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Dr. Bob is Robert Hsiung, MD,
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Posted by gostrider on March 26, 2012, at 13:21:33
In reply to Benzo free med suggestions for early awakening, posted by rculater on March 26, 2012, at 5:25:39
Sorry but 4am is not that early to wake, why not just go to bed a little later , problem solved .
Posted by Phillipa on March 26, 2012, at 19:00:26
In reply to Re: Benzo free med suggestions for early awakening, posted by gostrider on March 26, 2012, at 13:21:33
Must too early for me. Phillipa
Posted by phidippus on March 26, 2012, at 19:58:58
In reply to Benzo free med suggestions for early awakening, posted by rculater on March 26, 2012, at 5:25:39
You could try a low dose of Remeron or Luvox
Eric
Posted by SLS on March 26, 2012, at 20:20:29
In reply to Re: Benzo free med suggestions for early awakening » rculater, posted by phidippus on March 26, 2012, at 19:58:58
Linkadge has suggested using cyprohepadine (Periactin) as an alternative to mirtazapine (Remeron). I would never have thought of it myself, and it is a pretty heady choice.
- Scott
Posted by Phillipa on March 26, 2012, at 20:50:02
In reply to Re: Benzo free med suggestions for early awakening » rculater, posted by phidippus on March 26, 2012, at 19:58:58
Is this the reason I can't get off the 50mg of luvox? Phillipa
Posted by sigismund on March 27, 2012, at 1:53:31
In reply to Re: Benzo free med suggestions for early awakening » phidippus, posted by SLS on March 26, 2012, at 20:20:29
Careful dosing with trimipramine taken early in the evening, as low as possible, no more than 12.5mg.
Better, IMO, than cypro or mirtazepine. Less hangover and deeper sleep with lots of dreams.
Shorter acting than mirtazepine.
Posted by gostrider on March 27, 2012, at 3:31:59
In reply to Re: Benzo free med suggestions for early awakening, posted by gostrider on March 26, 2012, at 13:21:33
Depends on the posters sleeping habits,if retiring to bed at say 9pm thats 7 hours sleep till 4am the norm.But if they retire at 12pm then in therory will wake at 7am an 7 hour,s again. I actually would love 7 hours sleep,the poster also said they carry on with light sleep again normal.Why interfere with meds on a normal sleep pattern, unless the poster is going to bed at 2am an wakeing at 4am now that is a problem .
Posted by rculater on March 27, 2012, at 5:29:30
In reply to Re: Benzo free med suggestions for early awakening, posted by gostrider on March 27, 2012, at 3:31:59
I go to sleep easily about 1130-12. After i've awaken at 3 or 4am I lie awake for about a hour or 2 ,then I finally get a semi concious very light unrefreshing, vivid dream, broken sleep,till 7am. Get out of bed very tired and miserable.
Posted by SLS on March 27, 2012, at 6:06:43
In reply to Re: Benzo free med suggestions for early awakening, posted by sigismund on March 27, 2012, at 1:53:31
> Careful dosing with trimipramine taken early in the evening, as low as possible, no more than 12.5mg.
>
> Better, IMO, than cypro or mirtazepine. Less hangover and deeper sleep with lots of dreams.
>
> Shorter acting than mirtazepine.
Good reporting, Sigi. Will you be staying with trimipramine (Surmontil)?Thanks.
- Scott
Posted by SLS on March 27, 2012, at 6:11:29
In reply to Re: Benzo free med suggestions for early awakening » gostrider, posted by rculater on March 27, 2012, at 5:29:30
> I go to sleep easily about 1130-12. After i've awaken at 3 or 4am I lie awake for about a hour or 2 ,then I finally get a semi concious very light unrefreshing, vivid dream, broken sleep,till 7am. Get out of bed very tired and miserable.
For situations like that, I take Sonata (zaleplon). It is potent enough to put you to sleep, but exits the body rather quickly so there are few lingering effects upon waking in the morning. I find it to be a very clean drug. It does not have side effects that dull or slow the mind.
- Scott
Posted by sigismund on March 27, 2012, at 13:59:01
In reply to Re: Benzo free med suggestions for early awakening » sigismund, posted by SLS on March 27, 2012, at 6:06:43
Well the night before last I woke at 1am and despite temazepam did not really return to sleep, and then was a wreck all day.
Last night at 6pm I took around 10mg trimipramine and slept much better. Normally I don't sleep deeply enough to dream so it was nice to have some last night.
