Posted by alan on April 14, 2002, at 23:26:44
In reply to BZD Improved Sleep Architecture w/SSRI Treatment?, posted by fachad on April 14, 2002, at 19:57:47
> Quite a bit is made here of the fact that benzos disturb sleep architecture.
>
> Another less talked about item is that SSRIs wreck havoc on sleep architecture. This does not abate, but rather it continues for the duration of SSRI therapy.
>
> I'm wondering if the BZD disrupted sleep architecture is still better and closer to natural sleep architecture than the SSRI induced sleep disturbances.
>
> To me, it seems like there is a continuum from natural, perfect sleep to horrifically disrupted sleep, and that it goes something like this, from best to worse:
>
> 1. Natural sleep (best)
> 2. Benzo disturbed sleep (better than #3)
> 3. SSRI wrecked sleep + benzos (better than #4)
> 4. SSRI wrecked sleep (worst)
>
> Of course the only way to verify this would be to do a PSG sleep study, but it's how it seems subjectiely to me.
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Yours and my experience line up exactly. I was not aware until elizabeth's post that ssri's and other AD's disrupted or changed sleep architecture. Perhaps for some, it's the opposite - it just may depend on what change from "natural" is the least disruptive for any given individual. The sleep study would only confirm, scientifically speaking, what elizabeth described.
Individual responses to the different architechtures would be what really mattered it seems.My experience has been that anything in the newer AD class, regardless of whether the med had a "sedating" quality attributed to it (serzone, luvox, remeron) or not, the feeling I always got from all of them was that I was overstimulated and felt the wrong kind of sedation - both at the same time. Almost all of them inspired start-up agitation and sometimes downright panic unless taken with a bzd simultaneously. Sleeplessness and sexual side effects were always a problem and it was the main reason I stopped the many that I tried.
I tried different mood stabilsers in augmentation with these ssri's, etc, and in any number of combinations for 7 years - at my protest by the way. I finally concluded that after 3 pdocs, two of whom insisted that it was my stubborn disorder not the medication that was the problem (they even tried fitting my diagnosis around the medicine calling it "listening to the drug" - see Dr. Peter Kramer's "Listening to Prozac"), that the way to go was bzd's. Nothing in the stimulant or activating class of drugs would fundamentally get me past that artificially induced hyperaroused feeling. I fired two docs because of their anti-bzd bias. I essentially wasted 7 years at a very important time in my life because of that bias.
Anyway, if you want to know my opinion, AD's are indicated when depression is primary and anxiolytics when anxiety is primary. I'm a purist I guess because I sincerely believe that the many more anxiety sufferers are helped by them then the ssri types. The use of ssri's for anxiety disorders IMO - even though many are helped with their anxiety using them - are much less effective and complete - many times acheiving exactly the opposite effect from what is needed. Anxiety patients go through life thinking that that's just the best meds have to offer without having been given the freedom of choice to try bzd's on equal footing with ssri's and similiar drugs.
Maybe it just goes back to my disbelief at how the medical professionals have fallen so far for the promotion of these newer drugs in the treatment of anxiety for profit and political reasons - reasons you've expertly outlined here on this bboard before.
Alan
poster:alan
thread:103076
URL: http://www.dr-bob.org/babble/20020408/msgs/103091.html