![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by fachad on March 17, 2002, at 1:19:38
I have posted a few times here on my sleep woes.
It really seems to me like benzos are the best options given the problems I've had with everything else. But some have posted that benzos screw up sleep in the long run and end up causing more problems than they appear to solve in the short term. The last thing I need is to develop tolerance, have an unpleasant withdrawal, and have worse sleep problems that I started out with.
I could always just go back to Ambien.
I've never had any kind of substance abuse problems, even though I've had free access to problematic substances (e.g. narcotic pain meds, stimulants) from my docs for various things. Are benzos more likely than those meds to cause problems?
If it's really as bad as some say, I'd just like people to speak up, don't worry about coming off as an anti-benzo fanatic, and give me adequate warning. I give more credence to the stuff I read here than just about anything else, other than my own first hand experience.
Posted by JohnX2 on March 17, 2002, at 1:33:27
In reply to Benzos Ruin Sleep in the Long Run?, posted by fachad on March 17, 2002, at 1:19:38
Hi Fachad,This is my "opinion":
I don't feel that benzodiazepines should be prescribed purely for sleep disorders. The risk/reward doesn't seem to be there.I think you indicated earlier that you do not tolerate well medications like Remeron because of weight gain or something? is this correct?
Regards
John> I have posted a few times here on my sleep woes.
>
> It really seems to me like benzos are the best options given the problems I've had with everything else. But some have posted that benzos screw up sleep in the long run and end up causing more problems than they appear to solve in the short term. The last thing I need is to develop tolerance, have an unpleasant withdrawal, and have worse sleep problems that I started out with.
>
> I could always just go back to Ambien.
>
> I've never had any kind of substance abuse problems, even though I've had free access to problematic substances (e.g. narcotic pain meds, stimulants) from my docs for various things. Are benzos more likely than those meds to cause problems?
>
> If it's really as bad as some say, I'd just like people to speak up, don't worry about coming off as an anti-benzo fanatic, and give me adequate warning. I give more credence to the stuff I read here than just about anything else, other than my own first hand experience.
Posted by fachad on March 17, 2002, at 1:46:58
In reply to Re: Benzos Ruin Sleep in the Long Run? » fachad, posted by JohnX2 on March 17, 2002, at 1:33:27
John,
Yes, I gain weight quite quickly and dramatically on anti-histamine TCAs. Even 5mg/day of doxepin (which is enough to work for me for sleep) packs on about 2-3 lbs a week.
This weight gain is present even if I lower caloric intake and increase exercise. I am an honest and vigilant self-observer, so I know I'm not just deluding myself here. It has something to do with energy balance and fat storing mechanisms.
I haven't tried remeron, but I've heard it's worse than doxepin for weight. That's also why I've stayed away from Risperdal, Seroquel and Zyperexa.
The reason I am reluctant to go back to Ambien is that it is expensive and it only works for a few hours and then I wake back up.
So benzos are looking good to me - I just don't want to go down some primrose path that will lead me to more misery.
>
> Hi Fachad,
>
> This is my "opinion":
> I don't feel that benzodiazepines should be prescribed purely for sleep disorders. The risk/reward doesn't seem to be there.
>
> I think you indicated earlier that you do not tolerate well medications like Remeron because of weight gain or something? is this correct?
>
> Regards
> John
>
> > I have posted a few times here on my sleep woes.
> >
> > It really seems to me like benzos are the best options given the problems I've had with everything else. But some have posted that benzos screw up sleep in the long run and end up causing more problems than they appear to solve in the short term. The last thing I need is to develop tolerance, have an unpleasant withdrawal, and have worse sleep problems that I started out with.
> >
> > I could always just go back to Ambien.
> >
> > I've never had any kind of substance abuse problems, even though I've had free access to problematic substances (e.g. narcotic pain meds, stimulants) from my docs for various things. Are benzos more likely than those meds to cause problems?
> >
> > If it's really as bad as some say, I'd just like people to speak up, don't worry about coming off as an anti-benzo fanatic, and give me adequate warning. I give more credence to the stuff I read here than just about anything else, other than my own first hand experience.
