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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by DavidLA on December 19, 2007, at 22:40:40
I'm a 10-year Nardil veteran who takes 50-75 mg of Trazodone (Desyrel) nightly for MAOI-induced insomnia. Trazadone works like a charm, but I do have a noticeable "hangover" effect in the morning.
I'm ready to try something new, especially now that my wife and I just had a baby. So far I've tried Sonata and Ambien - they both got me to sleep, but couldn't keep me there.
I'm wary of benzos - probably overly so - but I don't like the memory impairment/dependence/poop-out potential.
Any suggestions from MAOI vets?
Posted by Racer on December 19, 2007, at 23:36:43
In reply to Alternatives to Trazodone for MAOI insomnia, posted by DavidLA on December 19, 2007, at 22:40:40
Not an MAOI vet, but I'm currently trying EMSAM and my doctor has prescribed Rozerem, which is also supposed to help augment the anti-depressant effect of the EMSAM. So far, I do notice a difference in sleep -- I'm staying asleep longer, and more consistently. It took a while -- it's not a "take it and be asleep in an hour" sort of drug for me.
Hope that helps.
Posted by jedi on December 20, 2007, at 2:23:52
In reply to Alternatives to Trazodone for MAOI insomnia, posted by DavidLA on December 19, 2007, at 22:40:40
Hi,
You seem to be very similar to me. I've been on Nardil for the better part of eleven years and the insomnia has never gone away. I have always had to medicate it. I started with Trazodone years ago but had the same hangover effect that you describe.I currently take 90 mg of Nardil. Also, 2 mg of clonazepam to augment Nardil for my social anxiety. I plan on cutting this back to .5 mg soon. The clonazepam doesn't even make me tired anymore. I can take it in the morning and not even notice a somnolence effect. For sleep I take 25 mg of Seroquel. Once in a great while I take 50 mg. I sleep all night on it. It has a small hangover effect, but at this small of a dosage I've noticed no other side effects. Antagonism of histamine H1 receptors may explain why it makes me so sleepy. I am really sensitive to meds that affect histamine. Diphenhydramine Hydrochloride (Benadryl) and othe antihistamines will knock me out, but I build up tolerance quickly. I don't seem to build up tolerance to Seroquel.
Take care,
Jedi> I'm a 10-year Nardil veteran who takes 50-75 mg of Trazodone (Desyrel) nightly for MAOI-induced insomnia. Trazadone works like a charm, but I do have a noticeable "hangover" effect in the morning.
>
> I'm ready to try something new, especially now that my wife and I just had a baby. So far I've tried Sonata and Ambien - they both got me to sleep, but couldn't keep me there.
>
> I'm wary of benzos - probably overly so - but I don't like the memory impairment/dependence/poop-out potential.
>
> Any suggestions from MAOI vets?
Posted by Justherself54 on December 20, 2007, at 7:35:00
In reply to Re: Alternatives to Trazodone for MAOI insomnia » DavidLA, posted by jedi on December 20, 2007, at 2:23:52
I'm not a Nardil veteran yet..but I feel for you with the insomnia..I take .05 clonazapam, 7.5 zopiclone and 50 mg seroquel (up from 25 mg)at bed and still am battling insomnia, but for some reason my energy is so high I'm don't feel too dragged out the next day..like I said in a previous post, I find that if I have nothing in my stomach after 6 p.m. (heartburn middle of the night, new to me)I seem to get into deeper and longer periods of sleep..I've been on zopiclone and clonazapam at bed for so long I'm sure they have lost their effectiveness, so I may have to do another increase of seroquel..will have to discuss with pdoc first.
The insomnia is so frustrating, but as a trade-off for the huge improvements in my life, I'll gladly toss and turn..
Posted by DavidLA on December 20, 2007, at 22:00:35
In reply to Re: Alternatives to Trazodone for MAOI insomnia, posted by Justherself54 on December 20, 2007, at 7:35:00
> I'm not a Nardil veteran yet..but I feel for you with the insomnia..I take .05 clonazapam, 7.5 zopiclone and 50 mg seroquel (up from 25 mg)at bed and still am battling insomnia, but for some reason my energy is so high I'm don't feel too dragged out the next day..like I said in a previous post, I find that if I have nothing in my stomach after 6 p.m. (heartburn middle of the night, new to me)I seem to get into deeper and longer periods of sleep..I've been on zopiclone and clonazapam at bed for so long I'm sure they have lost their effectiveness, so I may have to do another increase of seroquel..will have to discuss with pdoc first.
>
> The insomnia is so frustrating, but as a trade-off for the huge improvements in my life, I'll gladly toss and turn..I have experienced the same "lack-of-a-need-for-sleep" feeling with Nardil. Sleep deprivation can actually have an anti-depressent effect - up to a point. I have struggled with having to force myself to sleep more than I want to, just so my body gets enough rest. I've obviously not found a solution yet after many years of searching.
