![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Phoenix1 on February 13, 2008, at 8:44:44
Hello All,
I'm currently on the following meds:
Nardil 90mg
Seroquel 50mg at bedtime
Zopiclone 7.5mg at bedtimeMy problem is that I fall asleep easily, and then sleep well for 5-6 hours, and then am wide awake around 4AM, with no ability to fall back asleep again. Is this enough sleep? Should I be looking at something different for my sleep meds? Pdoc wants me off the seroquel soon, and won't really increase the Zopiclone because 7.5 mg is the PI maximum. I've tried trazadone and nortrypritylline in the past for sleep, and both left me excessively "fuzzy" the next day. Remeron works OK, but is contraindicated w/ the Nardil. Heavier benzos also work, but I am trying my hardest to avoid them. Any ideas?
Thanks,
Phoenix1
Posted by Justherself54 on February 13, 2008, at 10:22:55
In reply to Nardil + Sleep, posted by Phoenix1 on February 13, 2008, at 8:44:44
I know you don't want to increase the zopiclone but that's what really stopped the insomnia for me..I still wake up at during the night but fall right back asleep again..my pdoc told me to do the increase and stated he had patients who had to take more than 7.5..
However, when I take my meds, I get pretty much out of it, so would not take that dosage if I had my grandcritters overnight..they'd think grandma was drunk! I'd rather not sleep that night than run the risk of not hearing one of them call out..
I have fibromyalgia, I still get flare-ups and "fibro-fog" but I seem to bounce back quickly from them and I'm starting to wonder if it's the Nardil..however restorative sleep is critical with fibro, as fibro and depression can feed off each other, so I'd rather be a little overmedicated at night than have to go off Nardil.
I really, really hope you find something to help your sleep..I know you must be getting pretty anxious and frustrated..
Sorry if this post got a little rambling!
Posted by Phoenix1 on February 13, 2008, at 10:37:31
In reply to Re: Nardil + Sleep, posted by Justherself54 on February 13, 2008, at 10:22:55
> I know you don't want to increase the zopiclone but that's what really stopped the insomnia for me..I still wake up at during the night but fall right back asleep again..my pdoc told me to do the increase and stated he had patients who had to take more than 7.5..
>
> However, when I take my meds, I get pretty much out of it, so would not take that dosage if I had my grandcritters overnight..they'd think grandma was drunk! I'd rather not sleep that night than run the risk of not hearing one of them call out..
>
> I have fibromyalgia, I still get flare-ups and "fibro-fog" but I seem to bounce back quickly from them and I'm starting to wonder if it's the Nardil..however restorative sleep is critical with fibro, as fibro and depression can feed off each other, so I'd rather be a little overmedicated at night than have to go off Nardil.
>
> I really, really hope you find something to help your sleep..I know you must be getting pretty anxious and frustrated..
>
> Sorry if this post got a little rambling!
>
>Hi JustHerself,
No, you didn't ramble at all. Thanks for the response. Sorry to hear about the fibro, I'm sure that in combination with depression must be very challenging to live with at times. I too, am fairly out of it and sleepy after taking my sleep meds. The problem is that they wear off too fast, and then I'm just wide awake at 4AM...
Actually, I would love to increase the zopiclone to 11.25, in order to try to reduce the Seroquel further. I would take 7.5 right before bed, and then 3.75 around 1 or 2 when I go to the washroom. But my pdoc just won't prescribe a dose higher than 7.5, as indicated by the PI sheet. I'm going to do what you suggested and try it anyways one night, and if it works well, I will tell him about it and ask again. He would really like me off the Seroquel, so if it works, he might be willing to give it a try. One problem is that he monitors mey meds very closely, as in he gives me exactly 30 days worth and then won't prescribe again until 1 day before the script runs out (except for Nardil), so if I take more than I'm prescribed, I end up running out. I've had a problem with overusing benzos in the past, so he's just watching out for my best interests, but it is still annoying and worrisome at times...
Anyways, I'll try the zopiclone thing and then propose it to him. Thanks for your advice!
