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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by vbs on December 26, 2014, at 16:18:05
Well, I'm back to Rozerem for insomnia. I tried this med back in 2005 with little success, but I was prescribed CNS stimulants at the time that were worsening my insomnia. Common sedative-hypnotics like Ambien and Restoril are not available due to prescribing practices of public mental health care.
I dropped trazodone because it was activating my psychosis; hearing voices. I also stopped taking BuSpar since I'm not anxious in the first place.
I'm hopeful that Rozerem will benefit me.
Current psych meds:
Cymbalta 90 mg
Latuda 120 mg
Invega Sustenna 234 mg
Rozerem 8mgAll meds covered by insurance. No copays. Free!
Peace everyone.
~vbs
Posted by rjlockhart37 on December 26, 2014, at 20:20:46
In reply to Rozerem, posted by vbs on December 26, 2014, at 16:18:05
i've been on rozerm after the doctor yankked me off temazepam, it increases melatonin receptors, or the transmission, its not really a sedative, but rather just makes you feel the mood to go to sleep, not sedation to get to sleep
hope it works good for you
r
Posted by Christ_empowered on December 26, 2014, at 21:16:36
In reply to Re: Rozerem, posted by rjlockhart37 on December 26, 2014, at 20:20:46
yeah, I think public/community health is best for severe mental illness. The place I go is easy breezy, recovery model, all that. I get disability, so its free treatment and low co-pays...until such a time as I can (hoping, praying) support myself.
Anyway...they don't do controlled Rx here, either. I do take a low dose of neurontin as needed, usually as a sedative.
I hope everything works out for you. Rozerem seems like a good choice. Please keep us all posted.
Posted by SLS on December 27, 2014, at 1:47:15
In reply to Rozerem, posted by vbs on December 26, 2014, at 16:18:05
Has taking melatonin ever helped? I think most people are under the impression that you are supposed to take it 30 - 60 minutes before bedtime. On average, it is actually better to take it 2 - 4 hours before bedtime. Strangely enough, some people find it most helpful when taken during the afternoon. My guess is that the somnogenic effects of melatonin have more to do with circadian endocrine synchronization than acute sedation. I would not look at Roserem (ramelteon) as being a more potent form of melatonin. It might not function the same way.
The ideal time to take melatonin is variable, and might depend on the illness being treated and the schedule of drugs being taken. Experimentation is often necessary to establish the most effective parameters. It is important to avoid endocrine misalignment. We are not looking at a healthy system, so it probably does not make sense to assume that melatonin dosage and timing would follow the same pattern in illness as it does in health. Less is sometimes more. Unfortunately, the systematic study of the clinical use of melatonin is lacking. You could try taking 0.5 mg 2 hours before bedtime and work backwards if necessary. If you reach 4 hours without effect, you could then increase the dosage to 3.0 mg or higher.
http://www.ncbi.nlm.nih.gov/pubmed/20410229
- Scott
Posted by vbs on December 27, 2014, at 7:29:19
In reply to Rozerem, posted by vbs on December 26, 2014, at 16:18:05
I took trazodone last night in order to fall asleep. No voices. Voices are episodic. I think that trazodone treats underlying agitation that is like atypical anxiety. I will resume trazodone 100 mg.
~vbs
Posted by Christ_empowered on December 27, 2014, at 7:58:42
In reply to Re: Rozerem » vbs, posted by SLS on December 27, 2014, at 1:47:15
the alternative health people say sufficiently high doses of melatonin can reduce/reverse TD. I wonder if using melatonin while on a neuroleptic could reduce TD, maybe EPS as well?
Posted by SLS on December 27, 2014, at 8:09:43
In reply to Re: Rozerem - Update, posted by vbs on December 27, 2014, at 7:29:19
> I took trazodone last night in order to fall asleep. No voices. Voices are episodic. I think that trazodone treats underlying agitation that is like atypical anxiety. I will resume trazodone 100 mg.
Trazodone has a metabolite known as mCPP (m-chlorophenyl-piperazine) that acts as a serotonin 5-HT2c receptor agonist and 5-HT2b receptor antagonist. Not good. mCPP is known to be anxiogenic. My guess is that the degree to which someone experiences anxiety with trazodone is dependent upon their sensitivity to mCPP, dosage, metabolic rate, and timing post-dose. Hopefully, you can find the ideal lowest dosage of trazodone that does the job.
Have you ever thought to try low dosages of Remeron (7.5 - 15.0 mg) taken at bedtime? A little 5-HT2a/c antagonism along with histamine H1 antagonism might help with sleep and anxiety.
