![[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 jerryTRD on November 4, 2010, at 0:08:19
I've had constant nausea for over a month now and my Doc thinks it maybe an H. pylori infection. At any rate she prescribed Phenergan (Promethazine) for nausea because my insurance doesn't cover zofran.
I found that 50-75mg of Promethazine (an old antihistamine used for nausea, vomiting, and sedation) gives me the most peaceful sleep I've ever had. However, when talking to my family doc about using it for sleep she said it wasn't a good idea because potential side effects outweigh the positives.
So I called my pdoc and explained this to my pdoc's nurse - and asked if she could talk to my pdoc and see if there is anything similar that might work the same way. I'm taking 300mg of Seroquel just for sleep and I hate it and want off it!
Any of you honorary pharmacologists out there have any suggestions?
I was thinking maybe Vistaril/Atarax but I've been on that before and it wasn't strong enough although I would be willing to try it again.
Posted by ed_uk2010 on November 4, 2010, at 2:51:23
In reply to Promethazine gives me the most peaceful sleep but, posted by jerryTRD on November 4, 2010, at 0:08:19
>because potential side effects outweigh the positives.
A bit like Seroquel then - but 200 times less expensive.
You can buy Phenergan without a prescription here in packs of 56. I don't know whether you can.
Promethazine is a phenothiazine antihistamine. It's quite a strong antihistamine. It also had moderate anticholinergic effects and weak dopamine receptor blockade (weaker than antipsychotics). Promethazine is a relatively safe drug, if you can tolerate the daytime drowsiness.
Posted by Phillipa on November 4, 2010, at 10:52:01
In reply to Re: Promethazine gives me the most peaceful sleep but, posted by ed_uk2010 on November 4, 2010, at 2:51:23
If you have H pylori that is treated with antibiotics isn't it and would mean an ulcer. Or did I read this wrong? Phillipa
Posted by SLS on November 4, 2010, at 13:22:06
In reply to Re: Promethazine gives me the most peaceful sleep but, posted by ed_uk2010 on November 4, 2010, at 2:51:23
> >because potential side effects outweigh the positives.
>
> A bit like Seroquel then - but 200 times less expensive.
>
> You can buy Phenergan without a prescription here in packs of 56. I don't know whether you can.
>
> Promethazine is a phenothiazine antihistamine. It's quite a strong antihistamine. It also had moderate anticholinergic effects and weak dopamine receptor blockade (weaker than antipsychotics). Promethazine is a relatively safe drug, if you can tolerate the daytime drowsiness.I saw someone who was riddled with anxiety and being treated with Zyprexa unsuccessfully change over to promethazine (Phenergan) with great results. He didn't seem to be drowsy during the day, but perhaps this was idiosyncratic of his psychobiology.
- Scott
Posted by jerryTRD on November 6, 2010, at 13:52:57
In reply to Re: Promethazine gives me the most peaceful sleep but, posted by SLS on November 4, 2010, at 13:22:06
> > >because potential side effects outweigh the positives.
> >
> > A bit like Seroquel then - but 200 times less expensive.
> >
> > You can buy Phenergan without a prescription here in packs of 56. I don't know whether you can.
> >
> > Promethazine is a phenothiazine antihistamine. It's quite a strong antihistamine. It also had moderate anticholinergic effects and weak dopamine receptor blockade (weaker than antipsychotics). Promethazine is a relatively safe drug, if you can tolerate the daytime drowsiness.
>
> I saw someone who was riddled with anxiety and being treated with Zyprexa unsuccessfully change over to promethazine (Phenergan) with great results. He didn't seem to be drowsy during the day, but perhaps this was idiosyncratic of his psychobiology.
>
>
> - Scott
So Scott - would you say that promethazine is relatively safe for longer use? Even compared to the Seroquel my doc has me on now? I mean - why are my doctors shying away from using this if it is helping me more than the Seroquel?Jerry
Posted by jerryTRD on November 6, 2010, at 13:54:33
In reply to Re: Promethazine gives me the most peaceful sleep but, posted by ed_uk2010 on November 4, 2010, at 2:51:23
> >because potential side effects outweigh the positives.
>
> A bit like Seroquel then - but 200 times less expensive.
>
> You can buy Phenergan without a prescription here in packs of 56. I don't know whether you can.
>
> Promethazine is a phenothiazine antihistamine. It's quite a strong antihistamine. It also had moderate anticholinergic effects and weak dopamine receptor blockade (weaker than antipsychotics). Promethazine is a relatively safe drug, if you can tolerate the daytime drowsiness.
>
>Ed - do you know of any long-term use side effects? I don't understand why my docs are shying away from using this since it's been working much better than the Seroquel. And does it have LESS of a risk of EPS/Tardive Dyskinesia effects than mends like Seroquel?
Thanks
Jerry
Posted by jerryTRD on November 6, 2010, at 13:55:41
In reply to Re: Promethazine gives me the most peaceful sleep but, posted by Phillipa on November 4, 2010, at 10:52:01
> If you have H pylori that is treated with antibiotics isn't it and would mean an ulcer. Or did I read this wrong? Phillipa
Yes it's treated with antibiotics and proton pump inhibitors like Prilosec. But doesn't necessarily mean there's an ulcer.
Posted by ed_uk2010 on November 6, 2010, at 14:24:01
In reply to Re: Promethazine gives me the most peaceful sleep but » ed_uk2010, posted by jerryTRD on November 6, 2010, at 13:54:33
Hi Jerry,
>Ed - do you know of any long-term use side effects?
Adverse effects such as dizziness and drowsiness are very common. Serious side effects are rare, but may include jaundice, blood disorders and hypersensitivity to sunlight. Avoid strong sunlight.
>I don't understand why my docs are shying away from using this since it's been working much better than the Seroquel.
It's old and out of fashion. They haven't seen any glossy adverts for it. American docs love shiny new meds.
>And does it have LESS of a risk of EPS/Tardive Dyskinesia effects than mends like Seroquel?
I expect that the risk of TD is similiar to Seroquel, maybe lower. There aren't many reports. Promethazine is not sufficiently potent as a dopamine antagonist to be used alone as an antipsychotic, although it can be added to antipsychotics if increased sedation is required. An traditional treatment for severe acute agitation in mania or schizophrenia was haloperidol + promethazine. This is still sometimes used as a cheaper alternative to the likes of Zyprexa, especially in developing countries where Zyprexa is out of the question.
Promethazine is prescribed quite freuquently in the UK. It's used in children for insomnia (especially due to severe itching when eczema/dermatitis has been difficult to control), it's used for travel sickness when sedation is appropriate, for insomnia in adults when daytime drowsiness is acceptable, and for insomnia when potentially abusable meds are not appropriate. It's available OTC but many pharmacists are cautious about selling the large pack sizes because they feel that medical supervision is advisable for regular use.
As is the case with all sedative antihistamines, tolerance to the sleep inducing effects can develop fairly quickly in some cases.
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.