![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by floatingbridge on May 14, 2010, at 1:29:09
Lunesta over sonata?
Zanaflex?
Other tca's?
I think my happyhappy sleep pills are not good for me :(
Posted by SLS on May 14, 2010, at 8:09:07
In reply to aide for deep stage sleep /sleep architecture?, posted by floatingbridge on May 14, 2010, at 1:29:09
> Lunesta over sonata?
>
> Zanaflex?
>
> Other tca's?
>
> I think my happyhappy sleep pills are not good for me :(
Trimipramine is the only tricyclic that I am aware of that improves sleep architecture. It does not decrease REM sleep. It had been used as a sleep aid when tricyclics were more popular.Of the "Z" drugs, zopiclone is most apt to interfere with sleep-dependent cortical plasticity, which is necessary for learning and memory consolidation. Perhaps this is why it is more likely to produce anterograde amnesia. I'm not sure, though. I have seen more people taking eszopiclone than zaleplon.
Does Zanaflex have hypnotic properties?
- Scott
Posted by floatingbridge on May 14, 2010, at 12:00:49
In reply to Re: aide for deep stage sleep /sleep architecture? » floatingbridge, posted by SLS on May 14, 2010, at 8:09:07
Quick and sketchy web search does not show hypnotic properties (zanaflex) though mention abuse potential (?).
Sonata and anterograde amnesia a.k.a. my memory is shot I can vouch for :(
I'm calling my pdoc--. I'll post anything interesting.
Scott, is sleep an issue for you?
Hey, thanks for your reply!fb
Posted by linkadge on May 14, 2010, at 12:14:28
In reply to Re: aide for deep stage sleep /sleep architecture? » SLS, posted by floatingbridge on May 14, 2010, at 12:00:49
I have been having sucess with the OTC antihistamine chlorpheniramine. I recently read a study that suggested it increased slow wave sleep.
I don't get as much next day grogginess as with benadryl.
Linkadge
Posted by SLS on May 14, 2010, at 12:57:36
In reply to Re: aide for deep stage sleep /sleep architecture? » SLS, posted by floatingbridge on May 14, 2010, at 12:00:49
> Quick and sketchy web search does not show hypnotic properties (zanaflex) though mention abuse potential (?).
>
> Sonata and anterograde amnesia a.k.a. my memory is shot I can vouch for :(
>
> I'm calling my pdoc--. I'll post anything interesting.Looking forward to it.
> Scott, is sleep an issue for you?No. My sleep is now pretty regular. In the past, Nardil and Parnate produced insomnia that needed to be treated with sleep aids. Now, they don't affect me that way. I wish they did. For me, insomnia as a side effect has been a prognosticator of a good response. I have been on a low dose of Marplan since Monday. So far, I have not had any side effects.
- Scott
Posted by SLS on May 14, 2010, at 13:34:53
In reply to Re: aide for deep stage sleep /sleep architecture? » floatingbridge, posted by SLS on May 14, 2010, at 8:09:07
> Of the "Z" drugs, zopiclone is most apt to interfere with sleep-dependent cortical plasticity,
I misspoke. I meant zolpidem.
- Scott
Posted by ed_uk2010 on May 14, 2010, at 14:21:35
In reply to Re: aide for deep stage sleep /sleep architecture?, posted by linkadge on May 14, 2010, at 12:14:28
> I have been having sucess with the OTC antihistamine chlorpheniramine. I recently read a study that suggested it increased slow wave sleep.
>
> I don't get as much next day grogginess as with benadryl.
>
> Linkadge
>
>Do you think it helps? For me, chlorpheniramine is much less sedating than Benadryl.
Posted by linkadge on May 14, 2010, at 16:09:04
In reply to Re: aide for deep stage sleep /sleep architecture? » linkadge, posted by ed_uk2010 on May 14, 2010, at 14:21:35
Usually when I can't sleep its not lack of tiredness its anxiety. Chlorpheniramine seems to help the anxiety and then I can fall asleep.
Linkadge
Posted by floatingbridge on May 16, 2010, at 16:51:32
In reply to Re: aide for deep stage sleep /sleep architecture? » floatingbridge, posted by SLS on May 14, 2010, at 12:57:36
Scott, good luck! Today is almost a week....
How is it going?
fb
Posted by SLS on May 16, 2010, at 18:28:54
In reply to marplan » SLS, posted by floatingbridge on May 16, 2010, at 16:51:32
> Scott, good luck! Today is almost a week....
Thanks for thinking about me.
