ativan is the lesser of two evils for someone who is suffering from long-term anxiety and depression with insomnia (or insomnia with anxiety and depression? Sometimes this seems like one of those chicken-or-egg problems.)
>


Please don't begin taking Ativan on an every night basis for insomnia. I got myself into terrible trouble that way. I didn't realize at first I was addicted but over the years, I kept having to increase the dose and increase the dose and the insomnia kept getting worse so I'd increase the dose again and still not be able to sleep. When I finally stopped it in 1986, I went through hell. It was months before I didn't startle at small noises. For weeks, I barely slept at all. For the first week or so, I thought I was dying. It was a horrible withdrawal. Admittedly I was on it for nine years and quit cold turkey.

I guess my point is just that you build tolerance to it pretty quickly and withdrawal is really bad.
Marsha


 

Re: Ambien or Ativan?

Posted by Minnie-Haha on August 27, 2004, at 23:46:34

In reply to Re: Ambien or Ativan? » Minnie-Haha, posted by owensmar on August 27, 2004, at 20:35:43

> Please don't begin taking Ativan on an every night basis for insomnia. I got myself into terrible trouble that way. I didn't realize at first I was addicted but over the years, I kept having to increase the dose and increase the dose and the insomnia kept getting worse so I'd increase the dose again and still not be able to sleep. When I finally stopped it in 1986, I went through hell. It was months before I didn't startle at small noises. For weeks, I barely slept at all. For the first week or so, I thought I was dying. It was a horrible withdrawal. Admittedly I was on it for nine years and quit cold turkey.
>
> I guess my point is just that you build tolerance to it pretty quickly and withdrawal is really bad.

Do you mind my asking what dose you started/ended on? (I am taking .50 mg per night, sometimes only .25.)

 

Re: Ambien or Ativan?

Posted by owensmar on August 28, 2004, at 16:05:58

In reply to Re: Ambien or Ativan?, posted by Minnie-Haha on August 27, 2004, at 23:46:34

> > Please don't begin taking Ativan on an every night basis for insomnia. I got myself into terrible trouble that way. I didn't realize at first I was addicted but over the years, I kept having to increase the dose and increase the dose and the insomnia kept getting worse so I'd increase the dose again and still not be able to sleep. When I finally stopped it in 1986, I went through hell. It was months before I didn't startle at small noises. For weeks, I barely slept at all. For the first week or so, I thought I was dying. It was a horrible withdrawal. Admittedly I was on it for nine years and quit cold turkey.
> >
> > I guess my point is just that you build tolerance to it pretty quickly and withdrawal is really bad.
>
> Do you mind my asking what dose you started/ended on? (I am taking .50 mg per night, sometimes only .25.)
>

I started at 1mg per night. By the end I was taking 10mg per night and still couldn't sleep.

In the beginning it was so attractive because I would take my little white pill at about 10 pm. Then for about 2-3 hours I would have all this wonderful energy and could get all kinds of stuff done. Then I would start to get tired and drowsy and could drop right off to sleep. That lasted a couple of years (with increasing doses).

I've abused a lot of different stuff in my life but I remember the horror of those last years on Ativan so vividly that I know I will never, ever, let myself abuse any benzodiazapine again.

Just be careful. If you find yourself looking forward to your dose at night or moving up the time you take it, or increasing it without telling your Dr., take it as a sign.

Marsha

 

Re: Ambien or Ativan?

Posted by Minnie-Haha on August 28, 2004, at 16:46:11

In reply to Re: Ambien or Ativan?, posted by owensmar on August 28, 2004, at 16:05:58

> I started at 1mg per night. By the end I was taking 10mg per night and still couldn't sleep.
>
> In the beginning it was so attractive because I would take my little white pill at about 10 pm. Then for about 2-3 hours I would have all this wonderful energy and could get all kinds of stuff done. Then I would start to get tired and drowsy and could drop right off to sleep. That lasted a couple of years (with increasing doses).
>
> Just be careful. If you find yourself looking forward to your dose at night or moving up the time you take it, or increasing it without telling your Dr., take it as a sign.

