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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 38. Go back in thread:
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
Posted by morgan miller on August 29, 2011, at 22:35:20
In reply to Re: Valium users, I need input » morgan miller, posted by floatingbridge on August 29, 2011, at 21:39:54
Hey FB,
I only suggested an SSRI at a very low dose, doses that have been reported to be successful, without some of the unwanted side effects that you've experienced.
I hope lamictal really helps you. Ya know, it is not uncommon to combine a lithium with lamictal, so that is always an option down the road. I don't think a low dose of lithium will cause much in the way of mind numbing.
I'm doing pretty good, far from where I want to be, but doing well enough. I just moved out on my own for the first time in 3 1/2 years, so there is great progress here. Thank you for asking and caring.
By primal I pretty much meant meat and veggies, no heavy carb stuff. Eliminating grains would be a great step toward a dietary regimen that might would enhance health and well being. Gluten is bad stuff. Rice, not so bad, but still kinda bad. Dairy is o.k., especially grassfed, wholefat, and cultured. Nuts, berries/fruits, and eggs are a great addition to a more primal diet.
I look forward to hearing good news about your progress soon!
Morgan
Posted by floatingbridge on August 30, 2011, at 2:25:19
In reply to Re: Valium users, I need input, posted by morgan miller on August 29, 2011, at 22:35:20
Morgan,
What's a low dose of zoloft or lexapro ( that you are speking of)? Lexapro wasn't so bad years ago.....
Congratulations on the new place :-)
I'm glad brown rice is o.k. What about quinoa? Oatmeal? (We have a hand grinder.). I have thought of two tests, celiac and lactose intolerance. Finally, though going to yet another doc is not appealing.
We have chickens. Lots of good, fresh eggs. We'd like to get a milk goat, too.
Is there a book that has guided you in this diet? It's very interesting.
Enjoy your autonomy. That's great news.
fb
Posted by morgan miller on August 30, 2011, at 19:30:25
In reply to Re: Valium users, I need input » morgan miller, posted by floatingbridge on August 30, 2011, at 2:25:19
Hey FB,
A low dose of Zoloft would be 12.5 or 25 mg, and Lexapro would be 2.5 mg.
Brown rice is ok, but I think white might actually be better because it has no phytates, brown rice has lots. Phytates are believed to prevent essential nutrients from being absorbed. Quinoa is fine as a grain substitute.
Mark's Daily Apple and Weston A. Price are great sites to go to for information on a more primal diet-especially MDA. Mark of MDA wrote a goobook called The Primal Blueprint-I plan on reading it at some point.
Ya know, lithium has been used along with Lamictal with great success. So, if you still need more improvement after going up to 200 mg of LamictaL, you might want to consider going for a low dose of lithium instead of raising the Lamictal dose. I doubt a low dose of lithium would cause much mind numbing, if any at all.
I would be curious to see how you did on just 100 mg Lamictal for a month. I think it's interesting that your doctor isn't going to try this first. It may be worth asking him/her to do this before making the jump to 150 and 200.
Morgan
Posted by floatingbridge on August 30, 2011, at 20:48:17
In reply to Re: Valium users, I need input, posted by morgan miller on August 30, 2011, at 19:30:25
Thanks Morgan. He hasn't spoken of the higher doses on lamictal yet. Just see if I tolerate it, then see how I do. The starter pack only goes to 100mg. He knows I'm pretty med and sx sensitive, so I'm not too concerned about being pushed too hard.
I'm not too keen on Weston Price, though I won't discount the entire project. I'll check out Mark's Daily Apple.
Thanks for the dose information. I probably would prefer lexapro. I did o.k. on that, back in the day. Are you still taking one?
Posted by morgan miller on August 30, 2011, at 21:07:11
In reply to Re: Valium users, I need input » morgan miller, posted by floatingbridge on August 30, 2011, at 20:48:17
Just curious, what is it you don't like about Weston A. Price?
I am currently taking 2.5 mg Lexapro, and 25 mg Zoloft. I was taking 100 mg Zoloft and 2.5 Lexapro, but I decided to try just 25 mg Zoloft for now. I may go back up to 100 mg Zoloft and drop Lexapro completely for a while to see what happens.
I also take a few lithium orotate a day and 750 mg Depakote.
Morgan
Posted by morgan miller on August 30, 2011, at 21:08:31
In reply to Re: Valium users, I need input, posted by morgan miller on August 30, 2011, at 21:07:11
Do you like how the regimen I recommended is similar to mine? : ) The one exception to it being the higher doses of SSRIs.
Posted by floatingbridge on August 30, 2011, at 21:27:23
In reply to Re: Valium users, I need input, posted by morgan miller on August 30, 2011, at 21:08:31
> Do you like how the regimen I recommended is similar to mine? : ) The one exception to it being the higher doses of SSRIs.
:-). Yes. I thought that's what most of us do. I do. But your advice is pretty good, but maybe that's just cause it seems sensible. Plus, heck, it seems to be working for you. That's the best advertisement.
