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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by dave_fox on September 22, 2001, at 17:30:04
I am taking 10mg Ambien (zolpidem) at night but it seems to have only a little effect on promoting sleep.
I know that Ambien is a short-acting sleeping med and that, unlike the benzodiazepines, it does not promote muscle relaxation not does it relieve anxiety. However I feel I might need to take more than 10mg for a fuller effect.
However, I can not find any reference in the literature I have seen to taking a higher dose.
Why has the upper limit of this med been set at 10mg? Are the side effects of higher doses dangerous? Or perhaps it is thought that no-one would need a higher dose?
In fact, I am just a little bit suspicious of the manufacturers recommendation (here in the UK at least) of 10mg. Only 10mg is suggested and no range such as 5mg to 15mg is given. That seems a little bit odd.
You can see that I am confused! Any info would be most welcome.
Thank you.
Dave
Posted by kazoo on September 22, 2001, at 23:49:32
In reply to Can I take more than 10mg of Ambien?, posted by dave_fox on September 22, 2001, at 17:30:04
> Why has the upper limit of this med been set at 10mg? Are the side effects of higher doses dangerous? Or perhaps it is thought that no-one would need a higher dose?
^^^^^^^^^^^
If you feel the need to take more than 10 mgs., then, perhaps, the drug isn't right for you.You can take more than 10 mgs. as I have done on a few occasions with no deleterious effects.
If you do tell your doctor that you take more than prescribed, he'll probably cut you off, which may be a blessing in disguise.
Ambien is a strange drug anyway and I'm not quite sure if it's any good.
kazoo
Posted by dave_fox on September 23, 2001, at 6:24:36
In reply to Re: Can I take more than 10mg of Ambien? » dave_fox, posted by kazoo on September 22, 2001, at 23:49:32
>
> If you feel the need to take more than 10 mgs.,
> then, perhaps, the drug isn't right for you.
>Can I ask you why you say this? Are you kind of saying that my own metabolism is not responding to this med in the usual way?
>
> You can take more than 10 mgs. as I have done
> on a few occasions with no deleterious effects.
>What doses have you taken? 15mg? 20 mg? Higher?
> Ambien is a strange drug anyway and I'm not
> quite sure if it's any good.Yes, I too am starting to think this. OTOH it may be that the dose ranging studies for Ambien were done incorrectly and that the suggested therapeutic dose is now set too low.
Maybe some people here can help out with info on this and other points I raise in my initial posting.
Dave
Posted by kazoo on September 23, 2001, at 9:22:54
In reply to Re: Can I take more than 10mg of Ambien?, posted by dave_fox on September 23, 2001, at 6:24:36
> > If you feel the need to take more than 10 mgs.,
> > then, perhaps, the drug isn't right for you.
> >
>
> Can I ask you why you say this? Are you kind of saying that my own metabolism is not responding to this med in the usual way?^^^^^^^^^
I'm spinning my wheels in a mud puddle of ambivalence with my original statement and don't know how to answer you. I'm in no position to say either "yes" or "no."I've taken up to 20 mgs.
I would hope that the dosages were well thought out with this drug, but this could change. Your best bet would be to contact the manufacturer and pose the question directly to them. They have doctors and researchers on their staff that could answer your questions.
kazoo
Posted by dave_fox on September 23, 2001, at 9:27:34
In reply to Re: Can I take more than 10mg of Ambien? » dave_fox, posted by kazoo on September 23, 2001, at 9:22:54
> I would hope that the dosages were well thought
> out with this drug, but this could change.
> Your best bet would be to contact the
> manufacturer and pose the question directly to
> them. They have doctors and researchers on
> their staff that could answer your questions.I have tried contacting the manufacturers but the guys on the medical helplne just trot out what is said in their patient information leaflet or the standard physicians advice leaflet. Seems that they dare not say anything contary to that no matter what else they think!
That is what I think it i smore valuable to hear from people here about their own expriences in a clinical setting or from their own researches which may well be better than mine are.
Thanks again.
