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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 27. This is the beginning of the thread.
Posted by mike0388 on March 23, 2010, at 3:55:27
Besides Ambiem and Lunseta, they've worn out on me. Even a couple tabs a night dont do anything. Any recommendations, nothing too hard, something similar to ambien and such.
Posted by SLS on March 23, 2010, at 6:20:02
In reply to Whats a good prescription sleep aid?, posted by mike0388 on March 23, 2010, at 3:55:27
> Besides Ambiem and Lunseta, they've worn out on me. Even a couple tabs a night dont do anything. Any recommendations, nothing too hard, something similar to ambien and such.
By the wording of your question, I guess you are excluding Seroquel from consideration. For some people, it is the most consistently effective hypnotic. It is most effective at low dosages. It seems that 50mg is the most frequently chosen dosage for inducing sleep. Seroquel becomes less effective at dosages above 100mg, perhaps because of the NE reuptake inhibition produced by its major metabolite.
If you wish to avoid Seroquel, you can try combining Halcion with Ativan. That should do the trick.
- Scott
Posted by SLS on March 23, 2010, at 6:22:46
In reply to Whats a good prescription sleep aid?, posted by mike0388 on March 23, 2010, at 3:55:27
I forgot about Remeron. 15mg usually works. Like Seroquel, the higher the dosage, the less effective it is as a sleep-aid.
Some tricyclics are good for sleep: amitriptyline, doxepin, and trimipramine.
- Scott
Posted by mike0388 on March 23, 2010, at 7:09:27
In reply to Re: Whats a good prescription sleep aid? » mike0388, posted by SLS on March 23, 2010, at 6:22:46
When I did some googling on Seroquel, it did not mention it's used for sleep
"Seroquel is used to treat schizophrenia in adults and children who are at least 13 years old. It is used to treat bipolar disorder (manic depression) in adults and children who are at least 10 years old."
Posted by X-ray on March 23, 2010, at 7:10:11
In reply to Whats a good prescription sleep aid?, posted by mike0388 on March 23, 2010, at 3:55:27
> Besides Ambiem and Lunseta, they've worn out on me. Even a couple tabs a night dont do anything. Any recommendations, nothing too hard, something similar to ambien and such.
>Hi,
I sleep well on Remeron, which I augment with a small dose of Lyrica.
Best regards,
X-rayFor sleep: 60 mg Remeron + 50 mg Lyrica
Posted by X-ray on March 23, 2010, at 7:56:33
In reply to Re: Whats a good prescription sleep aid?, posted by mike0388 on March 23, 2010, at 7:09:27
> When I did some googling on Seroquel, it did not mention it's used for sleep
>
> "Seroquel is used to treat schizophrenia in adults and children who are at least 13 years old. It is used to treat bipolar disorder (manic depression) in adults and children who are at least 10 years old."Seroquel har become very popular as a sleep aid in the U.S.
Henry Nasrallah, a psychiatrist, in an article by Matthew Herper (Forbes.com):
A lot of our patients beg us for sleep. And if we are going to give them something for sleep,
we want to give them a mild, not harmful drug that seems to help both their sleep and their depression or anxiety.
Seroquel fits the bill.X-ray
Posted by JayBTV2 on March 23, 2010, at 9:39:53
In reply to Re: Whats a good prescription sleep aid?, posted by X-ray on March 23, 2010, at 7:56:33
Seroquel works amazingly well for sleep IMO - has worked for me for over 3 years at dosages between 25mg and 100mg.
Trazodone is another alternative. They like to use that in the hospitals around here. Technically it's an anti-depressant but it makes most people fall asleep so it's often used in that capacity.
Posted by Phillipa on March 23, 2010, at 10:57:27
In reply to Re: Whats a good prescription sleep aid?, posted by JayBTV2 on March 23, 2010, at 9:39:53
Boy we are all different as 50mg of seroquel left me unable to talk could think but not speak and so dizzy was put back to bed was in hospital at time also was on benzos so resistant to sleep and even 15mg of remeron. What ended up working was just a benzo low dose. Phillipa
Posted by orbital on March 23, 2010, at 12:57:00
In reply to Whats a good prescription sleep aid?, posted by mike0388 on March 23, 2010, at 3:55:27
This is what works for me (when I'm not suffering from med-induced insomnia):
Sure fire: Remeron 15mg / Mianserin 30mg
Okay: Trazodone (highish dose ~ 150mg)
Iffy: Ambien CR - the other flavours of Z-drugs never did a thing.
