Posted by Phoenix1 on December 31, 2007, at 9:00:00
In reply to The I can't find a med to help me sleep thread, posted by Maxime on December 31, 2007, at 0:58:38
Mi Maxime,
I have always had insomnia that got much worse during depression. And my currently low Nardil dosage is making it worse. I take 75mg Seroquel, and 7.5 Zopiclone (just switched from Oxazepam). I fall asleep fine, but wake up 2 or 3 hours later and then lie awake for the rest of the night. It's not much fun.
I don't think there are many other pharmaceutical options if you are trying to avoid benzos. (Not sure if you are or not) Temazepam and Oxazepam are both used for sleep and have appropriate half lives. If it's just sleep onset but not maintetnance that's the issue, then triazolam is sometimes used. Benzos like Valium and Clonazepam are not considered good sleep meds, especially clonazepam. More anxiolysis than sedation, and LONG half-lives. In my experience, while less potent on the charts, zopiclone makes a better sleep med than the traditional benzos. But I find that it is considered to be just about as dependance and tolerance causing as any of the benzos. (Please don't PBC me for overgeneralization, I can cite literature if necessary). For a while, we had a cool drug in Canada called Stil-Noc (I think Sonata in the US). Zaleplon is the generic name although it is no longer manufactured from what I understand. It worked well for me because it had such a short half life and quick onset of action that I could take one to fall asleep and then another in the middle of the night if I woke up again, and still not feel hung-over the next day. I wish we had Ambien CR in Canada...
There are antihistamines like diphenhydramine, hydroxyzine, or promethazine, but they have some drawbacks as well, and anyways the Seroquel your on has it's own antihistaminic action which I think is what is supposed to make it sedating.
And then there are things like doxepin and trazodone. I haven't had much luck with them, but many others have.
Finally, gabapentin and pregabalin seem to help sleep. There is literature on this if you do a search. They are not indicated for sleep, but I believe pregabalin is indicated for anxiety disorders in some countries. I certainly slept better while using either one of these. But, although there isn't much literature on this, I personally found that they caused worse dependance than the benzos, and my withdrawal experience from pregabalin (even in the presence of a taper) was horrid, and lasted for weeks.
Anyways, I'm sure you already know most of this, but just thought I'd post my experiences. I hope you find a way to sleep better, because I can certainly sympathize. I've had my share of those nights, and still battle them sometimes. See what your pdoc has to say. Mine thinks that establishing somewhat normal sleep patterns is an important part of relieving depression. Good luck.
Phoenix1
poster:Phoenix1
thread:803366
URL: http://www.dr-bob.org/babble/20071225/msgs/803404.html