![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 17 to 41 of 41. Go back in thread:
Posted by Joanne on December 16, 1999, at 10:05:16
In reply to Re: INSOMNIA, posted by Elizabeth on December 15, 1999, at 23:27:25
> > Andy: From what I understand, Ambien is a great drug, but (please correct me if I a wrong)it's for short term use, whereas nortriptyline can be used for extended periods of time.
>
> I asked my pdoc about this when he prescribed Ambien to use for insomnia daily. He replied that many people are able to take it longer term without developing tolerance. He also said that in his experience it actually works better if you take it every day than sporadically - perhaps this is because it keeps you on a regular sleep schedule (something that's always been a problem for me).
>
> I took it - 20mg/night - for a year or so, pretty much every night, without tolerance. My main peeve about it is that it's too short-acting.
>
> BTW, nortriptyline was not sedating for me, and it had anticholinergic effects that I had trouble tolerating, even at very low doses.
When I first started taking Ambien, it worked extremely well. It was very fast-acting, and had no "hangover" feeling the next day. I've been taking it for several months; unfortunately, I must have built up a tolerance to it, because now it no longer works on me. However, if you've never tried it, I would highly recommend it for insomnia. Mary, let me know how you're doing with the Ambien. I hope it's working well for you. Joanne
Posted by Andy on December 16, 1999, at 14:04:52
In reply to Re: INSOMNIA, posted by Elizabeth on December 15, 1999, at 23:27:25
>
I've used it for a couple of years and have not developed tolerance. I try to stay under 10mg since at 10 I begin to have some side effect the next day (slight dizzyness, slightly slurred speech, slightly slowed thinking). Under 10mg no side effect for me.Often it won't get me through the night. So I "cheat"--I break a 5mg pill in half and that is usually enough for me to get to sleep. If (usually when) I wake up two or three hours later I take the other half. If I wake up again I might take 2mg (break a 5mg pill unevenly and take the smaller piece).
Works for me. I started it for straight sleeping difficulties. Need it regularly now because I started prozac about six months ago.
> Andy: From what I understand, Ambien is a great drug, but (please correct me if I a wrong)it's for short term use, whereas nortriptyline can be used for extended periods of time.
>
> I asked my pdoc about this when he prescribed Ambien to use for insomnia daily. He replied that many people are able to take it longer term without developing tolerance. He also said that in his experience it actually works better if you take it every day than sporadically - perhaps this is because it keeps you on a regular sleep schedule (something that's always been a problem for me).
>
> I took it - 20mg/night - for a year or so, pretty much every night, without tolerance. My main peeve about it is that it's too short-acting.
>
> BTW, nortriptyline was not sedating for me, and it had anticholinergic effects that I had trouble tolerating, even at very low doses.
Posted by Adam on December 17, 1999, at 15:11:53
In reply to Re: INSOMNIA, posted by Andy on December 16, 1999, at 14:04:52
We've all heard about it, and it has been kicked around in the media quite a lot, with unrealistic claims both about its benefits and its risks...
Has anybody here tried melatonin? My take on it is it probably won't make you sleep, but it might help "renormalize" your sleep patterns and improve the quality of the sleep you do get if the timing of administration and the dosing is correct.
Has anyone tried it? Did it help?
Also, has anyone tried this with an MAOI? Are there any risks or issues with dosing beyond whatever should be the normal constraints on its use?
Thanks!
Thanks!
Posted by dove on December 19, 1999, at 9:50:39
In reply to Re: INSOMNIA, posted by Adam on December 17, 1999, at 15:11:53
I think a number of us have discussed the melatonin thing. While taking Prozac I had to up the amount I took every night, but since quiting the Prozac I am back to Melatonin 1mg. sublingual. I still take Amitriptyline before bed, but that alone is not, usually, enough to get me to sleep. My problem is not staying asleep but falling asleep, so this may be why sublingual melatonin works so well for me.
I am still in a bit of a funk, it worries me, one of the biggest lows I have had since I was a teenager, [and the longest time I have gone without being pregnant since getting married at 19] anyway, after reading Dr. Bob's pharmo-tips and finding the depressive effects of melatonin, I tried to go without, challenging the depression so-to-speak. I found myself even worse in the morning, so I still don't know if the melatonin is adding to the low or what?
My advice is, try melatonin if you wish, but be aware that it may add to any depressive characteristics, or it may help, I don't know. And try to get by with the smallest dosage that helps, the sublingual enables me to take way less that the normal swallow kind.
dove
Posted by Elizabeth on December 19, 1999, at 10:16:22
In reply to Re: INSOMNIA, posted by Adam on December 17, 1999, at 15:11:53
> Has anyone tried it? Did it help?
>
> Also, has anyone tried this with an MAOI? Are there any risks or issues with dosing beyond whatever should be the normal constraints on its use?I had mild symptoms of central serotonin syndrome (dilated pupils, inappropriate sweating, and - get this - insomnia) when I tried taking a low dose (1/2 mg I think) with Parnate.
I also tried it when I wasn't taking an MAOI. Despite the fact that I supposedly have a circadian rhythm disorder, it didn't do a thing, even at high doses.
Posted by Adam on December 19, 1999, at 12:34:28
In reply to Re: INSOMNIA, posted by Elizabeth on December 19, 1999, at 10:16:22
That's what I was afraid of, melatonin being a derivative of 5-HT. I could find nothing in the
literature about such a combination, though, or melatonin being associated with serotonin syndrome.
Despite the inkling there could be risks, and your apparent confirmation of this, I can't think of a
concrete reason, mechanistically, why this should happen. Do you have any theories. Does melatonin
have sympathomimetic properties? Is it recycled into 5-HT? Is it a 5-HT receptor agonist? Nothing
I have read would indicate any of these possibilites, but that certainly could be because I didn't
know where to look.Thanks in advance for your thoughts...
> > Has anyone tried it? Did it help?
> >
> > Also, has anyone tried this with an MAOI? Are there any risks or issues with dosing beyond whatever should be the normal constraints on its use?
>
> I had mild symptoms of central serotonin syndrome (dilated pupils, inappropriate sweating, and - get this - insomnia) when I tried taking a low dose (1/2 mg I think) with Parnate.
>
> I also tried it when I wasn't taking an MAOI. Despite the fact that I supposedly have a circadian rhythm disorder, it didn't do a thing, even at high doses.