Rozarem/Ramalteon is not available where I live, which is a shame, as I respond surprisingly well to melatonin and I suspect it'd work for me.
Seroquel didn't work for me, but it seems to do the job extremely well for a lot of people.
> Besides Ambiem and Lunseta, they've worn out on me. Even a couple tabs a night dont do anything. Any recommendations, nothing too hard, something similar to ambien and such.
>
Posted by X-ray on March 23, 2010, at 13:03:44
In reply to Re: Whats a good prescription sleep aid? » mike0388, posted by orbital on March 23, 2010, at 12:57:00
> This is what works for me (when I'm not suffering from med-induced insomnia):
>
> Sure fire: Remeron 15mg / Mianserin 30mg
>
> Okay: Trazodone (highish dose ~ 150mg)
>
> Iffy: Ambien CR - the other flavours of Z-drugs never did a thing.
>
> Rozarem/Ramalteon is not available where I live, which is a shame, as I respond surprisingly well to melatonin and I suspect it'd work for me.
>
> Seroquel didn't work for me, but it seems to do the job extremely well for a lot of people.
>
> > Besides Ambiem and Lunseta, they've worn out on me. Even a couple tabs a night dont do anything. Any recommendations, nothing too hard, something similar to ambien and such.
> >
>
>Hi,
What is your comparison of Remeron and Mianserin regarding sleep?
You don't mix these drugs, do you?
Best regards,
X-ray
Posted by mike0388 on March 23, 2010, at 14:01:34
In reply to Re: Whats a good prescription sleep aid?, posted by X-ray on March 23, 2010, at 7:56:33
I'm not sure I can take this medication, because I'm also prescribed Nardil, I take Ambien at night, i have to take a couple tablets to even feel a little bit groggy to fall asleep. So im taking it now with 1 mg of xanax which works, but I rather not take the xanax and just be able to take 1 sleeping pill to go to sleep.
Posted by Maxime on March 23, 2010, at 14:03:24
In reply to Re: Whats a good prescription sleep aid?, posted by mike0388 on March 23, 2010, at 7:09:27
Seroquel is used a lot for sleep. It may not be documented when you read about it because it's not approved for sleep. When I was in the hospital they used 25-50 mg of Seroquel for many of the patients. But like everything else it may stop working, still it's worth a try.
Posted by orbital on March 23, 2010, at 14:51:59
In reply to Re: Whats a good prescription sleep aid?Orbital, posted by X-ray on March 23, 2010, at 13:03:44
Hmm, good question.
I've never taken both simultaneously, but I have switched from one to the other directly.
However, I definitely don't think they're interchangeable, there's a subtle yet noticeable difference.
IME, for sleep and at equivalent doses (15mg Remeron = 30 mg Tolvon), I'd say that mianserin is "lighter" and more forgiving; it takes a while to kick in and, unlike Remeron, it allows me to stay awake if I want to. Mirtazapine feels like a sledgehammer to the head, and seems to promote deeper sleep; it sometimes gives me a hangover if I don't allow it to run its course (~10 hours).
I think they are excellent meds, for both sleep and for depression. As a side note, at higher doses Remeron feels agitating whereas mianserin feels activating - so I avoid high doses of Remeron. This is all subjective, of course.
I choose one or the other depending on my needs.
Hope this helps :)
> > This is what works for me (when I'm not suffering from med-induced insomnia):
> >
> > Sure fire: Remeron 15mg / Mianserin 30mg
> >
> > Okay: Trazodone (highish dose ~ 150mg)
> >
> > Iffy: Ambien CR - the other flavours of Z-drugs never did a thing.
> >
> > Rozarem/Ramalteon is not available where I live, which is a shame, as I respond surprisingly well to melatonin and I suspect it'd work for me.
> >
> > Seroquel didn't work for me, but it seems to do the job extremely well for a lot of people.
> >
> > > Besides Ambiem and Lunseta, they've worn out on me. Even a couple tabs a night dont do anything. Any recommendations, nothing too hard, something similar to ambien and such.
> > >
> >
> >
>
> Hi,
>
> What is your comparison of Remeron and Mianserin regarding sleep?
>
> You don't mix these drugs, do you?
