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Re: Ambien vs Ativan - which is better? » JonW

Posted by SLS on July 17, 2002, at 11:17:16

In reply to Re: Ambien vs Ativan - which is better? » SLS, posted by JonW on July 14, 2002, at 17:36:28

Hi Jon.

Thanks for your input.

> I hear you with the sleep problems! I'm on Nardil and I sleep zero without a sleep aid as well.

How long have you been taking Nardil for? Is it helping? Have you stopped dreaming or find that it has been significantly reduced?

> I take ambien 20mg which is twice the recommended max dose and it puts me to sleep but the amount of sleep I get varies. I usually get 4 maybe 4.5 uninterrupted hours of sleep. Oh how I long for a good deep 8 hour sleep! Nardil makes me tired several times during the day so I catch up on my sleep then, but that obviously isn't a permanent solution. The most noteable thing is that I never sleep long. During the day I sleep deeply, but never more than 2 hours at a time, even if I only got 2 hours the night before. Anyway, I like ambien because it is much better than nothing. 10mg never gave me a hangover, but I used to think 20mg did. However, getting up in the morning always feels like a hangover for me so it is hard to tell. The last 2 days I've taken 20mg and no hangover. I've also used a lightbox during the last few days so I'm going to stop that today to see which one is causing the improvement. I hope Nardil is making my mornings better, that would be a good sign. I've found playing a cd I like + turning on a fan + ambien to be the best combination so far for sleep but like I said before it only gets me like 4 or 5 hours. Anyway, I'd go for the ambien. Listen, if you find a solution to the sleep problems you are having let me know! I need sleep, among other things :-)


It is my doctor's approach that, if necessary, to treat the insomnia as aggressively as the depression itself. One of the things he would want me to try is:

Sonata 2mg + Ativan 4mg + Risperdal 1mg

Have you tried adding either Zyprexa or Risperdal?

For you, I think the best initial plan of attack is to break down the insomnia into its two components and target them both:

1. Getting to sleep:
(powerful first punch)
- Sonata
- Halcion

2. Staying asleep:
(and preventing rebound awakenings due to the disappearance from the blood-stream of the short-acting drugs in #1
- Ambien
- Restoril
- Ativan
- Xanax
- Klonipin

The one and only time I got well was in 1987 using a combination of Parnate 60mg + desipramine 150mg. I also had total insomnia. My doctor at the time chose Halcion + Ativan to treat it. Halcion probably packs the most punch of any hypnotic. The strategy worked very well. I can't remember the exact dosages, though. Most doctors now are very reluctant to prescribe Halcion, I think overly so. There are some genuine issues regarding its use, and with the advent of Sonata, would certainly not be a first choice. My current doctor wants to try to avoid it. However, I like the drug and feel that it is a powerful tool. I hope it remains available. Unjohn cut their recommended dosages by half to try to stave off the resistence to its usage. I think most of the complaints revolved around the fact that a small percentage of people will develop amnesia. I had no problem at all with it, and would not be afraid to use it again. If necessary, I will push my doctor into using it. I think it is worth a try using the original prescribed dosage range: 0.5-1.0mg immediately before bed.

I hope I've helped you a bit.


- Scott

 

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