![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by DC on April 5, 2000, at 4:32:23
I've always had insomnia, and it's only been worse on the various AD's I've taken and now Adderal, too. I've taken Trazodone for a long time but at the dose I need to fall asleep--200-300mg--it makes me feel really weird for about forty five minutes before I fall asleep. This is so unpleasant that I find myself avoiding going to sleep. I tried ambien and found I felt irritable in the morning. Most recently I tried Sonata. I think this is the best med so far but it wasn't quite strong enough. I needed 40 or 50mg and my pdoc said the maximum dose is 20. I also usually take 1mg of klonipan at night and sometimes Benadryl. It seems like I really have to be loaded up to fall asleep. Is there a potent short acting sedative/hypnotic that you folks would recommend? Any suggestions would be greatly appreciated.
Posted by Cindy W on April 5, 2000, at 8:30:40
In reply to Need advice on sleep meds., posted by DC on April 5, 2000, at 4:32:23
> I've always had insomnia, and it's only been worse on the various AD's I've taken and now Adderal, too. I've taken Trazodone for a long time but at the dose I need to fall asleep--200-300mg--it makes me feel really weird for about forty five minutes before I fall asleep. This is so unpleasant that I find myself avoiding going to sleep. I tried ambien and found I felt irritable in the morning. Most recently I tried Sonata. I think this is the best med so far but it wasn't quite strong enough. I needed 40 or 50mg and my pdoc said the maximum dose is 20. I also usually take 1mg of klonipan at night and sometimes Benadryl. It seems like I really have to be loaded up to fall asleep. Is there a potent short acting sedative/hypnotic that you folks would recommend? Any suggestions would be greatly appreciated.
DC, have you tried kava kava? I take this when I really have trouble sleeping, and it is available over the counter, leaves no apparent after effects, and seems safe (although ask CamW, to be sure!).
Posted by Cam W. on April 5, 2000, at 10:57:54
In reply to Re: Need advice on sleep meds., posted by Cindy W on April 5, 2000, at 8:30:40
DC - Kava kava is a decent anxiolytic/hypnotic, although it may not be strong enough for you. Also, you should use it longer than a couple of months in a row or you risk getting this freaky kind of rash.Perhaps, depending on what other medication you are taking, a gram or two of Tryptophan may work. It is available here in Canada on prescription and I have seen it work in some people who have had difficulty in getting to sleep. One problem with it is that, in some people who are taking SSRIs or other drugs affecting serotonin, Tryptophan can cause serotonin syndrome, which has led to hypertensive crisis leading to death in a few people. This is why it was taken off the OTC market in the U.S. People were taking massive doses with their Prozac and had heart attacks..
The more common hypnotics are the benzodiazepines (Temazepam, Nitrazepam, Triazolam, etc.). I do not recommend the Triazolam, unless you like throwing up in the lap of the Japanese prime minister (1/2 a tablet my ass, George). Anyway, the benzos can be addicting and you can build tolerance to them, but as long as you do not go raising the dose, these short-acting ones are fairly safe and effective. They give you a restful night's sleep, usually with no hangover effect (unless you take too large a dose). Hope this helps - Cam W.
Posted by FP on April 5, 2000, at 11:37:54
In reply to Re: Need advice on sleep meds., posted by Cindy W on April 5, 2000, at 8:30:40
For more info on Kava, click over to www.lycaeum.org - they are a bunch of burnt out acid heads (or worse), but they DO have good bibliographical sources / "trip reports" on many things, including Kava.
Used once in awhile, as directed, it IS safe. But when the label says not to take if you are already taking anti-depressent medications, THEY MEAN IT. Kava LOWERS serotonin levels - NOT the effect someone on SSRIs wants. (I haven't read back through all the posts, so don't know if that applies to you or not)
Kava is also addictive - in the South Seas there are many addicts. (Generally, Kava in the SSs is used ritually, not as an everyday thing).
Despite the overall scarey tone of this post, Kava is fine to use once in awhile if you are otherwise mentally healthy and don't have chemical dependency issues.
Hope that helps,
FP (who once took a whole bottle Kava pills, and learned some of this info the hard way)
Posted by kazoo on April 5, 2000, at 22:57:04
In reply to Need advice on sleep meds., posted by DC on April 5, 2000, at 4:32:23
> Any suggestions would be greatly appreciated.
^^^^^^^^^^^
Two words: CHLORAL HYDRATE ("NOCTEC")I've said this once before, and I'll say it again: the older remedies work best.
Greetings to DC.
kazoo
Posted by Elizabeth on April 6, 2000, at 22:25:53
In reply to Re: Need advice on sleep meds., posted by kazoo on April 5, 2000, at 22:57:04
> > Any suggestions would be greatly appreciated.
>
> ^^^^^^^^^^^
> Two words: CHLORAL HYDRATE ("NOCTEC")I have to disagree. DC, you said you have chronic insomnia, right? If you take chloral hydrate more than a few days in a row, you can probably expect it to stop working.
FWIW, I take 20mg of Ambien each night, where the "maximum" is supposed to be 10mg. Those ranges aren't appropriate for everybody. Talk to your doctor some more about high-dose Sonata, and see if you can't come up with something.
There are also many, many benzodiazepines - drugs in the same class as Klonopin - that you can try, and they don't always work identically. Some shorter-acting ones include Xanax, Ativan, and Halcion.
Finally, you can do cognitive-behavioral therapy for insomnia - believe it or not, this works for a lot of people.
Posted by DC on April 7, 2000, at 1:33:54
In reply to Re: Need advice on sleep meds., posted by Elizabeth on April 6, 2000, at 22:25:53
I think that high dose sonata might be a good idea--unless it starts to do weird things at higher doses. the problem is my pdoc isn't all that nice; he seems to be exasperated with me. Sometimes he does that sigh thing. But he does know a lot about meds and is supposedly an expert on sleep disorders. I think maybe I'll ask him why he seems exasperated--but I'm sort of afraid to.
Posted by medlib on April 9, 2000, at 16:58:55
In reply to Thanks for the advice, Elizabeth, posted by DC on April 7, 2000, at 1:33:54
> I think that high dose sonata might be a good idea--unless it starts to do weird things at higher doses. the problem is my pdoc isn't all that nice; he seems to be exasperated with me. Sometimes he does that sigh thing. But he does know a lot about meds and is supposedly an expert on sleep disorders. I think maybe I'll ask him why he seems exasperated--but I'm sort of afraid to.
DC- Sometimes docs get frustrated when a lot of things don't work, too. But sighing is just plain rude! The doc is a medical consultant you have hired; you have a right to expect courteous and professional service.Instead of asking, you might try telling him that you find sighing and other nonverbal expressions of exasperation unhelpful and that you expect him to be responsible for his nonverbal behavior by being both direct and explicit in his communications to you.
Good luck!--medlib
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.