Posted by Adam on December 19, 1999, at 13:18:14
In reply to Re: INSOMNIA [Melatonin], posted by dove on December 19, 1999, at 9:50:39
Thank you, dove.
I may just give melatonin a try. I'm still scratching my head over Elizabeth's adverse
troubles with it, and hopefully will get some insight into this. I did read about
it's possible depressive effects, and I think we both have to weigh such cautions against
the fact that even antidepressants can aggravate depression, depending on the individual
response to a drug.The trouble for me at this point is I am in a clinical trial, and this severely limits
what other drugs I can take concomitantly with selegiline. I can't even take Benadryl.
I might run into the same problem with melatonin under any circumstances, and so for the
next few months it might not be an option anyway.At this point exercise is the only solution I can think of that isn't forbidden.
What's weird, and has been my experience all along with selegiline, is that I got maybe
three hours of sleep last night (I should say this morning), and I feel fine. I feel
better and more alert than I used to feel getting my usual six or seven hours of sleep.
The problems have been that I am slowly moving into a nocturnal lifestyle, and I am
finding it very hard to reverse this. I am completely out-of-whack with the day-to-day
rhythms of my friends and coworkers. The vampire jokes have inevitably started, and
I sometimes wonder if Vlad the Impaler or whoever the inspiration for Dracula was didn't
have a sleep disorder. I'm hoping that melatonin might help me at least exert some
control over the pattern. I see my doctor in a few days. I'll let folks know what his
take on melatonin, combo. with MAOI, etc. is.Lastly, is it possible for a person to just go forever on 3-4 hours max. of sleep/day
and be healthy? Is one liable at this point to resort to hypnotics for self-preservation?
> I think a number of us have discussed the melatonin thing. While taking Prozac I had to up the amount I took every night, but since quiting the Prozac I am back to Melatonin 1mg. sublingual. I still take Amitriptyline before bed, but that alone is not, usually, enough to get me to sleep. My problem is not staying asleep but falling asleep, so this may be why sublingual melatonin works so well for me.
>
> I am still in a bit of a funk, it worries me, one of the biggest lows I have had since I was a teenager, [and the longest time I have gone without being pregnant since getting married at 19] anyway, after reading Dr. Bob's pharmo-tips and finding the depressive effects of melatonin, I tried to go without, challenging the depression so-to-speak. I found myself even worse in the morning, so I still don't know if the melatonin is adding to the low or what?
>
> My advice is, try melatonin if you wish, but be aware that it may add to any depressive characteristics, or it may help, I don't know. And try to get by with the smallest dosage that helps, the sublingual enables me to take way less that the normal swallow kind.
>
> dove
Posted by Noa on December 19, 1999, at 14:21:12
In reply to Re: INSOMNIA [Melatonin], dove., posted by Adam on December 19, 1999, at 13:18:14
Adam,
I vaguely remember hearing that melatonin can cause depression.
The guy at Yale that I told you about is, I think, THE expert on melatonin research. You might want to ask him.
Posted by Elizabeth on December 19, 1999, at 14:58:47
In reply to Re: INSOMNIA, posted by Adam on December 19, 1999, at 12:34:28
> Despite the inkling there could be risks, and your apparent confirmation of this, I can't think of a
> concrete reason, mechanistically, why this should happen. Do you have any theories. Does melatonin
> have sympathomimetic properties? Is it recycled into 5-HT? Is it a 5-HT receptor agonist?I dunno if this applies, but what about le Chatelier's principle?
Posted by Adam on December 19, 1999, at 16:05:27
In reply to melatonin, posted by Elizabeth on December 19, 1999, at 14:58:47
OK, stretching memory banks to the max here...
I don't think Le Chantelier's principle is applicable here because of the nature, if
any, if an "equilibrium" between 5-HT and melatonin production. If you consider the
rate limiting step (N-acetylation of 5-HT by seratonin acetyltransferase), the enzyme
can only drive the reaction in one direction. I can become saturated, but it won't
start making 5-HT our of N-acetyl-5-HT, so a chemical equilibrium does not exit per se
(wrong kind of catalyst). However, your intuition could lead one to considering
more complex feedback loops. Seratonin syndrome would thus depend on at least a
couple of things: There is a periodicity of serotonin production (probably timed with
the synthesis of melatonin), that administration of exogenous melotonin leads to
negative feedback on the melatonin synthesis pathway, and the rusultant surplus of
serotonin is large enough to be harmful.Not a bad theory, I guess.
> > Despite the inkling there could be risks, and your apparent confirmation of this, I can't think of a
> > concrete reason, mechanistically, why this should happen. Do you have any theories. Does melatonin
> > have sympathomimetic properties? Is it recycled into 5-HT? Is it a 5-HT receptor agonist?
>
> I dunno if this applies, but what about le Chatelier's principle?
Posted by Adam on December 19, 1999, at 22:49:06
In reply to Re: melatonin, posted by Adam on December 19, 1999, at 16:11:29
I don't know what the hell just happened above. Please forget about
all but the last message. Dr. Bob, could you please erase the others?
It looks kind of silly :).> OK, stretching memory banks to the max here...
>
> I don't think Le Chantelier's principle is applicable here because of the nature, if
> any, if an "equilibrium" between 5-HT and melatonin production. If you consider the
> rate limiting step (N-acetylation of 5-HT by seratonin acetyltransferase), the enzyme
> is essential, and the reaction only goes in one direction. The enzyme can become saturated,
> but it won't start making 5-HT out of N-acetyl-5-HT, so a chemical "equilibrium" does not
> exit per se. However, your intuition could lead one to considering an equilibrium based on
> more complex feedback loops. Seratonin syndrome would thus depend on at least a
> couple of things: There is a periodicity of serotonin production (probably timed with
> the synthesis of melatonin), that administration of exogenous melotonin leads to
> negative feedback on the melatonin synthesis pathway, and the rusultant surplus of
> serotonin is large enough to be harmful.
>
> Not a bad theory, I guess.
>
>
>
>
> > > Despite the inkling there could be risks, and your apparent confirmation of this, I can't think of a
> > > concrete reason, mechanistically, why this should happen. Do you have any theories. Does melatonin
> > > have sympathomimetic properties? Is it recycled into 5-HT? Is it a 5-HT receptor agonist?
> >
> > I dunno if this applies, but what about le Chatelier's principle?
