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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Legm82 on October 28, 2013, at 19:08:36
Hello,
Im looking for a substitute to Mirtazapine (poop out) , nor trazodone nor seroquel (quetiapine) or any antipsicotic.Im looking for a sedative TCA, more sedating than amitriptiline.
Maybe Surmontil (trimipramine) or Sinequan (doxepin) could help.
Any suggestions? Please share your experiences.
Posted by former poster on October 28, 2013, at 20:09:03
In reply to Trimipramine or Doxepin?, posted by Legm82 on October 28, 2013, at 19:08:36
It may be worthwhile to look into Cyproheptadine if you like sedation; I'm assuming to help you sleep? Also seems to have a mild AP effect.
Posted by sigismund on October 28, 2013, at 21:20:38
In reply to Trimipramine or Doxepin?, posted by Legm82 on October 28, 2013, at 19:08:36
I didn't like the quality of sleep on doxepin, whereas trimpramine made me sleep better. But if you are looking for something more sedating than ami......I dunno, I couldn't hack that either, not the day after especially.
I take only a little trimip.....a third of a 50mg cap a night.
Posted by Legm82 on October 28, 2013, at 21:25:03
In reply to Re: Trimipramine or Doxepin?, posted by sigismund on October 28, 2013, at 21:20:38
> I didn't like the quality of sleep on doxepin, whereas trimpramine made me sleep better. But if you are looking for something more sedating than ami......I dunno, I couldn't hack that either, not the day after especially.
>
> I take only a little trimip.....a third of a 50mg cap a night.Sig,
Have you tried the 3 of them? I mean ami, doxepin and trimipramine? Which one works the best for you? I guess trimipramine? I guess you take trimipramine 12.5mg aprox.
Posted by g_g_g_unit on October 28, 2013, at 22:24:36
In reply to Re: Trimipramine or Doxepin?, posted by sigismund on October 28, 2013, at 21:20:38
> I didn't like the quality of sleep on doxepin, whereas trimpramine made me sleep better. But if you are looking for something more sedating than ami......I dunno, I couldn't hack that either, not the day after especially.
>
> I take only a little trimip.....a third of a 50mg cap a night.Does trimipramine help you with sleep onset, sig? Or is it mainly maintenance?
Posted by sigismund on October 29, 2013, at 14:26:10
In reply to Re: Trimipramine or Doxepin? » sigismund, posted by Legm82 on October 28, 2013, at 21:25:03
Yes, I have tried all 3, but perhaps not in equivalent doses.
25mg ami was a nightmare the next day. God knows how people cop it.
The doxepin I don't recall, perhaps 5mg, though I didn't much like the quality of sleep.
Mirtazepine at 7.5 was good until the next morning. Do people get used to the next day thing or what?
But trimpiramine at low dose (around 15mg) was fine. I found it hard to believe that a TCA could be so unterrible. It improved the quality of my sleep, rather than being something that could be relied upon to make me sleep.
Posted by sigismund on October 29, 2013, at 14:29:24
In reply to Re: Trimipramine or Doxepin? » sigismund, posted by g_g_g_unit on October 28, 2013, at 22:24:36
Well, you know, I find it hard to avoid drink entirely, and drink disturbs my sleep, so that is part of my problem.
It may improve the quality of your sleep, which meant for me a deeper sleep with more dreams. I used to feel half awake all night. At the dose I take it won't knock you out and keep you out though.
I wonder what the genotoxic thing amounts to?
Posted by sigismund on October 29, 2013, at 15:35:06
In reply to Re: Trimipramine or Doxepin? » g_g_g_unit, posted by sigismund on October 29, 2013, at 14:29:24
The other thing I tried for my sleep was agomelatine which I took for maybe even years.
In the beginning in low doses it was really good.
Eventually the 5HT2C antagonism thing led to worse sleep, tolerance having been gained to the melatonergic thing.
Much less bad than mirtazepine though.
Posted by larryhoover on November 2, 2013, at 22:31:59
In reply to Trimipramine or Doxepin?, posted by Legm82 on October 28, 2013, at 19:08:36
I've been using 25 mg of trimipramine QHS for years and years. As sigismund reports, I have improved sleep quality with it. I also take 30 mg temazepam QHS. I consider good sleep to be of utmost importance to my well-being.
Lar
Posted by Legm82 on November 2, 2013, at 22:38:15
In reply to Re: Trimipramine or Doxepin? » Legm82, posted by larryhoover on November 2, 2013, at 22:31:59
> I've been using 25 mg of trimipramine QHS for years and years. As sigismund reports, I have improved sleep quality with it. I also take 30 mg temazepam QHS. I consider good sleep to be of utmost importance to my well-being.
>
> LarLarry
Thanks for your post.
How many years have you been using Trimipramine?
Do you think it could poop out?
Does the Trimipramine knock you out?
Thanks for your reply.
Regards,
Luis.
Posted by larryhoover on November 2, 2013, at 23:08:35
In reply to Re: Trimipramine or Doxepin? » larryhoover, posted by Legm82 on November 2, 2013, at 22:38:15
> How many years have you been using Trimipramine?
> Do you think it could poop out?
> Does the Trimipramine knock you out?
> Thanks for your reply.
> Regards,
> Luis.Fifteen years? It has, so far, not pooped out. It doesn't knock me out. It helps me to stay asleep.
About five years ago, I tapered the temazepam to none (it's a benzo, so tapering is required), and cut the trimipramine. I wanted to see if they were working/necessary. After complete withdrawal, I slept fitfully for 6 weeks. I became pretty much dysfunctional as a result. I was maybe feeling desparate one night, and I took both meds. I woke up the next day feeling brilliantly rested.
