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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by beardedlady on March 1, 2002, at 12:18:10
I have insomnia and panic attacks related to sleep only. I am 39, and early waking began when my daughter was four months old. Not sleeping began shortly after she quit nursing at eight months. After tries with Zoloft, Trazadone, and Xanax, we found Serzone, and it worked. I've been on it three years.
Now, because of the black box, I have to stop. My doctor prescribed Gabitril. He said he's had a lot of success with it in patients like me (he has a lot of us, as his is an anxiety and sleep-disorder practice). I'm scared.
If you have a similar problem and this has WORKED for you, please let me know. At this point, I'd rather hear from the folks who think it will, as my problem has more to do now with pessimism and lack of confidence about sleep than it does to do with chemicals in my brain.
Posted by JohnX2 on March 1, 2002, at 19:12:37
In reply to Treating INSOMNIA with SERZONE, now GABITRIL, posted by beardedlady on March 1, 2002, at 12:18:10
If you were just taking Serzone, are your sure
you needed to stop because of the Black Box? They
didn't pull the medicine off the shelves. They just
found that it had drug interactions with other medicines.-John
> I have insomnia and panic attacks related to sleep only. I am 39, and early waking began when my daughter was four months old. Not sleeping began shortly after she quit nursing at eight months. After tries with Zoloft, Trazadone, and Xanax, we found Serzone, and it worked. I've been on it three years.
>
> Now, because of the black box, I have to stop. My doctor prescribed Gabitril. He said he's had a lot of success with it in patients like me (he has a lot of us, as his is an anxiety and sleep-disorder practice). I'm scared.
>
> If you have a similar problem and this has WORKED for you, please let me know. At this point, I'd rather hear from the folks who think it will, as my problem has more to do now with pessimism and lack of confidence about sleep than it does to do with chemicals in my brain.
Posted by beardedlady on March 2, 2002, at 6:13:09
In reply to Re: Treating INSOMNIA with SERZONE, now GABITRIL » beardedlady, posted by JohnX2 on March 1, 2002, at 19:12:37
Not true. Some drug interactions have always been a problem. The black box is due to deaths because of liver failure, which has nothing to do, to my knowledge, with other drugs. Serzone alone is said to cause it.
I suggest you have a blood test, just to make sure your liver function isn't impaired.
Posted by JohnX2 on March 2, 2002, at 20:15:51
In reply to Re: Treating INSOMNIA with SERZONE, now GABITRIL, posted by beardedlady on March 2, 2002, at 6:13:09
I was aware that the medicine had drug interactions.
Since the black box, there have been a few notes regarding
other potential interactions. This was via a conversation
with a friend who is a pharmacist. I was a bit confused that
the black box was regarding these additional drug interactions
that needed to be noted that may have led to these liver failures.My pdoc put me on Serzone, its the only medicine that works
for me in some regards. He's looked carefully into drug interactions.
The alternative is to test Lithium, which is much harsher on the body's organs.
I may have my liver looked into anyways, thanks for the recommendation.If you belive the manufacturer's statistics on liver failures,
the odds of getting one are so small its rediculous. But its more than
the manufacturer originally led one to believe, hence the black box
warning. Some doctors of course will overreact because they have 2 things
at the top of there priority list 1) save my ass - liability/lawsuits
2) patient wellfare.Just my cynical thinking. Shouldn't put too much
faith in the pharmaceutical manufacturer's word either.Good luck on Gabitril.
Thanks,
John> Not true. Some drug interactions have always been a problem. The black box is due to deaths because of liver failure, which has nothing to do, to my knowledge, with other drugs. Serzone alone is said to cause it.
>
> I suggest you have a blood test, just to make sure your liver function isn't impaired.
