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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by blueberry on October 31, 2005, at 5:36:17
What are the best benzos for sleep? I don't need one for anxiety, just sleep, and probably just for short term or every other night or something, but not regular all the time.
I have tried xanax. It works ok, but I can feel tolerance to its sedating effects set in fairly rapidly. I'm hoping there is a benzo where tolerance isn't such a concern. From this board, I'm guessing that klonopin would be a possible choice.
Trazadone sucks. Remeron sucks. Tricyclics I can't tolerate. My depakote is not sedating to me. Zyprexa was wonderful but pooped out after 5 years...might be trying seroquel. Ambien isn't strong enough. Benadryl tolerance sets in real fast. Lunesta does ok, but still have many wakings and early waking.
Without regards to anxiety or depression, do you good folks have suggestions for good sleep benzos?
Posted by SLS on October 31, 2005, at 7:17:08
In reply to What are some of the best benzos for good sleep?, posted by blueberry on October 31, 2005, at 5:36:17
I don't think Klonopin would be your best choice because it has such a long half-life. There would definitely be a residual effect during the day. It seems to be a difficult drug to discontinue. In addition, some people feel Klonopin depresses them somewhat.
What about Seroquel 25mg?
Ambien?
Ativan and Restoril make good hypnotics. Ativan is anxiolytic as well, but its intermediate half-life allows for most of its effect to be gone by morning. Restoril is probably the least anxiolytic. However, it is not as good for initiating sleep as it is later in the night to prevent awakenings. For a really stubborn case of insomnia, you can combine a high-potency short-acting drug like Halcion or Sonata with a longer acting drug like Ativan or Restoril.
There are so many BZDs. People are going to have their favorites.
- Scott
Posted by Glydin on October 31, 2005, at 7:26:04
In reply to What are some of the best benzos for good sleep?, posted by blueberry on October 31, 2005, at 5:36:17
> I can feel tolerance to its sedating effects set in fairly rapidly.
I found that to be true while on routine Klonopin. After about two weeks of use, it's sedating effects abated and I was left with good antianxiety properties. For me, benzos, in general, were not good sleep aids. I have read of them being disruptive to third stage sleep and therefore aren't particularly good for sleep continuation (or induction) - but, I don't think that's a given for all folks and others may have different findings.
Posted by SLS on October 31, 2005, at 7:57:35
In reply to Re: What are some of the best benzos for good sleep? » blueberry, posted by Glydin on October 31, 2005, at 7:26:04
Hi.
Have you ever tried mirtazapine, nefazodone, or trimipramine? These antidepressants are supposed to enhance sleep architecture.
As far as Seroquel is concerned, it, too, is supposed to enhance sleep architecture and improve sleep efficiency. It is being used for PTSD and alcoholism to help normalize sleep. It might be that any potent 5-HT2a receptor antagonist offers this as an effect. Additionally, Seroquel has antihistaminic properties that might contribute to its reported sleep-inducing effects.
- Scott
Posted by Glydin on October 31, 2005, at 8:53:21
In reply to Re: What are some of the best benzos for good sleep? » Glydin, posted by SLS on October 31, 2005, at 7:57:35
Thankfully, I no longer have a problem with sleep and I rarely need to use Klonopin at present - although, it was a great med for me for toxic anxiety states.
Things are good for me right now and I'm very blessed.
Posted by Phillipa on October 31, 2005, at 18:27:24
In reply to Re: What are some of the best benzos for good sleep? » SLS, posted by Glydin on October 31, 2005, at 8:53:21
Well I guess I'm wierd but I still like valium. It puts me to sleep at l0mg and when I wake up I take another five mg. Maybe it's a placebo effect as it seems none of them help me sleep through the night. I was given seroquel 50mg with chloral hydrate l0cc's and xanax and small dose of klonopin in the hospital last year. And I still woke-up and they repeated seroquel and the morning after I almost fainted and couldn't speak. I could think but the words wouldn't come out. They immediately discontinued it. Anyone ever heard of someone like this? Only time I experienced good sleep was when I was drinking 5-6 beers nightly and taking .5mg of xanax. Slept like a baby. Fondly, Phillipa
Posted by iforgotmypassword on October 31, 2005, at 18:37:15
In reply to Re: What are some of the best benzos for good sleep?, posted by Phillipa on October 31, 2005, at 18:27:24
i remember some of my doctors prefering to prescibe temazepam for sleep, but it was probably due to impressions of it being less addictive. i think it does have a short half life though so there may be less chance of oversleeping or waking up with a hang over. on the flipside its prolly effective for a shorter duration, and for all i know not very effective at all. :(
Posted by Phillipa on October 31, 2005, at 21:29:34
In reply to Re: What are some of the best benzos for good slee, posted by iforgotmypassword on October 31, 2005, at 18:37:15
Is temazapane the same as restoril? I would like to try restoril. What category of med is it in. I don't think they prescribe it anymore . Probably because it works. Fondly, Phillipa
Posted by Larry Hoover on October 31, 2005, at 22:26:12
In reply to Re: What are some of the best benzos for good slee » iforgotmypassword, posted by Phillipa on October 31, 2005, at 21:29:34
> Is temazapane the same as restoril? I would like to try restoril. What category of med is it in. I don't think they prescribe it anymore . Probably because it works. Fondly, Phillipa
Yes, temazepam is sold as Restoril. Other good sleepy-time benzos are oxazepam (Serax) and nitrazepam (Mogadon). Some people also really do well with clonazepam (Klonopin/Rivotril).
I used temazepam for years, without substantial loss of efficacy. It lost a bit of its edge, but not much.