Posted by JohnX2 on March 17, 2002, at 2:15:57
In reply to Weight Gain from TCAs and Benzos for Sleep » JohnX2, posted by fachad on March 17, 2002, at 1:46:58
Which antihistamine TCA's caused the weight gain?A lot of these medicines block the "alpha-1" noradrenaline receptor as well as the histamine receptor. This "alpha-1" receptor affects your metabolism. Blockade of alpha-1 receptors or antihistamines can induce drowsiness.
I gained quite a bit of weight on Zyprexa and Serzone (both alpha-1 antagonists), except when I also used Topamax, then I didn't. Zyprexa and Serzone block the alpha-1 receptor but don't do squat with antihistamine (in fact Zyprexa is a bit pro-histamine).
Remeron I never gained weight on. Remeron is only an antihistamine, it doesn't goof with that alpha-1 receptor. I thought for sure I would gain weight, but I didn't.
John
> John,
>
> Yes, I gain weight quite quickly and dramatically on anti-histamine TCAs. Even 5mg/day of doxepin (which is enough to work for me for sleep) packs on about 2-3 lbs a week.
>
> This weight gain is present even if I lower caloric intake and increase exercise. I am an honest and vigilant self-observer, so I know I'm not just deluding myself here. It has something to do with energy balance and fat storing mechanisms.
>
> I haven't tried remeron, but I've heard it's worse than doxepin for weight. That's also why I've stayed away from Risperdal, Seroquel and Zyperexa.
>
> The reason I am reluctant to go back to Ambien is that it is expensive and it only works for a few hours and then I wake back up.
>
> So benzos are looking good to me - I just don't want to go down some primrose path that will lead me to more misery.
>
>
>
>
>
> >
> > Hi Fachad,
> >
> > This is my "opinion":
> > I don't feel that benzodiazepines should be prescribed purely for sleep disorders. The risk/reward doesn't seem to be there.
> >
> > I think you indicated earlier that you do not tolerate well medications like Remeron because of weight gain or something? is this correct?
> >
> > Regards
> > John
> >
> > > I have posted a few times here on my sleep woes.
> > >
> > > It really seems to me like benzos are the best options given the problems I've had with everything else. But some have posted that benzos screw up sleep in the long run and end up causing more problems than they appear to solve in the short term. The last thing I need is to develop tolerance, have an unpleasant withdrawal, and have worse sleep problems that I started out with.
> > >
> > > I could always just go back to Ambien.
> > >
> > > I've never had any kind of substance abuse problems, even though I've had free access to problematic substances (e.g. narcotic pain meds, stimulants) from my docs for various things. Are benzos more likely than those meds to cause problems?
> > >
> > > If it's really as bad as some say, I'd just like people to speak up, don't worry about coming off as an anti-benzo fanatic, and give me adequate warning. I give more credence to the stuff I read here than just about anything else, other than my own first hand experience.
Posted by fachad on March 17, 2002, at 14:20:31
In reply to Re: Weight Gain from TCAs and Benzos for Sleep » fachad, posted by JohnX2 on March 17, 2002, at 2:15:57
I've gained from Elavil and Doxepin. They both block a1 adrenegic receptors, but so does Serzone and it is considered "weight neutral" in both clinical studies and in my own experience.
If someone could figure out why these drugs cause weight gain that would be an enormous breakthrough.
Remeron causes weight gain in almost everyone, so I'd rather not try it.
I'm a little surprised that more people have not spoken up against benzos for insomnia.
>
> Which antihistamine TCA's caused the weight gain?
>
> A lot of these medicines block the "alpha-1" noradrenaline receptor as well as the histamine receptor. This "alpha-1" receptor affects your metabolism. Blockade of alpha-1 receptors or antihistamines can induce drowsiness.
>
> I gained quite a bit of weight on Zyprexa and Serzone (both alpha-1 antagonists), except when I also used Topamax, then I didn't. Zyprexa and Serzone block the alpha-1 receptor but don't do squat with antihistamine (in fact Zyprexa is a bit pro-histamine).
>
> Remeron I never gained weight on. Remeron is only an antihistamine, it doesn't goof with that alpha-1 receptor. I thought for sure I would gain weight, but I didn't.
>
> John
>
>
>
>
>
>
> > John,
> >
> > Yes, I gain weight quite quickly and dramatically on anti-histamine TCAs. Even 5mg/day of doxepin (which is enough to work for me for sleep) packs on about 2-3 lbs a week.