Posted by beardedlady on March 3, 2002, at 6:15:59
In reply to Re: Treating INSOMNIA with SERZONE, now GABITRIL » beardedlady, posted by JohnX2 on March 2, 2002, at 20:15:51
I'd still have that test if I were you. It's just a simple blood test. At least it will tell where you are. Meanwhile, tell me what other drug interactions you know about? (There are a few allergy meds, like hismanil(?), there's Cisapride, there's Xanax, etc.) What did I leave out?
I was trying to come off meds altogether, thought my insomnia was pretty well under control after six months of really good sleep. I was down to 250mg of Serzone and a Sonata once a month.
I know my doctor is worried about lawsuits, but I am also worried about death. Sure, it's a slim chance, but I think it's a bigger one than most people know. The liver thing is a problem with almost any pills.
Does Remeron do essentially the same thing as Serzone? If it's as sleep-inducing as many say, I may only need a low dose, since I'm not on for depression.
Thanks for your help, John.
Oh, I slept okay last night--no sleeping pill--on 4 mg. Gabitril, but I'm still on the 250 of Serzone! (I've had some opening night jitters with the new meds.) I slept because I took a 1.5 hour nap late yesterday afternoon. They tell those with chronic insomnia not to nap, but it works the opposite with me. It restores my confidence that I can sleep, without taking a pill first, so I'm able to go right to sleep at night.
Posted by JohnX2 on March 3, 2002, at 18:57:22
In reply to Re: Treating INSOMNIA with SERZONE, now GABITRIL » JohnX2, posted by beardedlady on March 3, 2002, at 6:15:59
I've been on 20+ medications. I'm desperate.
I have an excellent pdoc. It took him a few days
to research Serzone before OKing it. The original
intention was to use it to help me to taper off
a last mg of Klonopin that I am trying to quit, so
I don't know what his take is on taking it long
term. I think his number 1 concern is mental health.
I have balked at taking medicines like Lithium and
Zyprexa because they can really screw up your organs
(lithium) and Zyprexa can give you a life long movement
disorder (tardive dyskinesia). But I have also struggled
with obssesive thoughts of suicide and have even planned
it out. So I have to assess the risk/rewards in light of
this. Not getting my mental health resolved can result
in my death much more likely than getting a liver problem
. Frankly I'd rather get mentally healthy and squeeze in
20 good yrs (I'm 29), even if that meant that I died at
an early age from some organ disorder. Living with depression
is just as good as being the living dead.Best wishes. Good luck getting some sleep.
-John
> I'd still have that test if I were you. It's just a simple blood test. At least it will tell where you are. Meanwhile, tell me what other drug interactions you know about? (There are a few allergy meds, like hismanil(?), there's Cisapride, there's Xanax, etc.) What did I leave out?
>
> I was trying to come off meds altogether, thought my insomnia was pretty well under control after six months of really good sleep. I was down to 250mg of Serzone and a Sonata once a month.
>
> I know my doctor is worried about lawsuits, but I am also worried about death. Sure, it's a slim chance, but I think it's a bigger one than most people know. The liver thing is a problem with almost any pills.
>
> Does Remeron do essentially the same thing as Serzone? If it's as sleep-inducing as many say, I may only need a low dose, since I'm not on for depression.
>
> Thanks for your help, John.
>
> Oh, I slept okay last night--no sleeping pill--on 4 mg. Gabitril, but I'm still on the 250 of Serzone! (I've had some opening night jitters with the new meds.) I slept because I took a 1.5 hour nap late yesterday afternoon. They tell those with chronic insomnia not to nap, but it works the opposite with me. It restores my confidence that I can sleep, without taking a pill first, so I'm able to go right to sleep at night.
Posted by JohnX2 on March 3, 2002, at 19:12:57
In reply to Re: Treating INSOMNIA with SERZONE, now GABITRIL » JohnX2, posted by beardedlady on March 3, 2002, at 6:15:59
Sorry about my sob story on my earlier reply, I forgot to answer your Remeron question.
Remeron is an EXCELLENT sleep aid.
15 mg (the lower dosage range) will do the trick!