Posted by dove on December 20, 1999, at 8:54:03
In reply to Re: melatonin, ummm, posted by Adam on December 19, 1999, at 22:49:06
First laugh of the week, or should I say in a week, Yeah!! Adam, you have a way of being so entertaining, I don't know how you do it, it just sneaks up on me and I find myself smiling. Thank you for your humanity. I hate to add to the run-on threads, but I really wanted to say "It's okay Adam, your long list of posts are more than forgivable, they're welcome!"
smiling for once,
dove
Posted by Adam on December 20, 1999, at 13:00:18
In reply to Re: melatonin, ummm, posted by dove on December 20, 1999, at 8:54:03
I don't understand it. I wrote my little spiel about Le Chatelier's Principle,
hit send and...waited. And waited. So I'm sitting there, and of course all my
textbooks are at work so I'm paranoid I've said something stupid so I make some
cahnges to clarify and/or correct, hit stop, hit send again and I waited...and
waited...Finally I had to leave to go to another holiday gathering and just gave
up. I didn't think I posted anything at all. Then I logged on again VERY early
this morning and GAH, there's eight bazillion Adams in a row, both my first
crappy attempt and then my next somewhat less crappy attempt.Web wierdness.
> First laugh of the week, or should I say in a week, Yeah!! Adam, you have a way of being so entertaining, I don't know how you do it, it just sneaks up on me and I find myself smiling. Thank you for your humanity. I hate to add to the run-on threads, but I really wanted to say "It's okay Adam, your long list of posts are more than forgivable, they're welcome!"
>
> smiling for once,
> dove
Posted by Andy on December 22, 1999, at 11:10:45
In reply to Re: INSOMNIA, posted by JohnL on December 13, 1999, at 12:36:22
>John: What dose of Nortrip do you take for sleep? Any side effects ? Weight gain?
Hi Joanne,
>
> I think I've tried most everything out there for insomnia. Such as tricyclics, benzos, Remeron, Serzone, Trazodone. Of them all I personally have to say I like the tricyclics best. Even though they all put me to sleep and pretty much kept me asleep, the tricyclics gave me that feeling in the morning like I had really slept well. The others seem to give a strange kind of sleep for me.
>
> Tricyclics for me are smooth. And it seems like a high quality kind of sleep, not a drugged kind of false sleep that I get from everything else. I take one of the less sedating ones, called Nortriptyline, and it's just right. There are more sedating ones. And you won't need much more than a low dose which shouldn't affect you during the day. Since they come on a little slower and more subtle than other drugs, I dose anywhere from 3:00 to 5:00 in the afternoon. That way it's kicking in strongest just about bedtime. Any later messes with the next morning. I've seen the tricyclics, especially Nortriptyline, combined with Wellbutrin for refractory depression as well. Based on my experience, I'm putting a vote in here for a tricyclic for insomnia. Imipramine, Anafranil, and Amitriptyline are the more sedating ones, while Nortriptyline is a bit more mild. So before you see your doctor, sleep on it. :) JohnL
Posted by Phillip Marx on December 23, 1999, at 2:16:14
In reply to Re: INSOMNIA, posted by Adam on December 19, 1999, at 12:34:28
My house is wall-to-wall books, so I can't find it right now, but there is a very affordable book/thick pamphlet on 5-HTP available at better health food stores that shows all the precursors, enzymes and other organic chemistry reactions.
Phillip Marx
[email protected]> That's what I was afraid of, melatonin being a derivative of 5-HT. I could find nothing in the
> literature about such a combination, though, or melatonin being associated with serotonin syndrome.
> Despite the inkling there could be risks, and your apparent confirmation of this, I can't think of a
> concrete reason, mechanistically, why this should happen. Do you have any theories. Does melatonin
> have sympathomimetic properties? Is it recycled into 5-HT? Is it a 5-HT receptor agonist? Nothing
> I have read would indicate any of these possibilites, but that certainly could be because I didn't
> know where to look.
>
> Thanks in advance for your thoughts...
>
>
> > > Has anyone tried it? Did it help?
> > >
> > > Also, has anyone tried this with an MAOI? Are there any risks or issues with dosing beyond whatever should be the normal constraints on its use?
> >
> > I had mild symptoms of central serotonin syndrome (dilated pupils, inappropriate sweating, and - get this - insomnia) when I tried taking a low dose (1/2 mg I think) with Parnate.
> >
> > I also tried it when I wasn't taking an MAOI. Despite the fact that I supposedly have a circadian rhythm disorder, it didn't do a thing, even at high doses.
Posted by Phillip Marx on December 23, 1999, at 2:22:01
In reply to Re: INSOMNIA, posted by Andy on December 22, 1999, at 11:10:45
Are any of you diagnosed as severe (bizarre) insomniacs?
