![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 38. This is the beginning of the thread.
Posted by floatingbridge on August 27, 2011, at 12:37:14
I am thinking of requesting Valium for sleep. To help me sleep longer and the muscle relaxing qualities will help with my back.
I did a short round last June and liked it. (Though I have learned not to stress any pleasurable aspects of medication to doctors. It may alarm them.)
I could cut back on Xanax that way, too.
How does this sound?
The new Temazapam didn't help last night. I was awake by 3:00 anyways, just dopey. Does't feel so great, but able to skip morning Xanax.
Other long acting benzos (for sustaining sleep) seem to be Flurazapam (but that seems dicey sx-wise when I read Wiki), Quazepam, Loprazolam. Because they are longer acting then Temazapam.
Any cautions or comments? (I need sleep. TCA's are ruled out (maoi), and anti-histamines intolerable.)
The benzos are all so different. Some feel so yucky.
Thanks.
Posted by sigismund on August 27, 2011, at 15:26:09
In reply to Valium users, I need input, posted by floatingbridge on August 27, 2011, at 12:37:14
Did you like it? Maybe you did. I thought you didn't.
Be that as it may, I don't think Valium is good for sleep, in the same way benzos are not good for sleep, whether because they inhibit melatonin synthesis or whatever else.
And as you have found, temazepam is too short acting for sleep maintenance. Dalmane I liked once, when I didn't need it. It is longer acting. You could take the temazepam when you wake in the middle of the night. I did that. But it just jacked my benzo habit up.
You are probably running up against the limits of benzos
I don't know. I just put up with eccentric hours. In bed by 7.30pm and up by 1am.
Short acting mirtazepine would be the go if we had it. It's a horror show the day after for me.
You are still on Emsam? Which aggravates your insomnia?
Posted by sigismund on August 27, 2011, at 15:31:58
In reply to Re: Valium users, I need input » floatingbridge, posted by sigismund on August 27, 2011, at 15:26:09
The other thing which may not be entirely useless is to consider the lowest practical dose of gabapentin on retiring, even though you have finished with that.
Last night I took 150mg, which kept me in bed until 1.30am. Not a great advertisement, I can see.
Better than Valium for this purpose, IMO.
Posted by floatingbridge on August 27, 2011, at 15:52:15
In reply to Re: Valium users, I need input, posted by sigismund on August 27, 2011, at 15:31:58
> The other thing which may not be entirely useless is to consider the lowest practical dose of gabapentin on retiring, even though you have finished with that.
I haven't tried it. Lyrica, which was not good in anyway for me. But since then have come to think they aren't all that similar in action. So crud, I don't know.
>
> Last night I took 150mg, which kept me in bed until 1.30am. Not a great advertisement, I can see.
>Not exactly the perfect solution I was looking for....
But sig, if I have too many of these 3:00 am days (which might actually look somewhat good to your 1:30) I deteriorate quickly.
Your recollection is correct about Valium because I compared it to Xanax. It's in hindsight that I like Valium. Because every other benzo to date feels yucky. At least Valium was pleasant and relaxing :-/
Oh h*ll's bells.
> Better than Valium for this purpose, IMO.
Posted by sigismund on August 27, 2011, at 16:42:55
In reply to Re: Valium users, I need input » sigismund, posted by floatingbridge on August 27, 2011, at 15:52:15
Gabapentin probably has fewer side effects then Lyrica.
But let us use Lyrica, for arguments sake.
Could you have taken a single dose of Lyrica to help you stay asleep longer?
Your problem is you spend too much time sleeping in :)
Posted by floatingbridge on August 27, 2011, at 16:53:45
In reply to Re: Valium users, I need input » floatingbridge, posted by sigismund on August 27, 2011, at 16:42:55
:-)
Posted by jono_in_adelaide on August 27, 2011, at 18:53:05
In reply to Valium users, I need input, posted by floatingbridge on August 27, 2011, at 12:37:14
What dose of temazepam did you take last night?
If Xanax and temazepam arnt helping you sleep, its unlikely that Vslium will, given that all benzos are pretty much of a muchness.
