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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by wishingstar on May 6, 2008, at 20:39:20
I'm currently taking 2mg valium at night (9pm-ish) and 5mg adderall in the morning, and again in the afternoon if needed. The adderall gives me just enough energy to make me productive at work (rather than dread/avoidance of many things) and takes away the minor depression that usually hits in the mornings. Generally just one in the morning is enough to get me going and then I get into my day and do okay. However, I get home and cant turn it off. I've been sleeping very poorly due to some work-related stress/anxiety for awhile, which hasnt been a problem for me in the past. For this my dr is working with me to find a drug I can take in the evenings/before bed to calm me down and allow me to sleep more soundly. I know that 2mg valium and 5mg adderall are both very small doses - I'm a very petite person and tend to be fairly sensitive to drugs in general.
As I said, I'm currently taking 2mg valium around 9pm. I've take it for two days. I tried klonopin previously but had to discontinue it. What is the role of benzos in causing disinhibition, to use my pdocs word? I have a history of self-injury but have been free from this behavior for many years. I rarely feel a strong urge to do it anymore. However, while taking the klonopin I suddenly had much stronger and more frequent urges to self-injure. I've noticed this again in the last two days since I began the valium. Doctor mentioned disinhibition is sometimes a side effect of benzos but I know little about this. How does this work? Can anyone offer another solution to the problem I've described above? I'm somewhat hesitant to take a sleeping medication for many reasons and would like to avoid it if possible. I've tried benadryl, which has worked in the past, but doesnt seem to be working now. I've also tried xanax which does not have this problematic effect on me, but doesnt last long enough.
I posted recently about this but will say again... I feel weird taking a sedative in the evenings and a stimulant in the mornings. It feels like I'm using the drugs incorrectly by taking both, but I am taking both exactly as prescribed.
I'd love to hear what people know regarding these drugs and this "disinhibition" effect. Also, any opinions on other options/solutions are more than welcome. Thank you in advance!
Posted by Phillipa on May 6, 2008, at 21:02:45
In reply to benzos and disinhibition, posted by wishingstar on May 6, 2008, at 20:39:20
Maybe he thinks they relax you enough that you might do something. But if xanax works for you there is time release which would take you through the night. Phillipa
Posted by med_empowered on May 7, 2008, at 15:38:33
In reply to benzos and disinhibition, posted by wishingstar on May 6, 2008, at 20:39:20
Do you have insurance? There's a xanax xr that lasts somewhat longer than the old-school stuff, so if your doc is up for it, that might be worth a shot. There are all kinds of non-benzo sleeping pills on the market (seroquel, rozerem, vistaril, trazadone, so on, so forth), so if you really can't tolerate any benzodiazepines, you and your doc should still have plenty of options to explore.
I hope this works out for you.
Posted by undopaminergic on May 7, 2008, at 16:31:22
In reply to benzos and disinhibition, posted by wishingstar on May 6, 2008, at 20:39:20
As others have suggested, the extended release (XR) version of Xanax may be a solution.
Zolpidem (Ambien), zopiclone (Imovane), and eszopiclone (Lunesta) are non-benzodiazepine hypnotics that may be less likely to cause disinhibition.
Melatonin may be worthy of consideration.
Cyproheptadine (Periactin) is a sedating antihistamine like diphenhydramine (Benadryl), but it has the additional feature of serotonin 5-HT2A-receptor antagonism, which may improve sleep quality.
A possible solution is to use a short-acting benzodiazepine such as triazolam (Halcion) or midazolam (Dormicum) to induce sleep, in combination with a sedating antihistamine to maintain sleep throughout the night. Since the effects of the benzo would dissipate before the morning, disinhibition would not result.
Posted by TPirog on May 8, 2008, at 18:15:28
In reply to benzos and disinhibition, posted by wishingstar on May 6, 2008, at 20:39:20
Banzodiazepines are extremely addictive, and can be the very hardest drugs to quit. If you want to know more, suggest you google "benzo withdrawal" or "benzo addiction." Please tread very carefully.
Tony
Posted by bulldog2 on May 9, 2008, at 19:34:37
In reply to Re: benzos and disinhibition » wishingstar, posted by Phillipa on May 6, 2008, at 21:02:45
> Maybe he thinks they relax you enough that you might do something. But if xanax works for you there is time release which would take you through the night. Phillipa
Aren't you a bit wild and crazy when on valium?
Posted by Phillipa on May 9, 2008, at 19:42:14
In reply to Re: benzos and disinhibition, posted by bulldog2 on May 9, 2008, at 19:34:37
I think I'm asleep. Why did you ask? Love Phillipa
Posted by Racer on May 10, 2008, at 9:32:23
In reply to Re: benzos and disinhibition, posted by TPirog on May 8, 2008, at 18:15:28
While benzodiazepines do cause physical dependence over time, many people -- possibly most -- can take them for extended periods without problems. It's really only when they are misused that this becomes a problem. Some people take more, and more, and even more, and build up a high level of tolerance -- basically, they follow an addictive cycle, which leads to eventual withdrawal issues.
For those who take a stable dose long term -- as many people here do -- benzodiazepines are safe, effective, and appropriate medications.
Posted by Racer on May 10, 2008, at 9:38:16
In reply to benzos and disinhibition, posted by wishingstar on May 6, 2008, at 20:39:20
I don't know how to answer your question about what causes the disinhibition, beyond saying that they are mildly dissociative, so it may be as simple as "since you don't lay down memories normally, you don't have access to behavioral controls that might kick in...." I won't even venture to speculate...
What I will say is that I can't take benzos for anxiety, because I do get disinhibited, I get more agitated, I do not remember what happens, and I fly totally out of control. It's a terrifying and humiliating experience. And I also experience increased depression from them.
The best I have found in terms of sleep are Periactin, which someone else mentioned, and Rozerem. Rozerem isn't like the other hypnotics I've tried -- it hasn't put me out right away, and the effects are greater after a month than they are in the first days -- but it's offered me the best quality of sleep I've ever had on any sleeping medication, AND it has augmented the effects of my antidepressant. It might be well worth looking into for you -- if it helps multiple problems, it might be a boon.
Good luck with whatever happens.
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