Psycho-Babble Medication Thread 985529

Shown: posts 1 to 12 of 12. This is the beginning of the thread.

 

sleep for now....

Posted by floatingbridge on May 17, 2011, at 9:22:18

Yesterday my gp was open to a low dose amitriptyline trial (she did make a face, but that's cool; she just wants what's best for me), but sensibly asked me to wait until I had one month emsam under my belt. I am very thankful to have a doctor check my impulsivity : P

In the meantime, and it's kind of embarrassing to admit my temporary
solution because it's obvious, I take my daily 0.5 mg xanax XR (or CR) at night along with 0.5mg or 1.0mg regular xanax (amount depending how restless I feel) for sleep onset.

I had taken the XR during the day out of habit, and have continued, not because I really needed it--so far emsam has reduced my anxiety--but because I am concerned about inducing a withdrawal and muddying the emsam trial.

My gp suggested I remove 1/3 of patch at night. She gave me permission to fiddle
with the ratio. She told me a humorous/ poignant story of her smoking cessation patients who would leave their nicotine patches on all night and lie awake obsessing over smoking.

I also loved seeing her surprised but pleased expression at how well I am tolerating emsam. She had once said to me "you are just one of those people who can't tolerate medication!" I'm her
first emsam patient.

Xanax Xr (or CR) seems under-utilized by xanax users. I'm not sure why. Maybe because xanax is considered an emergency panic medication, and folks move on to longer acting agents. (But klonopin really tanked me!) The generic works for me--I did a blind comparison w/ the expensive brand name.

Long post for a simple solution. At least I hope last night's unbroken sleep is not an anomaly.

 

Re: sleep for now.... floatingbridge

Posted by rculater on May 17, 2011, at 10:21:14

In reply to sleep for now...., posted by floatingbridge on May 17, 2011, at 9:22:18

thats good news. i hope the ami works, or maybe you wont need in 1 month with the reduction of emsam.

 

Re: sleep for now.... floatingbridge

Posted by orbital on May 17, 2011, at 11:06:32

In reply to sleep for now...., posted by floatingbridge on May 17, 2011, at 9:22:18

That's great, FB :)

Sometimes I wish I were seeing my old doc, who was far more adventurous than the current one. The new one does have a penchant for using low doses of somewehat obscure APs as sleep aids, though, which is interesting.

I really wanted to like Xanax XR, but it made me feel hazy all day long, and I still had to endure the brutal regular Xanax "come down" at unexpected times. I found it to be very unpredictable, though my doc at the time raved about it.

Anyway, I hope you continue to improve :)

> Yesterday my gp was open to a low dose amitriptyline trial (she did make a face, but that's cool; she just wants what's best for me), but sensibly asked me to wait until I had one month emsam under my belt. I am very thankful to have a doctor check my impulsivity : P
>
> In the meantime, and it's kind of embarrassing to admit my temporary
> solution because it's obvious, I take my daily 0.5 mg xanax XR (or CR) at night along with 0.5mg or 1.0mg regular xanax (amount depending how restless I feel) for sleep onset.
>
> I had taken the XR during the day out of habit, and have continued, not because I really needed it--so far emsam has reduced my anxiety--but because I am concerned about inducing a withdrawal and muddying the emsam trial.
>
> My gp suggested I remove 1/3 of patch at night. She gave me permission to fiddle
> with the ratio. She told me a humorous/ poignant story of her smoking cessation patients who would leave their nicotine patches on all night and lie awake obsessing over smoking.
>
> I also loved seeing her surprised but pleased expression at how well I am tolerating emsam. She had once said to me "you are just one of those people who can't tolerate medication!" I'm her
> first emsam patient.
>
> Xanax Xr (or CR) seems under-utilized by xanax users. I'm not sure why. Maybe because xanax is considered an emergency panic medication, and folks move on to longer acting agents. (But klonopin really tanked me!) The generic works for me--I did a blind comparison w/ the expensive brand name.
>
> Long post for a simple solution. At least I hope last night's unbroken sleep is not an anomaly.
>
>

 

Re: sleep for now.... orbital

Posted by Phillipa on May 17, 2011, at 11:22:40

In reply to Re: sleep for now.... floatingbridge, posted by orbital on May 17, 2011, at 11:06:32

