Posted by yxibow on February 18, 2009, at 18:19:49
In reply to Temazepam (Restoril): 2 or 3 d/wk = no tolerance?, posted by myco on February 18, 2009, at 15:50:06
> hey,
>
> Going to a gp who specializes in sleep disorders tommorrow at his clinic. I am prepared to ask for restoril (temazepam) to help insomnia perhaps 2 or 3 days a week. I want to be able to demonstrate responsibility in using it therefor I would like to know how commonly one must use this (or benzo's in general) to develop tolerance. I know as little as one week everyday can increase tolerance likelihood but what about 2 days a week then some other type of sleep aid the others? Is that acceptable as a negotiation tool (an educated statement from a patient to a doctor) for him?
If a doctor is really competent in sleep disorders they may want to issue as few sleep agents as possible if not any. Have you had or does this doctor work with people who do "sleep studies" (you go in for a night and you're observed) ?
I don't think its productive to have a "negotiation tool" -- it is the psychiatrists' DEA license and their prescription pad.But suggestions that you might have heard I don't see why you can't present it, I'm sure the doctor is familiar with many agents and I don't see that you have to have the mindset coming into an appointment sort of thinking that the doctor will view suggestions as almost choices for addiction.
Just an opinion.
Restoril is a metabolite of Valium and yes, if you have ever taken or are currently taking other benzodiazepines, there will be diminishing returns.Its not a particularly strong benzodiazepine, Dalmane is stronger.
But yes, if you take it consistently for some weeks I imagine tolerance for sleep can be built up, even if it helps with anxiety which is a rare use for Restoril.
You would have better luck with a short to medium term pseudo-benzodiazepine, especially Lunesta which has been studied for that purpose.
But with all things there is diminishing return and that is really an individual thing and what sort of sleep disorder you have.
I know for myself I have a fairly significant sleep disorder and I have been through the gamut of choices -- that doesn't mean to reflect on how you would respond to things though.
Beyond that, there are TCAs such as amitriptyline and doxepin, tolerance buildup may vary but they can contribute a little to depression if you have that.
There are other agents, antihistamines that act more as sleep agents (e.g. doxylamine, Unisom), but I would probably go with the first choices.
Ultimately "natural sleep hygeine" is the best thing but it takes quite a while, weeks for the body to adjust from a lack of sleep and keeping yourself up in the day to shifting toward a more normal pattern. I'm not saying that it is easy at all and I haven't been successful at that yet.Many naps and caffeine will contribute to things too, of course.
-- hope that helps
Jay
poster:yxibow
thread:880939
URL: http://www.dr-bob.org/babble/20090213/msgs/880967.html