Weston Price. Something about his theory of certain races
having the best teeth. I can't quite remember, but I came away with some kind of cultural evolution theory of some races being better than others based on some subjective thinking. Plus, the man is into fat galore! I am not a fat phobe by any means and make sure wecall eat eggs, whole milk, butter. He seemed over the top. Plus some of his studies lacked scientific backing. This was about three years ago.Then again, he had the idea of bone broth and trace minerals (didn't he?) which seems very sound. A very mixed bag. Plus there is a cult of followers where I live, and they can be very judgmental, like everything can be cured if you eat this butter gold stuff. So there's my haphazard context for Weston Price. But I say, if the dietary practices work for someone, use them.
Posted by morgan miller on August 30, 2011, at 22:18:00
In reply to Re: Valium users, I need input » morgan miller, posted by floatingbridge on August 30, 2011, at 21:27:23
Ha ha, your funny FB. Yeah people can certainly get cultish about diets. Weston A. Price is not my bible, I just like a lot of the dietary philosophy.
As far as my regimen is concerned, it took a while to work and enable me to feel better.
Posted by ed_uk2010 on September 4, 2011, at 14:02:25
In reply to Valium users, I need input, 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.
Well, Valium 'kicks in' pretty quickly and does relax muscles, but it often doesn't last long after a single dose, often just a few hours. It only becomes long lasting after repeated doses, which will create daytime anxiolysis and sedation.
Posted by Tony P on September 8, 2011, at 22:09:45
In reply to Re: Valium users, I need input, posted by ed_uk2010 on September 4, 2011, at 14:02:25
Agreed - Valium works well if you don't already have a high tolerance to benzos & the "Zs", but not good for every night long-term. I'm on a s-l-o-w taper to get off it, and I find I get interdose withdrawal anxiety (especially if I take >= 10 mg) after about 4-6 hr., despite the long half-life.
Trimipramine (Surmontil) (25-100 mg) in my experience gives the most natural sleep, but unfortunately it's also very long-lasting -- I need a quadruple espresso the next morning ;-)
If muscle tension is a problem, have you tried Robaxin? In moderate doses it is only mildly sedating, not a sleeping pill by itself, but the best OTC muscle-relaxant I know. Might be really helpful in combination with one of the other sedatives. BTW, avoid the packaged combinations with analgesics (Robaxacet, Robax Platinum etc.) which are usually on the open shelves, unless you're having actual pain. What you want is pure Robaxin, which comes in 500 mg & 750 mg strengths. In BC/Canada the pure Robaxin is OTC, i.e. non-Rx but you have to ask the pharmacist for it. I prefer the 750's; 2 should make you as relaxed as a kitten! Caution: can develop tolerance & addiction, but in my exp. only if you exceed the recommended daily maximum.
A non-pharm idea from my Dr.: wear amber sunglasses at night! (remember Cory Hart, anyone?), especially if you're on the computer, watching TV or in bright/fluorescent light. Blue light blocks the production of melatonin, one of the body's main sleep triggers.
Tony P
> > I am thinking of requesting Valium for sleep. To help me sleep longer and the muscle relaxing qualities will help with my back.
>
> Well, Valium 'kicks in' pretty quickly and does relax muscles, but it often doesn't last long after a single dose, often just a few hours. It only becomes long lasting after repeated doses, which will create daytime anxiolysis and sedation.
>
>
>
Posted by floatingbridge on September 8, 2011, at 22:35:19
In reply to Re: Valium users, I need input, posted by Tony P on September 8, 2011, at 22:09:45
Hey, thanks. I don't know about roboxin, and yes, I could use a muscle relaxant. I am concerned when you mention developing a tolerance, well, because I have a tolerance to benzos! Which I am beginning to dislike very much.
I'll google it.
Seems every substance in the world that is pleasant builds a tolerance or is somehow abusable. Oh well.
The blue light thing is pretty interesting, isn't it. I read something about a third element in human eyes besides rods and cones that detects this light, and it is related to skin patches that detect light in eyeless creatures....?
Best of luck with your Valium taper! That is tough work IMO.
I have managed to shave a bit off my maintenance Xanax. But a serious taper, no, not yet :(
Posted by Phillipa on September 8, 2011, at 23:12:48
In reply to Re: Valium users, I need input » Tony P, posted by floatingbridge on September 8, 2011, at 22:35:19
Too early yet. Get stable first. Love Phillipa
Posted by floatingbridge on September 9, 2011, at 0:07:30
In reply to Re: Valium users, I need input » floatingbridge, posted by Phillipa on September 8, 2011, at 23:12:48
But you realize, after that withdrawal, it's like something broke. I hate it. I hate the Xanax. I hate being dependent it and other medications. I hate tolerance, escalation, side-effects, withdrawals. I fear it.
You are probably right, of course, about the Xanax. But I take maybe 30mg of Tenazapam at night. That equals about about 2mg. of Xanax right there. Add 2 more mg of Xanax as the new, post-withdrawal maintence, and I am way past my pre-withdrawal dose of 1.5mg of Xanax (plus the 'z' meds). You can probably see why I am
unhappy.Most days now, when I take the Tenazapam at night, I forgo the a.m. 1mg. Xanax XR. It gets dicey by late afternoon. But I really try and stick it out.
When it's time for script renewal, I will talk to him about .5mg pills to avoid the interdose effect. My anxiety is high. I'm getting used to it being at a new level.
This is the end of the thread.
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