It might be better to take a benzo in an appropriate dose (which one likely wont matter much) along with a dose of a sedating antidepressant (say, doxepin 25mg) as a "booster"
I dont think flurazepam will have nay more side effects than any other benzo, apart from perhaps hangover, because of its longer half life - and as you seem to need a longer acting drug, it would be well worth trying.
As flurazepam acts for about 3 days, you could perhaps take a decent dose of it at bedtime(say 30mg) and do without any benzo during the day, because the night befores flurazepam would still be in your system.
I'd give flurazepam or diazepam a try, and also ask for some 25mg doxepin capsules to use as an adjuvant, 1 at night, if your doctor is willing
Rough dose equivalence would be flurazepam 15mg = temazepam 15mg = diazepam 10mg = alprazolam 1mg
Posted by jono_in_adelaide on August 27, 2011, at 18:55:06
In reply to Valium users, I need input, posted by floatingbridge on August 27, 2011, at 12:37:14
Somthing else to consider might be rotating sleep meds, if you're going to need a hypnotic long term...... for example, taking (for example) flurazepam and doxepin alternatly, so the body doesnt build up a tolorance to either of them
Posted by Phillipa on August 27, 2011, at 20:13:34
In reply to Valium users, I need input, posted by floatingbridge on August 27, 2011, at 12:37:14
FB we are similar on this as valium always relaxed me also muscles and slept great on it. And yes you will be able to lower the xanax. That of course is my personal experience only Love Phillipa
Posted by Christ_empowered on August 27, 2011, at 20:36:10
In reply to Re: Valium users, I need input » floatingbridge, posted by Phillipa on August 27, 2011, at 20:13:34
I think you should ask your doc to go old school and request chloral hydrate.
Posted by jono_in_adelaide on August 28, 2011, at 6:58:14
In reply to Re: Valium users, I need input, posted by Christ_empowered on August 27, 2011, at 20:36:10
Tolorance to the hypnotic effect of chloral has been reported to be rapid 9within 2 weeks) where as with benzos this is much less the case
Posted by floatingbridge on August 28, 2011, at 9:39:44
In reply to Re: Valium users, I need input, posted by jono_in_adelaide on August 27, 2011, at 18:55:06
Doxipen was a disaster, no sleep, just drugged senseless unfotunately :-/,
.
Truly, I am sorry to have something crummy about everyone's suggestion. I'd rather not be fussy about this. Really.I took 45mg to sleep lat night of the tezanepam. And feel very, very doped today, but not depressed. Still, that is not as prescribed.
So tomorrow is Monday. I have mt doc's number on speed dial :-( and will reveal my overusgae.
You suggestion to abadon this class might just have to come to pass. Oddly, the anixolyc effects remain in place with benzos, but the hypnotic affect has vanished.
Know anything about prazosin?
Posted by Sailboat77 on August 28, 2011, at 18:45:39
In reply to Re: Valium users, I need input » jono_in_adelaide, posted by floatingbridge on August 28, 2011, at 9:39:44
You might remember from when I last posted maybe 3 months ago (sorry, I've been gone for a while), but Seroquel has been the only medication to provide me with quality sleep. I'm on 60mg's of Parnate and am unable to fall asleep at all without any medication.
I didn't like the idea of taking Seroquel for sleep because it's primarily used as an antipsychotic and I didn't want it to interfere with my mood or current medical regiment. But at doses lower than 200mg's, it's been shown to have no effect on a person's mood or depression.
It's the best sleep aid I've ever taken and I've tried many (Lunesta, Restoril, Xanax, ect.) The good thing about it is that unlike benzos, you don't become tolerant. But as everyone here probably knows, what works for one person doesn't always work for another.
I hope you find what your looking for and find a sense of contentment in the process.
-Best of luck
Posted by hyperfocus on August 28, 2011, at 20:09:53
In reply to Valium users, I need input, posted by floatingbridge on August 27, 2011, at 12:37:14
Years back lorazepam got me to sleep, eventually. But withdrawing was hellacious. I'm not a fan of benzos for sleep. It seems to me that they don't promote deep restful sleep. It's like they get you drowsy and relaxed and maybe you might nod off but it's a real hit-or-miss thing.