I haven't been to sleep for over five years without medication. I was up for over 14 days straight the first time, I think the record is 15, people start dying at ten, I was up 10 days straight the second time, but that time I really wanted to never have been born. As depressing as that ought to be I’ve had no unusual mood swings, though my worry thresholds have changed from being out of work these five years from crippling sedative buildups which did reverse a lot of stress damage, so I regret it more than I complain about it. I was lucky enough to be a zero-debt half millionaire when it happened, though that is half gone now. They tried lithium for about three years and gave up since it only gave me lithium withdrawals and zero improvement, even after an instance of severe dehydration from running a half marathon which exacerbated toxicity way past the toxic threshold maintenance they attempted to guarantee with time-released lithium and frequent blood tests. It should have helped. I found that exercising all the muscles just enough to trigger glycogen (et. al.) retention forced the blood brain barrier permeability to open up to sedatives (et.al.) enough better to benefit sleep even though exercise normally delays sleep. Muscles actually develop really well when subjected to immediate sleep for regeneration. The lithium also lowered my thyroid numbers to 20% my norms. UCI’s world famous Sleep Disorders Center failed to find relief without using long half-life medicines that kept me from ever waking up thoroughly since I had become immune to all the short half-life varieties, probably should have rotated and used higher doses early on. I used to be able to go to sleep in seconds and could even sleep a half-hour on the floor at work and then work another 24 hours straight since my sleep was apparently very efficient. SDI Research and Development had become suicidally competitive after Clinton was elected. I was also managing a proposal for Strategic Defense Initiative technology reinvestment in the commercial sector that would have shrunk the electronics for a 128-256 electrode geodesic array EEG sensor network from a cabinet the size of a couple of luggage trunks into a single NASA-grade, Rad-Hard IC chip the size of a thumbnail for http:// www.egi.com/Research.shtml (my former company is now working on a flexible wearable sensor with memory for sleep disorder diagnosis http://community-1.webtv.net/SYZYGIAN2/IRSNShareholder/page3.html (bottom of page) for NIH (NINDS)). Those work hours “grew” into working up to twice a month over 80 hours straight (3-1/2 days) without sleep with the last time being the time that broke something. I suspect EMF. I was working 4 computers simultaneously around me in a circle constantly, all within a couple of feet, without breaks. The government’s EMFRAPID program http://www.google.com/search?q=EMFRAPID&num=10&sa=Google+Search shows that 90% of the EMF research is on the pineal gland, the sleep center and it’s related organic chemistry, which is at or near the foci for the skull’s internal paraboloids. They won’t admit it (plausible deniability for litigation liability defense, especially the Navy), but they know or they would have funded the research on something else somewhere else. I’ve heard there is a lot of research going on regarding sound and light frequencies and juvenile computer addictions. I suspect the work was self-anaesthetizing addictively in a non-sedative way. Parabolas focus both sound and light. My doctor now, www.DrJensen.com has me on Halcion (triazolam) and Serzone combined, both of which have zero effect on me taken alone, it was a lucky find, nothing logical worked. According to the PDR, Serzone makes the Halcion 1.7 times stronger and last 2.8 times longer synergistically with a falloff instead of a taper-off from mere renal clearance. The only side effect is a persistent worry that I’ll get immune (tolerant) to this as well. It saved my life and gave me a life back for about two years now. I am now taking classes to transfer into something that has income for semi-retirement and getting the top grades in the classes: so it is working well. My home computer randomized I.Q. tester scores me between 135 and 150 consistently when fully awaken, much less when wearing off, well 150 only once, but with a large range that shows lingering sedation asymptotes are really low really quickly, though a 15 point plus (10%) daily range is still sometimes difficult to count on, though much better than the old 50-75% walking zombie stages.
If it is EMF, then there should be lots of victims like myself, though maybe most of them are in asylums on haldol or haloperidol because of the consequences of such severe sleep deficits on those with less endurance training. Because the loss of sleep function indicates mania, bipolar disorder is the first assumption. I’ve never switched back, it’s been almost 6 years, yet often feel it is eminent. Because traditional bipolar medications only produce side effects and not corrective effects on those who aren’t bipolar, with many of the side effects similar to the bipolar disorder they are attempting to treat (masking), I suspect most diagnoses de-specialize into atypical bipolar disorder eventually if the sleep deficits can be kept short of psychosis. Thus I would expect those other survivors most functional to be diagnosed with atypical bipolar disorder. Statistical diagnosis software will have to be redesigned to not filter out non-gaussian data to locate the rest of us. I’ve been forced to get relatively literate on all this and will be willing to contribute to any mutual assistance discussions.
There should be lots of people like me. Does this ring any bells?
Atypical Bipolar Disorder Insomnia (NOS)??
Phillip Marx
[email protected]> >John: What dose of Nortrip do you take for sleep? Any side effects ? Weight gain?
>
> Hi Joanne,
> >
> > I think I've tried most everything out there for insomnia. Such as tricyclics, benzos, Remeron, Serzone, Trazodone. Of them all I personally have to say I like the tricyclics best. Even though they all put me to sleep and pretty much kept me asleep, the tricyclics gave me that feeling in the morning like I had really slept well. The others seem to give a strange kind of sleep for me.
> >
> > Tricyclics for me are smooth. And it seems like a high quality kind of sleep, not a drugged kind of false sleep that I get from everything else. I take one of the less sedating ones, called Nortriptyline, and it's just right. There are more sedating ones. And you won't need much more than a low dose which shouldn't affect you during the day. Since they come on a little slower and more subtle than other drugs, I dose anywhere from 3:00 to 5:00 in the afternoon. That way it's kicking in strongest just about bedtime. Any later messes with the next morning. I've seen the tricyclics, especially Nortriptyline, combined with Wellbutrin for refractory depression as well. Based on my experience, I'm putting a vote in here for a tricyclic for insomnia. Imipramine, Anafranil, and Amitriptyline are the more sedating ones, while Nortriptyline is a bit more mild. So before you see your doctor, sleep on it. :) JohnL
Posted by Phillip Marx on December 23, 1999, at 2:52:17
In reply to Re: melatonin, ummm, posted by Adam on December 19, 1999, at 22:49:06
http://www.vh.org/Providers/Lectures/EmergencyMed/Psychiatry/MedEmergSerotonin.html
I'm seeing a lot of medications listed by posters that affect serotonin. Not just SSRIs (Selective Serotonin Reuptake Inhibitors) and such. The indicated site above will give you diagnostic indications as well as medications to PRE-lookup in your PDR (Physicians' Desk Reference) so that you can be pre-warned about medicines and inter-reactions before you are in a emergency befuddled state. If you think you are going to be susceptible, make a copy from that site and carry it with you so that whatever doctor you might be babbling to has half a chance of knowing what you are babbling about and give your theory a fair respect and hearing before deciding if it is or if it is something else.
Phillip Marx
[email protected]> I don't know what the hell just happened above. Please forget about
> all but the last message. Dr. Bob, could you please erase the others?
> It looks kind of silly :).
>
> > OK, stretching memory banks to the max here...
> >
> > I don't think Le Chantelier's principle is applicable here because of the nature, if
> > any, if an "equilibrium" between 5-HT and melatonin production. If you consider the
> > rate limiting step (N-acetylation of 5-HT by seratonin acetyltransferase), the enzyme
> > is essential, and the reaction only goes in one direction. The enzyme can become saturated,
> > but it won't start making 5-HT out of N-acetyl-5-HT, so a chemical "equilibrium" does not
> > exit per se. However, your intuition could lead one to considering an equilibrium based on
> > more complex feedback loops. Seratonin syndrome would thus depend on at least a
> > couple of things: There is a periodicity of serotonin production (probably timed with
> > the synthesis of melatonin), that administration of exogenous melotonin leads to
> > negative feedback on the melatonin synthesis pathway, and the rusultant surplus of
> > serotonin is large enough to be harmful.
> >
> > Not a bad theory, I guess.
> >
> >
> >
> >
> > > > Despite the inkling there could be risks, and your apparent confirmation of this, I can't think of a
> > > > concrete reason, mechanistically, why this should happen. Do you have any theories. Does melatonin
> > > > have sympathomimetic properties? Is it recycled into 5-HT? Is it a 5-HT receptor agonist?