Thank you for your response. A few more questions, and then I hope I won't have to keep pestering you. Do you still have insomnia, and if so how do you treat it now? Mine is painful of course because it's mixed with the anxiety. I have changed my diet, exercise, evening habits, etc., with a little improvement, but still not well. My new doc RXd Ambien (10 mg), which knocked me out the first two nights, but then starting failing me earlier and earlier in the morning. Also, I would have incredible headaches the next day. I'm at a loss. My psychologist and I have agreed that biofeedback might be worth a try, but it's not covered under my medical or behavioral health insurance.

 

Re: Ambien or Ativan?

Posted by owensmar on August 29, 2004, at 17:36:16

In reply to Re: Ambien or Ativan?, posted by Minnie-Haha on August 28, 2004, at 16:46:11

> > I started at 1mg per night. By the end I was taking 10mg per night and still couldn't sleep.
> >
> > In the beginning it was so attractive because I would take my little white pill at about 10 pm. Then for about 2-3 hours I would have all this wonderful energy and could get all kinds of stuff done. Then I would start to get tired and drowsy and could drop right off to sleep. That lasted a couple of years (with increasing doses)

> > Just be careful. If you find yourself looking forward to your dose at night or moving up the time you take it, or increasing it without telling your Dr., take it as a sign.
>
> Thank you for your response. A few more questions, and then I hope I won't have to keep pestering you. Do you still have insomnia, and if so how do you treat it now? Mine is painful of course because it's mixed with the anxiety. I have changed my diet, exercise, evening habits, etc., with a little improvement, but still not well. My new doc RXd Ambien (10 mg), which knocked me out the first two nights, but then starting failing me earlier and earlier in the morning. Also, I would have incredible headaches the next day. I'm at a loss. My psychologist and I have agreed that biofeedback might be worth a try, but it's not covered under my medical or behavioral health insurance.

Hi. You're not pestering me. I have deep sympathy for insomnia sufferers.

After d/cing the Ativan I was put on imipramine (a tricyclic a/d). I continued to have insomnia. (I don't know if it was from the drug or if it was just taking me a year or more to recover from the ativan abuse. I know it took many, many months before I recovered otherwise from it). Then I was on Prozac for nine years and continued with horrible, horrible insomnia on that - it generally took me about two hours to fall asleep -terrible racing thoughts. If I was away from home it might take me 5-6 hours to fall asleep if I could at all. For a while I treated it with benadryl and beer but then decided that wasn't a great idea. So I just suffered through it. At least once I was asleep I could sleep fine.
Then Prozac quit working and I went on Effexor. Within about two weeks, I could fall asleep within 45 minutes, sometimes within 30. That's where I am now. For several years now I have had only occasional insomnia while on Effexor. (Many other a/ds actually caused insomnia for me. That's one reason I've stayed on Effexor even though it's not very effective for my depression. I don't know if the Effexor actually treats the insomnia or if I just no longer have insomnia as badly now that I am off Prozac.

My main trouble now is that if I am ever prescribed any drug with the potential effect of "helping me sleep" I will use it at night whether I have insomnia or not. It's like I'm terrified of lying in bed awake so I won't even risk it - even when it isn't a risk.

So I have to keep drugs with abuse/addiction potential out of my house or I'll set myself up for another cycle of abuse.

Right now I'm taking Neurontin at night. It puts me to sleep. It is supposedly a very safe drug. However, I find I am taking it whether I need it or not to avoid even the possibility of insomnia so I guess I am going to have to quit it.

Truthfully, I always feel guilty when I take a pill at bedtime. I've always taken my A/D's in the morning so that I didn't get it in my head that they were helping me fall asleep.

HOpe this helps,

Marsha

 

Re: Ambien or Ativan?

Posted by Bela on August 30, 2004, at 9:55:19

In reply to Re: Ambien or Ativan?, posted by owensmar on August 29, 2004, at 17:36:16