- Scott
Posted by SLS on December 27, 2014, at 8:11:26
In reply to Re: Rozerem, posted by Christ_empowered on December 27, 2014, at 7:58:42
> the alternative health people say sufficiently high doses of melatonin can reduce/reverse TD.
I didn't know that.
> I wonder if using melatonin while on a neuroleptic could reduce TD, maybe EPS as well?
That's a big-time great question.
- Scott
Posted by vbs on December 27, 2014, at 8:35:15
In reply to Re: Rozerem - Update » vbs, posted by SLS on December 27, 2014, at 8:09:43
Pdoc said no to Remeron due to interactions. Trazodone 100 mg seems to do the job.
Cymbalta 90 mg
*Trazodone 100 mg
*Rozerem 8 mg
Latuda 120 mg
Invega Sustenna 234 mg* for sleep
Posted by SLS on December 27, 2014, at 9:28:44
In reply to Re: Rozerem - Update, posted by vbs on December 27, 2014, at 8:35:15
> Pdoc said no to Remeron due to interactions. Trazodone 100 mg seems to do the job.
That's great!
- Scott
Posted by Christ_empowered on December 27, 2014, at 9:39:22
In reply to Re: Rozerem - Update » vbs, posted by SLS on December 27, 2014, at 9:28:44
I'm glad trazodone works so well for you.
Posted by vbs on December 27, 2014, at 18:41:27
In reply to Re: Rozerem - Update, posted by vbs on December 27, 2014, at 8:35:15
So I took some BuSpar.
I gotta stop playing with my meds.
Cymbalta 90 mg
Latuda 120 mg
Invega Sustenna 234 mg
BuSpar 15 mg bid
Trazodone 100 mg
*Rozerem 8 mg*new med added
I feel like I'm on too many meds but when I stop one or two I experience withdrawal and return of symptoms. Schizoaffective disorder sucks. All my meds have no copays so money isn't an issue.I haven't been hearing voices as much lately. Sleep is important. I don't know if I'm allowed to take both Rozerem and trazodone. Probably an uncommon combination. I have a very long history of insomnia so personally I feel safe taking both. I slept an hour longer than I usually do with Rozerem. Anyway, that's the deal.
Peace...and be well babblers.
~vbs
Posted by SLS on December 27, 2014, at 23:16:27
In reply to Re: Rozerem - Update #2, posted by vbs on December 27, 2014, at 18:41:27
What role does Latuda play?
- Scott
Posted by vbs on December 28, 2014, at 2:14:28
In reply to Re: Rozerem - Update #2 » vbs, posted by SLS on December 27, 2014, at 23:16:27
Latuda is extra help to reduce the voices. I have schizoaffective disorder.
~vbs
Posted by SLS on December 28, 2014, at 6:29:26
In reply to Re: Rozerem - Update #2 » SLS, posted by vbs on December 28, 2014, at 2:14:28
> Latuda is extra help to reduce the voices. I have schizoaffective disorder.
>
> ~vbsLatuda is supposed to be good for bipolar depression, but I don't know how well it works for psychotic or schizoid disorders, despite its being approved for schizophrenia. I am disappointed that voices continue to be a problem for you. Was Zyprexa effective? Have you tried Saphris? It is not completely weight-neutral, but one can still lose weight with it. I am told that Saphris might be particularly effective where paranoia exists, but still might be worth exploring for auditory hallucinations. I have seen Saphris produce an antidepressant effect and improve cognition.
Latuda made my bipolar depression worse. Drugs with NE alpha-2 receptor antagonism like Remeron always do. My atypical response not withstanding, perhaps this property adds to the antidepressant effects of Latuda.
- Scott
Posted by jrbecker76 on January 8, 2015, at 12:54:47
In reply to Rozerem, posted by vbs on December 26, 2014, at 16:18:05
> Well, I'm back to Rozerem for insomnia. I tried this med back in 2005 with little success, but I was prescribed CNS stimulants at the time that were worsening my insomnia. Common sedative-hypnotics like Ambien and Restoril are not available due to prescribing practices of public mental health care.
>
> I dropped trazodone because it was activating my psychosis; hearing voices. I also stopped taking BuSpar since I'm not anxious in the first place.
>
> I'm hopeful that Rozerem will benefit me.
>
> Current psych meds:
>
> Cymbalta 90 mg
> Latuda 120 mg
> Invega Sustenna 234 mg
> Rozerem 8mg
>
> All meds covered by insurance. No copays. Free!
>
> Peace everyone.
>
> ~vbsI definitely suspect the m-CPP metabolite is the culprit with Trazadone.
This is the end of the thread.
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