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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by tensor on July 19, 2007, at 11:50:39
Since I started with Edronax I have had difficulties falling asleep and staying asleep. I recently got a new job in the IT industry and there is A LOT to learn and tempo is overall set high. So my stress level is high right now and I can't handle anything else but my job.
It has been several nights when I have gotten no sleep at all and yesterday I had to call in sick because I knew I wouldn't last a whole day without sleep. I take Remeron along with Edronax, but the benign sedative side effect isn't there anymore. One night I took 45mg and I didn't even noticed it. Not the least, it just gave me acid stomach the day after. I wonder if it actually does anything for me anymore and I'm thinking of dropping it, finally after nine consecutive years on it.
I also have Imovane(zopiclone) which also is completely useless even at 15mg. The anxiety level, racing thoughts and rapid heart beats keeps me effectively awake.
I have two pdocs I know well and who can fix an appointment pretty fast but they are both on vacation. I talked another pdoc today and she could see me at Wednesday next week, so I will have to endure, the weekends are no problem, because I don't have to get up in the mornings.
My experience with hypnotics or other meds used as hypnotics are limited. Zopiclone has been adequate until now and 30mg of Remeron used to be reliable.So I wonder what I should do, the problem is probably transient, at least I hope so. What could possibly work, I have been thinking about trimipramine, trazodone and hydroxyzine. I really don't like the TCA's but at least trazodone has a short half life. I take clonazepam 2mg daily, and I think there is some cross tolerance to zopiclone, but I'm not sure. If I manage to fall asleep with 15mg zopiclone, then for sure I wake 1-2hrs later and then it's impossible to fall back to sleep again.
Are there other BZD-like meds that could be worth trying, or is it waste of time? I remember the strong sedative effect of Remeron, which also gave me no hang over and let me sleep all night. So what do you think?
Posted by Phillipa on July 19, 2007, at 11:56:00
In reply to Insomnia!, posted by tensor on July 19, 2007, at 11:50:39
I use valium and .25 of xanax I'm pretty sure the new job is adding to your insomnia is it possible the remeron pooped out? Good luck Tensor. Love Phillipa
Posted by Viking on July 19, 2007, at 12:15:31
In reply to Insomnia!, posted by tensor on July 19, 2007, at 11:50:39
I have taken Edronax and Remeron together for some time, and I must agree with you that this combo is not sedative at all.
Recently I saw someone on PB suggest a supplement of Potassium Citrate. I have tried it and it works well for me. It helps me sleep longer in the morning, which was a problem before.
Could it be that your dose of Edronax is too high? I have found that 4 mgs/day is definitely enough. More than that only increases sideeffects.
Dont forget to exercise. It can help a lot.
Posted by Guy on July 19, 2007, at 13:31:06
In reply to Insomnia!, posted by tensor on July 19, 2007, at 11:50:39
I know you don't like TCA's, but I will suggest one anyway. I'm currently taking doxepin 100 mg and that seems to help with sleep. You could try less and see if it works. When all else fails, I resort to Zyprexa, but be warned: this med causes severe rebound insomnia if you ever want to quit.
Posted by tensor on July 19, 2007, at 15:45:16
In reply to Re: Insomnia!, posted by Viking on July 19, 2007, at 12:15:31
Actually nice tips, thank you. I have actually been thinking of reducing Edronax dosage from 8 to 6mg, taking the lower dose at bedtime, but I have not been in remission long enough so I don't dare yet. I also don't feel too energetic but slightly dysthymic. I will look into Potassium Citrate and ask the pdoc about Doxepin, that's a strong anti-histamine. Viking, may I ask where you are from? Edronax is not available/used in many countries if I remember correctly, not in the US anyway. I'm from Finland btw.
Thank you,
Mattias
Posted by Viking on July 19, 2007, at 23:57:12
In reply to Re: Insomnia! » Viking, posted by tensor on July 19, 2007, at 15:45:16
I know that Edronax is little used in many countries because of a bad reputation for side effects. IMHO that is because of too high a dose.
At the moment I am trying a low dose of Abilify on top of Edronax/Remeron. Until now it has done miracles when it comes to energy, motivation and social behaviour. And it started working in 2 days !!!
I am from Denmark. Edronax is available here but not much used. Anyway, I get all my meds on mailorder. After 30 years I have given up on doctors.
Good luck with your new job.
