![[dr. bob]](/dr-bob-sm.gif)
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 llurpsienoodle on July 23, 2008, at 20:34:16
So, let's say... hypothetically.. that one has been waking up WAY too early. (4 or 5am)
It started about 2 weeks ago since upping wellbutrin from 150 to 300mg, SR split dosing 8am and 3pm.
so here's what I've got at my disposal
sonata 10mg -lots
klonopin- lots
xanax- lots
ambien- (can't remember the dosage)
geodon 60mg caps
r.o. zydis, because I don't need to be comatose
and my regular meds
wellbutrin 300mg split SR
abilify 5mg
lamictal 300mg split
sertraline (zoloft) 100mg
I've got to be alert at 7:30 in the am to drive to work.Thanks for your help and wisdom. sorry such a last minute request
-Ll
Posted by raisinb on July 23, 2008, at 20:46:21
In reply to Easy Question? re sleeping meds, posted by llurpsienoodle on July 23, 2008, at 20:34:16
Hi Llurpsie,
i used to take Ambien. If it's not CR, the max dose is 10mg. If it is CR, I think the max is 12.5.
I hate to say it will keep you asleep without grogginess the next day, because it affects everyone differently. But it did frequently work for me (until it stopped).
One thing I used to do is take one pill (5mg), wait and see if it worked, and if it didn't, have a glass or two of wine. That usually did it. But of course you are not supposed to do that :)
Wellbutrin probably contributes to the insomnia, so maybe you could cut the dose for a few days--just until your therapist returns, your SIL leaves, and life is a bit more doable.
I hope you feel better soon. Sleeplessness is a terrible curse.
Posted by linkadge on July 23, 2008, at 21:00:48
In reply to Re: Easy Question? re sleeping meds, posted by raisinb on July 23, 2008, at 20:46:21
Sleeplessness sucks. It sucks when you can't fall asleap for hours, or when you wake up too early.
It can make you feel worthless and ineffectual.
And it is one of those anoying things that you just can't fix with willpower. The harder you try, the worse it can get.
Linakdge
Posted by Justherself54 on July 23, 2008, at 23:00:06
In reply to Re: Easy Question? re sleeping meds, posted by linkadge on July 23, 2008, at 21:00:48
There have been times when I've had early morning wakening even tho I take zopiclone. What I've done is take 1/2 a dose and it works to get me back to sleep...however, the 7:30 wake up call might be tricky...what time do you usually take your night meds? If you could try a half dose when you have an early awakening on a weekend/day where you don't have to work to see if you're too groggy at 7..I also take seroquel and depending how my my MAOI is causing insomnia, I've had to increase it also. I'm bipolar so I have to keep a pretty rigid sleep schedule, other wise trouble follows
Posted by Phillipa on July 23, 2008, at 23:28:48
In reply to Re: Easy Question? re sleeping meds, posted by Justherself54 on July 23, 2008, at 23:00:06
Can you take the wellbutrin earlier maybe or cut the dose. I'd take xanax to fall asleep quickly and don't they say sonata is okay to take if you wake early? Justherself Is right about trying on a day you don't work. I give you credit I worked 3-ll cause I'm a nighowl and couldn't get up at 5:30 which I did and it whooped me. Love Phillipa
Posted by blueboy on July 24, 2008, at 11:18:56
In reply to Easy Question? re sleeping meds, posted by llurpsienoodle on July 23, 2008, at 20:34:16
> So, let's say... hypothetically.. that one has been waking up WAY too early. (4 or 5am)
>Been there done that. Although I have to say, of all the insomnia I have had (which is a lot), waking up early is the best one.
Have you thought about trying to nap in the afternoon? I was very productive when i was waking up early and did the nap thing, even though I felt groggy for an hour or so after the nap.
> It started about 2 weeks ago since upping wellbutrin from 150 to 300mg, SR split dosing 8am and 3pm.
>Wellbutrin really destroyed my sleep. I was only on it a week or two.
> so here's what I've got at my disposal
>
> sonata 10mg -lots
> klonopin- lots
> xanax- lots
> ambien- (can't remember the dosage)
> geodon 60mg capsRegular Ambien only lasts about five hours or so. The CR would be great for this problem.
Klonopin -- it works great for me if the cause of insomnia is anxiety or hypomania. I don't think I'd suggest it for drug-induced early rising, but I don't know. Xanax, even less so.
Sonata I don't know about. Lunesta works great, although I don't take it because it leaves a terrible taste in my mouth for the entire day.
Posted by llurpsienoodle on July 25, 2008, at 6:49:03
In reply to Easy Question? re sleeping meds, posted by llurpsienoodle on July 23, 2008, at 20:34:16
Day 1) glass of wine at 7pm & sonata at 10:30 pm
woke up at 5:00 am, stayed in bed until 5:30 am. Felt in a daze all day long. Kind of tired, but caffeine stimulated.Day2) klonopin at 4pm & zolpidem at 10:30 pm. Woke up at 5, fell back asleep. woke up at 6, fell back asleep, got up at 7am. I feel groggy, but hopefully a cup of coffee can pull me back into the realm of the living undead.
-Ll
Posted by blueboy on July 28, 2008, at 10:04:30
In reply to 2 days' worth of experimentation, posted by llurpsienoodle on July 25, 2008, at 6:49:03
> Day 1) glass of wine at 7pm & sonata at 10:30 pm
> woke up at 5:00 am, stayed in bed until 5:30 am. Felt in a daze all day long. Kind of tired, but caffeine stimulated.
