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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by mantus on January 29, 2011, at 13:19:56
Hello,
I hate to continue to write about the same topic, but my insomnia due to Nardil is really beginning to hamper any positive results I feel. I have noticed that work is a little easier to get through and thoughts of "doing things" aren't quite as daunting. However, in my process in the past to overcome a depressive/anxiety ridden episode I always needed to find some level of stability before taking even more productice steps. In this case, the instability of not having crucial sleep is weighing heavily on my mind and of course on my body. I have tried ambien with no luck. I am currently trying 30mgs of restoril on the days I have to work, and don't take anything on off days. 15mgs didn't do anything (just tried one night) and 30mgs didn't seem to do much either (1 or 2 nights maybe?). The main problem is that around 10pm when I go to bed I tend to be able to find some level of sleepiness and comfort, but unfortunately by 1 or 2 I wake up and toss and turn for the rest of the night. I am going to try the restoril for maybe another week, but if it doesn't work I'm either trying something different or just going to do my best without. I am on 75mg and have been for about for about a week, would you suggest maybe going back down to 60 or staying with 75 in the hope that the insomnia gets better? Any and all suggestions would be appreciated.
Thanks,
Mantus
Posted by SLS on January 29, 2011, at 18:51:07
In reply to Insomnia, posted by mantus on January 29, 2011, at 13:19:56
Maybe Restoril (temazepam). It is not at all good for sleep initiating, but it does a good job with sleep maintenance. I occassionally use a combination of Sonata and Ativan. The Sonata initiates sleep and the Ativan maintains it. I consider this to be rational polypharmacy.
I am going to ask my doctor for Restoril. I think it will be better for me than Ativan. The half-life of Restoril is perfect: 8 to 10 hours. Ativan is too long: 10 - 20 hours. Restoril is less likely than Ativan to produce a hangover the next morning.
- Scott
Posted by floatingbridge on January 30, 2011, at 4:06:28
In reply to Insomnia, posted by mantus on January 29, 2011, at 13:19:56
Actually, my pdoc prescribed sonata because of early awakenings. I could wake up, take it at 2,3, even 4 and sleep well enough. During hard times, I will add a little xanax.
Lunesta lasts longer--6-8 hours.
I sometimes augment w/ zanaflex, a very (!) mild muscle relaxant. Many muscle relaxants like flexeril are far stronger,
and I would never combine nor suggest combining them.I haven't tried restoril. A nice, old fashioned name.
Posted by phillipa on January 30, 2011, at 11:27:12
In reply to Re: Insomnia » mantus, posted by floatingbridge on January 30, 2011, at 4:06:28
Ever try Soma? Phillipa
Posted by floatingbridge on January 30, 2011, at 11:50:33
In reply to Re: Insomnia » floatingbridge, posted by phillipa on January 30, 2011, at 11:27:12
No. What is it? A transdermal? You didn't care for it, I recall.
So let me rephrase :-). Yes, I've heard of it but have no idea what it is.
fb
Posted by floatingbridge on January 30, 2011, at 12:00:05
In reply to Insomnia, posted by mantus on January 29, 2011, at 13:19:56
Hi Mantus,
Call it the jinx factor, but I couldn't sleep for beans last night. Despite my protocol, I awoke with darn (!) RLS thing. Oh well.
How did you do?
Btw, everyone here is always posting about their same old issues. Please don't feel shy :-) about posting anything.
Posted by ed_uk2010 on January 30, 2011, at 13:52:32
In reply to Re: Insomnia » mantus, posted by SLS on January 29, 2011, at 18:51:07
>Maybe Restoril (temazepam). It is not at all good for sleep initiation....
You don't think so? It generally starts to work after about 30 minutes and lasts for a few hours.
Posted by floatingbridge on January 30, 2011, at 14:11:40
In reply to Re: Insomnia » SLS, posted by ed_uk2010 on January 30, 2011, at 13:52:32
Advantages of restoril over sonata?
Curious,
A sleep deprived fb
Posted by SLS on January 30, 2011, at 14:14:18
In reply to Re: Insomnia » SLS, posted by ed_uk2010 on January 30, 2011, at 13:52:32
> >Maybe Restoril (temazepam). It is not at all good for sleep initiation....
>
> You don't think so? It generally starts to work after about 30 minutes and lasts for a few hours.Has this been your personal experience with it. It has mine.
