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Dr. Bob is Robert Hsiung, MD,
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Posted by zenhussy on June 5, 2003, at 9:45:50
In reply to Re: update, posted by Larry Hoover on June 5, 2003, at 8:15:08
> > So, a couple weeks ago, we drop the Remeron, and I'm just taking the temazepam. It doesn't work well any more! Or, yet. I hope it's yet.
>
> Even though I'm two weeks into cold-turkey withdrawal, I decided to take 1/4 tab of mirtazapine (more or less, 7.5 mg), along with the temazepam, last night.
>
> I feel a &@/% of a lot better, today. I could have slept a lot longer, but I had to set the alarm for a morning appointment.
>
> Thanks for the support I received.
>
> Lar
You betcha Lar. Sucks not to sleep. That almost anyone can identify with. You're fortunate to have the knowledge of which rxs to mix within limits to achieve the right kind of boost.Well done and sleep away!
zenh.
Posted by johnj on June 5, 2003, at 13:18:12
In reply to Re: update, posted by Larry Hoover on June 5, 2003, at 8:15:08
Good to hear things are better Larry. I wish I would have done that instead of bump my benzo up last year.
I am also better since I went down from 30 to 15 mg. I had two bad nights and a so so 3rd and since they have been pretty steady. Not near as much head pressure since I went down. Do you experience any other side effects from remeron? I found sexual dysfunction is better on 15 than 30. At 30 it was dead "fred". I don't see how this helps ssri induced SD??? Then again, nothings seems to be the norm for me.
Now, if I could just get off the dreaded TCA. But, I am now smart enought now to wait for a longer period of improvement before I try to tweak anything. Things I have learned from you :)
Pleasant dreams Lar
I could have slept longer today but my wifes alarm woke me...better that than staring at it from 5 am on!
johnj
Posted by disney4 on June 5, 2003, at 20:51:01
In reply to Re: update, posted by Larry Hoover on June 5, 2003, at 8:15:08
Hi Larry,
I had the same sort of thing happen when I tried Wellbutrin again. I did continue my other meds, but they stopped working and in fact started doing exactly the oppisite of what they usually did. Instead of being calming, they made me anxious and added to the insomnia. I was up for 3 nights in a row, and finally my Dr had me take extra klonopin to knock me out. Gradually my system returned to normal and my meds are acting in their usual way. I felt just like you did. I wished the Dr had left well enough alone, and I was very depressed. I think it will take some time, but your medication will work well again. Hang in there. Elsie
Posted by Larry Hoover on June 6, 2003, at 12:15:39
In reply to Re: update » Larry Hoover, posted by johnj on June 5, 2003, at 13:18:12
> Good to hear things are better Larry. I wish I would have done that instead of bump my benzo up last year.
Let go of regret, buddy. It doesn't help you now.
> I am also better since I went down from 30 to 15 mg. I had two bad nights and a so so 3rd and since they have been pretty steady.
Try and resist the urge to "micro-manage" what's happening. Everybody has up and down days. Trends are what's really happening, IMHO.
>Not near as much head pressure since I went down. Do you experience any other side effects from remeron?
Far more side-effects in withdrawal than during the course of treatment, though impotency is unacceptable to me at any point in time.
>I found sexual dysfunction is better on 15 than 30. At 30 it was dead "fred". I don't see how this helps ssri induced SD??? Then again, nothings seems to be the norm for me.
Only discovered by doing the experiment.
I was talking to my counsellor yesterday about my Remeron withdrawal experience. He made a good point; I had taken drug withdrawal advice from someone (my shrink) who had never gone through it himself. I had been kind of kicking myself for "being so stupid" as to have believed that I could just go cold turkey. Whatever. I did it that way, learned from it, and I'm moving on.
> Now, if I could just get off the dreaded TCA. But, I am now smart enought now to wait for a longer period of improvement before I try to tweak anything. Things I have learned from you :)I'm glad to hear you're developing more patience. That's good news. I'm glad I've helped.
