Posted by Ron Hill on March 22, 2002, at 21:25:37
In reply to oy vey! » Ron Hill, posted by beardedlady on March 22, 2002, at 13:33:27
Ms. Lady,
Thank you so much for taking the time to help me understand your case history. Having read your response, I have completely changed my mind. I think there is a very high probability that SAM-e will fix both your insomnia and your anxiety if you do the trial correctly. Sorry to have come off so negative before. I just did not have enough of your case history. Please read my responses to your answers. It’s kinda cluttered with 49 posts crammed into one, but you can figure it out.
> > Yes, but what does this have to do with the reason you are tapering off Serzone?
> Oh, the liver thing. Serzone has that new black box, so I thought it best if I either switch to something else (but I dunno what) or try to live as I have for the 36 years before this happened to me.My recommendation: Don't worry too much about those "lawyer (shark) TV adds". JohnX2 takes Serzone, and he has posted that he is not concerned about it. John seems to think it's a lot to do over nothing. Personally, I have not taken the time to look into it since it does not affect me directly. However, I would be willing to bet dollars to donuts that John has looked into this Serzone issue VERY extensively because he takes the stuff (and because he is John!). John knows a lot about meds. I'd trust his judgment unless you have something that shows without a doubt that Serzone is dangerous.
I'm like you, I'd rather be off all man made medications. But you write that the Serzone is working well. If it ain't broke don't fix it. If it were me, I'd keep the Serzone in place while ramping up the SAM-e. Do this for one week, and if all is well, begin to carefully wean yourself off Serzone.
> > What or who gave you the impression that SAM-e is an appropriate treatment for insomnia? What does your pdoc think of the SAM-e trial? I feel sure that SAM-e will not harm you in any way, however, using it specifically to treat insomnia is, as I understand it, untried.
> No one gave me that impression. But I will try anything that's not a drug. And if it makes me feel good, maybe I won't worry so much about sleep.I'm on your side now. Start with 200 mg/day, and take the dose in the am.
> > Why hasn't your pdoc prescribed either sleeping pills or benzos to combat the insomnia?
>
> When this first happened three and a half years ago, we tried Ambien (one pill, one time), but I was so anxious I couldn't break through it, so it didn't work. Then we tried Xanax, which worked for short spurts of nap (but I was only on about .5 mgs!). Then we tried Zoloft and Xanax, and I got worse. Then we tried Trazodone and Xanax, and that worked for a month. Then we changed some timing, and it worked again for a month. Then we tried Serzone and quit the Xanax (yea! I hated it!), and my sleep returned to normal in about a week, and it hasn't stopped working.Serzone is working for you. Do not throw it away too soon. To reiterate; ramp up the SAM-e first, then slowly taper the Serzone, reversing course is it ends up that you can't sleep without it.
> Occasionally, when real life stuff interferes, I have breakthrough anxiety, and I use Sonata--a great drug (we discussed this before re: shelf life, which my pharmacist says is bunk because it's already months old in the pharmacy, and it has an expiration date of longer than a year on his bottle).
Good. One more tool in the tool box if it is needed.
> > Also you can do a search on the web (and on this site also) for the term "sleep hygiene" which is a set of rules (e.g. no sleeping during the day, etc) for the patient to follow in order to facilitate better quality sleep. I'm probably telling you a bunch of stuff that you already know and you're just eager for me to shut up.
> Yes. I know everything about it. I have great sleep hygiene. I never had this problem until my daughter quit nursing cold turkey the weekend before I started a new teaching job, which was right after my father-in-law's funeral!
This is one of two important bits of information that made me change my mind regarding the probable effectiveness of SAM-e to treat your insomnia and anxiety. I now believe that your insomnia is due to low serotonin and not related to GABA. SAM-e is quite capable of increasing serotonin levels so you should be good to go.
> > Do you have the type of insomnia that causes you to wake up in the middle of the night and then preclude you from getting back to sleep, or do you have the kind of insomnia that makes it hard to fall asleep from the get go?
> It started while I was nursing with waking up at 2:00 a.m. and lying there until I fell asleep at 4:00. This happened maybe five times in four months. On the rare nights (rare now, anyway) that I can't fall back to sleep at all (I lie there in bed "resting" all night anyway because I often can get another three hours if I'm patient), I have trouble falling asleep the next night.This also sounds like low serotonin.
> > Also, how do you know that the key to curing your panic is to cure the insomnia (first). How do you know it is not the other way around (solve panic to cure insomnia)? What does the pdoc think, chicken or egg?
> It's obviously the insomnia that caused the panic. I forgot to add that I took a diet pill (phentermine) when she quit nursing. I was on them for about a month or two a year before I got pregnant, and they not only worked on my weight but made me feel happy and energetic, so I wanted that again after nursing a baby. But it gave me insomnia, and I stopped taking it. The insomnia didn't go away, so I started to panic that I wouldn't be able to take care of my daughter. I panicked because of sleep, and that's all.
Okay, I hear you now. Your reaction to the diet pill is the second important bit of information that made me change my mind regarding the probable effectiveness of SAM-e to treat your insomnia and anxiety. This diet pill story makes me think that you will benefit from a small boost of dopamine. And SAM-e can certainly do that.
> Thanks for asking.
I feel like I hurt your feelings with my last post. At the time, I needed more info. Thanks for filling me in. I'm sorry that I caused hurt. Forgive me?
> So the reason I'm thinking SAM-e is that I might stop worrying if I feel good, which might let me rest at night once I'm off the Serzone (or on a really reduced dose). Otherwise, it might keep my liver healthy to counteract the possible liver toxicity of Serzone.
One thing is for sure, we won't know unless you try the SAM-e. Have you bought it yet? What day do you plan to start the SAM-e trial? Please post your results daily. You have my best wishes and I will try to remember to pray for you daily this coming week.-- Ron
P.S. My wife teaches fourth grade at a public charter school. Are you still teaching?
poster:Ron Hill
thread:98301
URL: http://www.dr-bob.org/babble/20020322/msgs/99555.html