> > >
> > > I dunno if this applies, but what about le Chatelier's principle?
Posted by Elizabeth on December 23, 1999, at 10:54:38
In reply to Re: INSOMNIA, posted by Phillip Marx on December 23, 1999, at 2:22:01
> Are any of you diagnosed as severe (bizarre) insomniacs?
What would "bizarre" insomnia constitute? I have primary insomnia, circadian rhythma disorder - irregular sleep-wake pattern type, and REM sleep behavior disorder. (The latter is under control.)
> I haven't been to sleep for over five years without medication.
At all? Even after being sleep-deprived for a long time?
> They tried lithium for about three years and gave up since it only gave me lithium withdrawals and zero improvement, even after an instance of severe dehydration from running a half marathon which exacerbated toxicity way past the toxic threshold maintenance they attempted to guarantee with time-released lithium and frequent blood tests.
What did the lithium withdrawals consist of? Lithium isn't suppose to cause withdrawal symptoms so I'm curious.
> I found that exercising all the muscles just enough to trigger glycogen (et. al.) retention forced the blood brain barrier permeability to open up to sedatives (et.al.) enough better to benefit sleep even though exercise normally delays sleep. Muscles actually develop really well when subjected to immediate sleep for regeneration. The lithium also lowered my thyroid numbers to 20% my norms. UCI’s world famous Sleep Disorders Center failed to find relief without using long half-life medicines that kept me from ever waking up thoroughly since I had become immune to all the short half-life varieties, probably should have rotated and used higher doses early on.
Exactly which medicines have you tried besides lithium, Halcion, and Serzone?
> There should be lots of people like me. Does this ring any bells?
> Atypical Bipolar Disorder Insomnia (NOS)??I've been diagnosed with bipolar NOS (it turned out to be a mixed episode from serotonin syndrome due to Effexor). Do you know what it refers to in your case? You do come across as quite manic. Which antimanic drugs have you tried?
Posted by Phillip Marx on December 23, 1999, at 11:03:16
In reply to Re: INSOMNIA, posted by Elizabeth on December 23, 1999, at 10:54:38
Working on reply: pm
> > Are any of you diagnosed as severe (bizarre) insomniacs?
>
> What would "bizarre" insomnia constitute? I have primary insomnia, circadian rhythma disorder - irregular sleep-wake pattern type, and REM sleep behavior disorder. (The latter is under control.)
>
> > I haven't been to sleep for over five years without medication.
>
> At all? Even after being sleep-deprived for a long time?
>
> > They tried lithium for about three years and gave up since it only gave me lithium withdrawals and zero improvement, even after an instance of severe dehydration from running a half marathon which exacerbated toxicity way past the toxic threshold maintenance they attempted to guarantee with time-released lithium and frequent blood tests.
>
> What did the lithium withdrawals consist of? Lithium isn't suppose to cause withdrawal symptoms so I'm curious.
>
> > I found that exercising all the muscles just enough to trigger glycogen (et. al.) retention forced the blood brain barrier permeability to open up to sedatives (et.al.) enough better to benefit sleep even though exercise normally delays sleep. Muscles actually develop really well when subjected to immediate sleep for regeneration. The lithium also lowered my thyroid numbers to 20% my norms. UCI’s world famous Sleep Disorders Center failed to find relief without using long half-life medicines that kept me from ever waking up thoroughly since I had become immune to all the short half-life varieties, probably should have rotated and used higher doses early on.
>
> Exactly which medicines have you tried besides lithium, Halcion, and Serzone?
>
> > There should be lots of people like me. Does this ring any bells?
> > Atypical Bipolar Disorder Insomnia (NOS)??
>
> I've been diagnosed with bipolar NOS (it turned out to be a mixed episode from serotonin syndrome due to Effexor). Do you know what it refers to in your case? You do come across as quite manic. Which antimanic drugs have you tried?
Posted by Phillip Marx on December 23, 1999, at 15:29:53
In reply to Re: INSOMNIA, posted by Phillip Marx on December 23, 1999, at 11:03:16
> > Are any of you diagnosed as severe (bizarre) insomniacs?
>
> What would "bizarre" insomnia constitute? I have primary insomnia, circadian rhythma disorder - irregular sleep-wake pattern type, and REM sleep behavior disorder. (The latter is under control.)
>
Insomnia (NOS) [not otherwise specified] per DSM-IV. Many sleep disorders are really bio-mechanical sleep disruptions from snoring and the like, not my problem. On video tape sedated (the only way to get me to sleep) I don’t budge for the whole time except to wave to the camera that I’m still not asleep. I guess I should try that again on the latest medications, I can sure wake up with sore muscles as if too long in uncomfortable positions. I have not had detectable circadian sensations for most of this time, though I have since a little over a year ago felt the afternoon yawns that won’t turn into sleep even if I lay down in a warm room with photo-black shades drawn, only rarely though, I’ll concede occasionally, so hope flickers. Bright light therapy with actual sun-tan lamps do nothing except irritate me that I had placed the timer switches so far away to discourage tampering since it turns out that none of the medications clear renally no matter how much light fries my skin. The paralysis stage of sedations wearing off had been mis-treated as negligible in my not-so-clever preliminary calculations, I couldn’t get to the timers until it was too late. I should have set a duration, not just a start time with over-evangelized anecdotal evidence. Sunburn irritates, not the medicine, not a psychologically significant mood swing, not aberrant mood, I SHOULD have known better, automatic regret conversion to repentance completed. I don’t know what sunburn does to the Vitamin D skin synthesis circadian triggers, I suspect the body would rather avoid more and encourage regeneration. Medications’ manufacturers recommend short-term interim use only (30-60 days max. typical, as does the huge sleep disorders book at the Hoag Hospital Medical Library), assuming normal function will return due to natural healing processes. My medicine rotations were only rotated after tolerance (immunity=loss of sufficient function) built up. Having been a multi-sport athlete (I joke to myself that I has been a has-been), I have quick recoveries (and addictions to the efficient use of quick recoveries, ACA, workaholic, overachiever, be over-prepared against all possible outcomes, preventing all possible negative outcomes, etc. factorial!) and so didn’t have to give up a medicine until the sleep=sedation dropped below 2-3 hours per day. No real instances of remission have occurred. There have been a couple of instances where I got an unplanned hour of sedation, but my retro-sight concludes that these were instances of delayed digestion from stresses that should have given me ulcers not of the heliobacter kind that occurred as I tried to maintain an unreasonable achievement level in spite of mental functions diminished by medications and sleep deprivations. The medications slowed my metabolism and the increased stress increased my digestion due to acidity increase so far that I gained almost 50 pounds. When they finally got me to sleep, I lost 80 pounds in just three months, too much of it muscle though from wasting as I just quit fighting to stay at work, stayed in bed, as I just gave in to the medicine and quit work. AeroSpace schedules are inflexible, no program schedule management software grants gracious extensions for medicinally degraded performance, efficient budgets don’t allow duplication of personnel, before this happened I lost three people working for me and tried to maintain the same level of output as when I was fully staffed. In order to maintain output at half-performance, I had elected to double performance time to maintain productive parity, which might have contributed to the failure of every early doctor’s prognosis that I would recover in mere weeks. My primary care physician claimed I didn’t really try to get better until after I gave up my most favorite job ever.> Exactly which medicines have you tried besides lithium, Halcion, and Serzone?