> >
> > This weight gain is present even if I lower caloric intake and increase exercise. I am an honest and vigilant self-observer, so I know I'm not just deluding myself here. It has something to do with energy balance and fat storing mechanisms.
> >
> > I haven't tried remeron, but I've heard it's worse than doxepin for weight. That's also why I've stayed away from Risperdal, Seroquel and Zyperexa.
> >
> > The reason I am reluctant to go back to Ambien is that it is expensive and it only works for a few hours and then I wake back up.
> >
> > So benzos are looking good to me - I just don't want to go down some primrose path that will lead me to more misery.
> >
> >
> >
> >
> >
> > >
> > > Hi Fachad,
> > >
> > > This is my "opinion":
> > > I don't feel that benzodiazepines should be prescribed purely for sleep disorders. The risk/reward doesn't seem to be there.
> > >
> > > I think you indicated earlier that you do not tolerate well medications like Remeron because of weight gain or something? is this correct?
> > >
> > > Regards
> > > John
> > >
> > > > I have posted a few times here on my sleep woes.
> > > >
> > > > It really seems to me like benzos are the best options given the problems I've had with everything else. But some have posted that benzos screw up sleep in the long run and end up causing more problems than they appear to solve in the short term. The last thing I need is to develop tolerance, have an unpleasant withdrawal, and have worse sleep problems that I started out with.
> > > >
> > > > I could always just go back to Ambien.
> > > >
> > > > I've never had any kind of substance abuse problems, even though I've had free access to problematic substances (e.g. narcotic pain meds, stimulants) from my docs for various things. Are benzos more likely than those meds to cause problems?
> > > >
> > > > If it's really as bad as some say, I'd just like people to speak up, don't worry about coming off as an anti-benzo fanatic, and give me adequate warning. I give more credence to the stuff I read here than just about anything else, other than my own first hand experience.
Posted by Janelle on March 17, 2002, at 14:23:10
In reply to Re: Weight Gain from TCAs and Benzos for Sleep » fachad, posted by JohnX2 on March 17, 2002, at 2:15:57
John,
Here I am again, back to pick your brain! Okay, you said that a lot of these medicines block the "alpha-1" noradrenaline receptor as well as the histamine receptor (I follow that!) and that this "alpha-1" receptor affects your metabolism, and that blockade of alpha-1 receptors or antihistamines can induce drowsiness.
You also said that you gained quite a bit of weight on Zyprexa and Serzone (both alpha-1 antagonists) so my question is: does the BLOCKADE of alpha-1 receptor and the metabolic changes this causes then result in weight gain?
I have been on Zyprexa for about a year - when I started on it my appetite became immense but I did NOT give into it (that was difficult but I managed). My depression had *helped* me in one way - I had lost my appetite and shed about 30 pounds which I really needed to lose. So when Zyprexa started giving me the munchies big time I just drank water or ignored them. After awhile the Zyprexa stopped increasing my appetite.
I'm surprised that you never gained weight on Remeron - just about everyone I read about who's on that one gains weighton it.
So, what's the story with weight gain - is it the blocking of the alpha-1 receptor that causes it? Thanks as always.
Posted by fachad on March 17, 2002, at 14:35:26
In reply to JOHNX2 - re weight gain » JohnX2, posted by Janelle on March 17, 2002, at 14:23:10
Janelle,
I don't think the drug induced weight gain can be explained by drug action at any single receptor site.
For awhile, they were saying it was the antihistamine property that caused the weight gain. But regular old antihistamines like Benedryl or Chlortrimaton block histamine as strongly as weight gain casuing TCAs and they don't cause weight gain.
Cyproheptadine (Periactin) is an old antihistamine that does cause weight gain. People speculated that it was the 5HT-2 blockade that caused the weight gain. But other strong 5HT-2 blockers like ritanserin and Serzone don't cause weight gain.
John's post is the first place I've heard of a1 blockade as a source of weight gain, but other a1 blockers like Serzone and antihypertensives don't cause weight gain.
Again, I think it's one of the most important questions in psychopharmacology, but it is not as simple as blockade of one, or even a known combination of receptors.
> John,
>
> Here I am again, back to pick your brain! Okay, you said that a lot of these medicines block the "alpha-1" noradrenaline receptor as well as the histamine receptor (I follow that!) and that this "alpha-1" receptor affects your metabolism, and that blockade of alpha-1 receptors or antihistamines can induce drowsiness.