> Pleasant dreams Lar
>
> I could have slept longer today but my wifes alarm woke me...better that than staring at it from 5 am on!
>
> johnjOne day at a time, bud.
Lar
Posted by Ron Hill on June 8, 2003, at 9:34:04
In reply to Re: update, posted by Larry Hoover on June 5, 2003, at 8:15:08
Hey Lar,
Did you sleep well last night? I'm cheering for you my friend. And I’ve prayed.
This Remeron deal was not your fault. Keep your positive thoughts flowing and, thereby, continue to nurture your positive attitude.
This too shall pass. You're a smart guy; you'll solve this problem.
I send to you my very best wishes.
-- Ron
---------------------------------
> > So, a couple weeks ago, we drop the Remeron, and I'm just taking the temazepam. It doesn't work well any more! Or, yet. I hope it's yet.
>
> Even though I'm two weeks into cold-turkey withdrawal, I decided to take 1/4 tab of mirtazapine (more or less, 7.5 mg), along with the temazepam, last night.
>
> I feel a &@/% of a lot better, today. I could have slept a lot longer, but I had to set the alarm for a morning appointment.
>
> Thanks for the support I received.
>
> Lar
Posted by Larry Hoover on June 9, 2003, at 10:32:38
In reply to Re: update » Larry Hoover, posted by Ron Hill on June 8, 2003, at 9:34:04
> Hey Lar,
>
> Did you sleep well last night? I'm cheering for you my friend. And I’ve prayed.Thanks. I do appreciate the support. I can feel it from here.
> This Remeron deal was not your fault. Keep your positive thoughts flowing and, thereby, continue to nurture your positive attitude.
Slipping into self-blame is almost an aspect of the disruption itself, a sign of the intensity of the disturbance. Once I'm aware that I'm doing that, I'm already 90% to solving it.
> This too shall pass. You're a smart guy; you'll solve this problem.I can already feel the difference that re-starting a tiny dose of Remeron has caused. It's taken the "edge" off, and the temazepam is coming back on stream.
I'm sensing my "slump" symptoms right now....quite interesting that work didn't trigger this process, but sleep disruption did. I don't anticipate a big slump, but time will tell. And, it provides a convenient opportunity to test the direct effect of NADH/TMG on acute slump symptoms. Up until now, I can only say that it seemed to be prophylactic.
> I send to you my very best wishes.
>
> -- RonThanks, buddy. I think I'm already over the hump.
Lar
Posted by Ron Hill on June 9, 2003, at 16:18:53
In reply to Re: update (insomnia) » Ron Hill, posted by Larry Hoover on June 9, 2003, at 10:32:38
Larry,
> I'm sensing my "slump" symptoms right now....quite interesting that work didn't trigger this process, but sleep disruption did. I don't anticipate a big slump, but time will tell. And, it provides a convenient opportunity to test the direct effect of NADH/TMG on acute slump symptoms. Up until now, I can only say that it seemed to be prophylactic.
Please post your results with regard to whether or not the Enada NADH/TMG supplements pull you out of your current CFS slump.
> I think I'm already over the hump.
Glad to hear it. I assume you plan to eventually wean yourself off of the Remeron completely.
-- Ron
Posted by Larry Hoover on June 9, 2003, at 18:25:58
In reply to Re: update (insomnia) » Larry Hoover, posted by Ron Hill on June 9, 2003, at 16:18:53
> Larry,
>
> > I'm sensing my "slump" symptoms right now....quite interesting that work didn't trigger this process, but sleep disruption did. I don't anticipate a big slump, but time will tell. And, it provides a convenient opportunity to test the direct effect of NADH/TMG on acute slump symptoms. Up until now, I can only say that it seemed to be prophylactic.
>
> Please post your results with regard to whether or not the Enada NADH/TMG supplements pull you out of your current CFS slump.I went back to a little bit of the "saturation" mode, taking 5 mg two days in a row (with 1 gram TMG). This has helped a lot.