Posted by susan C on September 23, 2001, at 12:45:57
In reply to Re: Can I take more than 10mg of Ambien?, posted by dave_fox on September 23, 2001, at 9:27:34
Hi,
I have been on ambien since November of 2000 after years of trazadone (pooped out) trial of sonota (didn't keep me asleep) Then followed dr orders to keep adding ambien until I got to sleep and stayed asleep. That happened at 30mg. I have interrogated him tentensively as to the amount and the discrepancy between what I am doing and what is in the literature and his response is one: other's are doing it and have for some time with no adverse affects in his observation. two: It is working for you. Three: it flushes out of your system quickly.There have been some times where after about 5 hours I can have wakefulness, but do return to sleep easily..
I too was frustrated by the lack of information in the printed literature that would reflect the experience I am specificially going through...I guess we are just weird birds, eh?
I have also read very negative experiences as at the same time I have had very negative experiences with things that others find quite helpful...go figure...There is a reason MDs are paid $200 an hour to get confused.
Sincerely,
Mouse sleeping soundly
Susan C> > I would hope that the dosages were well thought
> > out with this drug, but this could change.
> > Your best bet would be to contact the
> > manufacturer and pose the question directly to
> > them. They have doctors and researchers on
> > their staff that could answer your questions.
>
> I have tried contacting the manufacturers but the guys on the medical helplne just trot out what is said in their patient information leaflet or the standard physicians advice leaflet. Seems that they dare not say anything contary to that no matter what else they think!
>
> That is what I think it i smore valuable to hear from people here about their own expriences in a clinical setting or from their own researches which may well be better than mine are.
>
> Thanks again.
Posted by Janelle on September 23, 2001, at 15:35:16
In reply to Re: Can I take more than 10mg of Ambien?, posted by susan C on September 23, 2001, at 12:45:57
I took Ambien for awhile, 10mg/night worked for me except a few instances for which I needed 15 mg. I would suggest calling a pharmacist, heck call a few of them -- these people often know MORE than the docs and heck, maybe even the manufacturers! They may also know if the suggested dosing range for Ambien has been changed with time in the marketplace. In any event, I find pharmacists to be a fountain of information at times. Give that a try if you remain concerned; otherwise, I'd have to say at this point in time, based on what I've heard, don't take more than 15mg/night of Ambien and if this does not help you sleep, ask your doc for alternatives (Trazodone, etc.) Good luck!
-Janelle
Posted by Elizabeth on September 24, 2001, at 12:55:52
In reply to Can I take more than 10mg of Ambien?, posted by dave_fox on September 22, 2001, at 17:30:04
> I am taking 10mg Ambien (zolpidem) at night but it seems to have only a little effect on promoting sleep.
I had the same problem. Now I take 20 mg and it works fine (if only it lasted longer). No problematic side effects. It's a very safe drug and I think it's worthwhile to try a higher dose if the usual 10 mg doesn't work well enough for you. You might try 15, then go to 20 if 15 doesn't work.
> I know that Ambien is a short-acting sleeping med and that, unlike the benzodiazepines, it does not promote muscle relaxation not does it relieve anxiety.
It's not supposed to, but personally, I find it to be a great anxiolytic. (I discovered this because 10 mg wasn't sedating for me.)
> Why has the upper limit of this med been set at 10mg? Are the side effects of higher doses dangerous? Or perhaps it is thought that no-one would need a higher dose?
The latter -- most people don't need more. But obviously there are a few of us who benefit from a higher dose. That 10 mg doesn't work well for you should not be taken to mean that Ambien won't work at *any* dose. I know a few people who need 15 or 20 mg and one who takes 30-40.
I think Searle is being overly cautious about the dose range. Tell your doctor that 10 mg isn't working, and ask if you could try taking a bit more.
BTW, I wouldn't expect a pharmacist (except, of course, for our own marvelous Cam :-) ) to have much "real world" knowledge. Retail pharmacists seldom have any true clinical experience. (I had a very irritating experience with a pharmacist who insisted on calling my doctor to confirm that my prescription -- which I'd filled previously at the same pharmacy without any hassle! -- was in fact for 20 mg/night.)
