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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 linkadge on July 12, 2007, at 11:18:44
Can anyone campare the above in terms of use as a sleep aid?
Linkadge
Posted by Phillipa on July 12, 2007, at 12:02:57
In reply to low dose doxapin vs. amitryptaline or trimipramine, posted by linkadge on July 12, 2007, at 11:18:44
Welcome back missed you. Love Phillipa sorry had to say hello.
Posted by ttee on July 12, 2007, at 23:24:59
In reply to low dose doxapin vs. amitryptaline or trimipramine, posted by linkadge on July 12, 2007, at 11:18:44
I am also interested in any posts to Links question. I had my pdoc prescribe me a bottle of the liquid Doxepin to try for sleep in addition to my Zoloft. I have a little droper thing that will let me dose it as small as 1 mg. I was thinking of trying 3 mg of this stuff to see it it helps with sleep like the trials for Silenor say it will do.
Posted by polarbear206 on July 13, 2007, at 9:04:25
In reply to low dose doxapin vs. amitryptaline or trimipramine, posted by linkadge on July 12, 2007, at 11:18:44
> Can anyone campare the above in terms of use as a sleep aid?
>
> LinkadgeI would go with amitryptaline, more sedating of the group.
Polarbear
Posted by Guy on July 13, 2007, at 10:13:12
In reply to low dose doxapin vs. amitryptaline or trimipramine, posted by linkadge on July 12, 2007, at 11:18:44
As far as I know, doxepin is the most sedating of the group. Of the three, it is the only thing that helps me sleep. Unfortunately, after a month or so, when the AD effect kicks in, it starts to make me very agitated and I have to quit. Am currently taking 100 mg at bedtime. A therapeutic dose is around 200 mg. So, if you take 3 mg, you may not experience much, but who knows. Try it and see...it's easy to start and stop at low doses.
Posted by linkadge on July 13, 2007, at 16:12:22
In reply to Re: low dose doxapin vs. amitryptaline or trimipramine, posted by Guy on July 13, 2007, at 10:13:12
Well it doesn't matter anyway. The doctor dismissed the idea in favor of upping my seroquel.
Thats not happening. Seroquel feels like somebody hit me over the head with a hammer, its not a "good sleepy" feeling. When I'm low, seroquel just makes me feel lower, and then I can't sleep nomatter.I had tried doxapin in the past with sucess as a sleep aid, ususally 5-10mg,
but doctor said I might have problems trying to refill the prescription.
Yeah, like thats the problem.
He told me today that higher doses of seroquel were better because the drug reps had told him so.
It hate doctors, sometimes healing is so close, yet so far away.
Linkadge
Posted by Guy on July 13, 2007, at 17:53:14
In reply to low dose doxapin vs. amitryptaline or trimipramine, posted by linkadge on July 12, 2007, at 11:18:44
Doesn't sound like your pdoc is listening to you at all. That's not good. Sometimes it's better to go to your gp and ask for the meds you want, but that could of course cause problems between the two docs. My pdoc would never give me anything that I said made me feel ill.
Posted by ttee on July 13, 2007, at 18:20:55
In reply to Re: low dose doxapin vs. amitryptaline or trimipramine, posted by linkadge on July 13, 2007, at 16:12:22
Link - Why would it be difficult to refill a Doxepin prescription? Don't they still make it in a concentrated liquid form that would last 10 years at a dose of < 10 mg QD?
Posted by linkadge on July 13, 2007, at 20:21:17
In reply to Re: low dose doxapin vs. amitryptaline or trimipramine, posted by Guy on July 13, 2007, at 17:53:14
Yeah, I hate all the meds I am supposed to be taking. I don't know how I ended up on such a rotten combination.
Seroquel:I'm not psychotic, I just can't sleep. I'd rather not sleep. I am less impaired on 2 hours of sleep than I am on seroquel.
Linkadge
Posted by linkadge on July 13, 2007, at 20:30:41
In reply to Re: low dose doxapin vs. amitryptaline or trimipramine, posted by ttee on July 13, 2007, at 18:20:55
I don't know, he just doesn't really care. I told him I went from 3 hours of sleep to 6 with 10 mg of doxapin (which is the truth), but he doesn't care.
Its just reverse psychology. If I ask for something, he'll give me the opposite just to show that I do not make decisions.
It really sucks that I will have to go back to more insomnia.
Doxapin is available everywhere.
Oh well.
Linkadge
Posted by ttee on July 14, 2007, at 7:32:44
In reply to Re: low dose doxapin vs. amitryptaline or trimipramine » Guy, posted by linkadge on July 13, 2007, at 20:21:17
I'm with you on not taking seroquel for sleep. I don't find the sleep on seroquel worth the side effects, and ATP risks. I also don't do well with benzo's in the sleep dept. I get rebound anxiety the during the next day.
