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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by greywolf on May 2, 2009, at 1:17:49
Right now I'm taking Parnate 10mg 6x/day, Xanax at 4.5mg/day, Cytomel 50mcg/day, and Lunesta 3mg/night. Still, I have intractable insomnia.
The Lunesta gave me slight relief, but it's not covered by insurance, so 7 pills cost me $60. Ambien did nothing for me.
Basically, I sit up all night, then doze for an hour or two in early evening. This has been going on for months, punctuated by occasional days where I might get 4 or 5 hours of sleep.
Anyone have some sleep aid suggestions?
Thanks.
Greywolf
Posted by jedi on May 2, 2009, at 3:23:23
In reply to Anyone know of a good sleep aid?, posted by greywolf on May 2, 2009, at 1:17:49
Hi,
The sleep aids I have used with success on MAOIs were Seroquel & trazodone. I am really sensitive to the medications that antagonize the histamine receptors, so just 25mg of Seroquel would knock me out. It is expensive, but my MD would prescribe 75mg, and 25mg would almost always put me right out.Trazodone also worked well as a sleep aid for me. Sometimes both Seroquel and trazodone can leave you with a hungover feeling in the morning, so keep the dosages as low as possible.
I've also use the antihistamine diphenhydramine hcl (Benadryl) to induce sleep. Again, I am very sensitive to the medications that affect the histamine receptors, not everyone is this way.
Be Well,
Jedi
> Right now I'm taking Parnate 10mg 6x/day, Xanax at 4.5mg/day, Cytomel 50mcg/day, and Lunesta 3mg/night. Still, I have intractable insomnia.
>
> The Lunesta gave me slight relief, but it's not covered by insurance, so 7 pills cost me $60. Ambien did nothing for me.
>
> Basically, I sit up all night, then doze for an hour or two in early evening. This has been going on for months, punctuated by occasional days where I might get 4 or 5 hours of sleep.
>
> Anyone have some sleep aid suggestions?
>
> Thanks.
>
> Greywolf
Posted by yxibow on May 2, 2009, at 4:02:04
In reply to Anyone know of a good sleep aid?, posted by greywolf on May 2, 2009, at 1:17:49
> Right now I'm taking Parnate 10mg 6x/day, Xanax at 4.5mg/day, Cytomel 50mcg/day, and Lunesta 3mg/night. Still, I have intractable insomnia.
>
> The Lunesta gave me slight relief, but it's not covered by insurance, so 7 pills cost me $60. Ambien did nothing for me.
>
> Basically, I sit up all night, then doze for an hour or two in early evening. This has been going on for months, punctuated by occasional days where I might get 4 or 5 hours of sleep.
>
> Anyone have some sleep aid suggestions?
>
> Thanks.
>
> GreywolfLunesta is a bit stronger for some than Ambien, but since you're not benzodiazepine naive (Xanax 4.5mg /day), there's a chance of cross-pollination.
In a sense, those sleep aids are pseudobenzodiazepines, so having Xanax in your system could mean some possible tolerance, hence an agent like Ambien wouldn't work.
At least that's how I've experienced it.
And the naps in the evening, I'm familiar with that too -- yes, I do it, partially because I'm quite tired and have a sleep disorder most likely and also because it helps my symptoms.
But it does disrupt the sleep cycle. Possible regulating the naps with a timer a bit and getting a little bit of a walk or something like that a bit before going to sleep might help also.
Antihistamines are a possibility -- doxylamine succinate (Unisom doxylamine formulation) is a bit less of a sledgehammer than the diphenhydramine (Benadryl / Unisom / generic) formulation and is what I use currently as even the Seroquel I take for off label purposes won't give me full sleep.
The other one I believe would not mix with a MAOI, amitriptyline even at its lowest 10mg dose, a TCA would be certainly out of the question.It also is effective because of its antihistamine qualities but does have transmitter interactions that would be prohibitive for you -- but you'd have to ask your doctor about that one. I know its label doesn't allow for it.
-- tidings
Jay
Posted by greywolf on May 2, 2009, at 5:04:52
In reply to Re: Anyone know of a good sleep aid? » greywolf, posted by yxibow on May 2, 2009, at 4:02:04
Thank you for your thoughtful responses.
Been down the Seroquel route. Didn't make me sleepy as much as it did groggy the next a.m.