>
> Best regards,
> X-ray
Posted by morganator on March 23, 2010, at 15:10:28
In reply to Re: Whats a good prescription sleep aid?, posted by X-ray on March 23, 2010, at 7:10:11
> > Besides Ambiem and Lunseta, they've worn out on me. Even a couple tabs a night dont do anything. Any recommendations, nothing too hard, something similar to ambien and such.
> >
>
> Hi,
>
> I sleep well on Remeron, which I augment with a small dose of Lyrica.
>
> Best regards,
> X-ray
>
> For sleep: 60 mg Remeron + 50 mg LyricaI was going to suggest a low dose Lyrica. It may actually improve sleep architecture.
Posted by morganator on March 23, 2010, at 15:29:44
In reply to Re: Whats a good prescription sleep aid? » mike0388, posted by Maxime on March 23, 2010, at 14:03:24
I think there are too many options out there to try before trying seroquel.
What about some natural alternatives?(I already mentioned Lyrica, not a natural alternative)
GABA
Melatonin
Passion Flower
Scullcaps
Bacopa
Valerian
Glycine
Phosphatidyl Serine
Magnesium/Calcium
Suntheanine
Ashwagandha
Posted by morganator on March 23, 2010, at 15:30:43
In reply to Re: Whats a good prescription sleep aid?, posted by morganator on March 23, 2010, at 15:29:44
> I think there are too many options out there to try before trying seroquel.
>
> What about some natural alternatives?(I already mentioned Lyrica, not a natural alternative)
>
> GABA
> Melatonin
> Passion Flower
> Scullcaps
> Bacopa
> Valerian
> Glycine
> Phosphatidyl Serine
> Magnesium/Calcium
> Suntheanine
> Ashwagandha
>
>Combining several of these may be your best option.
Posted by mike0388 on March 23, 2010, at 17:18:39
In reply to Re: Whats a good prescription sleep aid?, posted by morganator on March 23, 2010, at 15:30:43
Would you be agaisnt this comboination for sleep, instead of taking multiple tablets of Ambien, would this be recommend or agaisnt
1 MG of Xanax + 1 10 MG tablet of Ambien
Posted by ed_uk2010 on March 23, 2010, at 17:33:09
In reply to Re: Whats a good prescription sleep aid?, posted by mike0388 on March 23, 2010, at 17:18:39
>1 MG of Xanax + 1 x 10 MG tablet of Ambien
No doubt it will work but this should be short term. Dependence will occur quickly and withdrawal symptoms can be extremely distressing.
Posted by ed_uk2010 on March 23, 2010, at 17:35:01
In reply to Re: Whats a good prescription sleep aid? » JayBTV2, posted by Phillipa on March 23, 2010, at 10:57:27
> Boy we are all different as 50mg of seroquel left me unable to talk could think but not speak and so dizzy was put back to bed was in hospital at time also was on benzos so resistant to sleep and even 15mg of remeron. What ended up working was just a benzo low dose. Phillipa
Unfortunately, many effective sleep aids such as Remeron are far too long-acting. Daytime sedation can be a major problem.
Posted by Sigismund on March 23, 2010, at 18:46:47
In reply to Re: Whats a good prescription sleep aid?, posted by morganator on March 23, 2010, at 15:10:28
>I was going to suggest a low dose Lyrica. It may actually improve sleep architecture.
Neurontin deepens sleep for me.
Posted by jedi on March 24, 2010, at 1:31:15
In reply to Re: Whats a good prescription sleep aid?, posted by mike0388 on March 23, 2010, at 14:01:34
Mike,
I'm also on Nardil and thus need something for sleep most every night. I rotate a variety of low dosage medications that work on the histamine receptors. I am very sensitive to these types of medications, so small is usually good.diphenhydramine HCL(Benadryl) 25-50mg
quetiapine fumarate(Seroquel) 12.5-25mg
trazodone(Desyrel) 50-100 mg
Jedi> I'm not sure I can take this medication, because I'm also prescribed Nardil, I take Ambien at night, i have to take a couple tablets to even feel a little bit groggy to fall asleep. So im taking it now with 1 mg of xanax which works, but I rather not take the xanax and just be able to take 1 sleeping pill to go to sleep.
