Posted by Don_Bristol on April 11, 2006, at 23:35:08
In reply to MAOI's and permanent sleep problems???, posted by Enigma on April 11, 2006, at 15:25:00
Enigma, please excuse typos below.
I have just posted to say how little sleep I can get (if I try specifically not to sleep much) while taking Parnate.
In my case I find it useful to have the extra time because unlike you I do not feel tired, exhausted, drained, and the sorts of things you describe.
You and I clearly do not have the same response to meds. However I too did experience the weirdest periods of sleepiness and wakefulness during the night while on Nardil.
Many of the antidepressants (eg Prozac) are reckoned to help with sleep because they improve low mood and anxiety which are preventing proper sleep. However Prozac. for example, is generally seen as a med which reduces the quality of sleep. So I guess it's mainly to do with whether the better sleep from mood improvement outweighs the reduced quality of sleep.
I guess it is perfectly possible that an MAOI has created irreversible changes but I must say I feel the odds are very much against it.
I sense that what is preventing you from sleeping is largely psychological disturbances. I found meditation (at any time in he day) helped me learn how to still the mind a little and gave me better sleep. I also found that relaxation tapes immediately before bedtime really did help a lot.
But maybe you feel too low to try this sort of stuff. I think you may be feeling zonked in the morning after seroquel or klonopin because, in part, you have so much sleep to catch up on and partly because those meds are known, on average, to still be in the system for longer than the 7 or 8 or 9 hours sleep you might get.
If you are not working (you are on disability) then why not give yourself a week of these meds and sleep in as long as you need to. A week is so that you can overcome the sleep deficit you have accumulated. (Yes, I know sleep and recovery from its deprivation does not really work in that way but I am sure you get the idea.)
Watch out though because over the course of a week the sleeping meds will start to reach higher levels in you. The med from the day before will not all have gone when you take the next med and you may have to adjust the dose accordingly. OTOH don't micromanage the dose by splitting tabs into seven-eights or any other such obsessional behavior.
Personally I prefer benzodiazepines but they are harder and harder to get. A couple of shorter acting ones are Lormetazepam and Lorazepam but they are not so short and you would still need to take them a few hours before going to bed.
Another alternative would be to take one of the old tricyclic antidepressants. Unlike the SSRIs these do not affect sleep architecture and are themselves sedating to a lesser or greater degree depending on which one you take. However they can give side effects (blurred vision, dry mouth, etc etc) which trouble some people. The antidepressant effect from these would be useful for you and help your sleep too but that would not kick in for a few weeks which I sense is to long for someone as restless as you currently seem to be to wait - and the AD effect may not occur in all people.
So you must take your choice. The "weird" stuff like relaxation and meditation has no side effects and will not affect you the next morning and can give benefit within a day or so of starting - so I would do those if you can. After that the choice of med is yours but do not overlook the underlying rage related problems which you allude to as they sound as if they are likely to be the root of almost all the trouble you experience. Therapy (such as CBT or even psychodynamic if a trauma is persisting) could be very useful for that - again no side effects, no morning hang overs.
best wishes.
poster:Don_Bristol
thread:631813
URL: http://www.dr-bob.org/babble/20060408/msgs/632025.html