If I recall correctly, Traz interacts with MAOIs, so that's out of the question.
Looks like getting more exercise and delaying or limiting the evening dozing is all I can do. Problem is that it would have been doable when I was off work for six weeks this Spring, but now I'm back to work and the hours are as unpredictable as ever. Guess I'll just have to become more sleep-disciplined.
Thanks again.
Greywolf
Posted by odon on May 2, 2009, at 9:45:11
In reply to Anyone know of a good sleep aid?, posted by greywolf on May 2, 2009, at 1:17:49
I hesitate to give any medical advice because I'm not good at giving such advice especially with typed words.There are alot of people here much better at that than me.--I will however mention powdered magnesium,not the pill form.There is a brand of magnesium citrate that you add to water,its relaxing and might help.Since it may be against the rules to mention the brand name I'll just say the product line is made by a company whose first name is "Peter".It's widely available everywhere, internet and health stores.
Posted by Phillipa on May 2, 2009, at 11:52:56
In reply to Re: Anyone know of a good sleep aid?, posted by odon on May 2, 2009, at 9:45:11
What about klonopin? I've taken and do take two benzos at the same time. Sleep is so very important. Phillipa
Posted by jedi on May 2, 2009, at 12:12:52
In reply to Re: Anyone know of a good sleep aid?, posted by greywolf on May 2, 2009, at 5:04:52
Hi Greywolf,
Though officially contraindicated, trazodone-in low dosages, is widely used for MAOI induced insomnia. I'm not saying that it is the best, but I took it for several years while on Nardil.
Good Luck,
Jedi
> Thank you for your thoughtful responses.
>
> Been down the Seroquel route. Didn't make me sleepy as much as it did groggy the next a.m.
>
> If I recall correctly, Traz interacts with MAOIs, so that's out of the question.
>
> Looks like getting more exercise and delaying or limiting the evening dozing is all I can do. Problem is that it would have been doable when I was off work for six weeks this Spring, but now I'm back to work and the hours are as unpredictable as ever. Guess I'll just have to become more sleep-disciplined.
>
> Thanks again.
>
> Greywolf
>
>
Posted by raisinb on May 2, 2009, at 13:42:38
In reply to Anyone know of a good sleep aid?, posted by greywolf on May 2, 2009, at 1:17:49
The things that have put me to sleep the most reliably are: Lunesta 3 mg or Xanax 2 mg.
OTC things like Unisom or Sleepinal do as well, but they give me a nasty hangover. Same effect from small doses of Remeron.
Ambien pooped out for me after about a year--and it was losing effectiveness for months before that.
My pdoc has also suggested Trazodone as a future option.
A few years ago, I had the discipline and time to meditate regularly--20-30 minutes per morning. After a few weeks, I started sleeping on my own, no problems. Also my skin (I had acne problems then) magically cleared. It worked the same for me about a year later. But it takes discipline and time, and not being so depressed or anxious that meditation puts you into a panic. It is worth a shot, though, I think. I always mean to get back into it when the conditions are right. Problem is, in real life, they seldom are.
Posted by manic666 on May 2, 2009, at 14:09:29
In reply to Anyone know of a good sleep aid?, posted by greywolf on May 2, 2009, at 1:17:49
hey buddy i take two mg ativan at night but thats adiction, so what it works for me,but listen have you ever tried an over the counter med , dont forget im in ingland there is nightol not great but better than zilt.an my favorit depending on where your from, night nurse ?a cold remerdy that knocks you spark out.so potant they will only sell you one bottle at a time,but you wake with a hangover feel
Posted by bleauberry on May 2, 2009, at 19:23:01
In reply to Anyone know of a good sleep aid?, posted by greywolf on May 2, 2009, at 1:17:49
Why not try taking the entire dose once in the morning instead of spread out 6 times a day? Or take half in the morning and half before noon?
Have you ever tried skipping days to see what happens? The MAOI action continues even if you miss a day, but you might be able to escape the stimulant part of the drug by doing that.
Try these:
3mg to 7.5mg Remeron...we're talking little chunks of the pill. These babies are a lot more sedative than higher doses. To me it is a much cleaner better more powerful antihistamine induced sleep than Seroquel, and without such a heavy carryover into the next day.
