Posted by Louisiana Sportsman on April 9, 2014, at 13:39:02
In reply to Sleep med advice, posted by vbs on April 7, 2014, at 8:04:17
Mirtazapine, as you've mentioned, is an idea. It depends on how well you respond to H1 antagonists such as diphenhydramine or doxylamine succinate. Try chlorpeniramine Maleate if you haven't already, it is an OTC antihistamine too.
I believe if a stronger H1 antagonist is needed then, as a previous poster suggested, hydroxyzine would be a great choice. But, I would think promethazine would be more sedating whereas hydroxyzine is more of an anxiolytic. I think promethazine would be a both more sedating and less side effect prone than Remeron.
I've seen mentions of pregabalin (Lyrica) and that may is somewhat advisable, but I've found it (and its cousin, gabapentin) somewhat activating, but your mileage may vary.
My personal suggestion would be generic Doxepin. They have Silenor that comes in 3mg. and 6mg. tablets for sleep. This is expensive and unnecessary. The suggested dosage for adults is 6mg. The lowest dosage of generic doxepin is 10mg. This is not too far off from the Silenor dosage of 6mg. I mean, if you can afford it-- go for it. They come in capsule form so you can't split them. The promethazine pills, however, are scored so you can break them in half if they're too strong. See if your doctor would write both scripts like:
#30 doxepin 10mg.
#30 promethazine 50mg.
poster:Louisiana Sportsman
thread:1063794
URL: http://www.dr-bob.org/babble/20140328/msgs/1063894.html