“Exactly” would require time-consuming regeneration. However, these are just some of the empties that made it into an old shopping bag for someday making a dull-thud wind-chime mobile. They aren’t in order and I know there are a lot missing from that bag since it never really was a high priority, just a self-humoring attempt to have SOMETHING good come out of all this.
5-HTP, Halcion – Triazolam, Neurontin – gabapentin, Melatonin (GI & sublingual), Valerian root and all the possible health-food relevant herbals, Pineal plus (pineal extracts), Tegretal – Carbamazepine, Anafranil – clomipramine HCL, Lamictal, Eskalith CD 450mg 5x p.o.d. Lithium, Lithobid 300mg 3x p.o.d. Lithium, Ativan – lorazepam, Loxitane – loxapine, Imipramine HCL, Ambien, Serzone, Depakote, Amoxil, Amoxicillin trihydrate- ooops, sleeps deficits run down immune systems too, Klonopin, Chloral Hydrate, Doral, Motrin – carpal tunnel, Desyrel, Restoril – temazapam, Trazadone hydrochloride, Sulindac – clinoril, Luvox – fluvoxamine maleate, Clonidine, Prozac, Serax – Oxapam, Surmontil, Celexa – citalopram HBr, Alprazolam.
> I haven't been to sleep for over five years without medication.
>
> At all? Even after being sleep-deprived for a long time?
The first instance I saw the doctor about 5-6 days without any sleep. I had been at work for the 80 hours straight that I had gotten too accustomed to and went home successful and couldn’t get to sleep for 2-3 more days even though there was zero remaining cause for stress. Eventually it occurred to me that doctors can get people to sleep. He gave me I think chloral hydrate, nothing happened at maximum doses. I went back two days later and got imipramine hydrochloride, nothing happened. I went back two days later and I can’t remember what he prescribed me, but it didn’t work either. Two more days and I drove in without feeling the slightest bit sedated and gave him all of the stuff back and ordered him to quit giving me placebos. He went whiter than the dentist did who had to send me down the hall to an oral surgeon to finish extracting my wisdom teeth. I think the conference just ended up recommending I just try them longer since Nature would take it’s natural course eventually (at the time I didn’t know that death was the natural next course and neither did he since he later confessed to me that he had never had any sleep disorder training but was scheduled for some), though, in answer to my question about whether these medications had interactions, he said no, presuming I meant taken on different days. He was pretty unhappy when he found out later that I had taken them all at once later, at full strength. All the local hospitals had said that they wouldn’t put me to sleep for a day, just to help me last, and that it wasn’t just an uncovered insurance expense issue. I got 18 hours sleep from it though, and a thorough tongue lashing later from him. During the next year, since I refused for that long to go see a psychiatrist who could legally prescribe me stronger stuff that had to be monitored by MDs so trained, I exhausted my endurance freak bank getting immune to all the short half-life medications he could prescribe. With that history the psychiatrists SLAM-dunked me on lithium.
>
> > They tried lithium for about three years and gave up since it only gave me lithium withdrawals and zero improvement, even after an instance of severe dehydration from running a half marathon which exacerbated toxicity way past the toxic threshold maintenance they attempted to guarantee with time-released lithium and frequent blood tests. I was better enough to exercise to extremes, but couldn’t synchronize sedation recovery periods with too short 24 hour realities of work-life since the medications build up to virtual mental paralysis.
>
> What did the lithium withdrawals consist of? Lithium isn't suppose to cause withdrawal symptoms so I'm curious. The lithium fooled me for a while into saying that I felt better, because I did after addiction to it started. This fooled the doctor too, my fault. When it would wear off I would start to feel terrible unless I took more unless it had worn completely off, which felt much better, subjectively, but took awhile to experience and consolidate experiences, objectively. The time-release maintenance of barely sub-toxic-level serum levels (maximum legal? therapeutic? dose) delayed this conclusion. If I felt good enough to forget to take it, and sedation prevented me from getting back to it, then I would feel better than if I had taken it, much better, which I knew subconsciously long before I consciously knew it and tested such hypothesis rigorously. I stopped cold-turkey several times AMA. Now I know why addicts persist in chemical addictions, it’s not always the high they want, it’s the withdrawal drop they want to avoid at all costs. The attempt to reduce an atypical mania robbed me of my thyroid energies which made me feel poisoned, I only had flicker energy. I eat powdered milk for a treat, so I am sure that with all the exercising I did, much lithium has been deposited along with the calcium due to the peizo-effect of that exercise on the electro-chemical attractions in the synovial fluids. I may never be rid of it short of unlikely osteoporosis. Lithium, sodium and potassium are all in group 1A on the periodic table of chemical elements. Those atoms and naturally occurring molecules have related molecular dynamics, they are grouped in the same column for that reason. I suspect that there is a distortion of the sodium-potassium cellular membrane action potential pump permeability curve to serum levels of lithium exceeding natural (I should maybe research what the known litium toxic mechanisms are). Any distortions of that curve related to either mitochondrial nutrition or waste disposal efficiencies would affect overall energy levels, times all the cells and their susceptibilities, specific or general, so affected and may be why it is useful as a “mania” control. I don’t think I am chemically driven, but am perceived needs (emergencies=adrenaline) driven, though for those perceived needs I mentally drove my chemistry (chicken/egg? or egg/chicken?). I am an ACA tee-totaller and don’t use any form of alcohol as Nature’s natural mania control mechanism. The brain is a content based processor and memory system. The microscopic parts you are using when drinking is the part you kill, which, in low doses, levels areas with disproportionately high metabolic rates, since they then request more blood flow which “sterilizes” addressed neurons by the increased alcohol thresholds displacing glucose and all, thus St. Paul’s exhortation “but use a LITTLE wine for thy stomach’s sake and thine often infirmities.” from (overactive stress?) nervousness, 1Tim5:23 KJV [“but wine a little use on account of thy stomach and frequent thy infirmities” more literally from the Greek, St. Paul had Dr. St. Luke of high repute for an advisor]. Excess alcohol use destroys more by causing function decay instead of function leveling. Thus, for example, people who use alcohol to get sex, they otherwise wouldn’t especially, end up beating their mates since dead brain sex appreciation circuits don’t work anymore which must be really frustrating to the circuits that are still working. People who fight drunk end up very passive. People challenged by police or relatives when drunk end up with their conscience and guilt circuits destroyed beyond therapeutic remedy if the alcohol is still strong enough when those mental circuits are vigorously over-activated. Since Lithium is known to affect and even damage thyroids in about 30% of patients, I correlate my thyroid TSH drops to it. I have a huge backlog of un-abandoned priorities (saved because they said for so long that normalcy was imminent) that I jump to them whenever my thyroid energy levels let me. This responsibilities guilt-recovery actually looks chemically manic, but I feel it is more activity rebound even after mentally subtracting denial tendencies. My temperature used to run almost exactly one degree low for much of this time, though I learned that thyroid extract (not even real pure levothyroxine) normalizes it as does, believe it or not, colloidal minerals, which probably removes or neutralizes serum lithium. Can’t find my ear thermometer right now to see if it’s still true.
