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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 CareBear04 on February 20, 2005, at 22:22:28
hi everyone-
i know there has been mention of this med on the board before, but when i did a search, i got a little confused since there's also a poster by that name.when is this drug going to come out? i'm desperate for something that works.
i have been on lots of sedatives like high-dose benzos, seroquel, ambien, haldol, other antipsychotics, and other stuff. my dr has decided that i need to be off sedatives, at least enough so that i act like a human and not like a robot. i'm allowed to take ambien, but after two years every night, it doesn't work anymore. another concern is urinary retention. seroquel was a big culprit for this, but it was great for sleep. i guess i'll try 15mg of remeron, maybe trilafon, maybe trazodone, if those are ok with the dr.
my pdoc and i are both waiting on end for lunesta! any idea when the wait will be over? thanks!!!
Posted by med_empowered on February 21, 2005, at 0:49:18
In reply to lunesta, posted by CareBear04 on February 20, 2005, at 22:22:28
hey! yeah, drug-resistant insomnia sucks. I think lunesta is supposed to come out soon...I believe this is the sleeping pill (a couple new ones are coming out...apprently the big pharm companies think sleeping pills may be the new anti-depressants in terms of sales) that got FDA approved specifically for longer-term use (above and beyond the standard 2-weeks). Anyway, remeron's supposed to be good, trazadone is pretty good, I personally wouldn't do trilafon or any other anti-psychotics, especially old ones, for sleep. The only other things I could suggest would be barbiturates. not many docs will write for them, but some will try out phenobarbital (its not as bad in terms of addiction or killing people as say, seconal) as a sedative/anxiolytic.
Posted by CareBear04 on February 21, 2005, at 11:03:32
In reply to Re: lunesta, posted by med_empowered on February 21, 2005, at 0:49:18
thanks, lunesta! you're as good as your name in terms of knowledge! and thanks for the other alternatives. i don't think my dr will write for barbiturates, but maybe some of the others?
Posted by SLS on February 21, 2005, at 11:18:04
In reply to Re: lunesta, posted by med_empowered on February 21, 2005, at 0:49:18
Hi M_E.
> The only other things I could suggest would be barbiturates. not many docs will write for them, but some will try out phenobarbital (its not as bad in terms of addiction or killing people as say, seconal) as a sedative/anxiolytic.
Have you ever heard of the use of phenobarbital to ease the withdrawal symptoms of benzodiazepines?
Thank.
- Scott
Posted by lunesta on February 21, 2005, at 14:30:40
In reply to lunesta, posted by CareBear04 on February 20, 2005, at 22:22:28
first quarter of 2005
Posted by med_empowered on February 21, 2005, at 15:44:39
In reply to Re: lunesta » CareBear04, posted by lunesta on February 21, 2005, at 14:30:40
Hey! Yeah, I've heard of barbiturates (again, usually phenobarbital) used for the withdrawal of both barbiturates (which, fortunately, is increasingly rare) and non-barbiturate drugs. Usually, even those who are on higher levels of benzos can be tapered right off whatever benzo they're using or switched over to valium and then tapered...most of tapering, fortunately, can be done out-patient with few hassles. But, of course, sometimes...its a problem. So, there are conversion formulas docs can use to convert all kinds of drugs (seconal, nembutal, miltown, and the benzos, for example) to more or less equivalent doses of phenobarbital...once that's done, the doc involved can write for phenobarbital and gradually reduce that. The other option is "loading", which is really useful when you're dealing with a poly-drug user who may relapse if he/she experiences too much discomfort OR is believed to be at a particularly high risk of seizure. Basically, the doc involved "loads" the patient with phenobarbital or nembutal (nembutal is faster acting) until the desired degree of sedation is reached. If nembutal is used, the dose is then converted into an equivalent phenobarbital dosage. This is the patient's starting dose; if done inpatient, the withdrawal from whatever substance(s) will be managed through IV admninistration of the drug; outpatient, an RX is written and the patient is closely monitored throughout the withdrawal process. Other options for less-painful benzo withdrawal include: an RX for beta-blockers (helps with anxiety and cardiovascular weirdness that may occur), an RX for tegretol or one of the newer anticonvulsants (obviously, prevents seizures; over time, may help with underlying anxiety, depression, mood-disorders, etc.), an RX for certain anti-anxiety agents (Buspar, Atarax, etc. seem popular), an RX for anti-depressant(s) (usually, by the time the taper is completed, the anti-depressant(s) should be helping somewhat to control anxiety, and may help with rebound anxiety/insomnia). Of course, there's also Trazadone, Remeron (good for insomnia), and all patients undergoing tapers need to be monitored and have the ability to contact their doc as needed.
Posted by SLS on February 21, 2005, at 16:47:41
In reply to barbiturates for withdrawalSLS, posted by med_empowered on February 21, 2005, at 15:44:39
Thanks.
:-)
- Scott
> Hey! Yeah, I've heard of barbiturates (again, usually phenobarbital) used for the withdrawal of both barbiturates (which, fortunately, is increasingly rare) and non-barbiturate drugs. Usually, even those who are on higher levels of benzos can be tapered right off whatever benzo they're using or switched over to valium and then tapered...most of tapering, fortunately, can be done out-patient with few hassles. But, of course, sometimes...its a problem. So, there are conversion formulas docs can use to convert all kinds of drugs (seconal, nembutal, miltown, and the benzos, for example) to more or less equivalent doses of phenobarbital...once that's done, the doc involved can write for phenobarbital and gradually reduce that. The other option is "loading", which is really useful when you're dealing with a poly-drug user who may relapse if he/she experiences too much discomfort OR is believed to be at a particularly high risk of seizure. Basically, the doc involved "loads" the patient with phenobarbital or nembutal (nembutal is faster acting) until the desired degree of sedation is reached. If nembutal is used, the dose is then converted into an equivalent phenobarbital dosage. This is the patient's starting dose; if done inpatient, the withdrawal from whatever substance(s) will be managed through IV admninistration of the drug; outpatient, an RX is written and the patient is closely monitored throughout the withdrawal process. Other options for less-painful benzo withdrawal include: an RX for beta-blockers (helps with anxiety and cardiovascular weirdness that may occur), an RX for tegretol or one of the newer anticonvulsants (obviously, prevents seizures; over time, may help with underlying anxiety, depression, mood-disorders, etc.), an RX for certain anti-anxiety agents (Buspar, Atarax, etc. seem popular), an RX for anti-depressant(s) (usually, by the time the taper is completed, the anti-depressant(s) should be helping somewhat to control anxiety, and may help with rebound anxiety/insomnia). Of course, there's also Trazadone, Remeron (good for insomnia), and all patients undergoing tapers need to be monitored and have the ability to contact their doc as needed.
Posted by Phillipa on February 21, 2005, at 17:44:32
In reply to Re: barbiturates for withdrawal - Very Helpful!, posted by SLS on February 21, 2005, at 16:47:41
I believe Lunesta should be out about now. Fondly, phillipa
This is the end of the thread.
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