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insomnia, Elavil, Remeron

Posted by zeugma on October 17, 2003, at 6:51:32

In reply to Re: Should I look into an EEG?, posted by john1022 on October 16, 2003, at 13:31:26

Effexor doesn't cause 5-HT 2 antagonism, but Elavil does. 5-HT 2 antagonism is supposed to be good for sleep, less as a sleep inducer than as a regulator of sleep architecture (it lengthens time spent in deep sleep). I have a good friend who was having easily disrupted sleep, not insomnia, on Effexor, tried trazodone (a 5-HT 2 antagonist) and is now much less likely to be awakened by her cat in the middle of the night. It sounds like your problems is more with insomnia itself. Theoretically, Elavil would help you with that, but you had a paradoxical reaction to it. Remeron is a 5-HT 2 antagonist and also a powerful H1 antagonist; H1 antagonism seems to be more involved with the initiation of sleep itself, rather than sleep quality. Elavil is one of the most powerful H1 antagonists in existence, but perhaps its effect on serotonin reuptake caused your paradoxical reaction to it. Remeron is also a powerful H1 antagonist. The difference between Remeron and Elavil is that Remeron blocks 5-HT receptors without blocking reuptake, while Elavil does both. Maybe Remeron is worth a shot. Moreover, in my admittedly less-than-authoritative guide to AD's, Remeron doesn't list 'ringing in ears' as a common or significant SE, while Elavil does. I have suffered from insomnia for most of my life, so I know how debilitating and just plain unpleasant it is. Good luck what whatever med you try.


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poster:zeugma thread:269998
URL: http://www.dr-bob.org/babble/20031015/msgs/270132.html