Posted by vbAgent on December 1, 2005, at 23:00:09
In reply to Re: Best meds for sleep disorders? » starfox, posted by Paulbwell on November 30, 2005, at 16:06:25
Hi there, don't despair even though you've tried the more commonly prescribed psychotropic drugs used to treat insomnia.
1) Like you stated: There are the benzos, but as you realize, the benefits of the benzodiazepines are compromised by their abuse potential. This is something you and the doctor need to discuss. Ativan is a strong benzo worth considering.
2) Ambien: Have you tried the new extended release formulation now available? It's called AmbienCR and supposedly works for 7-8 hours.
3) Seroquel: This is one of the newer generation atypical antipsychotics. Better side-effects profile compared to other antipsychotics. This medication will do the job when nothing else will. Psychiatrists normally prescribe 25-100mg (or more if necessary) taken at bedtime. I can vouch for Seroquel's efficacy in treating hopeless insomniacs.
4) I wouldn't suggest mixing tricyclics together to treat insomnia. The level of polypharmacy that you're seeking there seems almost dangerous. Keep it simple.
5) Avoid supplements and herbal products, except maybe St. John's Wort and Kava Kava. For example, don't take high doses of supplemental magnesium, taurine or melatonin unless you have a bona fide deficiency!! Also, essential fatty acids (i.e. omega-3,6 & 9) will not alleviate (chronic) insomnia.
6) Besides the benzodiazepines, you do have the barbiturates at your disposal. The problem is finding a doctor who's willing to prescribe one.
Based on your post, I think you could be challanged again with Ambien but ask for the "CR" version - maybe the extended release feature will make a positive difference. Then there's Ativan, a potent benzo, which you could try. I would suggest Seroquel in your case based on your history.
You definitely want to talk to your doctor about anything that "stands out" in your mind which was discussed in this thread.
Best of luck resolving your problem. ;-]
poster:vbAgent
thread:582983
URL: http://www.dr-bob.org/babble/20051126/msgs/584366.html