> > > I started at 1mg per night. By the end I was taking 10mg per night and still couldn't sleep.
> > >
> > > In the beginning it was so attractive because I would take my little white pill at about 10 pm. Then for about 2-3 hours I would have all this wonderful energy and could get all kinds of stuff done. Then I would start to get tired and drowsy and could drop right off to sleep. That lasted a couple of years (with increasing doses)
>
> > > Just be careful. If you find yourself looking forward to your dose at night or moving up the time you take it, or increasing it without telling your Dr., take it as a sign.
> >
> > Thank you for your response. A few more questions, and then I hope I won't have to keep pestering you. Do you still have insomnia, and if so how do you treat it now? Mine is painful of course because it's mixed with the anxiety. I have changed my diet, exercise, evening habits, etc., with a little improvement, but still not well. My new doc RXd Ambien (10 mg), which knocked me out the first two nights, but then starting failing me earlier and earlier in the morning. Also, I would have incredible headaches the next day. I'm at a loss. My psychologist and I have agreed that biofeedback might be worth a try, but it's not covered under my medical or behavioral health insurance.
>
> Hi. You're not pestering me. I have deep sympathy for insomnia sufferers.
>
> After d/cing the Ativan I was put on imipramine (a tricyclic a/d). I continued to have insomnia. (I don't know if it was from the drug or if it was just taking me a year or more to recover from the ativan abuse. I know it took many, many months before I recovered otherwise from it). Then I was on Prozac for nine years and continued with horrible, horrible insomnia on that - it generally took me about two hours to fall asleep -terrible racing thoughts. If I was away from home it might take me 5-6 hours to fall asleep if I could at all. For a while I treated it with benadryl and beer but then decided that wasn't a great idea. So I just suffered through it. At least once I was asleep I could sleep fine.
> Then Prozac quit working and I went on Effexor. Within about two weeks, I could fall asleep within 45 minutes, sometimes within 30. That's where I am now. For several years now I have had only occasional insomnia while on Effexor. (Many other a/ds actually caused insomnia for me. That's one reason I've stayed on Effexor even though it's not very effective for my depression. I don't know if the Effexor actually treats the insomnia or if I just no longer have insomnia as badly now that I am off Prozac.
>
> My main trouble now is that if I am ever prescribed any drug with the potential effect of "helping me sleep" I will use it at night whether I have insomnia or not. It's like I'm terrified of lying in bed awake so I won't even risk it - even when it isn't a risk.
>
> So I have to keep drugs with abuse/addiction potential out of my house or I'll set myself up for another cycle of abuse.
>
> Right now I'm taking Neurontin at night. It puts me to sleep. It is supposedly a very safe drug. However, I find I am taking it whether I need it or not to avoid even the possibility of insomnia so I guess I am going to have to quit it.
>
> Truthfully, I always feel guilty when I take a pill at bedtime. I've always taken my A/D's in the morning so that I didn't get it in my head that they were helping me fall asleep.
>
> HOpe this helps,
>
> Marsha
>
>
Dear Marsha and Minnie-Haha,
I just returned from being away the weekend and picked on the conversation between the two of you. I can sympathesize with everything both of you have experienced because it sounds so much like my own experiences since about 1997. I, too, have an addictive tendency, whether it be alcohol or prescription drugs. Fortunately, I never allowed myself to get into the illegal stuff or I would probably be dead by now.

In my original post (8/24/04)I asked for help breaking the Ambien addiction. I have taken 5-20 mg of Ambien every night for years, only going off of it when I was on a AD (Serzone, Remeron) that helped insomnia. I wake up EVERY night between 1:30 and 4 a.m., my mind-body telling me it's "Ambien Time." I hate it, but when I try to taper slowly off, my daytimes turn into zombie states and my work productivity falls to a level where I wonder why my boss hasn't replaced me with a sea slug. As one commenter (Bill LL, 8/25/04)said, "Ambien is far better than going sleep deprived." I would agree unless you find that you have to keep increasing the dose and your sleeps still aren't fulfilling.

So, I hear exactly what you are saying. Every AD I tried, and I have tried most of the SSRIs, eventually pooped out or I would still be taking them---probably Serzone or Remeron. And for those of you out there that have experienced dramatic SSRI poop-out, it is not a pleasant experience. It is like betting on a horse that is winning the race but drops over dead on the last furlong.

This message probably has not been very uplifting for anyone reading it, and I really apologize for that, but one positive thing seems to be emerging from this depression-insomnia-drug merry-go-round--at least for me: I am writing a book about it all. That fact alone doesn't do anything to help the insomnia but the fact that maybe I can help someone avoid some of the pitfalls I have fallen into, DOES give me some peace of mind, at least.