Phoenix 1
Posted by Phillipa on February 13, 2008, at 11:34:28
In reply to Re: Nardil + Sleep, posted by Justherself54 on February 13, 2008, at 10:22:55
Oh wow didn't know you had fibromyalgia too. Rozeram can take twice I think for sleep thought of that one? Sorry not more helpful. Phillipa
Posted by johnj on February 13, 2008, at 12:17:22
In reply to Re: Nardil + Sleep » Justherself54, posted by Phoenix1 on February 13, 2008, at 10:37:31
Can a person take a low dose of doxepin or trimipramine with Nardil? They both seem to help sleep greatly. I would think low doses would be ok as that is what I have read. I assume or tca's that work on serotonin are not allowed with nardil.
johnj
Posted by Phoenix1 on February 13, 2008, at 12:17:23
In reply to Re: Nardil + Sleep » Justherself54, posted by Phillipa on February 13, 2008, at 11:34:28
> Oh wow didn't know you had fibromyalgia too. Rozeram can take twice I think for sleep thought of that one? Sorry not more helpful. Phillipa
We don't have Rozerem in Canada yet. Anyways, I've heard from a LOT of people that it isn't as helpful as the other sleep aids. I would give it a try if it were avalable. I'm thinking it might be contrindicated with MAOIs because it is a melatonin receptor agonist and Phenelzine inhibits the breakdown of melatonin. I'm not sure on this though...
Phoenix1
Posted by Phoenix1 on February 13, 2008, at 12:24:29
In reply to Re: Nardil + Sleep » Phoenix1, posted by johnj on February 13, 2008, at 12:17:22
> Can a person take a low dose of doxepin or trimipramine with Nardil? They both seem to help sleep greatly. I would think low doses would be ok as that is what I have read. I assume or tca's that work on serotonin are not allowed with nardil.
>
> johnjYes, I'm really unclear on which TCAs I can use as a sleep aid. To be honest, I think my pdoc is as well. He has never prescribed Nardil before, so he is incredibly cautious. There is only one pdoc in my area that regularly prescribes MAOIs and he has a one year waiting list and is located really far away from me unfortunately.
Thanks for the suggestion though. I ask my pdoc about both of them as potential options.
Phoenix1
Posted by gardenergirl on February 13, 2008, at 12:47:55
In reply to Nardil + Sleep, posted by Phoenix1 on February 13, 2008, at 8:44:44
I had that problem, too. I had never taken any sleep meds prior to going on Nardil, though I always had a bad time getting to sleep. This was likely due more to poor sleep hygiene than a sleep disorder, though. Once I started waking at 4:00 a.m. every morning and not being able to go to sleep, I finally told my doc, and he gave me Ambien. That worked very well with both getting to sleep and staying asleep. Later on I added Provigil in hopes of reducing the inattentive ADD symptoms I have. That had the secondary benefit of really regulating my sleep/wake cycle, so now I seldom use Ambien at all. This has all taken place over 3-4 years, though.
Good luck with it. That early awakening was one of the worst side effects I had with Nardil.
gg
Posted by Justherself54 on February 13, 2008, at 13:14:37
In reply to Re: Nardil + Sleep » Phoenix1, posted by gardenergirl on February 13, 2008, at 12:47:55
P1:
I wish you had a more liberal pdoc but I also understand his concerns..he is looking out for you..but you can't go on without sleep either, it will just end up making it impossible to continue on Nardil..
Before Nardil, there were times I had early morning wakening..my pdoc told me to take half a zopiclone and it worked to get back to sleep..both my pdoc and his associate are pretty liberal thinking..when I was full of anxiety and thinking about cancelling a surgery his associate told me (mine was away of vacation) I had to have the surgery and if it meant knocking me out for the week before surgery on benzos that's what he would do!
Turned out I was ok until the day before when I had to use more clonazapam and I don't know what they put in my IV but you could have taken me to China and back I was so relaxed..wish I knew what that was!
