Posted by med_empowered on August 15, 2005, at 18:45:38
In reply to Re: Sleeping Meds, posted by Mike081078 on August 15, 2005, at 16:32:23
hey! Ambien doesn't cut it for a lot of people...for me, its OK short-term, but after a weeks, it just kind of stops doing anything. Restoril was helpful for me, although it didn't always cut it (add-on Vistaril or Tranxene was sometimes needed). The newer meds, like Lunesta, are more adjustable in terms of dosage than Ambien (usually Ambien is 10mgs,unless you have liver problems, in which case it 5mgs). Remeron is good for some people, but you might get weight gain/day time sedation, and there's the usual risk of (hypo)mania and other drug-induced craziness that you get from antidepressants. Hydroxyzine (Vistaril, Atarax) is an old-school antihistamine that helps with sleep...I liked it at first, but long term it seemed to flatten my mood, so I quit taking it. There's also the antipsychotics...Seroquel and Zyprexa are both used as sleep-aids. I don't like antipsychotics in general, but...if I had to choose, I'd say low-dose seroquel (25-100mgs) would be preferable to Zyprexa. If all else fails, you might want to try a barbiturate. It seems that Phenobarbital is the drug of choice in this category; it works, but it takes forever to kick in, lasts forever, and generally makes you feel icky. Nembutal, Seconal, and Tuinal (Amytal+Seconal mix) are the traditional top picks of the barbs for sleep; Alurate (aprobarbital) is another option that might be worth considering if your situation gets to that point...its a schedule III substance so you'll actually be able to get refills (Nembutal, Seconal, and Tuinal are schedule II, so no refills; Phenobarbital is schedule IV). There are also older non-barbiturate sedatives that still get RX'd now and then...Doriden, Placydil, those things. They're not all that safe, and they're not popular, but they're still an option for the chronically sleep-deprived. Neurontin is useful too...I hated it for anxiety (didn't work), but 600-1200mgs at bedtime was awesome for sleep. But..tolerance develops quickly, so the dose always has to be adjusted, and I usually had something of a morning hangover. If you're interested in doing the alternative health thing, there's 5-HTP, which apparently converts into serotonin after you ingest it. 100mgs, give or take, helped me sleep alot, but it can cause nausea, so watch out for that. Valerian, especially when combined with Passionflower, also helped me a lot, although when I took as much as I needed I did get a bit of a hangover (nothing crazy though). Melatonin is still popular, but if you have depression or have depressive tendencies, you might want to avoid it; it can apparently make depression worse (and presumably induce depression in those prone to it). Kava Kava was awesome for anxiety and sleep, but it killed some people so now its hard to find...avoid at all costs if your liver is anything but extremely healthy. Oh...lest I forget...chloral hydrate is another option. Its old (1800s old) its rough (tends to cause nausea) and the sedation is kind of heavy (kind of barbiturate-like...it was used in "knockout drops" to sedate people back in the day) but it does work, and hardcore insomniacs still sing its praises. If you do take chloral hydrate, you might wanna call a couple pharmacies and see if they have the capsules; those are much, much gentler on the stomach than the liquid form, which is incredibly rough. Good luck!
poster:med_empowered
thread:541901
URL: http://www.dr-bob.org/babble/20050811/msgs/542096.html