FB so for now it's 1/3 patch at night and the xanax did I get this right? Sounds wonderful for you so far. Love Phillipa

 

Re: sleep for now.... Phillipa

Posted by floatingbridge on May 17, 2011, at 16:29:52

In reply to Re: sleep for now.... orbital, posted by Phillipa on May 17, 2011, at 11:22:40

Phillipa, emsam might be a winner. I hope so. I wany to get something and stick with it. Insomnia I can find a way to deal with. Fibromyalgia, even the fatigue, maladaptive behavior, all the challenges I can adaptively address.

Please let this be the AD piece.


 

Re: sleep for now....

Posted by Christ_empowered on May 17, 2011, at 17:33:43

In reply to Re: sleep for now.... Phillipa, posted by floatingbridge on May 17, 2011, at 16:29:52

so, you like the xr xanax? That seems like it'd be easier to tolerate than Klonopin for a lot of people.

I hope the elavil helps you out and things starting coming together for you.

 

Re: sleep for now.... orbital

Posted by floatingbridge on May 17, 2011, at 17:51:27

In reply to Re: sleep for now.... floatingbridge, posted by orbital on May 17, 2011, at 11:06:32

Thanks Orbital, the xanax xr works now, but for about a year I needed klonopin for my more severe anxiety. Any when the going gets tough, I have 'chomped' the XR or doubled up with regular, so I think the xr has limited application.

I don't really want to trial ami, but when I survey my options, like narcotics for pain and escalating benzo's for sleep, I think it's worthwhile trying.

My gp is referring me to a university rheumy that has a reputation as using unconventional approaches to fibromyalgia with some success. S/he might be able to help with preserving sleep architecture. I think that's my priority. Ami is supposed to help do that. Hopefully my referral will go through soon, and I'll find out more. I'll post what I find out.

 

rculator + CE, thanks :-) (nm)

Posted by floatingbridge on May 17, 2011, at 17:52:48

In reply to Re: sleep for now.... floatingbridge, posted by rculater on May 17, 2011, at 10:21:14

 

Re: sleep for now.... floatingbridge

Posted by SLS on May 17, 2011, at 19:01:45

In reply to Re: sleep for now.... orbital, posted by floatingbridge on May 17, 2011, at 17:51:27

Trimipramine is the only drug used as a hypnotic that does not alter sleep architecture. It is sometimes better for sleep than amitriptyline. It is sometimes used for pain disorders. However, I don't know what its effects are on FM.

http://en.wikipedia.org/wiki/Trimipramine

"The spectrum of effects (strong antidepressant activity, sedation and anxiolysis) and side effects (strong anticholinergic and antiadrenergic symptoms) is similar to those of doxepin. It is also a more effective sedative than amitriptyline. Trimipramine is the only effective drug against insomnia known so far that does not alter the normal sleep architecture. In particular, it does not suppress REM sleep"


- Scott

 

Re: sleep for now.... SLS

Posted by floatingbridge on May 17, 2011, at 19:13:03

In reply to Re: sleep for now.... floatingbridge, posted by SLS on May 17, 2011, at 19:01:45

Scott,

I haven't come across this yet--thank you for this lead. :-) Do you have any or know of any second hand experience?

I'll do some research.

 

Re: sleep for now....

Posted by SLS on May 17, 2011, at 19:31:58

In reply to Re: sleep for now.... SLS, posted by floatingbridge on May 17, 2011, at 19:13:03

> Scott,
>
> I haven't come across this yet--thank you for this lead. :-) Do you have any or know of any second hand experience?
>
> I'll do some research.
>
>

I tried trimipramine (Surmontil) at dosages appropriate for treating depression. It did not help, but it did not hurt. Since I hadn't had difficulties with sleep at the time, I can't comment on its utility as a hypnotic.

anti-depressant
anti-anxiety
anti-insomnia


- Scott

 

thanks :-) (nm) SLS

Posted by floatingbridge on May 17, 2011, at 21:50:26

In reply to Re: sleep for now...., posted by SLS on May 17, 2011, at 19:31:58


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