Posted by torrid2 on March 27, 2012, at 18:44:53
In reply to Benzo free med suggestions for early awakening, posted by rculater on March 26, 2012, at 5:25:39
atarax is a antihistamine used to treat anxiety it's by perscription. I have had long lasting success with melitonin and atarax. I may be missspelling it hydroxizine is the chemical name but that to is likely miss spelled.
PLEASE THOSE SUFFERING WITH NOT BEING ABLE TO STAY ASLEEP TRY IT.
Posted by phidippus on March 28, 2012, at 17:52:56
In reply to Re: Benzo free med suggestions for early awakening » phidippus, posted by SLS on March 26, 2012, at 20:20:29
why so heady?
Posted by SLS on March 28, 2012, at 19:01:21
In reply to Re: Benzo free med suggestions for early awakening » SLS, posted by phidippus on March 28, 2012, at 17:52:56
> why so heady?
Linkadge took into consideration the 5-HT2a/c antagonist actions of cyproheptadine (along with H1 antagonism) when he made it his choice of an adjunct to hypnotics. I was impressed.
- Scott
Posted by torrid2 on March 28, 2012, at 19:32:38
In reply to Re: Benzo free med suggestions for early awakening » SLS, posted by phidippus on March 28, 2012, at 17:52:56
not understanding whay offends you
Posted by Raisinb on March 28, 2012, at 21:55:48
In reply to Benzo free med suggestions for early awakening, posted by rculater on March 26, 2012, at 5:25:39
Both Seroquel and Remeron are likely to work for you, but they might be more sedating than you want or need. Paxil is an option, as it makes many people very sleepy, even though it is not a sleep drug.
Posted by Phillipa on March 28, 2012, at 23:16:41
In reply to Re: Benzo free med suggestions for early awakening, posted by Raisinb on March 28, 2012, at 21:55:48
You know I think in the beginning was tired on l0mg of paxil first ad with xanax .25 three times a day. At the time thought it was the 25mg of lopressor the pdoc insisted I go on first in his words "To prepar my body for paxil". Prepare in what way cause anxiety so bad at the time. This calls for a google search? Phillipa
Posted by Vincent_QC on March 30, 2012, at 8:43:35
In reply to Re: Benzo free med suggestions for early awakening, posted by sigismund on March 27, 2012, at 13:59:01
> Well the night before last I woke at 1am and despite temazepam did not really return to sleep, and then was a wreck all day.
>
> Last night at 6pm I took around 10mg trimipramine and slept much better. Normally I don't sleep deeply enough to dream so it was nice to have some last night.Hi mister,
I plan to ask my Family Doc next week about a med to help me to fall asleep faster and stay asleep and I read that trimipramine (surmontil) is by far one of the best med as a sleep aid so maybe I should try it?Right now I take some mirtazapine (Remeron) but can't take more than 3.5 mg if so I feel the noradrenaline effect the next day ( I know it's not normal but i'm very sensitive with all the meds who act as a potent A2 antagonist or NE reputake) and have worse anxiety...also it's not working anymore, so have to take extra dose of benzo meds (Klonopin and Xanax or sometimes valium but that one do nothing even at 20 mg dose) all the time at night to be able to fall asleep and return to sleep when i'm awake...
For the trimipramine, do you know the lower dosage needed to induce sleep without having too much problem with the noradrenaline, since the trimipramine don't act directly as a noradrenaline reputake but more as a A1 + A2 (less potent than the Remeron on that one I think) antagonist, who is different from the others TCA's? Also do you know if it's better to go with the Doxepin (another potent H1 antagonist) since i'm having chronic tension headache (I assume that the Doxepin is worse cause of it's effect on the NE reputake as well as the A1 and A2 effect?
I'm very sensitive to the H1 antagonist effect, so I don't need a high dose normally.
I used in the past the seroquel as a sleep aid but I try it again 4 months ago and almost had a heart attack with it...seriously my heart rate was too high on it, I assume it's because of it's effect on the A1 receptor...
Since now my anxiety is all related to somatization symptoms mainly heart issues(tachycardia , irregular heart beat, low blood pressure, chronic chest pain and left arm numbness) and also head pain (tension headache, jaw pain, eyes pain)... I need a med who will not make me feel like I will die from a heart attack, if you understand what I mean...Also most of the time now I wake up in the middle of the night sweating from the forehead and my back and with a panic attack, it's happening every night now and I HATE IT!!!
Anyway thanks for any kind of advises about that med... really want to know how it's working, if the effect last all day long like feeling tired forever and like on some illegal drug until noon, if it's affecting the heart rate and the blood pressure since mine is on the low side and take some Inderal to lower the heart rate...also drug interractions with it?
