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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by dreamboat_annie on October 14, 2006, at 0:03:01
It takes me about 2 hours or more to actually fall asleep and then I wake up two or three time a night. I've always had mild insomnia, but it is getting worse. I tried Trazadone about 2 years ago and, 1/2 of a 25mg pill worked, but I was a total zombie the following day. It took until noon the next day for it to wear off. And, it made me feel very depressed after a few days of use. I figure if I can just get 2 or 3 nights of good sleep, then I will be fine for awhile again.
Any suggestions?
Thanks a bunch!
Posted by ronaldo on October 14, 2006, at 4:44:15
In reply to Wicked insomnia - what should I take?, posted by dreamboat_annie on October 14, 2006, at 0:03:01
Hello dreamboat_annie
I feel I might be the last person who should be advising you re insomnia. I have a pretty vile treatment resistant insomnia myself. Here's what I've tried and what has failed me.
Seroquel - various doses from 25 mg upto 100 mg and down again to as little as 12.5 mg (half a tablet). The best I got was 5 hours sleep, awake at 3.00 or 4.00 am and couldn't get back to sleep again. Some people have had a lot of success with Seroquel for sleep, some using as little as quarter of a tablet. See:
http://askapatient.com/viewrating.asp?drug=20639&name=SEROQUELNext thing I tried was Zopiclone - Zimovane in the UK, Imovane in the States? Same story - awake at 3.00 or 4.00 am, that was on 2 X 7.5 mg. Last night I tried 1 x 7.5 mg and was awake at 1.30 am whereupon I took another 7.5 mg and slept till 5.30 am.
Valerian root tea from health food store. Tried this for the first time last night. Strongish sedating effect, taken one hour before retiring.
I have a history of coming off Zyprexa (Olanzapine). Was on it at 5 mg for four years. Got off it, finally, three weeks ago. Got off Seroquel three days ago. I think I might have rushed the Seroquel. Still get anxiety attacks, I think I cannot breath. I once tried 12.5 mg of Seroquel (half a tablet) with 2 x 7.5 mg Zopiclone and got a very pleasant drowsy affect in the early morning but no sleep though. I suspect that the Olanzapine and certainly the Seroquel are still having an effect on my sleep.
I've heard good things about:
Nature's Way - Silent Night with Valerian 440 mg, 100 caps $5.00 (SRP $9.99)
Silent Night formula combines Valerian (Root), Hops and Skullcaps for a relaxing effect on the NS and to promote restful sleep.
www.iherb.com/store/Product Details...
Look under Valerian. Last time I looked, a few days ago it was not in stock. Maybe someone else has it.Sorry I have not been much help annie. I hope someone else can give you better hope.
Posted by ronaldo on October 14, 2006, at 4:48:51
In reply to Re: Wicked insomnia - what should I take?, posted by ronaldo on October 14, 2006, at 4:44:15
Posted by Phillipa on October 14, 2006, at 10:45:25
In reply to Re: Wicked insomnia - what should I take?, posted by ronaldo on October 14, 2006, at 4:44:15
Have you tried lunesta or ambien. I've heard if you don't want a benzo like me that lunesta works well. Love Phillipa
Posted by JOP on October 14, 2006, at 10:56:41
In reply to Wicked insomnia - what should I take?, posted by dreamboat_annie on October 14, 2006, at 0:03:01
> It takes me about 2 hours or more to actually fall asleep and then I wake up two or three time a night. I've always had mild insomnia, but it is getting worse. I tried Trazadone about 2 years ago and, 1/2 of a 25mg pill worked, but I was a total zombie the following day. It took until noon the next day for it to wear off. And, it made me feel very depressed after a few days of use. I figure if I can just get 2 or 3 nights of good sleep, then I will be fine for awhile again.
>
> Any suggestions?
>
> Thanks a bunch!After a few nights of insomnia, I like a high(er) dose of Ativan 1.5~2 mg. I find it has a really good kick on the front end that puts me right to sleep, but it is short acting enough that it doesn't leave me groggy the next day like other benzos. I also find that it helps to "normalize" my sleep patterns -- after 2 or 3 nights I am able to fall asleep and stay asleep through the night without it.