Posted by SteelyDan on February 13, 2008, at 16:25:40
In reply to Nardil + Sleep, posted by Phoenix1 on February 13, 2008, at 8:44:44
> Hello All,
>
> I'm currently on the following meds:
>
> Nardil 90mg
> Seroquel 50mg at bedtime
> Zopiclone 7.5mg at bedtime
>
> My problem is that I fall asleep easily, and then sleep well for 5-6 hours, and then am wide awake around 4AM, with no ability to fall back asleep again. Is this enough sleep? Should I be looking at something different for my sleep meds? Pdoc wants me off the seroquel soon, and won't really increase the Zopiclone because 7.5 mg is the PI maximum. I've tried trazadone and nortrypritylline in the past for sleep, and both left me excessively "fuzzy" the next day. Remeron works OK, but is contraindicated w/ the Nardil. Heavier benzos also work, but I am trying my hardest to avoid them. Any ideas?
>
> Thanks,
>
> Phoenix1I personly have been on Nardil and Parnate and i think 5-6 hours is pretty good for a person on Nardil. Adding a bunch of other meds may do more harm than good. I would try to get used to the 5-6 hrs. Just my opinion..Good Luck!
Dan
Posted by Phoenix1 on February 13, 2008, at 16:38:04
In reply to Re: Nardil + Sleep » Phoenix1, posted by SteelyDan on February 13, 2008, at 16:25:40
> > Hello All,
> >
> > I'm currently on the following meds:
> >
> > Nardil 90mg
> > Seroquel 50mg at bedtime
> > Zopiclone 7.5mg at bedtime
> >
> > My problem is that I fall asleep easily, and then sleep well for 5-6 hours, and then am wide awake around 4AM, with no ability to fall back asleep again. Is this enough sleep? Should I be looking at something different for my sleep meds? Pdoc wants me off the seroquel soon, and won't really increase the Zopiclone because 7.5 mg is the PI maximum. I've tried trazadone and nortrypritylline in the past for sleep, and both left me excessively "fuzzy" the next day. Remeron works OK, but is contraindicated w/ the Nardil. Heavier benzos also work, but I am trying my hardest to avoid them. Any ideas?
> >
> > Thanks,
> >
> > Phoenix1
>
> I personly have been on Nardil and Parnate and i think 5-6 hours is pretty good for a person on Nardil. Adding a bunch of other meds may do more harm than good. I would try to get used to the 5-6 hrs. Just my opinion..Good Luck!
>
> DanThanks for everyones comments and advice. Maybe I will just see how I do on 5-6 hours of sleep for a while. If it becomes an issue, I'll look at changing sleeping drugs or adding something else. But maybe 5-6 hours is enough for the long term...
Phoenix1
Posted by SteelyDan on February 13, 2008, at 17:06:46
In reply to Re: Nardil + Sleep, posted by Phoenix1 on February 13, 2008, at 16:38:04
> > > Hello All,
> > >
> > > I'm currently on the following meds:
> > >
> > > Nardil 90mg
> > > Seroquel 50mg at bedtime
> > > Zopiclone 7.5mg at bedtime
> > >
> > > My problem is that I fall asleep easily, and then sleep well for 5-6 hours, and then am wide awake around 4AM, with no ability to fall back asleep again. Is this enough sleep? Should I be looking at something different for my sleep meds? Pdoc wants me off the seroquel soon, and won't really increase the Zopiclone because 7.5 mg is the PI maximum. I've tried trazadone and nortrypritylline in the past for sleep, and both left me excessively "fuzzy" the next day. Remeron works OK, but is contraindicated w/ the Nardil. Heavier benzos also work, but I am trying my hardest to avoid them. Any ideas?
> > >
> > > Thanks,
> > >
> > > Phoenix1
> >
> > I personly have been on Nardil and Parnate and i think 5-6 hours is pretty good for a person on Nardil. Adding a bunch of other meds may do more harm than good. I would try to get used to the 5-6 hrs. Just my opinion..Good Luck!
> >
> > Dan
>
> Thanks for everyones comments and advice. Maybe I will just see how I do on 5-6 hours of sleep for a while. If it becomes an issue, I'll look at changing sleeping drugs or adding something else. But maybe 5-6 hours is enough for the long term...
>
> Phoenix1I think that's a smart decision..and then if 5-6 hrs. becomes a problem, then you can try something else or increase what you are currently taking.
Dan
Posted by Phillipa on February 13, 2008, at 19:15:39
In reply to Re: Nardil + Sleep, posted by Justherself54 on February 13, 2008, at 13:14:37
Was it versed a lovely med!!!!! Love Phillipa
This is the end of the 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.