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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by AdamCanada2 on February 10, 2009, at 12:39:23
To my surprise Ambien is approved for use yet not sold in Canada. Gee I sure wish my pdoc told me that.
I was going to the emergency room today or planning to until a pharmacist whom i bought bus tickets from told me ambien not available here. I was pretty shocked.
What on earth can I take available in canada? Google searches bring up a bunch of ughhh online pharmacies. I am on Parnate 10mg for over a week and used to be on 20mg for like 3 weeks. Ugh who knows how long really. But insomnia would get worse and worse and maybe reached it's peak where I have to somehow live a life where I get average literally 2 and a half hours sleep a day.
I need serious help.
What sleep meds in canada are stronger than Immovane? Immo does not work for me. Sedative Hypnotic? I need something to make me drowsy. I have had insomnia ever since i was a teenager and Parnate makes it so much worse. Drowsiness has been the only effect that works such as meds like Zyprexa but that which I took years ago made me sleep 12+ hours a day and I would be sleepy the entire time I would be awake. Also stuff like Benadryl while I was on Paxil would help etc but not on Parnate.
So pleaseeeee tell me what is available in canada as a serious and potent sleep medication for severe cases such as mine because my life has been on hold for the past several days because I cannot make plans or do anything which this kind of exhaustion. I cannot tolerate this unless it somehow diminishes (im going up to 20mg parnate today because it seems dosage doesn't matter when it comes to the insomnia and 10mg doesnt help enough for my dep/SA).
I look like a zombie. If someone making a zombie movie and paying well I can fit the role. I can act as a zombie too. I can naturally speak slowly and in monotone as well.
Pls tell me what can work, or what anti-deps or anti-psychotics etc can be good augmentors. Risperdal? Zyprexa too darn strong.
Oh what about Sulpiride? It looks so promising but it seems activating unless I'm mistaken?
pls help. out of 20+ meds for strong major dep/ melanchalonia/ social anxiety.... only few have helped and Parnate initially seemed like it was the best one yet. I dont want to give up on Parnate unless I have to.
pls offer any advice.
Posted by Phillipa on February 10, 2009, at 12:53:28
In reply to Sleep Meds In Canada? Ambien not available :(, posted by AdamCanada2 on February 10, 2009, at 12:39:23
Don't you have lunesta isn't that immovane there? Phillipa
Posted by myco on February 10, 2009, at 13:15:56
In reply to Sleep Meds In Canada? Ambien not available :(, posted by AdamCanada2 on February 10, 2009, at 12:39:23
Hey Adam,
Try zopiclone (a nice effective 'pseudobenzo' like ambien or lunesta) available in Canada and generic is available I believe. Ive used it with success for anxiety and AD related insomnia. Same feel as benzo's (for me) a nice slow effective relaxing delivery into sleep. Be aware these rx sleep meds (benzos and pseudobenzo's - not quite "benzo's" technically but work on benzodiaz sites in the brain - so same sh*t pretty much) may develop tolerance though...the doc will mention this anyway.
myco
Posted by West on February 10, 2009, at 13:52:51
In reply to Adam: a suggestion similar to Ambien for Canada » AdamCanada2, posted by myco on February 10, 2009, at 13:15:56
It sounds like you're going through a punishing stretch of sleep deprivation. I am no stranger to this myself, and as with most insomniacs antidepressants exacerbate the issue.
What I would say is pay a visit to your doc and let him know on no uncertain terms how sh*t you're feeling. If the day is too much of a struggle book the last appointment you can.
I would fare terribly on tranylcyromine given the common insomnia side effect. If you want to give it a proper go, see if adding a low dose antipsychotic (seroquel 25-50mg) or trazadone (50mg) lets you fall asleep. Both are safe. The seroquel will in theory disable monoamine activity and allow for REM sleep while its 5HT-2a antagonism should allow you feel sleepy. Trazadone just does the latter.
If after time neither strategy works get off the parnate and switch to venlafaxine, escitalopram, sertraline, mirtazapine or bupropion or a tricyclic either alone or in any combination (minus ssri-ssri). They have advantages over the MAOIs regarding tolerabilty and have well established efficacy.
West
Posted by AdamCanada2 on February 10, 2009, at 15:43:45
In reply to Adam: a suggestion similar to Ambien for Canada » AdamCanada2, posted by myco on February 10, 2009, at 13:15:56
hi. zipiclone is called immovane here in canada or it's called simply both. didn't work enough for me. once it worked on 15mg (other times at 15mg it didn't) and would make me feel depressed in the morning.