Thanks ;-)
Vince
Posted by phidippus on March 30, 2012, at 13:04:34
In reply to Re: Benzo free med suggestions for early awakening » phidippus, posted by torrid2 on March 28, 2012, at 19:32:38
What offends me?
Eric
Posted by torrid2 on March 30, 2012, at 13:07:45
In reply to Re: Benzo free med suggestions for early awakening » SLS, posted by phidippus on March 28, 2012, at 17:52:56
> why so heady?
seems like this responce took offence
Posted by phidippus on March 30, 2012, at 13:17:53
In reply to Re: Benzo free med suggestions for early awakening » phidippus, posted by torrid2 on March 30, 2012, at 13:07:45
What was I saying heady to? I usually mean 'challenging' when I say heady.
Eric
Posted by torrid2 on March 30, 2012, at 13:40:11
In reply to Re: Benzo free med suggestions for early awakening » torrid2, posted by phidippus on March 30, 2012, at 13:17:53
I missunderstood you. To answer you, I seen so many people using benzo's that possibly don't need them. After 3-4 years without clonipin this week I asked the doc to write me 10 1mg tabs so I'm not against benzo's. I'm in a very bad way and need help this week. For sleep wich I have life long difficulties with, nightmares, sleepwalking and constant waking. Sleep doesn't come natureal to me. I have had great success with atarax and melitonin and I feel most people just dissmiss atarax. I can't spell it its a antihistamine used for anxiety. It is marginally helpful for anxiety for me but helpful none the less. When I'm out of control with anxiety it does help. Now if I'm sleepwalking or having terrible nightmares, the kind that stay with you the next day leaving tired and fearful, well I perfer to use clonipin or restiril, but for the constant waking all night long I wish you guys would give it a try. If you hold back on the benzo's for the very hard times and use melitonin and atarax for when things aren't as bad tolerance can be avoided. If you only ask your doc for 10-15 benzo's each month it shows a responcable approach to your use of these meds.
Posted by sigismund on March 30, 2012, at 14:22:17
In reply to Re: Benzo free med suggestions for early awakening » sigismund, posted by Vincent_QC on March 30, 2012, at 8:43:35
>I used in the past the seroquel as a sleep aid but I try it again 4 months ago and almost had a heart attack with it...seriously my heart rate was too high on it, I assume it's because of it's effect on the A1 receptor...
Oh Vincent, that is just awful.
I don't know anything about the pharmacology of trimipramine. I recall someone saying that it was a little like an AP. It doesn't feel to me as if it could cause anxiety or tachycardia but you are very sensitive.
This is what I do. At least 2 hours before I want to go to sleep (for me this is 6pm) I take around 12.5mg trimipramiine or a little less. This way I have only a little hangover the next day. My guts are a bit sluggish, but that is about it.
It is better for me than doxepin, which did not deepen sleep in the same way. Neither did amitrip. Mirtazepine did but lasted all the next day. Same with cyproheptadine.
I take it with maybe 2mg prazosin split into two doses.
This is physically calming.
Posted by Vincent_QC on March 30, 2012, at 16:13:10
In reply to Re: Benzo free med suggestions for early awakening » Vincent_QC, posted by sigismund on March 30, 2012, at 14:22:17
>
> Oh Vincent, that is just awful.
>Well awful cause I was on a pretty high dose of Seroquel (100mg) for my insomnia back in 2009 with no hangover side-effects the next day, so when my Doc suggest it to me again I say why not since I was able to tolerate that med in the past, a small 25 mg will not kill me... but my body seem very sensitive now to it and almost all the meds and always answer with cardiovasculars side-effects who worse my anxiety...
> I don't know anything about the pharmacology of trimipramine. I recall someone saying that it was a little like an AP. It doesn't feel to me as if it could cause anxiety or tachycardia but you are very sensitive.
>I think they use the Doxepin as an AP sometimes but the Trimiprimine is used mostly for depression... My Family Doc seem to not want to RX the low dose of Trimipramine saying it will just make my heart issues worse, well it was last january when I saw him the last time but I will ask him again about the Trimiprimine since at a low dose it's seem to be as safe as the Remeron and don't affect the noradrenaline like the Remeron do... I guess 2 mg will be enough for me.
> This is what I do. At least 2 hours before I want to go to sleep (for me this is 6pm) I take around 12.5mg trimipramiine or a little less. This way I have only a little hangover the next day. My guts are a bit sluggish, but that is about it.
