Posted by yxibow on October 28, 2006, at 21:03:16
In reply to Re: Lunesta, posted by notfred on October 28, 2006, at 10:35:01
> > 6.. wow... I don't think my psychiatrist would start out at that :). That's like 30mg of Ambien or something. I did once take 25mg of Ambien, not much difference.
> >
>
> I see a top psycopharmacologist, he is the first doc to have recognized I am a fast metabolizer.As I do too if we're not trading me toos and silly mine is better... :)
> It is nice to not be limited the standard PDR dose or at least being able to quickly move to the higher ranges indicated
> by the monograph. I burn up normal doses too fast for them to often be effective, for some drugs.I do also. It's called practice out of standard psychiatric care but both of us know that there is a level of certain medications that will burn through me too.
>
> My pdoc is/or did do research w/Lunesta. He was telling me about a conference he went to, there may be a change in the dosage indications for this drug.That would be good to bring it into "mainstream". I know its already regularly challenged at 4 from what I can see on here.
> I would not compare it to Ambien, the half lives are very different. The indications are different,
> It does not seem Ambien CR is really more effective in stopping early waking.Correct, I was just lumping it into the category of pseudobenzodiazepines. Lunesta, which is the only useful/active metabolite of the generic zopiclone sold around the world is a cyclopyrrone while Ambien is a imidazopyridine.
>
> Of course I did not start at 6. Lunesta did not work for me till I went to 6 mg, I started at 3. I don't have any real sig. hangover, I just woke up from 8 hrs sleep and am typing on the laptop w/i 10 mins of waking.Pretty good. I wouldn't have any "hangovers" if it weren't for the Seroquel too, probably.
> I just checked, I have been on lunesta for 10 months now (I have been saying 7, which was a guess). In the past I have avoided true hypnotics for sleep for several reasons.
>
> 1) They all cause speech problems. I have a background in speech pathology so I am very sensitive to fluency and articulation problems,
> most people might call this slurring ones words.
> I always have it, usually after waking, on hypnotics. It tends to happen a bit during the day
> and although very minor, I do not suspect people notice, but it drives me crazy.Other medications that modulate GABA also have speech problems: Neurontin, especially at the beginning can cause major amounts of it as it tapers as one is used to it. The patient (at least in my opinion) is rarely aware.
> 2) memory problems
That is a problem with a number of things that modulate GABA as well.
> 3) Interaction with PRN Ativan, increasing common benzo side effects.
The Ativan actually means you're not benzodiazepine naive and therefore there is crospollination which besides high metabolizing may necessitate a higher dose of a pseudobenzodiazepine (e.g. Lunesta.)
>
> Lunesta is not causing any of this yet, & at 10 months it is getting quite likely it is not going to happen. Ambien most likely would not either; it is just too short acting to work for me.Sounds great -- I assume you get your liver levels checked at a physical, etc.
poster:yxibow
thread:698049
URL: http://www.dr-bob.org/babble/20061028/msgs/698587.html