Posted by mike0388 on March 24, 2010, at 3:04:54
In reply to Re: Whats a good prescription sleep aid? » mike0388, posted by jedi on March 24, 2010, at 1:31:15
> Mike,
> I'm also on Nardil and thus need something for sleep most every night. I rotate a variety of low dosage medications that work on the histamine receptors. I am very sensitive to these types of medications, so small is usually good.
>
> diphenhydramine HCL(Benadryl) 25-50mg
> quetiapine fumarate(Seroquel) 12.5-25mg
> trazodone(Desyrel) 50-100 mg
> Jedi
>
>
>
>
>
> > I'm not sure I can take this medication, because I'm also prescribed Nardil, I take Ambien at night, i have to take a couple tablets to even feel a little bit groggy to fall asleep. So im taking it now with 1 mg of xanax which works, but I rather not take the xanax and just be able to take 1 sleeping pill to go to sleep.
>
>I currently take Ambien for my sleeping problems. How is the Nardil doing for in regards to your social anxiety?
Posted by jedi on March 24, 2010, at 10:13:05
In reply to Re: Whats a good prescription sleep aid? » jedi, posted by mike0388 on March 24, 2010, at 3:04:54
Hi Mike,
Along with the Nardil I have been taking clonazepam for years. Currently I am taking 2mg of clonazepam, which helps me keep my Nardil dosage down to 60mg and minimize the side effects. For most of the last 12 years I have been on 90mg of Nardil.Nardil augmented with clonazepam, IMHO, is simply the best combination for atypical depression and social anxiety. It is the only thing that has worked for me and I have been on 45+ combinations of antidepressants and augmenters. I still have a residual level of dysthymia but no major depression as long as I am taking Nardil.
My main side effects have been weight gain and delayed orgasm. The only bad side effect of the clonazepam is CRS(Can't remember S**t).
I take the clonazepam at night, and this also helps with sleep. I've tried cutting down on the clonazepam and even quitting it, because of the memory problems, but then I end up raising the Nardil dosage to handle the atypical depression and social anxiety. Both of the medications affect GABA and work well for social anxiety.I have had social anxiety disorder since I was a teenager. Though undiagnosed in the early years, I would self medicate with alcohol use pot for the social outlet. Pot did not make me more outgoing, but this was back in the 70's and the use of pot was so common it was a real excuse to be around people and not be alone.
I think that social anxiety goes hand in hand with the rejection sensitivity of atypical depression. Before Nardil, rejection to me was just devastating. I never asked a girl out in high school because the thought of her saying no would be so frightening. In college, when I forced myself to go beyond the fear of social rejection; I remember the times that the rejection happened, the pain was almost unbearable. Most people do not realize how this kind of social anxiety can affect your life. It changes your career path, your choice of partners, just about everything in your life.
Good Luck with the battle,
Jedi
>
> I currently take Ambien for my sleeping problems. How is the Nardil doing for in regards to your social anxiety?
Posted by mike0388 on March 24, 2010, at 14:51:49
In reply to Re: Whats a good prescription sleep aid? » mike0388, posted by jedi on March 24, 2010, at 10:13:05
Offtopic,
Are you still able to eat hamburgers with no cheese? And hot dogs? Fast food? I know it can't contain Tyramine for nardil, but was wondering if you could shed some light into some foods that Nardil might interact with even though I have a pretty safe list what to stay away from to raise BP, just wanted your thoughts.
Posted by jedi on March 24, 2010, at 19:11:54
In reply to Re: Whats a good prescription sleep aid? » jedi, posted by mike0388 on March 24, 2010, at 14:51:49
I eat hamburgers with processed cheese or mozzarella. Same with hot dogs. I'm not big on fast food, but all of their cheese is processed, I don't worry about it. I eat normal pizza, just no aged cheeses. I also drink small amounts of alcohol with no problem.
I have a small list I avoid. All aged cheese. These are the worse because I really like cheese. Tap beer, because you don't know how clean the tap is. Avoid all over the counter cold remedies, they don't really work anyway.
This is the list I use:
http://www.dr-bob.org/babble/20020718/msgs/113175.html
Be Well,
Jedi> Offtopic,
>
> Are you still able to eat hamburgers with no cheese? And hot dogs? Fast food? I know it can't contain Tyramine for nardil, but was wondering if you could shed some light into some foods that Nardil might interact with even though I have a pretty safe list what to stay away from to raise BP, just wanted your thoughts.
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