Lar
Posted by Phillipa on October 31, 2005, at 22:54:06
In reply to Re: What are some of the best benzos for good slee » Phillipa, posted by Larry Hoover on October 31, 2005, at 22:26:12
Lar, thanks I thought it was. Klonopin just made me depressed. Fondly, Phillipa
Posted by ed_uk on November 1, 2005, at 15:50:50
In reply to Re: What are some of the best benzos for good slee » Phillipa, posted by Larry Hoover on October 31, 2005, at 22:26:12
Temazepam is a good benzo for sleep
Ed
Posted by Chairman_MAO on November 1, 2005, at 19:55:06
In reply to What are some of the best benzos for good sleep?, posted by blueberry on October 31, 2005, at 5:36:17
You could get good results using clonidine 0.1-0.3mg + ramelteon + hydroxyzine/diphenhydramine.
Benzos are not the best things to take for sleep if you can help it. If you need to though, I feel lorazepam (you can use alprazolam) is the best to try first due to its ~8hr half-life and lack of active metabolites.
Temazepam is often a favorite. Midazolam a lot of people seem to like and is used pre-op, but AFAIK it is nowhere near as special orally as if you took it intravenously--which I, fortunately and unfortunately, have never tried, so I cannot tell you what that's like. :)
Overall, the most effective (not potent, but effective) I ever took was nitrazepam 10-20mg. 5mg seems to be the starting dose. Too bad it also keeps you "tore up" for half the day!
I suggest you try zolpidem 5-20mg, zopiclone 7.5-15mg/eszopiclone 3-6mg before you even touch the benzos.
FWIW, for severe insomnia, nothing comes even remotely close--remote as in the north pole relative to costa rica on the globe--as the barbiturates. Of course, those build tolerance--which you will probably stop exceeding at some point when you are satisfied with your level of residual daytime intoxication. ;)
The _BEST_ ones IMHO (read: this is due to my reading of anecdotes, monographs, etc--I havent even taken these drugs) are flunitrazepam or brotiozolam (I may have spelled this wrong). Neither are available in the us. Nimetazepam is also incredibly powerful.
Avoid diazepam like the plague for sleep, please.
Posted by Bobby on November 1, 2005, at 21:45:26
In reply to What are some of the best benzos for good sleep?, posted by blueberry on October 31, 2005, at 5:36:17
I don't know what your dx is but a lot of bipolars have success with Serax. I'm supposed to take 30mg three times a day--but I save them up for night and take 90mg at one time. I'm in no way telling you to try that. 30mg should do the trick.
Posted by ed_uk on November 2, 2005, at 14:01:22
In reply to Re: What are some of the best benzos for good slee » blueberry, posted by Chairman_MAO on November 1, 2005, at 19:55:06
Hi Chairman,
>Overall, the most effective (not potent, but effective) I ever took was nitrazepam 10-20mg. 5mg seems to be the starting dose.
Nitrazepam is relatively widely used in the UK. I thought it wasn't available in the US. How did you come to try it?
>Avoid diazepam like the plague for sleep, please.
I've always found diazepam ok for sleep!
Kind regards
Ed
Posted by Chairman_MAO on November 2, 2005, at 15:57:53
In reply to Re: What are some of the best benzos for good slee » Chairman_MAO, posted by ed_uk on November 2, 2005, at 14:01:22
I obtained it from India on the cheap (Nitravet 10mg tabs). It used to be marketed under the trade name Mogadon (sounds like an intergalactic warlord in an Ed Wood movie, just as all of the MAOIs do, especially Nardil and Marplan, IMO) in the US.
Diazepam is bad to use for sleep because of creeping concentrations of nordiazepam in the blood encouraging the already present tendency to escalate the dose to deal with tolerance/loss of effect. At least with nitrazepam there is a smooth curve pharmacokinetically, IIRC.
Posted by ed_uk on November 3, 2005, at 16:55:47
In reply to Re: What are some of the best benzos for good slee » ed_uk, posted by Chairman_MAO on November 2, 2005, at 15:57:53
Hi Chairman
>Mogadon
It was marketed as Mogadon in the UK. Everyone takes the generic these days though.
>Diazepam is bad to use for sleep because of creeping concentrations of nordiazepam in the blood
I find it good for prn use though.
Kind regards
Ed
Posted by Bobby on November 3, 2005, at 21:49:26
In reply to Re: What are some of the best benzos for good slee » Chairman_MAO, posted by ed_uk on November 3, 2005, at 16:55:47
and a totaled Minivan that says don't take Valium and drive.
Posted by paulbwell on November 3, 2005, at 21:56:10
In reply to Re: What are some of the best benzos for good slee » Chairman_MAO, posted by ed_uk on November 3, 2005, at 16:55:47
Despite the media hopla-this pill iss very effective, along the lines as Mogadon (Nitrazepam).
Failing that if your insomnia is BAD, i would consult your Physician about a remedy that WILL help-Seconal (100mgs Caps-red coloured), will have you asleep, in times of need.
A restfull nights sleep is VERY mportant!!.for mental health, however it it is acheived-Ambien, halcion, variours benzos, Barbiturates:ie Seconal, Tuinal-for SEVER cases.
Cheers
Posted by Phillipa on November 4, 2005, at 19:55:58
In reply to I've got a broken hand, posted by Bobby on November 3, 2005, at 21:49:26
I've taken valium for years for sleep. I was prescribe l0mg for sleep at night and 5mg for the daytime. Since I usually wake up around 4-5 that's wnen I take my am dose. And because of the long half life don't need it during the day. Sometimes I don't think I need anything at all. But eight hours of uninterrupted sleep would probabaly allow me to awaken feeling much better. Fondly, Phillipa
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