>
> You also said that you gained quite a bit of weight on Zyprexa and Serzone (both alpha-1 antagonists) so my question is: does the BLOCKADE of alpha-1 receptor and the metabolic changes this causes then result in weight gain?
>
> I have been on Zyprexa for about a year - when I started on it my appetite became immense but I did NOT give into it (that was difficult but I managed). My depression had *helped* me in one way - I had lost my appetite and shed about 30 pounds which I really needed to lose. So when Zyprexa started giving me the munchies big time I just drank water or ignored them. After awhile the Zyprexa stopped increasing my appetite.
>
> I'm surprised that you never gained weight on Remeron - just about everyone I read about who's on that one gains weighton it.
>
> So, what's the story with weight gain - is it the blocking of the alpha-1 receptor that causes it? Thanks as always.
Posted by Janelle on March 17, 2002, at 14:48:56
In reply to Re: JOHNX2 - re weight gain - no single receptor » Janelle, posted by fachad on March 17, 2002, at 14:35:26
Posted by Hal on March 17, 2002, at 17:06:49
In reply to Benzos Ruin Sleep in the Long Run?, posted by fachad on March 17, 2002, at 1:19:38
Hey,
I am sorry if I missed this in your post, but what is the cause of your insomnia (medications, unresolved depression, primary insomnia, etc)? Do you have difficulties falling asleep, early awakenings or during the entire night?
Hal
Posted by fachad on March 17, 2002, at 18:06:25
In reply to What type of sleeping difficulty? » fachad, posted by Hal on March 17, 2002, at 17:06:49
When I started Prozac last May, I immediately developed a severe problem with frequent early awakenings and poor quality sleep. I thought it would go away, and the depression was lifting, so I stayed on Prozac.
My pdoc gave me Ambien (he was extremely anti-benzo) and it really helped with rapid sleep onset, but I still had early morning awakenings.
Since my pdoc at the time was extremely anti-benzo, it was Ambien or nothing. So I took Ambien.
That pdoc closed his practice and now I have a new pdoc. He is not anti-benzo, and when I told him that Ambien was costing me a fortune and was not helping with my frequent / early awakening, he gave me temazepam.
Now it turns out that I did not used to have a problem initiating sleep, only a problem staying asleep, but after 7 months of regular Ambien usage, I cannot fall to sleep easily without it. And I still wake up early! Doooooo!
Just quit Prozac, you say? Well I tried and I got severe discontinuation symptoms. I know you are not supposed to with Prozac, long half-life and active metabolites, etc, but if I miss a dose I get a sore throat and feel flu-ish all day. By the second day I am miserable. Even though I did not expect discontinuation symptoms, I got them; and my direct experience is real to me regardless of what the textbooks describe.
I have managed to taper Prozac very gradually from 20mg/day to 5 mg/day over the last 6 months. I'm hoping that when I stop taking Prozac, my sleep will find it's way back to normal.
In the meantime, I need to sleep so I can function, but I don't want to create another problem like I did (inadvertently) by taking Ambien.
BTW, I did not develop any tolerance to Ambien, even though I took it EVERY night, without fail for 7 months. I don't have any "moralistic" problems taking benzos indefinitely if they keep working. I'm really just wondering if tolerance develops: Always, or Usually, or Sometimes, or if there's a decent shot that they'll keep working for sleep.
What say the PSBers?
> Hey,
>
> I am sorry if I missed this in your post, but what is the cause of your insomnia (medications, unresolved depression, primary insomnia, etc)? Do you have difficulties falling asleep, early awakenings or during the entire night?
>
> Hal
Posted by Hal on March 17, 2002, at 18:41:39
In reply to Prozac - Early Awakenings and Ambien caused... » Hal, posted by fachad on March 17, 2002, at 18:06:25
Hey,
So it sounds like your insomnia is medication induced. Ambien is a good medication for difficulty falling asleep, but poor for maintaining sleep throughout the night (half life too short). I was going to recommend a more sedating SSRI like paxil, but your almost off prozac. I believe benzos restore sleep to a fairly normal pattern, just decrease stage IV to a minor degree. Trazadone/serzone are good for restoring sleep patterns. I would stay away from antihistamines (benadryll, TCA, atarax) because althought they are excellent at inducing sleep, they destroy individuals sleep cycles, and you wake up not feeling refreshed. Some people take 5 mg of ambien at bedtime and 5 mg half way through the night when they awake.