;(
> Hey Adam,
>
> Try zopiclone (a nice effective 'pseudobenzo' like ambien or lunesta) available in Canada and generic is available I believe. Ive used it with success for anxiety and AD related insomnia. Same feel as benzo's (for me) a nice slow effective relaxing delivery into sleep. Be aware these rx sleep meds (benzos and pseudobenzo's - not quite "benzo's" technically but work on benzodiaz sites in the brain - so same sh*t pretty much) may develop tolerance though...the doc will mention this anyway.
>
> myco
Posted by AdamCanada2 on February 10, 2009, at 15:46:21
In reply to Re: Sleep Meds In Canada? Ambien not available :( » AdamCanada2, posted by Phillipa on February 10, 2009, at 12:53:28
nope. the name Immovane uses here is Ziplicone (spelling).
/meows at you
> Don't you have lunesta isn't that immovane there? Phillipa
Posted by AdamCanada2 on February 10, 2009, at 16:11:04
In reply to Re: Adam: a suggestion similar to Ambien for Canada, posted by West on February 10, 2009, at 13:52:51
thx for your suggestions. the seroquel recommendation makes me put another star beside it on my list of things that can help augment.
the other meds u mentioned i tried all except for that newer version of celexa which i would be scared of because celexa would make my depression and pain worse. TCA's I only tried Desipramine.
> It sounds like you're going through a punishing stretch of sleep deprivation. I am no stranger to this myself, and as with most insomniacs antidepressants exacerbate the issue.
>
> What I would say is pay a visit to your doc and let him know on no uncertain terms how sh*t you're feeling. If the day is too much of a struggle book the last appointment you can.
>
> I would fare terribly on tranylcyromine given the common insomnia side effect. If you want to give it a proper go, see if adding a low dose antipsychotic (seroquel 25-50mg) or trazadone (50mg) lets you fall asleep. Both are safe. The seroquel will in theory disable monoamine activity and allow for REM sleep while its 5HT-2a antagonism should allow you feel sleepy. Trazadone just does the latter.
>
> If after time neither strategy works get off the parnate and switch to venlafaxine, escitalopram, sertraline, mirtazapine or bupropion or a tricyclic either alone or in any combination (minus ssri-ssri). They have advantages over the MAOIs regarding tolerabilty and have well established efficacy.
>
> West
Posted by Larry Hoover on February 10, 2009, at 16:26:31
In reply to Sleep Meds In Canada? Ambien not available :(, posted by AdamCanada2 on February 10, 2009, at 12:39:23
I've used temazepam (Restoril) for years, without loss of efficacy.
Lar
Posted by West on February 10, 2009, at 16:55:09
In reply to Re: Sleep Meds In Canada? Ambien not available :( » AdamCanada2, posted by Larry Hoover on February 10, 2009, at 16:26:31
> I've used temazepam (Restoril) for years, without loss of efficacy.
>
> LarYes prescribing habits will vary between doctors/psychs/hospitals/countries but other benzo hypnotics often used here for short term insomnia (2-4 weeks) are temazepam and nitrazepam. Other benzos for sleep are:
* Estazolam
* Flunitrazepam
* Midazolam
* Quazepam
* TriazolamOther z-drugs not mentioned:
* Zaleplon
Ramelton is a melatonin agonist
Older GABA agonist sedative hypnotics:
Glutethimide
Chloral Hydrate
Ethchlorvynol
ClomethiazoleOff label:
Cyclobenzaprine is related to the tricyclics imipramine and amitryptaline and has some use in pain disorders where sleep in also disturbed. It also improves sleep in fibro patients.While pigs might fly there is an off label use in GHB (Xyrem) for insomnia
West
Posted by linkadge on February 10, 2009, at 21:05:38
In reply to Re: Adam: a suggestion similar to Ambien for Canada, posted by West on February 10, 2009, at 13:52:51
Zopiclone can work, but I personally found it has nasty withdrawl. Ativan, for some reason, gives me no rebound withdrawl, yet zopiclone is like I am in hell.
Bottom line - if you ever want to get a good nights sleep again, get off the parnate.
MAOI's are overhyped. Try some zoloft + nortripyline.
Linkadge
Posted by myco on February 16, 2009, at 19:30:48
In reply to Re: Adam: a suggestion similar to Ambien for Canada, posted by linkadge on February 10, 2009, at 21:05:38
Hi Linkage,
Were you taking a maoi at one point, i cant remember? Can I ask ya your diag? What does zoloft and nortrip do for you and how does it compare to a maoi in terms of results (if you took one)?
thnx
> Zopiclone can work, but I personally found it has nasty withdrawl. Ativan, for some reason, gives me no rebound withdrawl, yet zopiclone is like I am in hell.
>
> Bottom line - if you ever want to get a good nights sleep again, get off the parnate.
>
> MAOI's are overhyped. Try some zoloft + nortripyline.
>
> Linkadge
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