Posted by zeugma on October 10, 2004, at 7:40:19
In reply to I no longer respond to benzos. Need some insight., posted by jerrympls on October 9, 2004, at 1:03:42
Tolerance to the sedative effects of benzodiazepines is a well-known phenomenon. That is one reason (not the only one) that they are not recommended for long-term insomnia.
The other reason they are not ideal for long-term sleep use is that they block slow wave sleep. There is apparently some controversy over this, and Dr. Paul Cheney, who is a great advocate of klonopin, says this is a myth. (Sorry, I am writing this from memory and too tired to dig up a link.) Cheny treats fibromyalgia patients who often experience chronic sleep difficulties. If I understand Cheney's practice, however, as opposed to his false claim about clonazepam, it is this: He advocates simulatneous use of low doses of doxepin, which enhances restorative sleep and would counteract the block on SWS from Klonopin. The articles I have read on long-term treatment of insomnia all come to a similar conclusion: "although more study is needed" (everything in psychiatry comes with this irritating disclaimer), TCA's such as doxepin or amitriptyline induce little tolerance and actually seem to correct the hypothesized HPA axis dysregulation that causes the insomnia in the first place. The reason these studies are buried in obscure academic journals is because they have been off patent for decades and psychiatry is more business practice than medicine. Have you tried TCA's for your sleep problems?
-z
poster:zeugma
thread:400640
URL: http://www.dr-bob.org/babble/20041007/msgs/401102.html