-elizabeth
Posted by Janelle on September 24, 2001, at 13:53:08
In reply to Re: Can I take more than 10mg of Ambien?, posted by Elizabeth on September 24, 2001, at 12:55:52
I guess we have had very DIFFERENT experiences with pharmacists - the ones I have dealt with and asked questions of have all been very knowlegeable and helpful. And I DO expect them to have some "real world" knowledge because of their education and many of them have access to computerized drug interactions right as they fill prescriptions. You are right, however, that retail pharmacists seldom have any true "clinical" experience.
And in my humble opinion (and it's just my opinion!), although it was an irritating experience if the pharmacist who insisted on calling your doctor to confirm that your prescription was in fact for 20 mg/night, if he was NOT the one who'd filled it previously, then it was *wise* on his part to be cautious and want to confirm it with your doc, since 20mg does exceed the manufacturer's recommended maximum dose. Again, all of this is just my humble opinion! I've been *lucky* with pharmacists being able to answer questions and guide me if needed.
Posted by terra miller on September 24, 2001, at 22:42:13
In reply to Can I take more than 10mg of Ambien?, posted by dave_fox on September 22, 2001, at 17:30:04
i take 15mg as needed with psychiatrist's blessing. 10mg worked sometimes, but 15mg is perfect. it gets me into deep sleep, which i don't tend to do on my own. however, i usually choose to use it 1-2 times a week. seems benign to me from my experience. take care, terra
Posted by dave_fox on September 25, 2001, at 4:16:55
In reply to Re: Can I take more than 10mg of Ambien?, posted by Elizabeth on September 24, 2001, at 12:55:52
> Now I take 20 mg and it works fine (if only it lasted longer).
> No problematic side effects. It's a very safe drug and I think
> it's worthwhile to try a higher dose if the usual 10 mg doesn't
> work well enough for you. You might try 15, then go to 20
> if 15 doesn't work.Elizabeth,
Thank you for your encouragement. I am heartened and I think I will explore those higher doses like 15 or 20mg.
But I have to admit to still being a litle bit worried about side effects. I don't mean those sorts of side effects where you feel dizzy or forget things or feel lethargic or have a headache.
I mean side effects where some damage may get done to, say, your liver. It's this sort of thing which you don't get to notice it at the time. Then a long time later the damage becomes permanent. Of course, in this example I'm just guessing but it's an illustration of the sort of thing I am thinking about.
Dave
Posted by PaintItBlack on September 25, 2001, at 11:48:46
In reply to Can I take more than 10mg of Ambien?, posted by dave_fox on September 22, 2001, at 17:30:04
> Why has the upper limit of this med been set at 10mg? Are the side effects of higher doses dangerous? Or perhaps it is thought that no-one would need a higher dose?
Probably because that's where "most" people responded in their testing.
10mg gives me 5-6 hours sleep, which is good, but not quite enough. My pdoc has me take 1-2mg Klonopin on top of it, which gives me 7-8 hours most nights. So one strategy might be "augment" it.
Paint It Black
Posted by Elizabeth on September 25, 2001, at 17:19:04
In reply to Re: Can I take more than 10mg of Ambien?, posted by dave_fox on September 25, 2001, at 4:16:55
> I mean side effects where some damage may get done to, say, your liver.
AFAIK, Ambien is relatively safe (compared with other drugs that are used long-term), assuming that you don't already have compromised liver functioning. If you're really concerned, you might ask your doctor about having regular liver function tests. (This might be a good idea for anyone who's taking medication long-term.) You'd probably only need to have the test done once a year or less, I would think (again this is assuming your liver is healthy to start with).
You can also get regular tests (e.g., blood counts) for other potential long-term effects. I don't know of any long-term adverse reactions that are associated with Ambien, though, so I wouldn't know what to test for. Again, ask your doctor if you're really concerned.
-elizabeth
This is the end of the thread.
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