> > I think I'm already over the hump.
>
> Glad to hear it. I assume you plan to eventually wean yourself off of the Remeron completely.The reintroduction of the Remeron was to make "the hump" smaller, by reducing the intensity of the withdrawal symptoms. If I might project into the future, I might take another 1/4 tablet after a few days. I'm hoping to not have to.
> -- RonThanks for caring.
Lar
Posted by Boba Fat on June 10, 2003, at 3:48:48
In reply to Re: update (insomnia) » Ron Hill, posted by Larry Hoover on June 9, 2003, at 18:25:58
I've followed this thread with interest. My problem with sleep was that it used to take me hours to get off. No matter how tired I was I would be tossing and turning. I was also a waker, I would wake 7 or 8 times, sometimes bolt upright - wide awake over a 5-6 hour 'sleep'. My other problem was occasional sleep paralysis and regular nightmares. Over the years my doctors have been reluctant to prescribe sleep aids and I have had to rely on Valerian, chamomile tea and warm milk - not the greatest sleep aids for someone with serious sleep problems. Recently since giving up most alcohol and stimulants I have had tons of energy which has manifested my problems into true insomnia. I concur that lack of sleep worsens anxiety and mood so I sought a solution. My doctor would only prescribe dothiepin but this only helped marginally. After only a few weeks stopped working at all. I had to stop taking it anyway because of the e-numbers, lactose and wheat starch it contained (because of my pesky diet) but it was neither helping my depression or sleep anyway. Now I rely on self medicated Klonopin, Diphenhydramine, codeine and the old Valerian and chamomile, often combining all five. This isn't a permanant solution though as I don't want to become tolerant or dependant to klonopin as I would rather save it for social anxiety and panic attacks (it is also expensive). There is a risk of tolerance with Diphenhydramine with long term use and the problems with possible codeine addiction are scary. The valerian and chamomile on their own just don't cut it though. I am interested in melatonin but it is not available here in England so I would have to mail order it (don't worry Bob, I won't ask where I can get it though! ;) ). Anyway that is my story. Sorry about the length but I just thought I would add my 2 cents to this interesting and relevant thread.
Posted by Larry Hoover on June 10, 2003, at 7:05:00
In reply to Re: update (insomnia), posted by Boba Fat on June 10, 2003, at 3:48:48
> I've followed this thread with interest. My problem with sleep was that it used to take me hours to get off. No matter how tired I was I would be tossing and turning. I was also a waker, I would wake 7 or 8 times, sometimes bolt upright - wide awake over a 5-6 hour 'sleep'. My other problem was occasional sleep paralysis and regular nightmares. Over the years my doctors have been reluctant to prescribe sleep aids and I have had to rely on Valerian, chamomile tea and warm milk - not the greatest sleep aids for someone with serious sleep problems.
No kidding! What is wrong with your friggin' doctors?
I'll tell you, without a shred of doubt, that getting my sleep back to being restorative was the turning point in my own struggle with mood.
>Recently since giving up most alcohol and stimulants I have had tons of energy which has manifested my problems into true insomnia. I concur that lack of sleep worsens anxiety and mood so I sought a solution. My doctor would only prescribe dothiepin but this only helped marginally. After only a few weeks stopped working at all. I had to stop taking it anyway because of the e-numbers, lactose and wheat starch it contained (because of my pesky diet) but it was neither helping my depression or sleep anyway.
I don't understand these e-numbers. You've mentioned them before.
>Now I rely on self medicated Klonopin, Diphenhydramine, codeine and the old Valerian and chamomile, often combining all five. This isn't a permanant solution though as I don't want to become tolerant or dependant to klonopin as I would rather save it for social anxiety and panic attacks (it is also expensive). There is a risk of tolerance with Diphenhydramine with long term use and the problems with possible codeine addiction are scary. The valerian and chamomile on their own just don't cut it though. I am interested in melatonin but it is not available here in England so I would have to mail order it (don't worry Bob, I won't ask where I can get it though! ;) ). Anyway that is my story. Sorry about the length but I just thought I would add my 2 cents to this interesting and relevant thread.