Sleep is a large factor of your quality of life. What about non-med alternatives? What characterizes your insomnia - is it runaway negative thoughts? Or too much stimulation? Could you describe like a typical night of no sleep - what are your thought patterns like?
For me it was like I couldn't get my brain to shut off the tragic murderous soap opera that was my life. non-med things that helped: jogging, aromatherapy, music. You might find meditation or yoga or tai-chi beneficial.
But if you're going the med route I think something like seroquel or risperidone before bed could work. Risperdal is like #2 behind amitriptyline on my fav sleep meds list. Sulpiride is #3.
Posted by floatingbridge on August 28, 2011, at 22:15:46
In reply to Re: alternatives » floatingbridge, posted by hyperfocus on August 28, 2011, at 20:09:53
HP,
It's different now. I have not much problem with sleep onset; it's staying asleep for more than two-three hours that's the difficulty. When younger, it was racing thoughts and onset, then 12+ hours of sack time.
Now, exhausted and trancelike, but no sleep or very little.
Benzos are not great for sleep. They wreck the archetecture. But for my psyche, it beats no sleep. I can get delirious.
Doc will not script ami with Emsam. I asked three times.I would have to do a 14 day wash. Not stable enough yet.
Risperdone helps. Took .5mg last night but awake at 1:30. Fell back asleep around 4:00.
How much Risperdone do you take at night? Maybe it's in your signature.
Sulphride is not FDA approved. I'd need to go rogue in order to use. Not up for that.
Pdoc talking up saphris. Any experience with that?
In the future, my line up might be lamictal, amitriptyline, risperdone like substance.
You know about invega? The son of risperdone?
Always good to see your posts. Thanks.
fb
Posted by jono_in_adelaide on August 28, 2011, at 22:34:15
In reply to Re: alternatives » hyperfocus, posted by floatingbridge on August 28, 2011, at 22:15:46
You could ask your doc about chloral, but as tolorance develops quite quickly (in around 2 weeks) you'd probably want to use it only on alternate nights, it might be worth a short trial?
Posted by floatingbridge on August 28, 2011, at 23:04:13
In reply to Re: alternatives, posted by jono_in_adelaide on August 28, 2011, at 22:34:15
> You could ask your doc about chloral, but as tolorance develops quite quickly (in around 2 weeks) you'd probably want to use it only on alternate nights, it might be worth a short trial?
Hi Jono, I can run it by him. I don't know. I thought it was somehow related to alcohol?
I'm still thinking benzo short term, but that might not work, or an increase in risperdone. I feel like I've got too many meds piling up :-/
But i'llput it on my list. Thank you.
Posted by Phillipa on August 28, 2011, at 23:52:01
In reply to Re: alternatives, posted by floatingbridge on August 28, 2011, at 23:04:13
Chloral hydrate took a few years due to the taste as not pill form anymore I often wonder if it was responsible ultimatedly for my loss of taste so bitter. It was magic for over a year at 5cc. Doubt anyone uses here anymore. Love Phillipa
Posted by jono_in_adelaide on August 29, 2011, at 18:40:06
In reply to Re: alternatives, posted by floatingbridge on August 28, 2011, at 23:04:13
I guess flurazepam is your next port of call..... maybe in a higher dose, 30-60mg at night?
I would definatly try that before chloral hydrate (yes, it is related to alcohol..... chloral hydrate is metabolised in the body to trichloroethanol)
If you're taking a high dose of flurazepam at night, its likely you will be able to reduce or stop your Xanax during the day, which would be nice.
Best of luck!
Posted by morgan miller on August 29, 2011, at 20:58:10
In reply to Re: Valium users, I need input » sigismund, posted by floatingbridge on August 27, 2011, at 15:52:15
Hey FB,
I can't remember, have you taken Depakote before? Is so, do you remember how much and for how long?
What's holding you back from taking lithium right now?
I strongly believe that taking mood stabilizers and possibly a very low dose of an SSRI-Zoloft or Lexapro-could be beneficial in the long run. No miracles in the short run, but if you stick with the regimen for a while, tweak the dosages to find your sweet spots(hopefully you have some), and take some supportive supplements, eventually you may find yourself feeling better. You may also begin to have the strength to start making drastic changes in your diet-like going primal-and engaging in proper exercise, both of which may go a long way to improving your condition and preventing relapse.
