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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Guy on October 2, 2005, at 8:24:13
I have suffered with severe agitation and insomnia for the past nine years. What a strange coincidence that I first really fell off my horse after my first presciption of oxazepam ran out! Yes, I had anxiety and depression before the pills, but after that first prescription of 20 pills ran out I went four days without sleep and cracked up so badly I had to go to the psych clinic. Since that time, I have seen numerous psychiatrists and psychologists and tried a myriad of medications. I still feel like hell most days, and am almost convinced that this is what I have to look forward to for the rest of my life. (I'm 51 now.) I firmly believe that, had I never touched pharmaceuticals, I would have recovered from my anxiety/depression within a few months. The worst is the "bed phobia" I developed after that first round of meds. I became so afraid of not sleeping that I couldn't even look at my bed without feeling anxious. Now, nine years later, I still have anxiety attacks if I do not take my meds every night. The problem is that my sleep meds (Zyprexa and clonazepam) keep pooping out, forcing me to take higher and higher doses. Also, I believe the meds prevent me from getting the deep (Stage IV) sleep I need to feel better. On top of all my anxiety, I have chronic pain in my head, neck and back. And I have become so sensitive to insomnia! Even one night of poor sleep leaves me feeling like I'm having a nervous breakdown. How the heck do I get out of this mess? I can't tolerate insomnia, yet that is the door I have to walk through if I want to get off the med merry-go-round. Can I use a tricyclic such as Doxepin or Trimipramine to wean off the benzo, and then slowly wean off the tricyclic? Are tricyclics easier to stop that benzos? Any suggestions or comments would be greatly appreciated.
Posted by SLS on October 2, 2005, at 8:37:47
In reply to A lifetime of mental illness?, posted by Guy on September 27, 2005, at 22:02:29
Hi.
Regarding your question involving the discontinuation of benzodiazepines (BZD), you might want to post a question on the "Withdrawal" board.
I am currently interested in the use of anticonvulsants to help reduce the symptoms of BZD withdrawal. This would involve drugs like Depakote, Trileptal, and Topamax. Perhaps even Neurontin. I have never heard of the use of tricyclics to combat BZD withdrawal. Have you come across anything that suggests it might be effective?
How do you plan to treat the anxiety and agitation once the BZD is discontinued?
- Scott
Posted by iforgotmypassword on October 2, 2005, at 8:46:21
In reply to Re: A lifetime of mental illness?, posted by SLS on October 2, 2005, at 8:37:47
like zaleplon (Sonata, Starnoc) or zopiclone (Imovane)... they may be helpful. i've never tried them but they're specifically made for sleep. are they safe to use continuously and less addictive, SLS?
Posted by Phillipa on October 2, 2005, at 18:44:03
In reply to for sleep you could try a GABA-A agonist..., posted by iforgotmypassword on October 2, 2005, at 8:46:21
Guy, I know exactly what you mean. I've been on benzos since I was 24 and I'm in my 50's also. I too could never sleep if it wasn't for a benzo. The way I see it my brain has adapted to them. If only they'd known about this years ago. But I'm interested in the theory or your thought that a TCA etc could substitute. Fondly, Phillipa
Posted by yxibow on October 4, 2005, at 0:21:14
In reply to A lifetime of mental illness?, posted by Guy on September 27, 2005, at 22:02:29
> I have suffered with severe agitation and insomnia for the past nine years. What a strange coincidence that I first really fell off my horse after my first presciption of oxazepam ran out!
Wow! I'm glad you're safe.
Yes, I had anxiety and depression before the pills, but after that first prescription of 20 pills ran out I went four days without sleep and cracked up so badly I had to go to the psych clinic.
Sleep is a very important aspect to psychiatric disorders, I can tell you firmly -- I've had insomnia for years.
Since that time, I have seen numerous psychiatrists and psychologists and tried a myriad of medications. I still feel like hell most days, and am almost convinced that this is what I have to look forward to for the rest of my life. (I'm 51 now.)
There's always another route around the corner -- I dont know what country you're in so my recommendations may only apply for the US
I firmly believe that, had I never touched pharmaceuticals, I would have recovered from my anxiety/depression within a few months. The worst is the "bed phobia" I developed after that first round of meds. I became so afraid of not sleeping that I couldn't even look at my bed without feeling anxious. Now, nine years later, I still have anxiety attacks if I do not take my meds every night. The problem is that my sleep meds (Zyprexa and clonazepam) keep pooping out, forcing me to take higher and higher doses. Also, I believe the meds prevent me from getting the deep (Stage IV) sleep I need to feel better. On top of all my anxiety, I have chronic pain in my head, neck and back.
I'm not your doctor but I would recommend Robaxin (methocarbamol) for your chronic back pain -- it has few drug interactions unless you reach a high dose and it might interfere with some antidepressants.
And I have become so sensitive to insomnia! Even one night of poor sleep leaves me feeling like I'm having a nervous breakdown. How the heck do I get out of this mess? I can't tolerate insomnia, yet that is the door I have to walk through if I want to get off the med merry-go-round. Can I use a tricyclic such as Doxepin or Trimipramine to wean off the benzo, and then slowly wean off the tricyclic? Are tricyclics easier to stop that benzos? Any suggestions or comments would be greatly appreciated.
All medicines have to be tapered off to some extent. If you start Sinequan (Doxepin), it may knock you off your socks to begin with. It is very sedating. I switched from Trazodone to it temporarily because I suffered from the priapism problem (not majorly -- but it happens more often than they say).I think a more modern sleep agent would be better. I don't know what your doctor feels comfortable prescribing but Ambien can be taken up to 20mg long term regardless what the PDR may say. I and numerous people do. There is also now the choice of Lunesta, which is approved for longterm, but is a bit more subtle than Ambien and for a large percentage of people will have a strange metallic taste for the first few hours. There is a third, Sonata, but it is in my opinion weaker than all of them. They are all related but not exactly benzodiazepines, so if you have a high tolerance to benzodiazepines they may not be as effective, initially anyway. But in my opinion, I would go with the modern sleep agents (or at least ones designed for sleep especially, like Temazepam), instead of ones that you are merely using for side effects. The only one that may promote REM sleep, for its side effects, is Remeron. But it can promote weight gain in a major fashion so that is a tradeoff.
There is now a completely different class of medication, Rozerem (ramelteon), which is basically prescription Melatonin in a more targeted fashion. For depression, a hormone is generally not recommended. It could be used for a very short term use to reset your body clock.
I hope that provides some information, and I wish you a good night's sleep
Tidings
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