Bela

 

Re: Ambien or Ativan? » Bela

Posted by owensmar on August 31, 2004, at 11:27:24

In reply to Re: Ambien or Ativan?, posted by Bela on August 30, 2004, at 9:55:19

> Dear Marsha and Minnie-Haha,
> I just returned from being away the weekend and picked on the conversation between the two of you. I can sympathesize with everything both of you have experienced because it sounds so much like my own experiences since about 1997. I, too, have an addictive tendency, whether it be alcohol or prescription drugs. Fortunately, I never allowed myself to get into the illegal stuff or I would probably be dead by now.

Me too. AT least we have *some* sense, right?

> In my original post (8/24/04)I asked for help breaking the Ambien addiction. I have taken 5-20 mg of Ambien every night for years, only going off of it when I was on a AD (Serzone, Remeron) that helped insomnia. I wake up EVERY night between 1:30 and 4 a.m., my mind-body telling me it's "Ambien Time." I hate it, but when I try to taper slowly off, my daytimes turn into zombie states and my work productivity falls to a level where I wonder why my boss hasn't replaced me with a sea slug. As one commenter (Bill LL, 8/25/04)said, "Ambien is far better than going sleep deprived." I would agree unless you find that you have to keep increasing the dose and your sleeps still aren't fulfilling.

Do you have to take the Ambien to fall asleep to start with at night? Or just after you wake up in the 1 - 4 a.m. time period? I've always thought it was awful lying in bed for hours waiting to fall asleep but I can see how it would be worse to wake up so early and not be able to go back to sleep.

How have you avoided tolerance and increasing the dosage?

I would have to think Ambien would be better than Ativan. I was told the Ativan was contributing to my depression and that an A/D wouldn't help much as long as I continued with the ATivan. I don't know if that's true but all benzos now do have a noticeable depressant effect on me. In any case, that was the only way I managed to get off the ATivan. I was so miserable that I was willing to go through hell to feel better. And that's exactly what it turned out to be.

Marsha

p.s. I had a bad night last night. No Neurontin at bedtime and it took me three hours to fall asleep. Rebound insomnia. I'm hoping it will only last a couple of days, though.

>
>

 

Re: Ambien or Ativan?

Posted by Bela on August 31, 2004, at 12:48:31

In reply to Re: Ambien or Ativan? » Bela, posted by owensmar on August 31, 2004, at 11:27:24

> > Dear Marsha and Minnie-Haha,
> > I just returned from being away the weekend and picked on the conversation between the two of you. I can sympathesize with everything both of you have experienced because it sounds so much like my own experiences since about 1997. I, too, have an addictive tendency, whether it be alcohol or prescription drugs. Fortunately, I never allowed myself to get into the illegal stuff or I would probably be dead by now.
>
> Me too. AT least we have *some* sense, right?
>
Yeah, I am a fairly disciplined person in most respects but addiction to prescription drugs has me by the nose.

> > In my original post (8/24/04)I asked for help breaking the Ambien addiction. I have taken 5-20 mg of Ambien every night for years, only going off of it when I was on a AD (Serzone, Remeron) that helped insomnia. I wake up EVERY night between 1:30 and 4 a.m., my mind-body telling me it's "Ambien Time." I hate it, but when I try to taper slowly off, my daytimes turn into zombie states and my work productivity falls to a level where I wonder why my boss hasn't replaced me with a sea slug. As one commenter (Bill LL, 8/25/04)said, "Ambien is far better than going sleep deprived." I would agree unless you find that you have to keep increasing the dose and your sleeps still aren't fulfilling.
>
> Do you have to take the Ambien to fall asleep to start with at night? Or just after you wake up in the 1 - 4 a.m. time period? I've always thought it was awful lying in bed for hours waiting to fall asleep but I can see how it would be worse to wake up so early and not be able to go back to sleep.
>
No, I rarely have trouble falling asleep. When I take Ambien before bedtime in hopes of sleeping through the night, I always wake up at "Ambien Time." Basically, my biological clock has been reprogrammed to wake me up after about 3-4 hours of sleep. Now, granted I have not tried mega-doses of Ambien at bedtime, but the thought of having to become unconscious to sleep 7 hours isn't particularly enticing.