In fact at a higher dose, a chemical norepinephrine kicks in which makes it a better
anti-depressant, but is stimulating and can stymie
the sleep effect a bit.
Fast acting.Possible side effects possibly include sedation, weight gain, happiness.
I didn't have problems with weight gain. I was
having substantial problems falling asleep as I
grew tolerant to a benzodiazepine Klonopin and
was *guzzling* anti-histamines. After a while
my body was falling apart from lack of sleep.
Remeron fixed it all. Since then, I have used
Zyprexa as a sleep aid (just as good). And have
returned to Serzone.Best Wishes,
John
> I'd still have that test if I were you. It's just a simple blood test. At least it will tell where you are. Meanwhile, tell me what other drug interactions you know about? (There are a few allergy meds, like hismanil(?), there's Cisapride, there's Xanax, etc.) What did I leave out?
>
> I was trying to come off meds altogether, thought my insomnia was pretty well under control after six months of really good sleep. I was down to 250mg of Serzone and a Sonata once a month.
>
> I know my doctor is worried about lawsuits, but I am also worried about death. Sure, it's a slim chance, but I think it's a bigger one than most people know. The liver thing is a problem with almost any pills.
>
> Does Remeron do essentially the same thing as Serzone? If it's as sleep-inducing as many say, I may only need a low dose, since I'm not on for depression.
>
> Thanks for your help, John.
>
> Oh, I slept okay last night--no sleeping pill--on 4 mg. Gabitril, but I'm still on the 250 of Serzone! (I've had some opening night jitters with the new meds.) I slept because I took a 1.5 hour nap late yesterday afternoon. They tell those with chronic insomnia not to nap, but it works the opposite with me. It restores my confidence that I can sleep, without taking a pill first, so I'm able to go right to sleep at night.
Posted by beardedlady on March 4, 2002, at 6:49:05
In reply to Re: Remeron » beardedlady, posted by JohnX2 on March 3, 2002, at 19:12:57
John:
Even at a low dose I will feel sedated in the morning? Last night, I took my 4 mg of Gabitril, my 250 mg. of Serzone, and I woke up at midnight and 2, not able to fall back to sleep at 2, so I took a Sonata and lay awake for another two hours. I feel like crap today, don't know when the Gabitril is going to kick in (and wondering if my carpal tunnel is worse because of it), and I don't feel like doing this again. It was a bad time when I was testing meds for six months.
I think if you don't sleep, depression is worse. If you sleep well, you have better coping skills. But then, I'm only depressed when I can't sleep, so who knows.
So, questions are here: will a low dose of remeron, while taking it only--nothing else--sedate me all day? And what is Zyprexa? And will that sedate me? And can I take that alone?
Sorry for all the questions, but since you've had it all and respond to my best med yet, I figured you're the one to ask.
beardy
Posted by JohnX2 on March 4, 2002, at 17:05:53
In reply to Re: Remeron » JohnX2, posted by beardedlady on March 4, 2002, at 6:49:05
hi beardy,I don't know how the Remeron will affect you
the following day (its an individual matter). But like
you said, if you get a good nights sleep you are less
likely to feel tired and groggy the next day. Personally Remeron did not make
me feel sedated the next day. This seems to be more a
complaint with Serzone however. I would just give the
Remeron a test run and see how it goes. Don't worry too
much about tapering into it, its pretty easy to get onto.
Not anywhere near the complexity of something like Serzone.