Posted by cactus on July 20, 2007, at 1:01:14
In reply to Insomnia!, posted by tensor on July 19, 2007, at 11:50:39
If mogadon(nitrazepam) is available in your country then give it a go, it's the best sleep med I have ever taken. You might find it better than klonopin for sleep even though it's a hypnotic, it also covers you the next day for anxiety. I think mogadon and klonopin have similar half lives. I have tried imovane too and it actually made my anxiety worse the next day and didn't help much for sleep even at 15mg. And never rule out good old valium
Posted by tensor on July 20, 2007, at 2:02:36
In reply to Re: Insomnia! » tensor, posted by cactus on July 20, 2007, at 1:01:14
Under current circumstances, neither clonazepam nor zopiclone does anything for my sleep. Nitrazepam is available here, so I will add it to my list. There is a problem when I take clonazepam on a regular basis that these kinds of meds are not as effective as for others. Therefore, a powerful anti-histamine might be more hypnotic.
/Mattias
Posted by Guy on July 20, 2007, at 6:58:33
In reply to Re: Insomnia!, posted by Viking on July 19, 2007, at 23:57:12
Hey Viking,
Jeg kommer ogsa fra Danmark! Jeg flyttede til Canada med min familie i 1960 da jeg var 6 ar gammel. Det er en skam at du ogsa lider af sovnloshed. Har det virkeligt vaerede 30 ar? Jeg har glemt sa meget af mit dansk men jeg leser stadig Berlingske Tidende naesten hver dag. Jeg elsker ogsa at lytte til dansk musik, isaer Kim Larsen. Han er helt fantastisk. Det er nu klokken fire om morgen her i Canada og jeg sover ikke! Hvis du har lost, send mig en babble-mail og sa kan vi snakke vidre.
Guy
Posted by cactus on July 20, 2007, at 7:01:50
In reply to Re: Insomnia! » cactus, posted by tensor on July 20, 2007, at 2:02:36
> Under current circumstances, neither clonazepam nor zopiclone does anything for my sleep. Nitrazepam is available here, so I will add it to my list. There is a problem when I take clonazepam on a regular basis that these kinds of meds are not as effective as for others. Therefore, a powerful anti-histamine might be more hypnotic.
>
> /MattiasSorry I didn't explain myself properly, nitrazepam is a very powerful hypnotic, slightly related to flunitrazepam (rohypnol) where clonazepam is more for anxiety and seizures, etc... I have found in the past that powerful anti-histamines leave me very sleepy the next day and I find it hard to function. I hope that was of some help.
Posted by Guy on July 20, 2007, at 7:06:36
In reply to Insomnia!, posted by tensor on July 19, 2007, at 11:50:39
Viking, den sidste hilsen pa dansk var selvfolgelig for dig.
Posted by tensor on July 20, 2007, at 7:07:28
In reply to Re: Insomnia!, posted by Guy on July 20, 2007, at 6:58:33
4 am and no sleep, I recognize that. Isn't it amazing how fast the hours tick by when you can't sleep and you know you have to get up at 7am?
Posted by Viking on July 20, 2007, at 7:47:20
In reply to Insomnia!, posted by tensor on July 19, 2007, at 11:50:39
When I take zopiclone occasionally, I often take it with a beer (just one!). That combo knocks me out every time like a sledgehammer. It does not give me any hangover.
To avoid acid reflux I always add some Ranitidine (Zantac).
Posted by tensor on July 23, 2007, at 2:08:20
In reply to Re: Insomnia!, posted by cactus on July 20, 2007, at 7:01:50
Isn't the long half-life of nitrazepam a problem? I've read about users complaining about a hang-over that lasts the whole day after. I wonder how powerful shorter acting benzos are compared to nitrazepam, e.g. triazolam or temazolam
Posted by cactus on July 23, 2007, at 4:16:42
In reply to Re: Insomnia! » cactus, posted by tensor on July 23, 2007, at 2:08:20
> Isn't the long half-life of nitrazepam a problem? I've read about users complaining about a hang-over that lasts the whole day after. I wonder how powerful shorter acting benzos are compared to nitrazepam, e.g. triazolam or temazolam
Yes, it is for the first few days but nothing that a coffee and shower won't fix, and if you get 5mg tabs you can break them in half and see how that works. A powerful anti-histamine makes it hard for me to get out of bed.
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