I experienced a small improvement yesterday, but it didn't last. Today wasn't too good. I'll try to be patient. Things have been difficult, although they could certainly be worse.
What direction are you headed in regarding sleep?
- Scott
Posted by floatingbridge on May 17, 2010, at 1:44:36
In reply to marplan » SLS, posted by floatingbridge on May 16, 2010, at 16:51:32
Trying for deep stage sleep (level 4?). Just about all my meds (except for lithium, I hope) are said to disrupt this--and this is where (or when), theory leads, muscular regeneration and other life-enhancing processes take place....
(That and my memory consolidation and word recall would be embarrassing if I was with it enough to care... but that's rem sleep, maybe.) Natural sleep-- like I had less and less of since about age 8 :)
So back to lunesta unless my shrink cooks up better plans. I better sign off before it kicks in, though I wrote the best E-mail of my life waiting for the lunesta to a literary editor after receiving a rejection slip. I even forgot I wrote it until he wrote me back! Commenting on, my husband said "ummyeah, "little off the cuff, maybe." I delighted in my salty and bold alter ego that didn't give a flying f*ck. Love to have that fortitude everyday. Hmmm, lunesta as writning aide.
Won't try for that same luck tonight :)
Best to you,
fbI'll be hoping for you and wondering how it's going. Patience and a mind for possibility....
Posted by Brainbeard on May 23, 2010, at 6:22:28
In reply to aide for deep stage sleep /sleep architecture?, posted by floatingbridge on May 14, 2010, at 1:29:09
Drugs that promote deep stage sleep are, to begin with, all 5HT2A-antagonists (as long as they don't have other properties that negate the effects of 5HT2A-antagonism on sleep). Amitriptyline is a moderately strong 5HT2A-antagonist, while its antihistaminergic sedation may help with falling asleep. Nortriptyline, amitriptyline's metabolite, is less strong but can still make a great difference for sleep. Its effects on noradrenaline may also be paradoxically sedating.
Geodon (ziprasidone) is a very potent 5HT2A-antagonist, while its effects on noradrenaline are highly sedating for many. I slept very deeply on 20-40mg of Geodon.
Risperdal is also a highly potent 5HT2A-antagonist, but it may have other properties that interfere with deep sleep. I experienced alternating sleeplessness and very deep sleep on low doses.
Pipamperone is a lesser known antipsychotic (brand name Dipiperone) that is also a fairly potent 5HT2A-antagonist.Neurontin (gabapentin) promotes deep stage sleep as well.
Posted by floatingbridge on May 23, 2010, at 14:49:00
In reply to aide for deep stage sleep /sleep architecture?, posted by floatingbridge on May 14, 2010, at 1:29:09
Taking low dose tizanidine (zanaflex) at night, and lunesta when needed. My best research showed them least disruptive of deep stage sleep for now.
Brainbeard, thanks for the info. My truly wonderful pdoc had no info on this issue.
Scott, how is the marplan doing in week two? Hope improvement is noted, however atypical a start. Let me know if you will.
fb
Posted by SLS on May 23, 2010, at 16:00:41
In reply to Re: aide for deep stage sleep /sleep architecture?, posted by floatingbridge on May 23, 2010, at 14:49:00
> Scott, how is the marplan doing in week two? Hope improvement is noted, however atypical a start. Let me know if you will.
I'm hanging in there and trying to be patient. I cannot detect any improvement at this point. However, I am at 30mg. 60mg will probably be the target. I am grateful that I am not feeling as bad as I could be.
As always, thank you so much for your concern and support.
- Scott
Posted by desolationrower on May 23, 2010, at 17:41:41
In reply to Ami-/nor-triptyline, Neurontin, pipamperone, posted by Brainbeard on May 23, 2010, at 6:22:28
Generally REM is not 'good sleep'. though if you just want the fun of dreams, REM does do that.
5ht2c antagonists are several times stronger at improving SLS as are 5hta antagonists. antihistamines improve it somewhat as well.
i'd guess anticholinergics would help too, at least nicotine increases REM. antimuscarinics, i dunno.
-d/r
Posted by Conundrum on May 25, 2010, at 22:40:58
In reply to Re: Ami-/nor-triptyline, Neurontin, pipamperone, posted by desolationrower on May 23, 2010, at 17:41:41
Aren't most 5HT2A antagonists also 5 HT2C antagonists as well? The only ones I can think of that aren't are trazodone and nefazodone. Mirtazapine, the TCAs, and AAPs are all antagonists at both receptors. Obviously some vary. I think Zyprexa and Nortriptyline are stronger at the 5 HT2C receptors than the 2A.
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.