10mg-25mg Amitriptyline. Safe with your MAOI. Very good sedative TCA.
Klonopin. Try substituting this in place of Xanax. Xanax has a way of worsening things in the insomnia department. Long story, it just does. At patient-rated forums, Klonopin is a well liked popular piggback with Parnate, primarily for sleep but also for antianxiety.
Posted by greywolf on May 2, 2009, at 20:29:20
In reply to Re: Anyone know of a good sleep aid?, posted by bleauberry on May 2, 2009, at 19:23:01
Thanks for the responses.I take the last dose of Parnate no later than dinner to try to reduce some of its stimulant effect.
I will check into your Remeron suggestion. It surely must be better than Seroquel.
I've tried Klonopin with no success.
Thanks for the help.
Greywolf
> Why not try taking the entire dose once in the morning instead of spread out 6 times a day? Or take half in the morning and half before noon?
>
> Have you ever tried skipping days to see what happens? The MAOI action continues even if you miss a day, but you might be able to escape the stimulant part of the drug by doing that.
>
> Try these:
>
> 3mg to 7.5mg Remeron...we're talking little chunks of the pill. These babies are a lot more sedative than higher doses. To me it is a much cleaner better more powerful antihistamine induced sleep than Seroquel, and without such a heavy carryover into the next day.
>
> 10mg-25mg Amitriptyline. Safe with your MAOI. Very good sedative TCA.
>
> Klonopin. Try substituting this in place of Xanax. Xanax has a way of worsening things in the insomnia department. Long story, it just does. At patient-rated forums, Klonopin is a well liked popular piggback with Parnate, primarily for sleep but also for antianxiety.
>
>
Posted by desolationrower on May 3, 2009, at 14:31:10
In reply to Re: Anyone know of a good sleep aid?, posted by greywolf on May 2, 2009, at 20:29:20
trazadone, clonidine, both would probably help a lot.
-d/r
Posted by bleauberry on May 3, 2009, at 17:29:55
In reply to Re: Anyone know of a good sleep aid?, posted by greywolf on May 2, 2009, at 20:29:20
>
> I take the last dose of Parnate no later than dinner to try to reduce some of its stimulant effect.That seemss kind of late in the day to me. I would think for someone with sleep problems the last dose should be no later than noon.
Actually I don't even understand why it has to be dosed multiple times in a day. Other people take it all in one morning dose. The drug might have a very short halflife, but the effect on shutting down MAO enzymes goes on for many days after a dose. I don't understand why hours would be so critical. I would try it all as a morning dose, or split into two morning doses.
In any case, dinner is way too late in the day to be taking a stimulating med of any kind.
>
> I will check into your Remeron suggestion. It surely must be better than Seroquel.And remember to cut the pills. Try either 1/4 of a 15mg tab or 1/2. Even 1/8 has stronger power than you would imagine looking at the tiny crumb.
And don't forget Amitriptyline.
>
> I've tried Klonopin with no success.That is a bummer.
Posted by sowhysosad on May 3, 2009, at 19:44:39
In reply to Re: Anyone know of a good sleep aid? » greywolf, posted by bleauberry on May 3, 2009, at 17:29:55
> Actually I don't even understand why it has to be dosed multiple times in a day. Other people take it all in one morning dose. The drug might have a very short halflife, but the effect on shutting down MAO enzymes goes on for many days after a dose. I don't understand why hours would be so critical. I would try it all as a morning dose, or split into two morning doses.
Yeah, doesn't Ken Gillman speculate you could probably skip a day or more in between MAOI doses whilst still maintaining the same level of MAO inhibition?
Posted by desolationrower on May 3, 2009, at 23:37:24
In reply to Re: Anyone know of a good sleep aid?, posted by sowhysosad on May 3, 2009, at 19:44:39
MAOIs do things besdies said inhibition...
-d/r
Posted by Neal on May 4, 2009, at 2:49:32
In reply to Re: Anyone know of a good sleep aid?, posted by desolationrower on May 3, 2009, at 23:37:24
have you tried 1000mgs of niacinimide?
Posted by Neal on May 4, 2009, at 2:51:51
In reply to Anyone know of a good sleep aid?, posted by greywolf on May 2, 2009, at 1:17:49
Neurontin 900mg helps some individuals
This is the end of the thread.
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