>Ok... you go in bed early ;-) I normally go to the bed at 11 PM, so if I take it 2 hours before did I will fall asleep on the couch while I watch the tv? lol It take forever now to fall asleep, go in bed at 11 PM and don't sleep before 2-3 AM and i'm awake most of the time 2-3 hours later and it's very hard to fall asleep again and need to take extra Klonopin or Xanax since I wake up all the times now after vivid dreams and nightmares, that last since 1 month now and have panic attack also every night with the sweating on the forehead like I have fever, it's really weird and annoying and I don't like it at all... I don't like the fact that I also need to take extra benzo meds at night cause i'm addicted to them and they do nothing to help my anxiety now, i'm on a high dose of Klonopin 8 mg day + Xanax 0.25 mg day (usually 0.125 mg as soon as i'm awake in the morning and sometimes in the middle of the night or when I have very bad anxiety when i'm alone at home) and sometimes add some valium up to 20 mg 1 hour before I go to sleep... not suppose to take the Xanax but start it again when the panic attack in the middle of the night start 1 month ago...but will run out of stock soon and my Fam Doc will not RX it again...so I have to find a fix to treat my insomnia and increasing the Remeron is not the solution, don't want that high noradrenaline level in my brains...
> It is better for me than doxepin, which did not deepen sleep in the same way. Neither did amitrip. Mirtazepine did but lasted all the next day. Same with cyproheptadine.
>My experience with Mirtazapine (Remeron) in the past was positive, I was on 45 mg before bedtime back in 2007 but I find out that the sedative effect didn't last so I had to increase from 15 mg to 30 mg and then hit 45 mg and at the end it was not doing anything to make me sleep... but it was not also doing me anxious or more awake cause of the noradrenaline effect... but at the time I was addicted to coffee BIG time, for me 12 cups a day wasn't enough... lol It's when my stupid PDoc ask me to stop drinking coffee that things start to be worse for me!!! Weird no?
I was on Elavil for my headache back in 2007, at the same time then the Mirtazapine, went from 25 mg who did nothing at all and increase to 50 mg before bedtime and it was doing nothing just putting more weight on me so I stop it after 6 months... My experience with the TCA's is not very possitive, it's seem that most of them increase my heart rate into a tachycardia at rest state, especially the Nortriptiline... The Clomipramine wasnt also a good experience, had electric shock all over my body and had the worse headache ever on it...same for the Imipramine, don't know if i'm having a weak heart or something else, even if I have almost all the cardio tests done for my heart and nothing seem to be bad with it... I just don't know why I was so overreactive with those meds at the time...I was sensitive to them back in 2009 before I had the heart issues and anxiety who is mainly focused on my heart now, so I can't imagine returning on a TCA right now, that's why I wanted to know about the Trimipramine, it's seem to be the only one who don't affect the reputake of the NE, so maybe I will not have the scary fast heart rate on it...
> I take it with maybe 2mg prazosin split into two doses.
>
> This is physically calming.
>Have to ask about the Clonidine or Prazosin to my Doc also, the Inderal is not very good for the kind of problem I have right now, also it's not decreasing my heart rate like in the past, i'm on 5 mg x 3 times a day but overall only use 10 mg maximum a day cause if I use more my blood pressure drop too much and have worse anxiety... with the not stable blood pressure, orthostatic hypotension, low blood pressure OR high blood pressure, I don't know what is the problem but the inderal is not the med I need to treat my heart issues for sure... I don't know what make me so anxious, what is my problem, is it too much adrenaline or NE, is it too low adrenaline or NE, is it too low cortisol level, too low serotonin or too high...had tests done for the level of those neuro and results was very low for cortisol, adrenaline, low-normal NE and normal dopamine... normal VMA also... anyway...
Thanks for your answer, very helpful ;-)
Posted by sigismund on March 31, 2012, at 2:06:30
In reply to Re: Benzo free med suggestions for early awakening » sigismund, posted by Vincent_QC on March 30, 2012, at 16:13:10
Vincent, let me mention just one thing from your post.
You are taking a lot of benzos and you sleep badly.
My experience has been (I think) that LONG TERM benzo use damages sleep.
Since you are addicted to them the best you can do is try to limit their use.
My suspicion (uninformed!) is that trimipramine could be helpful without the NA of mirtazepine, and that it would be better for the quality of your sleep than doxepin.
But I don't know. Scott or Linkadge probably would.
You can search Babble for thread on trimpramine. I think there is discussion somewhere about the pharmacology of it.
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