I no longer question the drugs.
BTW, I did try doxepin. It was fifteen years ago, but I think I recall that it had a significant "hangover" effect.
Lar
Posted by sigismund on November 4, 2013, at 15:24:38
In reply to Re: Trimipramine or Doxepin? » Legm82, posted by larryhoover on November 2, 2013, at 23:08:35
I get a bit of RLS with doses of trimip above 12.5mg. I start kicking around in bed and my partner notices it at least as much as I do. At 12.5 it is fine, useful, humane and insufficient, but hey, you know how it is.
Posted by Legm82 on November 4, 2013, at 15:41:06
In reply to Re: Trimipramine or Doxepin?, posted by sigismund on November 4, 2013, at 15:24:38
Just to get it right.
You use Trimip to stay asleep and for good quality of sleep. But it doesnt help to knock out, that means that for beggining the sleep you need a benzo or another med, is that right?
Posted by sigismund on November 4, 2013, at 19:13:26
In reply to Re: Trimipramine or Doxepin? » sigismund, posted by Legm82 on November 4, 2013, at 15:41:06
>You use Trimip to stay asleep and for good quality of sleep. But it doesnt help to knock out, that means that for beggining the sleep you need a benzo or another med, is that right?
We only have trimip in 50mg caps here. If I take more than around 12.5mg I get restless legs. The more you take the stronger it will be, and (because the drug is working) then I do not notice the restless legs as much as my partner. At higher doses it is good for sleep maintenance. But I have settled on 12.5mg. A benzo settles the restless legs down and helps with sleep maintenance. Ambien is too expensive here but I prefer it somehow over temazepam. I normally have no trouble getting to sleep, it's staying there. It's not horrible stuff, so you can experiment. The first doses are felt more strongly so it makes sense to start low.
Posted by Legm82 on November 4, 2013, at 19:58:16
In reply to Re: Trimipramine or Doxepin? » Legm82, posted by sigismund on November 4, 2013, at 19:13:26
I need medication for both sleep onset and stay asleep.
I can't rely on Ambien, I developed tolerance to it. I can't rely on Remeron (mirtazapine) either.
That's why I'm looking for a TCA to do the work.
I thought that perhaps Trimip or Doxepin could do the job.
What do you think about it?
Any chance it could work or should try another options?
Posted by former poster on November 4, 2013, at 23:47:00
In reply to Re: Trimipramine or Doxepin? » sigismund, posted by Legm82 on November 4, 2013, at 19:58:16
I took Doxepin in the 70's. It was awful then. Caused me more anxiety. However, you might not respond the same. It did help me sleep as I recall. Possibly combined with other med. might be an option to consider.
Posted by sigismund on November 5, 2013, at 12:21:04
In reply to Re: Trimipramine or Doxepin? » sigismund, posted by Legm82 on November 4, 2013, at 19:58:16
Well,yes, you developed a tolerance to Ambien (as have I, to that and temazepam) but the best outcome I could arrange for myself would be say 20mg temazepam and 15 of trimipramine. It's not perfect, but more trimip without the temaz is not ideal either. Doxepin is not as good as trimip, IMO. I also tried agomelatine and even liked it, before it made my sleep worse (after 6 months). Is it similar to Remeron in the 5HT2C thing? It is a lot easier to handle though. I couldn't cop Remeron. If your aim is to avoid a benzo habit (good idea of course) I am out of ideas for you (as I am for me, although I try herbs and stuff)>
Good luck
Posted by sigismund on November 5, 2013, at 12:22:24
In reply to Re: Trimipramine or Doxepin? » Legm82, posted by former poster on November 4, 2013, at 23:47:00
> It was awful then. Caused me more anxiety.
And it has this dead horrible feeling.
trimip makes you dream a lot
Posted by Legm82 on November 6, 2013, at 15:41:47
In reply to Re: Trimipramine or Doxepin? » Legm82, posted by sigismund on November 5, 2013, at 12:21:04
I need something equivalent to Remeron (mirtazapine) that helps me with sleep onset and sleep maintenance.
Remeron helped me as a sleep aid for many years, more than 9 years.
Remeron and Trazodone are known for its usefulness in the insomnia treatment. They are first line option and second line are some TCA like Amitriptiline, Doxepin and Trimipramine.
Please if there is someone that used Remeron as sleep aid and then had to use a TCA, your input is very welcomed.
Posted by sigismund on November 6, 2013, at 16:47:55
In reply to Re: Trimipramine or Doxepin? » sigismund, posted by Legm82 on November 6, 2013, at 15:41:47
I've used both. I could not stand the hang over from Remeron next day.
You can take way more trimp than I do. You may not get RLS. The dry mouth may not bother you or you may not get it. No other downsides really. Someone here takes 100 trimip, someone else 25.
Posted by Legm82 on November 6, 2013, at 17:05:27
In reply to Re: Trimipramine or Doxepin? » Legm82, posted by sigismund on November 6, 2013, at 16:47:55
> I've used both. I could not stand the hang over from Remeron next day.
>
> You can take way more trimp than I do. You may not get RLS. The dry mouth may not bother you or you may not get it. No other downsides really. Someone here takes 100 trimip, someone else 25.Hello sig,
The truth is that Remeron next day hangover doesnt last forever. You get used to the med, besides the recomended dose for insomnia is 30mg at bedtime. I can assure you that taking less than that will give you a terrible hangover next day say 15 or 7.5mg. Above 30mg enhaces the noradrenergi lc effect that dimishes the hangover next day.
This is the end of the thread.
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