Posted by DavidLA on December 20, 2007, at 22:17:22
In reply to Alternatives to Trazodone for MAOI insomnia, posted by DavidLA on December 19, 2007, at 22:40:40
Do any MAOI users have experience with the following meds for insomnia? What dosages were helpful? Thanks.
Sonata
Ambien
Ambien CR
Lunesta
Rozerem
Posted by Phoenix1 on December 21, 2007, at 9:34:34
In reply to Re: Alternatives to Trazodone for MAOI insomnia, posted by Racer on December 19, 2007, at 23:36:43
Hi Racer,
I read that melatonin was contraindicated with MAOI's because the MAOI prevents melatonin catabolism. Wouldn't Rozerem fall in the same class because it is really just a synthetic melatonin or melatonin agonist? If there isn't a contraindication, maybe plain old melatonin would help. I've heard anectodal reports that Rozerem is no more effective than a 3mg dose of melatonin except for the length of action. Any comments?
Phoenix
> Not an MAOI vet, but I'm currently trying EMSAM and my doctor has prescribed Rozerem, which is also supposed to help augment the anti-depressant effect of the EMSAM. So far, I do notice a difference in sleep -- I'm staying asleep longer, and more consistently. It took a while -- it's not a "take it and be asleep in an hour" sort of drug for me.
>
> Hope that helps.
Posted by Reggie BoStar on December 22, 2007, at 3:16:15
In reply to Re: Alternatives to Trazodone for MAOI insomnia » Racer, posted by Phoenix1 on December 21, 2007, at 9:34:34
Wow Phoenix, I'm amazed by the tolerances reported by the folks in this thread. I've been cruising the board to see if anyone was as knocked out by Trazodone as I was. I started with my first 50mg dose two days ago and I'm just getting up and around now. Within half an hour of taking it, I was out like a hibernating bear for over 30 hours. It wasn't the first time I've ever slept that long, but it sure was the hardest time I had trying to get out of bed.
My pdoc prescribed it to try to help with my totally chaotic waking/sleeping cycle. I doubt I'll go back for even a second dose now.
As far as Melatonin goes, even there the doses are surprising me. The highest dose of Melatonin I can hack is 300 MICRO grams, or 0.3 mg. That knocks me right out for a long night of deep sleep.
The one time I tried 3mg, i.e. 3000 micrograms or 10 times the comfortable dose for me, I slept for over 20 hours and had brutal nightmares the whole time. I thought it would work OK if I took it "time-release" by placing the 3mg tab under my tongue before I went to bed; this was recommended to me as a way to combat jet fatigue. Next time I'll be more than happy to have jet fatigue instead!
Now here I see that "Rozeram is **no more effective** than 3mg of Melatonin...".
That's good to know! If my pdoc ever suggests Rozeram, I'm going to run screaming out of his office!
Phew. Meanwhile, back on the subject of Trazodone, I was wondering how intense the "hangover effect" reported by DavidLA was, and if any of the other folks posting here reacted the same way to it. Does it get better over time? Has anyone gone to a higher dose?
I've been tried on so many things over the years that I've already lost all hope of being marginally functional. Even ECT has had no staying power to speak of. My pdoc is the only one trying anything new these days.
Thanks to all who took the time to read this,
Reggie BoStar
Posted by Justherself54 on December 22, 2007, at 8:33:54
In reply to Re: Alternatives to Trazodone for MAOI insomnia » Phoenix1, posted by Reggie BoStar on December 22, 2007, at 3:16:15
> Wow Phoenix, I'm amazed by the tolerances reported by the folks in this thread. I've been cruising the board to see if anyone was as knocked out by Trazodone as I was. I started with my first 50mg dose two days ago and I'm just getting up and around now. Within half an hour of taking it, I was out like a hibernating bear for over 30 hours. It wasn't the first time I've ever slept that long, but it sure was the hardest time I had trying to get out of bed.
>
> My pdoc prescribed it to try to help with my totally chaotic waking/sleeping cycle. I doubt I'll go back for even a second dose now.
>
> As far as Melatonin goes, even there the doses are surprising me. The highest dose of Melatonin I can hack is 300 MICRO grams, or 0.3 mg. That knocks me right out for a long night of deep sleep.
>
> The one time I tried 3mg, i.e. 3000 micrograms or 10 times the comfortable dose for me, I slept for over 20 hours and had brutal nightmares the whole time. I thought it would work OK if I took it "time-release" by placing the 3mg tab under my tongue before I went to bed; this was recommended to me as a way to combat jet fatigue. Next time I'll be more than happy to have jet fatigue instead!
>
> Now here I see that "Rozeram is **no more effective** than 3mg of Melatonin...".
>
> That's good to know! If my pdoc ever suggests Rozeram, I'm going to run screaming out of his office!
>
> Phew. Meanwhile, back on the subject of Trazodone, I was wondering how intense the "hangover effect" reported by DavidLA was, and if any of the other folks posting here reacted the same way to it. Does it get better over time? Has anyone gone to a higher dose?