Latency versus Maintenance:http://www.mentalhealth.com/drug/p30-r01.html
- Scott
Posted by linkadge on January 30, 2011, at 15:04:45
In reply to Re: Insomnia » ed_uk2010, posted by SLS on January 30, 2011, at 14:14:18
Ativan has been the best for me, followed by zopiclone or temazepam. Temazepam can be bad on next day cognition though, wherase ativan seems pretty neutral (for me at least).
Linkadge
Posted by floatingbridge on January 30, 2011, at 15:33:01
In reply to Re: Insomnia » ed_uk2010, posted by SLS on January 30, 2011, at 14:14:18
Any being discussed promote good sleep architecture? LMK
fb
Posted by ed_uk2010 on January 30, 2011, at 16:18:59
In reply to Re: Insomnia » ed_uk2010, posted by SLS on January 30, 2011, at 14:14:18
Like most hypnotic drugs, temazepam is unlikely to improve onset of sleep if it's taken immediately before getting into bed. It would be better to take it say 40 minutes before going to bed.
Posted by SLS on January 30, 2011, at 18:51:21
In reply to Re: Insomnia, posted by linkadge on January 30, 2011, at 15:04:45
> Ativan has been the best for me, followed by zopiclone or temazepam. Temazepam can be bad on next day cognition though, wherase ativan seems pretty neutral (for me at least).
Oh, crap. It figures.
Thanks for the heads-up. Perhaps I'll stick with Ativan for awhile and see if the hangover effect disappears.
- Scott
Posted by phillipa on January 30, 2011, at 19:30:41
In reply to Re: Insomnia » linkadge, posted by SLS on January 30, 2011, at 18:51:21
In all seriousness Ativan also worked for me for sleep never had a hangover from any meds used to sleep? Even chloral hydrate with benzos added per pdoc? Phillipa
Posted by Phidippus on January 30, 2011, at 21:08:11
In reply to Insomnia, posted by mantus on January 29, 2011, at 13:19:56
Just take something for the insomnia. That's what I have to do. Here's some suggestions:
Clonidine
Intuniv
Prazocin
Lyrica
Gabitril
Cyproheptadine
Seroquel
Thorazine
Lunesta
Ambien
OpiatesP
Posted by roscopeeco on January 31, 2011, at 14:56:10
In reply to Re: Insomnia, posted by phillipa on January 30, 2011, at 19:30:41
I can take 30 to 45 mg of restoril and still not sleep good. I am on Parnate though. I haven't taken parnate in two days because my script ran out. I am getting it refilled and dropping my dose from 50 to 40mg. I can't take my current sleep cycle. It is horrible. It seems like I go straight into REM sleep and stay there. My dreams are vivid and not all that pleasant. I don't know what to do next regarding sleep.
Posted by ed_uk2010 on January 31, 2011, at 15:52:23
In reply to Re: Insomnia » linkadge, posted by SLS on January 30, 2011, at 18:51:21
> > Ativan has been the best for me, followed by zopiclone or temazepam. Temazepam can be bad on next day cognition though, wherase ativan seems pretty neutral (for me at least).
>
> Oh, crap. It figures.
>
> Thanks for the heads-up. Perhaps I'll stick with Ativan for awhile and see if the hangover effect disappears.I don't think it's likely to be a problem with temazepam unless the dose is high.
Posted by floatingbridge on January 31, 2011, at 22:38:04
In reply to Re: Insomnia, posted by roscopeeco on January 31, 2011, at 14:56:10
Roscoepeeco,
That is an awful place to be. I wish I had an answer for you.
A ptsd thread has mentioned alpha blockers (not that I know what that means) for stopping nightmares--.
Guanfacine (sp?) aka tenex, and prazosin.Get some good sleep soon.
Sometimes I add zanaflex (interesting mild muscle relaxant sometimes used in conjunction w/adhd therapy). Some use flexeril--too heavy weight for me.
Maybe above are contraindicated w/maoi's.
fb
Posted by roscopeeco on February 2, 2011, at 2:38:31
In reply to Re: Insomnia » roscopeeco, posted by floatingbridge on January 31, 2011, at 22:38:04
Yeah...I don't know how an alpha blockade would help with nightmares. Alpha blockage is usually for blood vessels to potentiate vasodilation. Who knows. I am thinking about just coming off parnate so I can sleep and get on a beta blocker for anxiety. My resting heart rate is consistently in the 90s. That needs to come down.
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