>
> > I found that exercising all the muscles just enough to trigger glycogen (et. al.) retention forced the blood brain barrier permeability to open up to sedatives (et.al.) enough better to benefit sleep even though exercise normally delays sleep. Muscles actually develop really well when subjected to immediate sleep for regeneration. The lithium also lowered my thyroid numbers to 20% my norms. UCI’s world famous Sleep Disorders Center failed to find relief without using long half-life medicines that kept me from ever waking up thoroughly since I had become immune to all the short half-life varieties, probably should have rotated and used higher doses early on.
>
>
> > There should be lots of people like me. Does this ring any bells?
> > Atypical Bipolar Disorder Insomnia (NOS)??
>
> I've been diagnosed with bipolar NOS (it turned out to be a mixed episode from serotonin syndrome due to Effexor). Do you know what it refers to in your case? You do come across as quite manic. Which antimanic drugs have you tried?I am familiar with bipolar-like and mania-like (NOS not otherwise specified means: “like” but no known or consensus-approved specifiable type). What looks like bipolar mania on me is persisting systemic rebound attempts and results from non-mania destruction of pineal gland function and/or some other iteration interrupting process in my sleep chemistry. The symptoms really are bipolar-like=atypical bipolar=bipolar NOS, all of which I have suffered treatment for. After three frustrating years I discovered Dr. Jensen who had me functioning in a mere week, though I had lost my ability to concentrate (atrophy from neglect due to surrender to sedation and declining hopes of recovery resulting in severe loss of motivation, all surprisingly unemotional since what could be done, had been done to the point of total guilt-freedom) and had to rehabilitiate myself. That medicine suddenly stopped working a few months later and I almost died again. The only thing I deliberately stayed alive for was getting my Will done since I still had significant assets. In something like ten days after retrying all the old stuff, we experimented into what is working so well now. I’m fine and functional if I get sleep, I just can’t get sleep without intervention, and I’m no longer willing to go for days trying to see if it will finally kick in anymore either. I’ve almost died twice from it and am now relatively shock-recovered enough to sustain a more objective academic interest, but, though my Will is done, I see no reason to hasten its necessity (ha, hasten it’s execution) by experimenting with sleep deprivation factor brinkmanship further. Besides, Revocable Living Trusts are much better than wills, and my RLT is taking a long time to perfect.
Look at http://www.vh.org/Providers/Lectures/EmergencyMed/Psychiatry/MedEmergSerotonin.html
Also use www.google.com to search for web-free info, both point and counter-point.There is a lot of literature developing describing and consolidating research of the chemistry and inter-dependencies for serotonin and all the other neurotransmitters, electrolytes and other organic metabolites, start simple. Simplified Reader’s digest versions are available from better health food stores and magazines such as Prevention. Next level down, maybe sooner than later to be treated as surprisingly up, are the traditional legacy herbals now getting more than anecdotal respect as their antique documentation gets verified and translated into modern terms. The literature is still relatively immature but much better and more current than ever, because what didn’t work as advertised was mostly weeded out centuries ago. Next level up are the human neuro-psychology texts trying to link the chemistry to the cognition and behavioral systems, formerly treated as independent by psychologists, from chemistry way too long. Next level up are the research studies documented in medline and medical research periodicals. Next level up is the research contemplated in the various research RFPs. Trying to do a spectacular job at such a proposal was my final camel back straw. www.egi.com has the most reasonable way to immediately visualize brain stimulus responses in pseudo-color 3-D. Irvine Sensors Corporation has the only integrated circuit technology simply adaptable to make the system umbilical-free and virtually weight-free. If I ever get back to it I would like to follow up an assumption that each and every neuro-transmitter chemical reaction has a signature waveshape that can be characterized and quantized for quantity, quality and intensity, maybe using something as simple as a massive array of analog SAWs (surface acoustic wave correlator devices) since almost every chemical reaction involves at least valence band activity. Today’s most exotic systems are net-sum variance voltage detection systems that will someday be thought of as quite crude.
I “want” to rebound with activity after so much involuntary inactivity, to me it’s natural joy, not un-natural mania, anti-shame and anti-embarrassment for deferred maintenance, my house used to be one of the best looking on the block, now only the front of the house shows maintenance. Actually, there should be a comma between atypical bipolar and insomnia(NOS). They weren’t linked initially by my physicians, pardon my sloppy proofing.
Phillip Marx
[email protected]
> Working on reply: pm
>
>
> > > Are any of you diagnosed as severe (bizarre) insomniacs?
> >
> > What would "bizarre" insomnia constitute? I have primary insomnia, circadian rhythma disorder - irregular sleep-wake pattern type, and REM sleep behavior disorder. (The latter is under control.)
> >
> > > I haven't been to sleep for over five years without medication.