>
> I've been tried on so many things over the years that I've already lost all hope of being marginally functional. Even ECT has had no staying power to speak of. My pdoc is the only one trying anything new these days.
>
> Thanks to all who took the time to read this,
> Reggie BoStar
>The first time I tried Trazodone I felt so horrible the next day I never took another one..I was totally incapacitated from functioning..so that was enough for me..
Posted by Reggie BoStar on December 23, 2007, at 5:09:57
In reply to Re: Alternatives to Trazodone for MAOI insomnia, posted by Justherself54 on December 22, 2007, at 8:33:54
Hi Justherself54,
My sentiments exactly. It's been two days now and I still don't feel right. I'm less tired now but I've got a real case of the creeps. I'm especially antsy about going to sleep because I don't want to experience another round of those terrible dreams.Well, at least we found out in a hurry that it wasn't right for us. Imagine if it kicked in like Prozac, after 30 days of being on it. Then it would take another 30 days to stop. We're lucky in that respect.
Have a happy holiday,
Reggie BoStar
Posted by Greenmtn on December 23, 2007, at 5:53:57
In reply to Alternatives to Trazodone for MAOI insomnia, posted by DavidLA on December 19, 2007, at 22:40:40
I’ve been on Emsam since July and have terrible insomnia. For me:
Sonata: not tried
Ambien: Awoke wide awake after several hours of sleep
Ambien CR: not tried
Lunesta: Not much good. Slept a few hours and awoke agitated.
Rozerem: Yuk. Did not work for insomnia. Next day felt knocked out.Trazodone 100 mg for several weeks. My sleep went up from about 3 hours to 6 hours.
It totally reversed my mental state. Back into deep deep depression. I have been off it for 2 nights. Feel great again but slept about 3 hours of broken up sleep both nights. Last night had (have) very bad headache. I’ll have to check withdrawal posts. This insomnia seems like such a universal problem withput many good solutions.P.S. I have found helpful sitting comfortably in a dark room listening to radio music on headphones has helped last 2 nights. Something about feeding music into the brain may help induce sleep. Hope this helps.
Posted by Justherself54 on December 23, 2007, at 10:05:25
In reply to Re: Alternatives to Trazodone for MAOI insomnia, posted by Greenmtn on December 23, 2007, at 5:53:57
Increasing the seroquel did help..I had trouble falling asleep but once I did I only woke once or twice for brief seconds..got 8 hours last night..that's a first!
Posted by Phoenix1 on December 23, 2007, at 14:21:26
In reply to Re: Alternatives to Trazodone for MAOI insomnia, posted by Justherself54 on December 23, 2007, at 10:05:25
I found that I had to start at 50 of Seroquel and am now taking 75 in order to sleep well. On top of a benzo... I'm worried about the metablic side effects. Has anyone lese noticed that tolerance to Seroquel for sleep occurs?
Phoenix1
> Increasing the seroquel did help..I had trouble falling asleep but once I did I only woke once or twice for brief seconds..got 8 hours last night..that's a first!
Posted by Justherself54 on December 26, 2007, at 14:47:17
In reply to Re: Alternatives to Trazodone for MAOI insomnia » Justherself54, posted by Phoenix1 on December 23, 2007, at 14:21:26
Before Nardil 25 mg of seroquel did the trick with sleep..it was only after starting Nardil that I had to increase it, and it's still a crap shoot whether or not I'll sleep through the night..have been waking frequently..I won't increase the dosage until I speak to pdoc..
> I found that I had to start at 50 of Seroquel and am now taking 75 in order to sleep well. On top of a benzo... I'm worried about the metablic side effects. Has anyone lese noticed that tolerance to Seroquel for sleep occurs?
>
> Phoenix1
>
> > Increasing the seroquel did help..I had trouble falling asleep but once I did I only woke once or twice for brief seconds..got 8 hours last night..that's a first!
>
>
Posted by 49er on December 29, 2007, at 12:40:00
In reply to Alternatives to Trazodone for MAOI insomnia, posted by DavidLA on December 19, 2007, at 22:40:40
David,
I have never taken MAOIs but am still on Remeron and Doxepin. Due to tapering the Remeron, I was at risk for insomnia since I take Remeron for sleep.
Since adding 3/4 teaspoon of Magnesium, I have had the best sleep I have had in years while on my full complement of psych meds.
A medical professional suggested that I take it for other reasons just so you know this isn't a recommendation from an alternative med. nut.
The way it has worked is that when I lie down to go to bed, I can feel myself relaxing naturally. I don't even need a sleep music CD I used to need.
Go to one of the med sites and make sure that magesium can be taken with your meds. If you ask your doctor, he/she isn't probably going to know about it.
Since I have tried this about 3 months ago, I have had about 2 to 3 nights of insomina.
I would use the powder form as that gives dosing flexibility. Do a google search as I don't think I am allowed to mention names.
489er
This is the end of the thread.
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