> How have you avoided tolerance and increasing the dosage?
>

Actually, I haven't really avoided tolerance and dosage escalation but I put limits on how high I will go (usually) and that ceiling is about 20 mg.
>

I would have to think Ambien would be better than Ativan. I was told the Ativan was contributing to my depression and that an A/D wouldn't help much as long as I continued with the ATivan. I don't know if that's true but all benzos now do have a noticeable depressant effect on me. In any case, that was the only way I managed to get off the ATivan. I was so miserable that I was willing to go through hell to feel better. And that's exactly what it turned out to be.
>

Marsha, I am actually beginnning to think that the Ambien encourages depression, too. I realize that may come as bad news, and until recently, I thought the opposite, but now I am not sure. Yes, I get a reasonably good sleep from it, but frequently I wake up very depressed and often remain so all day or at least until the effects of the Ambien wear off. I don't know if there is a relationship there or not;it is confusing to me. All I know is that prior to gettng hooked on Ambien in 1997, I was a morning person, and loved the early morning. I rarely had a problem getting up. Of course I was a little younger then, too, but the difference now is profound; I loathe many mornings now days.

Perhaps someone else can comment on whether they think that Ambien can actually enhance depression.


> Marsha
>
> p.s. I had a bad night last night. No Neurontin at bedtime and it took me three hours to fall asleep. Rebound insomnia. I'm hoping it will only last a couple of days, though.
>
> >
> >
>
>

 

Re: Ambien or Ativan?

Posted by Minnie-Haha on August 31, 2004, at 13:27:53

In reply to Re: Ambien or Ativan?, posted by owensmar on August 29, 2004, at 17:36:16

> Hi. You're not pestering me. I have deep sympathy for insomnia sufferers.
>
> After d/cing the Ativan I was put on imipramine (a tricyclic a/d). I continued to have insomnia. (I don't know if it was from the drug or if it was just taking me a year or more to recover from the ativan abuse. I know it took many, many months before I recovered otherwise from it). Then I was on Prozac for nine years and continued with horrible, horrible insomnia on that - it generally took me about two hours to fall asleep -terrible racing thoughts. If I was away from home it might take me 5-6 hours to fall asleep if I could at all.
For a while I treated it with benadryl and beer but then decided that wasn't a great idea. So I just suffered through it. At least once I was asleep I could sleep fine.

Well, here is one area where we are different. I rarely have trouble falling asleep, it's that I usually wake up between 2 a.m. and 4 a.m. and have trouble getting back to sleep. I frequently wake with specific anxieties -- sometimes even panic -- but often it's just a lot of noise in my head, snippets of songs, counting... kind of like random processing with some low-level intrusive thoughts thrown in for good measure (though not like of death or disease or anything like that). What the Ativan does for me -- and once again, I rarely take more than 0.5mg, frequently only 0.25mg -- is push out the wake-up hour from say 2 a.m. to 4 a.m. I do not tend to get addicted to substances or abuse them. I rarely drink and always take the lowest doses possible of drugs to help me. Over the past year, it's been me expressing concerns repeatedly to my psychiatrist about not wanting to get addicted to Ativan, but she said it was better for me to be taking the small dose I'm taking and sleeping, than getting sleep deprived and anxious and falling into catastrophic thinking and panic.

When I switched to Ambien (10mg) I had a couple of OK nights (I'd still wake, but I was too groggy to stay awake and worry, so I'd fall back to sleep), but then started having daytime anxiety and depression. When I asked my new psychiatrist (old one is closing her practice) if I could be having withdrawal symptoms, he said that he thought it unlikely considering what a small dose I was on, and that I'd recently been able to go 3-4 days without it with OK results. He said I could try discontinuing the Ambien, or cut the dose in half, or return to the Ativan, which I've done, and once again, I am sleeping a little better.

My PCP wants me to get on a low dose of a tricyclic (like 10mg Elavil) at night to help me sleep, but since my DX is Bipolar II, my psychiatrist seems reluctant to start me on any anti-depressant, even such a small dose. (I am taking 150mg Trileptal -- mood stabilizer -- in the a.m. and 300mg in the p.m.) He wants to address my sleep disorder first and see if that clears up my depression. My daytime affect runs from so-so (brief spurts of being able to smile or laugh) to flat or downright sad or tearful.

> Then Prozac quit working and I went on Effexor. Within about two weeks, I could fall asleep within 45 minutes, sometimes within 30. That's where I am now. For several years now I have had only occasional insomnia while on Effexor. (Many other a/ds actually caused insomnia for me. That's one reason I've stayed on Effexor even though it's not very effective for my depression. I don't know if the Effexor actually treats the insomnia or if I just no longer have insomnia as badly now that I am off Prozac.