And of course good sleep hygiene is the most important thing you can do (the rule of 2's-no caffiene after 2 pm, no exercise 2 hours before bedtime, etc.)
I hope this didn't put you to sleep, if so-just read this post before bedtime!
Hal
Posted by fachad on March 17, 2002, at 19:09:32
In reply to Re: Prozac - Early Awakenings and Ambien caused... » fachad, posted by Hal on March 17, 2002, at 18:41:39
Paxil was the shortest ever med trial in my life. I think I took it 2 or maybe 3 days, and it was the most awful stuff. It made me groggy all day, unable to sleep at night, and of course completely anorgasmic.
You are right on about Ambien and falling asleep vs. staying asleep.
I took Serzone for a while; it caused the same problem as trazodone did for me. Those make me really sleepy, then I wake up after about two hours with a headache and unable to go back to sleep.
TCAs really make me gain weight, even if I decrease food intake and increase exercise.
Atarax, been there, done that, I did not know that it was possible to fall asleep during a brisk walk on a cold morning. Seriously, that stuff would make me sleep all day the next day.
So why is Ambien preferable to benzos? It is so expensive, and I'd have to wake up in the night and take it again anyway. Why not just take Restoril or Ativan which are dirt cheap generics, and stay asleep all night?
Is the reason to prefer Ambien over benzos theoretical, practical, moralistic, or just based on marketing hype from Ambien reps? I'm really skeptical of marketing claims for expensive patent meds.
BTW, I do know all about good sleep habits, no naps, no caffene after noon, etc.
> Hey,
>
> So it sounds like your insomnia is medication induced. Ambien is a good medication for difficulty falling asleep, but poor for maintaining sleep throughout the night (half life too short). I was going to recommend a more sedating SSRI like paxil, but your almost off prozac. I believe benzos restore sleep to a fairly normal pattern, just decrease stage IV to a minor degree. Trazadone/serzone are good for restoring sleep patterns. I would stay away from antihistamines (benadryll, TCA, atarax) because althought they are excellent at inducing sleep, they destroy individuals sleep cycles, and you wake up not feeling refreshed. Some people take 5 mg of ambien at bedtime and 5 mg half way through the night when they awake.
>
> And of course good sleep hygiene is the most important thing you can do (the rule of 2's-no caffiene after 2 pm, no exercise 2 hours before bedtime, etc.)
>
> I hope this didn't put you to sleep, if so-just read this post before bedtime!
>
> Hal
Posted by Hal on March 17, 2002, at 20:04:12
In reply to Paxil, Atarax, TCAs, and Ambien vs. Benzos » Hal, posted by fachad on March 17, 2002, at 19:09:32
Theoretically, ambien is more selective at the benzo receptor .... so there is less dependence and cognitive disfunction. I don't know about the reality of the med.
Other options:
neurontin
depakote
melatonin
remeron(although some histamine effect)Or read an organic chemistry textbook, a real sleeper!
Hal
Posted by MB on March 18, 2002, at 15:07:18
In reply to Re: Weight Gain from TCAs and Benzos for Sleep » fachad, posted by JohnX2 on March 17, 2002, at 2:15:57
> Zyprexa and Serzone block the alpha-1 receptor but don't do squat with antihistamine (in fact Zyprexa is a bit pro-histamine).My 2000 PDR says that "Olanzapine's antagonism of histamine H-1 receptors may explain the somnolence observed with this drug." Have they found out something new since then? Maybe time to get a new PDR.
Also, I was always under the impression that Serzone was low on the weight gain spectrum of the other serotonin potentiating drugs. I *did* hear a seminar once where it was proposed that adrenergic a-1 blockade might be partly responsible for weight gain seen with use of some neuroleptics. When I read that Serzone blocked a-1 I was a little dismayed (actually I was dismayed before then: when I stood up out of bed after my first nightly dose of 200mg--titrated up to there--and I passed out and hit my head). Orthostatic hypotention and sluggish metabolism and possible liver failure, well, sucks. I haven't gotten fat thanks to Adderall...but that may not last much longer, I don't know.