It's totally relevant. What I don't understand is the attitude of your doctors. You're forced to resort to inadequate alternatives with possible long-term adverse effects.
Here's my slant on benzos for sleep (e.g. temazepam). I think the situation is analogous to opiate use in chronic pain. If the correct dose of the correct opiate is chosen, the pain sufferer experiences no psychogenic effects, but merely a relief from pain. Rather than becoming addicted, these individuals experience a substantial increase in functionality, and do not experience tolerance.
I do believe it's the same with benzos for sleep disorders, at least for me. I have been on a stable dose for years, and it's the same dose I started at. No tolerance has developed. It remains effective for me. I'm not addicted to it, or dependent on it (I went off it in the winter when I started a trial of Remeron, and I went cold turkey).
Have you asked what your doctor's reticence in prescribing hypnotics arises from? I don't understand it.
Lar
Posted by Boba Fat on June 10, 2003, at 7:51:35
In reply to Re: update (insomnia) » Boba Fat, posted by Larry Hoover on June 10, 2003, at 7:05:00
The situation with e-numbers.
Many artificial colourings, preservatives and sweeteners are known to be the cause of ADD, ADHD, Depression and Anxiety in some people. Also wheat starch contained in some meds can cause depressive illness to those with a wheat intolerance or allergy. I am currently doing an exclusion (allergy diet) to see if cutting out these things will help with my mental problems. The problem is that meds for ADD, Depression, Anxiety and Allergy contain E-numbers that some people are sensitive to, thus causing the exact problem that the medication is supposed to be helping you for. Ironic, huh?
The situations with doctors and hypnotics.
UK Doctors won't prescribe them, simple as that. The hysteria over possible sedative abuse and dependance and the worry of legal action taken because someone has become addicted to them means they will not prescribe them. In my experience - and I have seen many GP's and Psychiatrists, the only things doctors are prepared to prescribe for sleep are trycylics or antihistamines but even then with great reluctance. Most British doctors will not prescribe benzo's for love nor money.
Posted by Larry Hoover on June 10, 2003, at 8:27:38
In reply to Re: update (insomnia), posted by Boba Fat on June 10, 2003, at 7:51:35
> The situation with e-numbers.
I could have just googled it myself.....the reason I've never heard of this concept is because it is an initiative of the EU, under the auspices of WHO.
It doesn't exist in North America, but it would be a useful tool for the consumer, no doubt.
Lar
Posted by Larry Hoover on June 10, 2003, at 8:30:23
In reply to Re: update (insomnia), posted by Boba Fat on June 10, 2003, at 7:51:35
> The situations with doctors and hypnotics.
>
> UK Doctors won't prescribe them, simple as that.
> Most British doctors will not prescribe benzo's for love nor money.
>I just checked the BNF (British National Formulary), and these two non-benzodiazepine hypnotics are available.
zolpidem (Stilnoct)
zopiclone (Zimovane, Zileze)Lar
Posted by disney4 on June 10, 2003, at 10:55:26
In reply to Re: update (insomnia) » Boba Fat, posted by Larry Hoover on June 10, 2003, at 8:30:23
>
>
> > The situations with doctors and hypnotics.
> >
> > UK Doctors won't prescribe them, simple as that.
> > Most British doctors will not prescribe benzo's for love nor money.
> >
>
> I just checked the BNF (British National Formulary), and these two non-benzodiazepine hypnotics are available.
>
> zolpidem (Stilnoct)
> zopiclone (Zimovane, Zileze)
>
> Lar
>
> Hi Larry,Are these two non-benzodiazepene hypnotics available in the US? I take a small dose of klonopin and Neurontin to help with disruptive sleep and bipolar disorder, yet I still start off the night in a trance like partially aware state for at least an hour.
