Posted by SLS on November 3, 2024, at 20:21:14
In reply to Re: Need advice on meds for sleep, posted by deniseuk190466 on October 27, 2024, at 15:14:32
Hi, Denise.
I ended up writing far too much to answer your question. Sorry about that.
Has your friend tried zolpidem (Ambien) or any of the other z-drugs? What drugs has he tried so far?
If his main problem is falling asleep rather than staying asleep, it could help. I have found it consistently effective, even after 4 years. It is not a benzodiazepine. I found that there are no hangovers, and that I feel refreshed the next morning. Zolpidem does not produce physiological dependence or dosage escalation. The only withdrawal symptom I had when discontinuing zolpidem was mild to moderate insomnia. After two nights, I was able to sleep without it. I am currently taking 5.0 mg, but no more than 30 minutes before going to bed. It works quick. It reminds me of triazolam (Halcion) but is not as potent. Both drugs have a short half-life. However, benzodiazepines can be incredibly hard to discontinue if they had been taken chronically.
A rather unique side effect of zolpidem is night binge-eating. The following morning, it is unlikely that you will remember doing it. This doesn't happen to everyone, and it can be managed behaviorally. I think most doctors will try 5.0 mg hs first, and go to 10 mg hs if necessary.
The other Z-drugs include zopiclone, ezopiclone, and zaleplon. Eszopiclone (Lunesta) has a significantly longer half life than zopiclone and zaleplon. It might be a better choice if staying asleep is a problem. It can produce a metallic taste as a side effect.
Among the tricyclics, amitriptyline, doxepin, and trimipramine can be effective when treating insomnia, but might not be an ideal solution if high dosages are required. Anticholinergic side effects emerge. Of the three, doxepin is the most potent H1 histamine blocker (antihistamine). This is the property that makes diphenhydramine (Benadryl) so effective at producing sedation.
As an aside, doctors have used trazodone as a sleep aid for people taking MAOIs. It is presumed that serotonin syndrome does not occur when it is given to someone taking a MAOI. From what I understand, this is usually the case and is used effectively. However, When trazodone was introduced to me while I was taking a MAOI, I experienced an episode of being unable to move my legs in order to walk. I could stand without effort, and there was no rigidity. My legs simply didn't obey my command to walk. It was weird, but I was rather unconcerned. It was more amusing than it was frightening. My doctors at the NIH felt that this episode was a sort of mild hyperserotonergic reaction.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.The only thing necessary for the triumph of evil is that good men do nothing.
poster:SLS
thread:1122403
URL: http://www.dr-bob.org/babble/20230117/msgs/1122406.html