Posted by Viridis on October 4, 2003, at 18:42:16
In reply to Ambien- dependency potential?, posted by Budgie on October 2, 2003, at 11:28:39
The insomnia issues get pretty complicated, and I think that a lot of it comes down to what's causing it. I used to suffer from episodes of severe insomnia due to anxiety and depression. Occasionally I could get a prescription for Xanax, and it was great for insomnia -- plus the quality of sleep was excellent. But, the prescriptions I got were always short-term, and doctors warned me about "addiction" etc. etc.
Then I went through a period where I used Trazodone, which my GP touted as the "best" sleeping pill. I didn't like it at all -- I never felt truly rested, was groggy in the morning, and just wasn't comfortable with taking it on a regular basis. There are also some genuine safety issues, especially for males.
Finally, I found my current pdoc, who prescribed both Klonopin and Xanax for my anxiety problems. He emphasized, though, that he did not want me to use these for insomnia on a regular basis, because (in his experience) tolerance often develops rapidly to the anti-insomnia effects. In addition, he suspects that benzos disrupt sleep architecture. However, tolerance to the anti-anxiety effects isn't much of a problem in his opinion, so he's fine with daily use of Klonopin and as-needed use of Xanax -- just not regular use of either for sleep.
Well, since my anxiety has been reduced with Klonopin, insomnia isn't much of a problem any more. So, even though I'm not taking it as a sleep med, it has the side benefit of controlling insomnia. And I haven't developed any tolerance to its benefits yet, after 2 1/2 years.
For a long time, I took Xanax here and there for especially stressful situations, and occasionally for sleep. Strangely, though, I do seem to have developed tolerance to it, even though I may only take it every week or two. It now takes at least 3-4 times as much to achieve the same effects as previously, so I'm really limiting its use. My pdoc says he's seen this before with Xanax; he's quite willing to keep prescribing the same amount as usual, and doesn't mind if I use more at a time, as long as my frequency of use doesn't increase.
The point is that individual responses can vary a lot, even just to different benzos, and I expect that this applies to use of benzos and related drugs for sleep too. And, if anxiety (or an activating med like Parnate) is causing insomnia, perhaps use of a safe, reliable anti-anxiety med like Klonopin on a regular basis might help indirectly.
I haven't tried Ambien, but it sounds like it can be used safely for many in the long term, and in fact, I have a doctor friend who swears by it for insomnia (and has used it daily for quite a while at the same dosage).
poster:Viridis
thread:264925
URL: http://www.dr-bob.org/babble/20031004/msgs/265604.html