I am happy to hear your temazepam is starting to work for you again. How does this med differ from klonopin?
Elsie
Posted by Larry Hoover on June 10, 2003, at 11:10:26
In reply to Re: update (insomnia) » Larry Hoover, posted by Ron Hill on June 9, 2003, at 16:18:53
> Please post your results with regard to whether or not the Enada NADH/TMG supplements pull you out of your current CFS slump.
It seems to be working. My energy and initiative are returning, and my cognition has improved dramatically.
One good day does not create a pattern, but the signs are suggestive.
Lar
Posted by Ron Hill on June 10, 2003, at 11:12:41
In reply to Re: update (insomnia), posted by Boba Fat on June 10, 2003, at 3:48:48
Hi Boba,
Just a thought; this may or may not have applicability to your situation. In the past, I (like most mental health patients) struggled with insomnia (getting to sleep and staying asleep). However, I now take 800 mg of magnesium at bedtime each night and it knocks me out like turning off a light and keeps me asleep throughout the night like a hibernating bear. I awake the next morning feeling refreshed and restored. YMMV.
I'm also convinced that the magnesium exerts positive effects on my brainchemistry functioning throughout the day.
Larry can say it better than I, but not all forms of magnesium are created equal when it comes to absorption. I take 400 mg/day (measured as Mg) of magnesium citrate and 400 mg/day (measured as Mg) of magnesium malate. If it causes diarrhea, back off on the dosage.
Do you take a magnesium supplement? What chelating agent? How much? What time of day do you take it?
I agree with what you all have already said; good sleep quality and duration is essential for good mental health.
-- Ron
------------------------------------
> I've followed this thread with interest. My problem with sleep was that it used to take me hours to get off. No matter how tired I was I would be tossing and turning. I was also a waker, I would wake 7 or 8 times, sometimes bolt upright - wide awake over a 5-6 hour 'sleep'. My other problem was occasional sleep paralysis and regular nightmares. Over the years my doctors have been reluctant to prescribe sleep aids and I have had to rely on Valerian, chamomile tea and warm milk - not the greatest sleep aids for someone with serious sleep problems. Recently since giving up most alcohol and stimulants I have had tons of energy which has manifested my problems into true insomnia. I concur that lack of sleep worsens anxiety and mood so I sought a solution. My doctor would only prescribe dothiepin but this only helped marginally. After only a few weeks stopped working at all. I had to stop taking it anyway because of the e-numbers, lactose and wheat starch it contained (because of my pesky diet) but it was neither helping my depression or sleep anyway. Now I rely on self medicated Klonopin, Diphenhydramine, codeine and the old Valerian and chamomile, often combining all five. This isn't a permanant solution though as I don't want to become tolerant or dependant to klonopin as I would rather save it for social anxiety and panic attacks (it is also expensive). There is a risk of tolerance with Diphenhydramine with long term use and the problems with possible codeine addiction are scary. The valerian and chamomile on their own just don't cut it though. I am interested in melatonin but it is not available here in England so I would have to mail order it (don't worry Bob, I won't ask where I can get it though! ;) ). Anyway that is my story. Sorry about the length but I just thought I would add my 2 cents to this interesting and relevant thread.
>
Posted by Ron Hill on June 10, 2003, at 12:49:09
In reply to Re: slump response to NADH » Ron Hill, posted by Larry Hoover on June 10, 2003, at 11:10:26
Larry,
> > Please post your results with regard to whether or not the Enada NADH/TMG supplements pull you out of your current CFS slump.
> It seems to be working. My energy and initiative are returning, and my cognition has improved dramatically.
> One good day does not create a pattern, but the signs are suggestive.Good news. Hope it continues.