> >
> > At all? Even after being sleep-deprived for a long time?
> >
> > > They tried lithium for about three years and gave up since it only gave me lithium withdrawals and zero improvement, even after an instance of severe dehydration from running a half marathon which exacerbated toxicity way past the toxic threshold maintenance they attempted to guarantee with time-released lithium and frequent blood tests.
> >
> > What did the lithium withdrawals consist of? Lithium isn't suppose to cause withdrawal symptoms so I'm curious.
> >
> > > I found that exercising all the muscles just enough to trigger glycogen (et. al.) retention forced the blood brain barrier permeability to open up to sedatives (et.al.) enough better to benefit sleep even though exercise normally delays sleep. Muscles actually develop really well when subjected to immediate sleep for regeneration. The lithium also lowered my thyroid numbers to 20% my norms. UCI’s world famous Sleep Disorders Center failed to find relief without using long half-life medicines that kept me from ever waking up thoroughly since I had become immune to all the short half-life varieties, probably should have rotated and used higher doses early on.
> >
> > Exactly which medicines have you tried besides lithium, Halcion, and Serzone?
> >
> > > There should be lots of people like me. Does this ring any bells?
> > > Atypical Bipolar Disorder Insomnia (NOS)??
> >
> > I've been diagnosed with bipolar NOS (it turned out to be a mixed episode from serotonin syndrome due to Effexor). Do you know what it refers to in your case? You do come across as quite manic. Which antimanic drugs have you tried?
Posted by esquisse on December 24, 1999, at 5:55:52
In reply to INSOMNIA, posted by Joanne on December 12, 1999, at 9:19:34
I have several also a lot of problems with sleep and antidepressant medications (especially SSRI)
(sorry for my english, my mother tongue is french)
Has someone any opinion on this:
1) I've already tried nearly all SSRIs, the last on was Serzone for 5 week's at low doses. This medication is not supposed to disturb the sleep.
But with me it's nor the case. After 5 week I'm still unable to sleep. Is it still possible that it changes in a couple of days?
2) I tried trazodone, but It provokes agitation in the legs during all night, has someone experience this with this medication? and does it make weight gain ?
3) And what about trimipramine ?
(notice: I can't take any anticholinergic medication like amitriptyline, Ludiomil, Pamelor, as well as benzo. because of memory impairments with theses kind of medic.)
Thanks for any advice.
Posted by JohnL on December 24, 1999, at 6:37:55
In reply to Re: INSOMNIA, posted by esquisse on December 24, 1999, at 5:55:52
You might want to consider one of the following:
1. Remeron (Mirtazipine), 7.5mg to 15mg an hour before bedtime. A good antidepressant for sleep. Not anticholinergic. Daytime sedation goes away quickly as you get used to the drug. It would enhance whatever SSRI you are taking also.
2. One of the benzos. These are the sleep meds. Xanax has a short halflife which is good for sleep with minimal effect during the day.
3. Ambien is another sleep med that works well with some people. Didn't do much for me though.
4. One of the sedating tricyclics you mentioned, like Amitriptyline or Pamelor, except also take Bethanecol with it. Bethanecol is a cholinergic drug used to counter the anticholinergic side effects of tricyclics. Or, just take a small dose of the tricyclic for sleep in addition to your SSRI. The anticholinergic effects of a low dose shouldn't cause any problems other than maybe a slightly dry mouth. And the combination of the small dose of tricyclic and the SSRI will probably work better on your depression than the SSRI alone.A lot of people use Trazodone. But like you, I didn't like it. It made me restless and gave me headaches and bad nightmares. But there are plenty of choices. Talk to your doctor about the choices I mentioned. Maybe your doctor has a favorite way to treat antidepressant insomnia.
I have tried everything. My personal favorite is a small dose tricyclic. It's a good sleep. My second favorite choice is Remeron. But we're all different. Other people might prefer one of the benzos. You might have to try a couple different things to find what you like best. JohnL
Posted by Joanne on December 24, 1999, at 18:30:55
In reply to Re: INSOMNIA, posted by esquisse on December 24, 1999, at 5:55:52
> I have several also a lot of problems with sleep and antidepressant medications (especially SSRI)
> (sorry for my english, my mother tongue is french)
> Has someone any opinion on this:
> 1) I've already tried nearly all SSRIs, the last on was Serzone for 5 week's at low doses. This medication is not supposed to disturb the sleep.
> But with me it's nor the case. After 5 week I'm still unable to sleep. Is it still possible that it changes in a couple of days?
> 2) I tried trazodone, but It provokes agitation in the legs during all night, has someone experience this with this medication? and does it make weight gain ?
> 3) And what about trimipramine ?
> (notice: I can't take any anticholinergic medication like amitriptyline, Ludiomil, Pamelor, as well as benzo. because of memory impairments with theses kind of medic.)
> Thanks for any advice.Dear esquisse,
Although I still have problems sleeping straight through the night (I wake up after 2-3 hours), I'm at least now able to initially fall asleep with a combination of Ambien and a new sleeping aid called Sonata. My doctor and pharmacist told me it's the latest thing out on the market, and what's great about it is that you can take one if you wake up in the middle of the night, and it helps you go right back to sleep. You can take this medication more than once a night, so it's great if you have the "early morning awakening" problem. It leaves no "hangover" feeling either. However, I was curious about what anti-depressant you're currently taking. Have you tried Remeron? I was on it for about six months, and it was a great anti-depressant that was very sedating as well. After awhile, it became too sedating for me and I was OVERsleeping, but you might have good results with it. I would recommend trying Remeron before suggesting a sleeping pill. However, as far as sleep aids go, I know that Ambien is absolutely wonderful and works EXTREMELY WELL if you haven't tried it yet. Unfortunately, I built up a tolerance to it (which I understand is rare). That's why I'm taking the Sonata in addition to it, but if you haven't tried Ambien yet, I would highly recommend it. Good Luck, and let me know how it goes. Merry Christmas Everyone. Joanne
Posted by jj051797 on November 11, 2003, at 1:52:52
In reply to INSOMNIA, posted by Joanne on December 12, 1999, at 9:19:34
am I the only one with insomnia
Posted by Ilene on November 11, 2003, at 17:08:57
In reply to Re: INSOMNIA, posted by jj051797 on November 11, 2003, at 1:52:52
> am I the only one with insomnia
No. It's getting worse and worse. Don't know what to do.
Ilene
This is the end of the thread.
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