Posted by myco on March 28, 2009, at 2:42:29
In reply to Re: Changing insomnia meds, posted by bleauberry on March 27, 2009, at 20:10:12
Thanks for the well detailed response, you always put effort into them.
Unfortunately for me gp is phobic about many things...anything benzo or pseudo-benzo like lunesta is out of the question for him. Zyprexa he refused to recognize as useful...I will have to delve into the literature to show support as a sleep aid for that one...i'm willing to try anything as long as it agrees with nardil.
Remeron is something he wouldnt buy into either...he doesnt like augmenting anything really...his philosophy is "we dont want to add more drugs" and I should just meditate to sleep LOL ya right, meditate for sleep on moderately high dose nardil hmmm lol ok. I think I can budge him on the zyprexa though...I will concentrate there I think. Remeron is ssri is it? ive never used it but if it's tca or ssri he doesnt like it with maois.
Although I have used amitriptyline with success for sleep (worthless to me as an AD though) in the past through a pdoc....cant wait to get a new pdoc...soon. Ya my fight or flight is seriously messed up...I panic easily but usually nardil has this under control.
Tension and anxiety dominate my life when not on a proper med. I also think you may be right about the fibromalagia...at some point I may get it in the future as muscle tension easily develops into debilitating pain. I think it was you who mentioned that to me once...that I sound a candidate for that.
I have heard of hydrocortisone works well...will have to look more into it. I have this ocd tendency I think lol i read and read and read whenever I start something new....i never just start.
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> While none of the sleep meds were perfect for me, I had by far the best results with either Zyprexa (8 years at 5mg) or Lunesta (1/2 dose as needed) or Remeron (3.75mg-7.5mg).
>
> With the exception of those meds, everything else...Seroquel, Trazodone, benzos...left me significantly more depressed the next day. And very lethargic.
>
> That brings me to Remeron. Excellent sleep med at the right dose. I think if people would take a 15mg tab and cut it into quarters, try one quarter, and then try two quarters, they would find that 3.75mg or 7.5mg is a good sleep. It comes with a slight morning grogginess hangover thing that disappears in a couple weeks, but no depression. For me anyway. And I am easily depressed by meds. Higher doses to me were more activating and not as good for sleep. I swear, little chunks of Remeron are powerful good sleep meds.
>
> Though I've never tried Amitriptyline myself, I know a couple people that have used it nightly for years in doses of 10mg-25mg.
>
> I suspect if you have a damaged sympathetic system (fight or flight), you would do best with Amitriptyline.
>
> Contrary to what your docs said, I have to put a good word in for Zyprexa. It is a good med to try and should not be haphazardly lumped into a category with other APs.
>
> No matter what you take, be sure it is brand and not generic. If you are on generic, switch to brand before switching meds. I'm not kidding.
>
> At the right doses...Remeron, Amitriptyline, Lunesta, Zyprexa...there you have four excellent alternatives to put on your menu. No shortage of options. With the exception of Amitriptyline, be sure they are not generic.
>
> As a side note, another excellent sleep/anxiety med was Hydrocortisone tablets at just 1.25mg (1/4 of the smallest pill). If you have ever googled adrenal fatigue and it looked like something that fit you, then HC would do wonders. Amitriptyline is sort of in that same circuitry.
poster:myco
thread:887265
URL: http://www.dr-bob.org/babble/20090322/msgs/887354.html