A quick 2-3 day trial of Remeron and you'll know where it
is at.Zyprexa is in a class of medications called "atypical
anti-psychotics", don't let the name scare you. At the lower
dose it acts more like an anti-depressant,anti-anxiety,sleep
aid. Major side effect is weight gain. At higher doses it
can combat mania (too much dopamine) in manic-depression, which
is one reason I took it (it's a mood stabilizer). Generally doesn't cause
grogginess during the day. Pretty easy medicine to get onto, fast
acting. I think for your goal I would stay away from Zyprexa and focus on Remeron.You can take both Remeron and Zyprexa alone, or in
combo with other meds as supervised by a physician.I asked an in-law who is a pharmacist at a
major chain store about Gabatril and he says that when it came
out there were quite a few scripts written, but now he hardly ever
sees it prescribed (didn't really know why). He's a good
contact for me to have, knows all the "behind the scene"
info/secrets going on between the pharmaceutical makers
/physicians/patients. Don't see too many people talking
about that one on this news group, but on paper it looks
like an interesting medicine.Best wishes. Hopefully you'll be counting
those sheep again soon.-John
> John:
>
> Even at a low dose I will feel sedated in the morning? Last night, I took my 4 mg of Gabitril, my 250 mg. of Serzone, and I woke up at midnight and 2, not able to fall back to sleep at 2, so I took a Sonata and lay awake for another two hours. I feel like crap today, don't know when the Gabitril is going to kick in (and wondering if my carpal tunnel is worse because of it), and I don't feel like doing this again. It was a bad time when I was testing meds for six months.
>
> I think if you don't sleep, depression is worse. If you sleep well, you have better coping skills. But then, I'm only depressed when I can't sleep, so who knows.
>
> So, questions are here: will a low dose of remeron, while taking it only--nothing else--sedate me all day? And what is Zyprexa? And will that sedate me? And can I take that alone?
>
> Sorry for all the questions, but since you've had it all and respond to my best med yet, I figured you're the one to ask.
>
> beardy
Posted by beardedlady on March 4, 2002, at 18:46:34
In reply to Re: Remeron » beardedlady, posted by JohnX2 on March 4, 2002, at 17:05:53
John:
Thanks for the info. I'm going to stop the Gabitril, I think. I am feeling arthritis-like symptoms, and I am in pain. I'll talk to my pdoc tonight about Remeron.
beardy
Posted by beardedlady on March 4, 2002, at 19:30:08
In reply to Re: Remeron » beardedlady, posted by JohnX2 on March 4, 2002, at 17:05:53
Is Remeron anything like Trazodone? I took that for a while with Xanax, and it stopped working after about a month. I remember that Trazodone was easy to get into too, without having to do the slow-dose thing. I was hoping Remeron resembled Serzone more, because that's what I really need.
I read these posts and feel so sad for most of you. I feel like since all I have is a little panic-induced insomnia (panic about sleep, that is!), I don't really belong. But then I think of how awful I feel when I lie in bed for ten hours without sleeping. I spend the next day crying and feeling totally depressed and worthless and hopeless. And then I sleep two hours the next night, and the cycle continues for four days.
So I know how it feels to be miserable and depressed and have horrible thoughts, but I don't feel that way most of the time. Only when I don't sleep, really.
beardy
Posted by JohnX2 on March 4, 2002, at 21:03:10
In reply to Re: Remeron P.S. » JohnX2, posted by beardedlady on March 4, 2002, at 19:30:08
Hi,Remeron is nothing like Trazodone. Completely different mode of action.
I had massive insomnia for a few days when I was trying to quit
a medication, I almost went insane steering at the wall. I felt like
I had this steady low-level supply of energy that just wouldn't let me
fall asleep but at the same time I felt like shit. It was horrible.
So I ?kinda? know where you are coming from.
Fortunately I generally don't have the depression that is coupled with insomnia.
Anyways,please don't feel a need to compare pain stories with one another. Everyone
deserves a dignified quality of life, no matter what the situation.take care,
John
> Is Remeron anything like Trazodone? I took that for a while with Xanax, and it stopped working after about a month. I remember that Trazodone was easy to get into too, without having to do the slow-dose thing. I was hoping Remeron resembled Serzone more, because that's what I really need.
