Posted by yxibow on August 17, 2006, at 1:11:01
In reply to (es)zopiclone not working, posted by Keith Talent on August 15, 2006, at 8:02:57
> Hi all,
>
> I was prescribed zopiclone (called Imovane here) but it doesn't seem to put me to sleep, whether with 1 or 2 7.5 mg tabs. Has anyone else had this problem? Also is the cleaner eszopiclone (Lunesta) superior is this respect?
>
> KT
>Its gone through one metabolic process but its not particularly different. I don't know what leeway your doctor has in Canada being a public health system if that is the case (I'm guessing Canada -- maybe another country using Imovane), but a higher dose usually works. Here, I would say that Lunesta in people with a significant amount of insomnia (like myself) would probably be tried at 4mg. Personally I use Ambien at 20mg, which is twice the normal dose. But I am not benzodiazepine "naive", which is probably part of the issue as there are cross-pollination if you have already used benzodiazepines.
On my soapbox I think that still sleep medications like Lunesta, Ambien, Sonata, Ramelteon (possibly -- melatonin depression could occur), intended for sleep should be used for sleep.
The whole idea of going to sleep on Trazodone was plain yucky for me, personally. Not to mention in people with any tendency towards psychosis or the like can be hit negatively with its metabolite mCPP and the priapism occurs in males more than is stated. It also eventually escalates into an adult dose of antidepressant and has to be scaled back and forth again.
An antipsychotic for sleep wouldn't be my first choice, although the low dose on Seroquel I guess isn't particularly of harm at 50mg and some people seem to benefit greatly for some reason. Its really just a giant antihistamine.
The other anti-benzoish favorite is Remeron, which at 7.5mg also makes for some positive REM sleep at times, but again carries a caveat of extreme weight gain at any size of dose (I haven't observed the extreme-high-dose-opposite weight loss when I took it for its primary use, some say it happens.)
I would try the pseudobenzodiazepine sleep agents meant for long term sleep purposes, if necessary at a higher dose and adjust accordingly your response to it and operating machinery, etc., rather than using off-label drowsy making antidepressants. But your doctor may vary in opinion on these things. There's always the benzodiazepine sleep agents like Restoril and Dalmane (scary stuff personally, it is quite powerful), but they carry a greater risk of habituation than the modern things like Ambien/AmbienXR.
-- Jay
poster:yxibow
thread:676611
URL: http://www.dr-bob.org/babble/20060810/msgs/677323.html