>
> Day2) klonopin at 4pm & zolpidem at 10:30 pm. Woke up at 5, fell back asleep. woke up at 6, fell back asleep, got up at 7am. I feel groggy, but hopefully a cup of coffee can pull me back into the realm of the living undead.
>My first reaction is that your time period is way too short to draw any kind of conclusion. My sleep patterns vary more than this even when I'm not taking any drug at all.
Also, for me, your "Day 2" would be a successful night of sleep, LOL. A lot of people, especially as they grow older, have problems with waking up for a while, then going back to sleep.
Of course, if you're feeling out-of-it all day, that's the litmus test. I have spent years trying to guess what to do at night by reading my syptoms. I'm bipolar and if I'm truly hypomanic, the only thing that helps is a big dose of klonopin at bedtime. For anxiety or simple insomnia, Ambien or even nothing. But Ambien is a lot better for going to sleep, since it lasts about 5 hours.
If I wake up, wide awake, 5 or more hours before I have to get out of bed, Ambien.
Posted by yxibow on July 29, 2008, at 2:08:54
In reply to 2 days' worth of experimentation, posted by llurpsienoodle on July 25, 2008, at 6:49:03
> Day 1) glass of wine at 7pm & sonata at 10:30 pm
> woke up at 5:00 am, stayed in bed until 5:30 am. Felt in a daze all day long. Kind of tired, but caffeine stimulated.Okay -- here's where stacking sleep agents is a BAD thing. The half life of alcohol, for a female, I believe you are, but I could be mistaken, would still be in you when you took the Sonata. Not a good thing.
Sonata is fairly weak though as a sleep agent for most people.
> Day2) klonopin at 4pm & zolpidem at 10:30 pm. Woke up at 5, fell back asleep. woke up at 6, fell back asleep, got up at 7am. I feel groggy, but hopefully a cup of coffee can pull me back into the realm of the living undead.
Here we have an example of why Ambien won't work if you're taking Klonopin regularly. The pseudobenzodiazepine agents are fairly useless if you are already taking a benzodiazepine as they eventually all act on the sleep receptor of GABAa.
And yes, things have to be tried more than one time. But I can't emphasize enough that stacking sleep agents can get one into real trouble -- the desire to sleep leading to oh, well, I'll take a benadryl with some Ambien and.... yes, respiratory depression, coma, etc.
Of all the agents though, I guess I would either go for the Ambien or the Sonata. Habituation occurs much faster with any benzodiazepine.
It's not an "easy question". Sleep regulation is a hard thing, trust me, I have been through multiple agents. But then again -- everyone is different. I'm just saying if you have a potential sleep disorder, there's a merrygoround of medications that one may have to use to not acclimate to one or the other.
But please don't mix alcohol with any significant quantity of them at bedtime.... its not a teetotaler's comment, its just well, I think common sense.
Anyhow that's just my 2c, as everything, everyone will vary.-- tidings
Jay
Posted by llurpsienoodle on July 29, 2008, at 16:01:58
In reply to Re: 2 days' worth of experimentation » llurpsienoodle, posted by yxibow on July 29, 2008, at 2:08:54
> > Day 1) glass of wine at 7pm & sonata at 10:30 pm
> > woke up at 5:00 am, stayed in bed until 5:30 am. Felt in a daze all day long. Kind of tired, but caffeine stimulated.
>
> Okay -- here's where stacking sleep agents is a BAD thing. The half life of alcohol, for a female, I believe you are, but I could be mistaken, would still be in you when you took the Sonata. Not a good thing.
Yep, I am a woman. A giant woman, but still female. :)>
> Sonata is fairly weak though as a sleep agent for most people.
>It has such a short half-life, that's why I think that I can't stay asleep past 3-5am
>
> > Day2) klonopin at 4pm & zolpidem at 10:30 pm. Woke up at 5, fell back asleep. woke up at 6, fell back asleep, got up at 7am. I feel groggy, but hopefully a cup of coffee can pull me back into the realm of the living undead.
>
>
> Here we have an example of why Ambien won't work if you're taking Klonopin regularly. The pseudobenzodiazepine agents are fairly useless if you are already taking a benzodiazepine as they eventually all act on the sleep receptor of GABAa.
>I wonder how much benzo usage it takes to downregulate the brain's natural production/response to GABA? I was off of klonopin for several weeks. Maybe 4-6 weeks? Then my mom came to visit :(
>
> And yes, things have to be tried more than one time. But I can't emphasize enough that stacking sleep agents can get one into real trouble -- the desire to sleep leading to oh, well, I'll take a benadryl with some Ambien and.... yes, respiratory depression, coma, etc.((((yxibow))))) thank you for your concern. I will try to be more careful
>
>
> Of all the agents though, I guess I would either go for the Ambien or the Sonata. Habituation occurs much faster with any benzodiazepine.
>okay- good to know
>
> It's not an "easy question". Sleep regulation is a hard thing, trust me, I have been through multiple agents. But then again -- everyone is different. I'm just saying if you have a potential sleep disorder, there's a merrygoround of medications that one may have to use to not acclimate to one or the other.
>
>
> But please don't mix alcohol with any significant quantity of them at bedtime.... its not a teetotaler's comment, its just well, I think common sense.
>yes- wine at dinner and sonata at night are to be enjoyed on separate occasions.
>
> Anyhow that's just my 2c, as everything, everyone will vary.
>
> -- tidings
>
> Jaythanks so much for your thoughts. Have a good night's sleep
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.