MB
Posted by JohnX2 on March 18, 2002, at 17:19:27
In reply to JOHNX2 - re weight gain » JohnX2, posted by Janelle on March 17, 2002, at 14:23:10
> John,
>
> Here I am again, back to pick your brain! Okay, you said that a lot of these medicines block the "alpha-1" noradrenaline receptor as well as the histamine receptor (I follow that!) and that this "alpha-1" receptor affects your metabolism, and that blockade of alpha-1 receptors or antihistamines can induce drowsiness.
>
> You also said that you gained quite a bit of weight on Zyprexa and Serzone (both alpha-1 antagonists) so my question is: does the BLOCKADE of alpha-1 receptor and the metabolic changes this causes then result in weight gain?
>
> I have been on Zyprexa for about a year - when I started on it my appetite became immense but I did NOT give into it (that was difficult but I managed). My depression had *helped* me in one way - I had lost my appetite and shed about 30 pounds which I really needed to lose. So when Zyprexa started giving me the munchies big time I just drank water or ignored them. After awhile the Zyprexa stopped increasing my appetite.
>
> I'm surprised that you never gained weight on Remeron - just about everyone I read about who's on that one gains weighton it.Maybe it is not a good idea to make too many generalizations. Everyone who takes medicines will find one where they are an exception to the rule and escapes the statistical bad side effect. Don't shy away from testing out medicines with bad reps if you have beaten down the better paths with failures and are grasping at staws (just my opinion). Of course, you would like to hear a few success stories on that medicine (like Serzone). This is just my opinion.
>
> So, what's the story with weight gain - is it the blocking of the alpha-1 receptor that causes it? Thanks as always.My doctor claims it is increased appetite and not metabolic slow down. This would seem to correlate with my Topamax add on which killed my appetite and stopped the weight gain of Zyprexa and Serzone. I'm not convinced there can't be a metabolic link also.
Thanks for the insightful questions.
regards
John
Posted by 3 Beer Effect on March 19, 2002, at 0:48:44
In reply to Benzos Ruin Sleep in the Long Run?, posted by fachad on March 17, 2002, at 1:19:38
Since Ambien is too expensive, you might want to try Ativan which is available is generic. Ativan is long acting (i think about 8 hours) & so you should be able to stay asleep all night. It is also the strongest Benzos except for Klonopin.
I take Klonopin, but it isn't a very good sleeping pill since it takes 60 mins just to start working & lasts too long (12 hrs) which would give you a hangover.
Ativan is much faster acting, & probably makes a good sleeping pill in adequate doses, but i've heard that it won't "knock you out" like Ambien which is considered the best sleeping pill out there.
Benzo addiction is very controversial. I think the problem is that Valium (in the 1960s & 70s) & now Xanax for whatever reason seem to be abused much more frequently than any of the other benzos. (Personally I think Xanax should be rescheduled because the bad press generated from its abuse rubs off on more effective anti-anxiety benzos like Klonopin & Ativan). But benzos don't cause euphoria unless combined with alcohol, & drug treatment centers rarely see people who are seeking help for solely a benzo addiction. People that abuse benzos are usually poly drug abusers that will abuse anything they can get their hands on. One study I read said that among drug abusers Qualudes, barbituates, & even alcohol are sought out & much more highly prized than benzos.
I have been able to stop high-dose Klonopin 4 mg/day cold turkey & haven't had any addiction problems with it, even though in the past I have abused adderall, ritalin, dexedrine, cocaine, soma, & alcohol. Klonopin is one of the only drugs I haven't abused! If you take more than you are supposed to, you just feel drowsy, & really you just feel like crap! I don't see why anyone would want to abuse benzos-there is no euphoria which is the foundation all drugs of abuse share. Considering you never abused your narcotic pain meds or stimulants, your chances of becoming hooked on or abusing benzos is about nil.
If my doctor gave me a prescription for a narcotic pain med I would probably barely be able to contain my 'glee happy feeling' & I would smile all the way home from the pharmacy! (I got this feeling every time I filled a prescription for Ritalin or Dexedrine- but eventually I figured out that meds, especially ADD meds, work much better & last longer if you swallow them rather than snort them & don't abuse them- which skyrockets tolerance at amazing rates- Now I just stick to once per morning long acting stimulants).
Posted by fachad on March 19, 2002, at 3:17:08
In reply to You might want to try Ativan, posted by 3 Beer Effect on March 19, 2002, at 0:48:44
Yeah, I think I'll try Ativan.