Posted by ttee on July 14, 2007, at 7:35:47
In reply to Re: low dose doxapin vs. amitryptaline or trimipramine, posted by ttee on July 14, 2007, at 7:32:44
Link - Your relationship with your pdoc doesn't sound very good. What a pain to look for a new one, but there are some better at listening. Good luck.
Posted by zatar on July 14, 2007, at 14:13:05
In reply to low dose doxapin vs. amitryptaline or trimipramine, posted by linkadge on July 12, 2007, at 11:18:44
> Can anyone campare the above in terms of use as a sleep aid?
Doxepin increases stage IV sleep as well as VIPS (vasoactive intestinal peptides). My IBS symptoms have improved on 10mg doxepin and I certainly sleep through the night, but a blood level drawn at that dose measured zero and I'm still drowsy during the day. I'm titrating upwards using doxepin liquid. I'm going to give it a couple of days at each increased dose to see if the grogginess goes away.
Amitriptyline 50mg used to work great for sleep years ago, but now I cannot tolerate even 5mg. Too many receptors have been changed by all the meds I've tried.
My psychiatrist also said that there are bursts of growth hormone after REM sleep and therefore increasing sleep is importtant for fibromyalgia symptoms.
http://www.psychiatrist.com/pcc/pccpdf/v03n03/v03n0303.pdf
I'd personally like to try mirtazapine, if increasing the doxepin doesn't work.
-zatar
Posted by linkadge on July 14, 2007, at 18:42:31
In reply to Re: low dose doxapin vs. amitryptaline or trimipra, posted by zatar on July 14, 2007, at 14:13:05
Yeah, most antiderpessants reduce REM sleep, including Remeron. I think trimipramine *increases* REM sleep however.
Linkadge
Posted by zatar on July 15, 2007, at 11:54:39
In reply to Re: low dose doxapin vs. amitryptaline or trimipra, posted by linkadge on July 14, 2007, at 18:42:31
> Yeah, most antiderpessants reduce REM sleep, including Remeron. I think trimipramine *increases* REM sleep however.
>
> Linkadgehttp://209.85.165.104/search?q=cache:_IsenF1tZzsJ:www.nature.com/npp/journal/vaop/ncurrent/full/1300923a.html+REM+Sleep+Architecture+Spectral+Composition&hl=en&ct=clnk&cd=1&gl=us&lr=lang_en
This article says that studies in rats show a decrease in REM and an increase in slow wave sleep at higher doses of mirtazapine.Regarding trimipramine, here's a previous Babble post with trimipramine articles:
http://www.dr-bob.org/babble/20020525/msgs/107821.htmlTrimipramine sounds interesting.
--zatar
Posted by linkadge on July 15, 2007, at 14:17:01
In reply to Re: low dose doxapin vs. amitryptaline or trimipra » linkadge, posted by zatar on July 15, 2007, at 11:54:39
Yeah it is a strange drug. It has some mild neuroleptic like effects (dopamine blockade), but its principle activity is likely serotonin receptor antagonism. Kind of like minaserin, (or maybe I'm thinking ritanserin)
Linkadge
Posted by Oppycat on July 17, 2007, at 8:27:52
In reply to low dose doxapin vs. amitryptaline or trimipramine, posted by linkadge on July 12, 2007, at 11:18:44
> Can anyone campare the above in terms of use as a sleep aid?
>
> LinkadgeI only have experience with amitryptaline among those 3, which I found very effective, even at 25mg. I have heard that Doxapin is even more sedating. Amityptaline was the first AD I ever took and I found it more sedating than Remeron, which I take now.
Posted by Oppycat on July 18, 2007, at 6:51:51
In reply to low dose doxapin vs. amitryptaline or trimipramine, posted by linkadge on July 12, 2007, at 11:18:44
I forgot to add that I also found Seroquel unsatisfactory as a sleep aid. Although I usually slept all night, the strange dreams made me wake up feeling like I had run a marathon all night. The blurred vision I had every morning convinced me that there had to be better solutions, at least for me.
Posted by linkadge on July 18, 2007, at 9:49:28
In reply to Re: low dose doxapin vs. amitryptaline or trimipramine » linkadge, posted by Oppycat on July 18, 2007, at 6:51:51
Thats exactly what I said to the doctor! I said seroquel essentially makes me feel like sombody hit me over the head with a baseball bat. Sure, I occasionally loose contiousness, but the sleep is light, is broken, and the next day hangover is too much.
I was hoping to try a bit of either trimipramine, or doxapine with some time release melatonin.
Linkadge
Posted by Larry Hoover on July 20, 2007, at 10:37:42
In reply to low dose doxapin vs. amitryptaline or trimipramine, posted by linkadge on July 12, 2007, at 11:18:44
I've used them all. In my body, doxepin = trimipramine, both better than amitryptiline.
Based on histamine binding affinity, doxepin has a slight advantage of trimipramine, and both are much more powerful than is amitryptiline.
Your brain may vary.
Lar
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