Posted by SLS on February 6, 2012, at 5:55:17
In reply to Re: starting Parnate tomorrow » SLS, posted by g_g_g_unit on February 6, 2012, at 3:35:29
> I've tried the "Z-drugs" like Ambien etc., which allowed me to sleep rather restfully, but produced hallucinations.
>
> I've tried Seroquel, which caused RLS.
>
> I've tried Xanax, Temazepam, Lorazepam - none of which allowed me to sleep restfully, with all producing rebound depression (agitation, suicidal ideation) the next day.I see. All of the things that you describe are consistent with what each of those drugs are capable of. Trazodone may, indeed, represent a reasonable alternative. It has been a common practice to use it with Parnate for over 20 years. Finding the lowest effective dosage is important to help prevent a "hangover" sedation the next day. There are the antihistamines (hydroxyzine, cyproheptadine, diphenhydramine). It might be an option to combine one of these drugs with trazodone if trazodone by itself is insufficient. Cyproheptadine adds some serotoninergic properties that may be helpful and that may actually guard against serotonin syndrome. Certain tricyclics can be combined safely with Parnate. Amitriptyline, trimipramine, and doxepin are all sedating and useful to treat insomnia. Mirtazapine would be a nice tool to work with, but I am not convinced that it is safe when combined with Parnate. One would think so. Sonata (zaleplon), a "Z" drug, might be worth a try. It is rather gentle, and works well to initiate sleep. Again, you could add an antihistamine to it in order to help keep you asleep. One should not generalize to all of the "Z" drugs the amnestic or hallucinatory effects of Ambien (zolpidem). Prazosin can help with sleep, but might be too mild. Melatonin might be helpful. You would have to experiment with it to discover what time is best for you to take it. Many people take it about an hour before bed. Others have more success with two hours. Infrequently, taking melatonin in the afternoon works and helps align one's circadian rhythms.
If I were you, I would probably opt to try trazodone first, possibly to be combined with an antihistamine. Linkadge has had success using cyproheptadine.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1009314
URL: http://www.dr-bob.org/babble/20120202/msgs/1009434.html