-- Ron
Posted by johnj on June 10, 2003, at 17:06:58
In reply to Re: slump response to NADH » Ron Hill, posted by Larry Hoover on June 10, 2003, at 11:10:26
Lar,
Hope things are going well and sleepy time has returned for you. Are you off the remeron completely? Hope things smooth out for ya.
I am much better on 15 mg remeron for a sleep aid. Some SE, but I can live with them for now.
I will try some TMG and/or Enada in the future. Just need to be stabilized so I know what is doing what.
Take care and remember we are rooting for ya. How are you doing Ron?
Posted by Boba Fat on June 11, 2003, at 9:38:43
In reply to Re: update (insomnia) » Boba Fat, posted by Larry Hoover on June 10, 2003, at 8:30:23
Re: Zolpimed,Zopiclone
Doctors are still wary of prescribing these things because of addiction and abuse problems -especially considering I have had a few drug and alcohol related difficulties in the past.
Besides I tried a mail ordered generic of zopiclone (zopimed) and it was useless.
Posted by Boba Fat on June 11, 2003, at 9:41:52
In reply to Re: Magnesium as a sleep aid » Boba Fat, posted by Ron Hill on June 10, 2003, at 11:12:41
Re: Magnesium
What is the differance between magnesium citrate and magnesium malate? If I buy magnesium from a health food shop will it tell me what kind it is? Also what is a chelating agent? How much do you recommend to start off with?
Posted by Maxime on June 11, 2003, at 19:52:24
In reply to Re: Magnesium as a sleep aid, posted by Boba Fat on June 11, 2003, at 9:41:52
Since it's Magnesium Citrate that causes the runs, will taking magnesium malate alone promote sleep?
If you have to go to the hospital for test re. your stomach you have to drink a bottle of magnesium citrate the night before to clean you out .....
hence my question
Max
Posted by Ron Hill on June 13, 2003, at 0:49:08
In reply to Re: Magnesium as a sleep aid, posted by Boba Fat on June 11, 2003, at 9:41:52
Boba Fat
> What is the differance between magnesium citrate and magnesium malate?
Different chelating agent; citrate in the first, malate in the second.
> If I buy magnesium from a health food shop will it tell me what kind it is?
Sure, just read the label.
> Also what is a chelating agent?
Others on this board could tell you much better than I, but basically it refers to the molecule bonded to the magnesium (i.e.; citrate or malate in the case at hand)
> How much do you recommend to start off with?
Start out with 400 mg (measured as magnesium) per night. Slowly titrate up to 800 - 1000 mg per night. Reduce the dosage if diarrhea occurs.
-- Ron
Posted by Boba Fat on June 13, 2003, at 3:35:05
In reply to Re: Magnesium as a sleep aid » Boba Fat, posted by Ron Hill on June 13, 2003, at 0:49:08
Thanks Ron, sounds like an excellant non addicting solution to me, leaving me able to take 1 -2mg klonopin on occasional social situations, without having built up a tolerance and having to up the dose because I am taking upto 6mg a night because I can't sleep. I'm quite looking forward to this little experiment actually! I love a good nights sleep, I hope its as effective as you say! I can still take the valerian/chamomile tea I'm guessing? These things aren't tolerance inducing are they?
Posted by McPac on June 13, 2003, at 21:27:20
In reply to Re: Magnesium as a sleep aid » Boba Fat, posted by Ron Hill on June 10, 2003, at 11:12:41
Go with magnesium glycinate...magnesium citrate is good for an enema, lol.
Posted by Ron Hill on June 13, 2003, at 23:18:50
In reply to Re: Magnesium as a sleep aid, posted by McPac on June 13, 2003, at 21:27:20
McPac,
> Go with magnesium glycinate...magnesium citrate is good for an enema, lol.
I tried magnesium glycinate but it did not feel as good in my brain (if that makes any sense). I'll probably try it again soon since I bought a big bottle of it and it's still almost full.
For Boba Fat, the magnesium glycinate might be the better fit.
-- Ron (loose as a goose and always on the run)
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