>
> I read these posts and feel so sad for most of you. I feel like since all I have is a little panic-induced insomnia (panic about sleep, that is!), I don't really belong. But then I think of how awful I feel when I lie in bed for ten hours without sleeping. I spend the next day crying and feeling totally depressed and worthless and hopeless. And then I sleep two hours the next night, and the cycle continues for four days.
>
> So I know how it feels to be miserable and depressed and have horrible thoughts, but I don't feel that way most of the time. Only when I don't sleep, really.
>
> beardy
Posted by JohnX2 on March 4, 2002, at 21:11:14
In reply to Re: Remeron P.S. » beardedlady, posted by JohnX2 on March 4, 2002, at 21:03:10
Back track, Trazodone has some anti-histamine properties
which Remeron also does. Besides that they are not
too similar. I grew tolerant to Benadryl sleep
properties but not Remeron.-John
>
> Hi,
>
> Remeron is nothing like Trazodone. Completely different mode of action.
>
> I had massive insomnia for a few days when I was trying to quit
> a medication, I almost went insane steering at the wall. I felt like
> I had this steady low-level supply of energy that just wouldn't let me
> fall asleep but at the same time I felt like shit. It was horrible.
> So I ?kinda? know where you are coming from.
> Fortunately I generally don't have the depression that is coupled with insomnia.
>
>
> Anyways,please don't feel a need to compare pain stories with one another. Everyone
> deserves a dignified quality of life, no matter what the situation.
>
> take care,
> John
>
>
> > Is Remeron anything like Trazodone? I took that for a while with Xanax, and it stopped working after about a month. I remember that Trazodone was easy to get into too, without having to do the slow-dose thing. I was hoping Remeron resembled Serzone more, because that's what I really need.
> >
> > I read these posts and feel so sad for most of you. I feel like since all I have is a little panic-induced insomnia (panic about sleep, that is!), I don't really belong. But then I think of how awful I feel when I lie in bed for ten hours without sleeping. I spend the next day crying and feeling totally depressed and worthless and hopeless. And then I sleep two hours the next night, and the cycle continues for four days.
> >
> > So I know how it feels to be miserable and depressed and have horrible thoughts, but I don't feel that way most of the time. Only when I don't sleep, really.
> >
> > beardy
Posted by beardedlady on March 5, 2002, at 13:50:58
In reply to Re: Remeron P.S., posted by JohnX2 on March 4, 2002, at 21:11:14
pdoc says no to Remeron. He says there's too great a tendency to gain weight, and I won't be happy. (I've already put on ten pounds from Serzone.)
We're thinking about trying Trazodone again. I don't think that gave me any side effects. Is it possible that the effects might stick around this time, especially if I'm now getting therapy and taking vitamins and exercising and all? Or will it still probably poop out?
He said I might as well just stick with Serzone, but he's the one who told me to get off. Now I'm really confused.
: )>
Posted by JohnX2 on March 5, 2002, at 16:48:49
In reply to Re: Remeron P.S. » JohnX2, posted by beardedlady on March 5, 2002, at 13:50:58
> He said I might as well just stick with Serzone, but he's the one who told me to get off. Now I'm really confused.
>
> : )>Hey you had a good point about Serzone, if there
was a viable alternative then why not make a switch.I'm not convinced about the weight gain. I gained a lot
of weight on Serzone but non on Remeron. I feel that the
mechanisms that cause the weight gain are different and
vary from person to person. But your pdoc has treated
a lot of people so he probably sees the statistical trends
regarding weight gain more clearly.best wishes,
john
Posted by Shyla on March 4, 2004, at 8:52:05
In reply to Re: Remeron P.S. » beardedlady, posted by JohnX2 on March 5, 2002, at 16:48:49
I have been taking 5 mgs of Ambien with my 8 mls of Gabatril. That combo helps me sleep through the night. I take Effexor during the day for social anxiety. I used to take Remeron, and often complained of feeling dopey during the day, and having no energy to do much. Effexor has changed all of that.
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