Posted by King Vultan on November 11, 2004, at 21:48:27
In reply to help- sleeping meds, posted by bark2323 on November 11, 2004, at 18:04:30
Ambien, along with Sonata, which is a very similar med with an even shorter half life, seem to have a minimal tendency to cause tolerance to their effects, but this can still be a problem for some susceptible individuals. The benzo sleep med with the least tendency to induce tolerance is probably Halcion/triazolam, which has a mean half life of 3.5 hours (Ambien is about 2.6, and Sonata is only 1 hour), but it seems clear that Halcion is not nearly as good as the other two meds in this respect. FWIW, though, it does seem to be more powerful.
One thing you can do to reduce tolerance is to alternate these benzo-type sleep meds with other drugs that are sedating. I alternated Halcion and Benadryl while I was on Nardil, taking each every other night, and found this to work relatively well. Unfortunately, now that I am on Parnate and am suffering even worse insomnia, the Benadryl is proving inadequate. In my case, I have now started alternating between Ambien and Halcion, which I know won't work for you because of tolerance issues, but I also use sleep/relaxation CDs that I find incredibly helpful. Particularly, they seem to keep my thoughts from racing in the middle of the night when I wake up, and this allows me to get back to sleep. They also seem to improve the quality of my sleep.
There are some powerful drugs available that are almost guaranteed to knock you out, but some of them, such as chloral hydrate, really should not be used with alcohol. I believe the same is true of the barbituates. My understanding is that even mixing benzos and alcohol can be problematic, but I am not an expert on that particular interaction. I don't know what sedating ADs you've tried, but the tricyclics doxepin and Surmontil/trimipramine are both extremely powerful antihistamines and might be worth considering. I believe that doxepin is the strongest antihistamine known, and it is extremely sedating, while Surmontil seems to provide extremely high quality sleep. Amitriptyline is another sedating TCA, but I almost never recommend it because it is so anticholinergic (dry mouth, constipation, etc.).
However, perhaps the brain fog that anticholinergic drugs also tend to produce might be helpful in slowing down your thoughts (doxepin and Surmontil are also relatively anticholinergic), but that is just a thought that may have nothing to it. FWIW, other antihistaminic, anticholinergic drugs are diphenhydramine (Benadryl, Simply Sleep, etc.), doxylamine succinate (Unisom tablets), and promethazine/Phenergan, the first two being OTC drugs in the US.
Todd
poster:King Vultan
thread:414713
URL: http://www.dr-bob.org/babble/20041108/msgs/414791.html