Morgan
Posted by floatingbridge on August 29, 2011, at 20:58:37
In reply to Re: alternatives, posted by jono_in_adelaide on August 29, 2011, at 18:40:06
> I guess flurazepam is your next port of call..... maybe in a higher dose, 30-60mg at night?
>
> I would definatly try that before chloral hydrate (yes, it is related to alcohol..... chloral hydrate is metabolised in the body to trichloroethanol)
>
> If you're taking a high dose of flurazepam at night, its likely you will be able to reduce or stop your Xanax during the day, which would be nice.>
> Best of luck!The doc says 45mg of Tenazapam for the next little bit, and to see about cutting or skipping a.m. dose of Xanax. He seems less concerned then myself; but I'm the one who would experience any withdrawal, so I'm concerned (!)
If this doesn't work I'm to call back Wed.
Thanks again.
Posted by Phillipa on August 29, 2011, at 21:23:39
In reply to Re: alternatives » jono_in_adelaide, posted by floatingbridge on August 29, 2011, at 20:58:37
FB let them walk in our shoes and then see what happens I wonder? Love Phillipa
Posted by floatingbridge on August 29, 2011, at 21:39:54
In reply to Re: Valium users, I need input, posted by morgan miller on August 29, 2011, at 20:58:10
> Hey FB,
>
> I can't remember, have you taken Depakote before? Is so, do you remember how much and for how long?
>
> What's holding you back from taking lithium right now?
>
> I strongly believe that taking mood stabilizers and possibly a very low dose of an SSRI-Zoloft or Lexapro-could be
beneficial in the long run. No miracles in the short run, but if
you stick with the regimen for a while, tweak the dosages t
o find your sweet spots(hopefully you have some), and take some supportive supplements, eventually you may find yourself feeling better. You may also begin to have the strength to start making drastic changes in your diet-like
going primal-and engaging in proper exercise, both of which may go a long way to improving your condition and preventing relapses.
>
> MorganHey Morgan, I was wondering how you have been.
I started lamictal today. Bipolar. After going back and forth, I
requested lamictal. After going back and forth my doc agreed on lamictal over lithium so I would be less prone to flattening.The Emsam might be exacerbating my insomnia. We'll have to see. Frankly, I have been more active and eating better.
Added 5-loxin, and looks like a real keeper. I think it's already helping. Piracitam (sp?). Are you still doing that? I go slow, but hope to try that soon.Many herbs seem to disrupt my *sleep* as it used to be called, like cucurim derivatives. I need to go very slow with the supplements. Still doing krill (well restarted) but at a lower dose.
Is a 'primal' diet like a type O blood type diet? Meat and veggies? I'm not too far from that except for my love affair with dairy products.
It's a slow return to living for me right now. But the past few days are better. Even less, way less caffiene. I love my
black tea, though.Depakote was a no-go previuosly. But that was 12 or so years ago. Didn't seem to work. But I did not want to acknowledge the bipolar piece. I know you like the ssri's,
but I'm not sure they are so good for me. Not that benzos are, but that started a long time ago before I knew how insidious they would be for me. Well, Emsam might not be right, so may need an AD of some sort. You don't cycle on zoloft? (That's what you take?)I gotta sleep or I deteriorate within days :-/
Thanks for wishing me luck. Hope you're well enough and still on the mend.
fb
Posted by floatingbridge on August 29, 2011, at 22:05:32
In reply to Re: alternatives » floatingbridge, posted by Phillipa on August 29, 2011, at 21:23:39
> FB let them walk in our shoes and then see what happens I wonder? Love Phillipa
You mean the docs? Yeah. Two in particular I have in mind at the moment :-/
Posted by Phillipa on August 29, 2011, at 22:09:09
In reply to Re: alternatives » Phillipa, posted by floatingbridge on August 29, 2011, at 22:05:32
FB yes the docs and got more than two right now!!! Love Phillipa
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.