Good luck!
Posted by Emme on October 14, 2006, at 12:02:01
In reply to Wicked insomnia - what should I take?, posted by dreamboat_annie on October 14, 2006, at 0:03:01
Hi. For insomnia I have tried trazodone, lunesta, ambien, rozerem, and seroquel. 6.25-12.5 mg of seroquel was by far the best for me, with the most natural drifting off and not too much hangover.
If I only need help nodding off and am not having problems staying asleep, a little xanax works. On my current regimen (Lamictal, abilify, focalin, xanax) my sleep is much better regulated than it has been in years, so I only need seroquel once in a while. Good luck.
emme
Posted by yxibow on October 15, 2006, at 2:58:34
In reply to Wicked insomnia - what should I take?, posted by dreamboat_annie on October 14, 2006, at 0:03:01
> It takes me about 2 hours or more to actually fall asleep and then I wake up two or three time a night. I've always had mild insomnia, but it is getting worse. I tried Trazadone about 2 years ago and, 1/2 of a 25mg pill worked, but I was a total zombie the following day. It took until noon the next day for it to wear off. And, it made me feel very depressed after a few days of use. I figure if I can just get 2 or 3 nights of good sleep, then I will be fine for awhile again.
>
> Any suggestions?
>
> Thanks a bunch!Trazodone takes getting used to, just like the off-label use of Sinequan (doxepine). Doxepine especially requires a weekend to devote to getting used to, its heavily sedating to start with.
The trouble is eventually you do get used to Trazodone though it is not a scheduled drug -- surprised about depression as an adult dose (which would put anyone to sleep and isn't used any more) was an antidepressant. At any rate eventually 25 becomes 125, etc, and you're starting to get into the serotonergic range and you have to drop and go back if you dont want hangover effects.
I'm not a particular fan of off label medications, but some doctors are benzophobes or feel their patients with depression shouldn't be taking them.
Personally though I would still recommend the pseudobenzodiazepine class, which depending where you live, includes either Lunesta (the active metabolite of Zopiclone, sold generic elsewhere but the US), Ambien, and Sonata.
If you have depression, I would probably not take Rozerem. It is just an expensive target for the same melatonin receptors that OTC melatonin targets, albeit probably a little cleaner. It can cause hormonal changes which is not good for affective disorders. Melatonin is good for resetting jet lag, but not really for a long term basis especially with those with affective disorders.
If you're already used to benzodiazepines, you may have to take more than the recommended dosage for pseudobenzodiazepines, e.g. 4mg of Lunesta or 15-25mg of Ambien. That's up to your doctor though.Hope you get some pleasant dreams.
There is one off label, I think I've posted this before, Remeron, which at its lowest dose 7.5mg is a good REM medication. Unfortunately, unless you're among the small percentage of people who don't gain weight on it, you'll gain quite quickly if you don't restrict a diet firmly.
-- tidings
Jay
Posted by dreamboat_annie on October 28, 2006, at 9:12:34
In reply to Re: Wicked insomnia - what should I take?, posted by JOP on October 14, 2006, at 10:56:41
I'm so sorry I didn't respond sooner and thank you all for taking the time to respond and offer advice and suggestions. What I ended up doing was taking Xanax, but double the dose that I would take for anxiety. Although it didn't help me fall asleep, it relaxed me and, when I did fall asleep, I slept though the night. I am also trying Ashwagandha and it seems to make me sleepy and help me sleep through the night. So, I have two options now.
I had to confess to my pdoc that I used Xanax (it was an old prescription given by my old family doctor which I have rarely used in the past 1 1/2 years), and my pdoc was not mad at all. He even said he uses Xanax when he travels and when stressed. Go figure :-) Then he really surprised me and asked if I need a prescription for Xanax, which I didnt, but it's nice to know if I need a refill I won't have to beg for it. I am so grateful that I found this pdoc.
Anyway, thanks again, and sorry for being so tardy in responding.
This is the end of the thread.
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