I will miss that "hit on the head by a shovel" *wham* out cold thing from Ambien. I'd gladly pay the money if it would just last longer and keep me from waking up at 2 AM.
Maybe someday they'll release Ambien XR.
Posted by JohnX2 on March 19, 2002, at 4:58:03
In reply to You might want to try Ativan, posted by 3 Beer Effect on March 19, 2002, at 0:48:44
> I have been able to stop high-dose Klonopin 4 mg/day cold turkey & haven't had any addiction problems with it3B,
Since you grew tolerant to the 4 mg dose, how many days have you been able to quit cold turkey without withdrawl effects?
Before becoming tolerant, I found that I could quit the medicine cold turkey twice without withdrawl symptoms. After noticing tolerance and attempting a cold turkey quit there was a 3 day lag before the withdrawl symptoms really "stung".
John
Posted by 3 Beer Effect on March 20, 2002, at 0:56:04
In reply to Re: You might want to try Ativan » 3 Beer Effect, posted by JohnX2 on March 19, 2002, at 4:58:03
I only stopped the Klonopin for three days & started getting rebound anxiety & had to go to work on Monday so I started retaking it. I noticed I actually slept more (like 12 hours) when during the withdrawl period. I usually only sleep 8 or 9 hours when I am on Klonopin.
I guess your really not supposed to stop cold turkey but, I think most people could taper it fairly quickly over a few weeks without that many problems.
I just don't know how long you would have to be totally off Klonopin in order to get back to square one. (I could probably take Benadryl as a substitute for sleep if I stopped taking Klonopin for a few weeks - i've heard that Benadryl (diphenhydramine) also has anxiolytic effects, but it makes me act kind of 'dippy' & dumb if I take it in the daytime.
I noticed if you develop tolerance to Ritalin you only have to stop taking it for one week before you are back to square one & it works great again.
Posted by JohnX2 on March 20, 2002, at 1:30:47
In reply to only stopped Klonopin for 3 days, posted by 3 Beer Effect on March 20, 2002, at 0:56:04
> I only stopped the Klonopin for three days & started getting rebound anxiety & had to go to work on Monday so I started retaking it. I noticed I actually slept more (like 12 hours) when during the withdrawl period. I usually only sleep 8 or 9 hours when I am on Klonopin.
Yes, please taper the Klonopin. We don't want to be calling you "3 day effect"! I found that if I dropped the dose a bit every 3 days I got the smoothest ride.
>
> I guess your really not supposed to stop cold turkey but, I think most people could taper it fairly quickly over a few weeks without that many problems.
>
> I just don't know how long you would have to be totally off Klonopin in order to get back to square one. (I could probably take Benadryl as a substitute for sleep if I stopped taking Klonopin for a few weeks - i've heard that Benadryl (diphenhydramine) also has anxiolytic effects, but it makes me act kind of 'dippy' & dumb if I take it in the daytime.The benadryl will just goof up your sleep in my experience, it never helped me while I was rebounding off Klonopin. Only Remeron and Zyprexa worked. Remeron nearly saved my life. I was going batty from lack of good sleep at one point, and Remeron really smoothed things over for me.
If you can get some Remeron or something, I think the quality of sleep is better. I liked the Zyprexa. It helped a lot with the sleep. I don't take the stuff any more because I got a bit of a dystonia in my hand, but it really kills the anxiety and helps the sleep. The other thing that helped is this thing at Randall's called "Hyland's Natural Relief for Insomnia and Restlessness". I made some posts about this. Maybe it just worked for me, but it was great.
It has anticholinergic compounds, but I didn't get strong anticholinergic side effects. A little leary about taking it because some of the ingredients are unknown mode of action,...but when you need sleep. Its out of your body by the time you wake up. Check for drug interactions..at your own risk..(Recommended by clerk at Texaco).
>
> I noticed if you develop tolerance to Ritalin you only have to stop taking it for one week before you are back to square one & it works great again.Don't know about the Klonopin. I saw your post about the studies on epilepsy and the poop out after 3 months. I wonder since you and I exhibit bipolar symptoms if this is any indicator that we are more prone to certain "tolerance" symptoms as we may be utilizing the anticonvulsant actions of the medicine for our treatment some ? what do you think?
please take care.
best wishes
John
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