Posted by chad_3 on October 5, 2002, at 14:43:55
In reply to Re: Nardil veterans...how do you sleep? » dlevine, posted by SLS on October 4, 2002, at 12:16:25
I never had sleep problem with Nardil monotherapy at high dose - but ....
I know that sometimes trazodone (I don't really recommend it) is used.
Ambien is often used.
Klonopin I believe is excellent to try because if it works for you it may work very well without any undue negative effect.However I think the best solution is to avoid drugs to make you sleep unless unavoidable. If there anyway to keep yourself very alert during the day ... also good sleep habits ... well maybe nothing of great insight here ... but sometimes daytime sedation or napping can aggrevate insomnia ...
just a thought...
Chad
http://www.socialfear.com/
> Hi.
>
>
> > > I don't think Klonopin is as effective a hypnotic as these other drugs. Are you sure you need it to treat your SP? How often is Ativan effective for SP? Do you think substituting Ativan for Klonopin and adding one of the short-acting drugs might be worth considering?
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> > My biggest problem is not falling asleep, but STAYING asleep. I rarely ever sleep more than 3 hours straight using my current sleep meds.
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> > I take the Klonopin (and Trazadone) to fall asleep only--not to treat my SP. My Pdoc says that Klonopin is the safest benzo to use for sleep(it has a long half-life). I've never tried anything other than Trazadone & Klonopin for my insomnia. Maybe I should consider something else?
>
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> I think the half-life of Klonopin (clonazepam) is far too long to be used routinely as a hypnotic to treat insomnia. It stays with you all day long. This is why I questioned as to whether it was a critical component to your SP treatment. Being in your position a few times, I have favored using either Ativan (lorazepam), which also has significant anxiolytic properties, or Restoril (temazepam). Both have medium half-lives.
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> Drug Name (generic name)
> Half-Life
>
>
> Klonopin (clonazepam)
> 30 to 40 hours
>
> Ativan (lorazepam)
> 12 to 18 hours
>
> Restoril (temazepam)
> 3.5 to 18.4 hours (mean 8.8 hours)
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> Halcion (triazolam)
> 1.5 to 5.5 hours
>
> Ambien (zolpidem)
> 1.4 to 4.5 hours
>
> Sonata (zaleplon)
> 1 hour
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>
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> > I fear taking more benzos for such a long time frame (it may be forever). Am I wrong to? What are my non-benzo alternatives other than Trazadone?
>
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> I think there is still quite a bit of debate about this. My opinion at this point is that the benzodiazepines have proven themselves safe for long-term use. I hope others offer their own opinions here. It is an important issue. You should be able to find related threads using the 'Search' function at the top of page.
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> > BTW, I also take a small dose (50mg) of Depakote to minimze any manic symptoms caused by Nardil. It works well. Maybe you should consider that for use in your bipolar treatment.
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> Thanks for the suggestion. Depakote has worked well for me during the few times I've had manic reactions to antidepressants. I might still consider it as an adjunct to antidepressants for the depression itself.
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> I'm pretty sure you'll be able to improve your sleep somehow. I think it might be worth trying Neurontin (gabapentin). It can be a great help for sleep and is often very helpful for social anxiety.
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> Good luck.
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>
> - Scott
>
poster:chad_3
thread:121735
URL: http://www.dr-bob.org/babble/20020930/msgs/122447.html