When I was first DXd BP2 I was put on Depakote and Effexor, which was fairly effective for a year or two, but I gained 30 pounds, my menstrual cycle and my metabolism changed, and I started getting depressed again. I don't know if I'm ready to get back on it (Effexor) or any other SSRI at this time. Since my original DX of BP2, I have reason to question it, went to a psychologist just to discuss the possibility that it could be wrong (since I'd come to believe that my anxiety had been mistaken for manic agitation), and then walked away with an OCD DX! Yikes! I really feel like what I have is depression and anxiety, but what ya gonna do?...

Finally, FWIW, my PCP had me try Zyprexa once. I took like 2.5mg and it knocked me out: no chatter in my head and I slept like a rock, but I also felt like a zombie the next day... physically and mentally clumsy. Yikes!

Thanks again for your feedback. It has given me some things to consider.

 

Re: Ambien or Ativan?

Posted by Minnie-Haha on August 31, 2004, at 13:30:18

In reply to Ambien or Ativan?, posted by Minnie-Haha on August 23, 2004, at 19:19:13

> Info out there on whether or not Ambien or Ativan is the lesser of two evils for someone who is suffering from long-term anxiety and depression with insomnia (or insomnia with anxiety and depression? Sometimes this seems like one of those chicken-or-egg problems.)

OK. Does anyone have anything to say about Buspar as an alternative to benzos?

 

Re: Ambien or Ativan?

Posted by Minnie-Haha on August 31, 2004, at 13:43:13

In reply to Re: Ambien or Ativan?, posted by Bela on August 31, 2004, at 12:48:31

> Marsha, I am actually beginnning to think that the Ambien encourages depression, too. I realize that may come as bad news, and until recently, I thought the opposite, but now I am not sure. Yes, I get a reasonably good sleep from it, but frequently I wake up very depressed and often remain so all day or at least until the effects of the Ambien wear off. I don't know if there is a relationship there or not;it is confusing to me. All I know is that prior to gettng hooked on Ambien in 1997, I was a morning person, and loved the early morning. I rarely had a problem getting up. Of course I was a little younger then, too, but the difference now is profound; I loathe many mornings now days.
>
> Perhaps someone else can comment on whether they think that Ambien can actually enhance depression.

Yes... this is exactly what I wondered after 3-4 nights on Ambien (10mg). I had taken it briefly (less than one week) several years ago for insomnia without ill effect (that I remember) but I was also on an anti-depressant at the time. So maybe instead of having withdrawal from my very low dose of Ativan (0.25-0.5 mg) -- which I've been taking pretty regularly for about 10 months now for middle-of-the-night insomnia and axiety -- maybe I was having a depressive side effect from the Ambien -- which I was taking to try to replace the Ativan -- and maybe this depression was feeding my anxiety and insomnia? Lord, trying to figure out illness puzzles is such a pain!

 

Re: Ambien or Ativan?

Posted by Minnie-Haha on August 31, 2004, at 13:58:10

In reply to Re: Ambien or Ativan?, posted by Bela on August 31, 2004, at 12:48:31

> Marsha, I am actually beginnning to think that the Ambien encourages depression, too. I realize that may come as bad news, and until recently, I thought the opposite, but now I am not sure. Yes, I get a reasonably good sleep from it, but frequently I wake up very depressed and often remain so all day or at least until the effects of the Ambien wear off. I don't know if there is a relationship there or not;it is confusing to me. All I know is that prior to gettng hooked on Ambien in 1997, I was a morning person, and loved the early morning. I rarely had a problem getting up. Of course I was a little younger then, too, but the difference now is profound; I loathe many mornings now days.

It's really confusing, depressing, etc., how often drugs that are supposed to help anxiety, depression, insomnia, etc., list as side effects anxiety, depression, insomnia, etc.!

For instance, at HealthSquare.com, Ambien's rather short list of common side effects is: allergy, daytime drowsiness, dizziness, drugged feeling, headache, indigestion, and nausea. However, the list of less common side effects (over 70!) includes anxiety, depression, and insomnia. On the other hand, HealthSquare's list of Ativan's more common side effects is: dizziness, sedation (excessive calm), unsteadiness, and weakness. But it's list of less common side effects (12) includes agitation, depression, and sleep disturbance.


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