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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Crazy Horse on July 18, 2006, at 10:23:27
Insomnia probs...UGH. Lunesta and Ambien don't work. Serequel frightens me because of the possibility of developing TD. Current regimine is Trazodone 250 mgs. at bedtime, also take Klonopin 1.5 mgs at 6:00 and 1/4 mg of ativan at bedtime. Prob is i've developed tolerance to benzos over the past 26 years.
Soooooooo..a friend of mine swears by Chloral Hydrate. Is it a Benzo? And what do you think of it for my EMSAM 6 mg. induced early morning wakening? This is the only side effect i am getting from EMSAM, otherwise i love it! Please offer your suggestions and opinions. Thanks!Monte
Posted by Phillipa on July 18, 2006, at 11:31:40
In reply to Desperate here..opinions on Chloral Hydrate Please, posted by Crazy Horse on July 18, 2006, at 10:23:27
Was it me that mentioned chloral hydrate to you?
As I took it for years no alchohol with it or a Mickey Finn. It is the ultimate sleep med. Been around since the late l800's. They use it a lot in baby's for minor surgical proceedures and the elderly. I loved it. In l5-20 minutes you're out cold. That was on 5cc's. It comes in liquid form. For me it was a miracle for sleep. Tastes terrible. But believe me you will sleep. I don't think many docs use it anymore. But if that doesn't work nothing will. Love Phillipa
Posted by Squiggles on July 18, 2006, at 12:02:11
In reply to Re: Desperate here..opinions on Chloral Hydrate Please » Crazy Horse, posted by Phillipa on July 18, 2006, at 11:31:40
I read in Healy's "The Creation of Psychopharmacology", p. 43, the following:
"Within mental hospitals, the pressing need was
for sedation.....Liebig and Wohler synthesized
chloral in 1832. In 1869, Otto Liebrich discovered
that chloral had more reliable sedative properties
than any other drug at that time. Liebrich's discovery led rapidly to chloral's widespread use for sedation [14]."
----------I think it was also used in dentistry in the
early days. However, the problem with
this sedative was what we would now say it has a
narrow therapeutic index. A little too much
and the respiratory failure would lead to death.
It is a dangerous drug:1: Vet Hum Toxicol. 1979;21 Suppl:53-6. Related Articles, Links
Chloral hydrate poisoning: its mechanism and therapy.
Gerretsen M, de Groot G, van Heijst AN, Maes RA.
Chloral hydrate is a dangerous hypnotic drug to prescribe. Lethal dose can be a small as 4 gm. Nowadays the effects on the circulatory system are most dangerous. Which metabolite is responsible remains to be investigated. Haemoperfusion seems to be best method of lowering plasma levels of the metabolites, although the clearance of trichloroacetic acid is considered lower than of trichloroethanol.
Publication Types:
* Case Reports
PMID: 505984 [PubMed - indexed for MEDLINE]Squiggles
Posted by rjlockhart on July 18, 2006, at 13:08:23
In reply to Desperate here..opinions on Chloral Hydrate Please, posted by Crazy Horse on July 18, 2006, at 10:23:27
Barbiturates such as Nembutal, Amytal, Seconal (the main drug of choice for sleep in the 50's)
But they have a bad repuation for all the overdoses they produced. People died. Forget they took a dose, which was common, it was called something, where you forget you took it and take it again. Well thats not really what where talking about.
Restoril (Temazepam) is a good sleep aid of choice, also Xanax, is good the only problem is they wear off quick, like 2 hours. I have suddently woke up on Xanax.
Ask your doctor about another drug of treatment, i hope he or she does not say seroquel. I hate antipsychotics! '
Give it try.
Matt
Posted by silvercoin on July 18, 2006, at 13:58:32
In reply to Desperate here..opinions on Chloral Hydrate Please, posted by Crazy Horse on July 18, 2006, at 10:23:27
> Insomnia probs...UGH. Lunesta and Ambien don't work. Serequel frightens me because of the possibility of developing TD. Current regimine is Trazodone 250 mgs. at bedtime, also take Klonopin 1.5 mgs at 6:00 and 1/4 mg of ativan at bedtime. Prob is i've developed tolerance to benzos over the past 26 years.
> Soooooooo..a friend of mine swears by Chloral Hydrate. Is it a Benzo? And what do you think of it for my EMSAM 6 mg. induced early morning wakening? This is the only side effect i am getting from EMSAM, otherwise i love it! Please offer your suggestions and opinions. Thanks!
>
> Monte
The chances of developing TD from Seroquel, particularly a low dose for sleep, is so close to zero it is not even worth thinking about. It is nearly as risk free in this regard as clozapine, considered to have the lowest rate of EPSEs among antipsychotic drugs.I have actually tried chloral hydrate myself during a period of severe depression and extremely severe insomnia (due to withdrawal after a high dose Halcion regimen that induced dependency and mania), and it had no effect, but nothing else at that time worked either. It is reputed to be a powerful hypnotic, though. It is not a benzo but is actually more similar to alcohol and is thought to exert its therapeutic effects through a trichloroethanol intermediate, or somesuch thing. However, it does work on the GABA system as do the benzos, and it apparently has a fairly substantial dependency/tolerance potential. My regular Walgreen's did not stock it, and I was directed to another one, where I had to cough up a $50 copay, as this is a Tier 3 drug for United Health for some reason or another. The cost would not have bothered me if it had actually worked, so bad was my insomnia.
Todd
Posted by Phillipa on July 18, 2006, at 14:27:40
In reply to Re: Drug interaction tool online? » Phillipa, posted by Squiggles on July 18, 2006, at 12:02:11
Squiggles and to think the who I call the bad pdoc had me on 20cc of ch , xanax, and klonopin all at the same time. I guess that's why my tolerance is so high. And he told me when I voiced my concerns that it was so safe it was used in babies. Thanks Love Phillipa
Posted by yxibow on July 18, 2006, at 17:28:35
In reply to Desperate here..opinions on Chloral Hydrate Please, posted by Crazy Horse on July 18, 2006, at 10:23:27
> Insomnia probs...UGH. Lunesta and Ambien don't work. Serequel frightens me because of the possibility of developing TD. Current regimine is Trazodone 250 mgs. at bedtime, also take Klonopin 1.5 mgs at 6:00 and 1/4 mg of ativan at bedtime. Prob is i've developed tolerance to benzos over the past 26 years.
> Soooooooo..a friend of mine swears by Chloral Hydrate. Is it a Benzo? And what do you think of it for my EMSAM 6 mg. induced early morning wakening? This is the only side effect i am getting from EMSAM, otherwise i love it! Please offer your suggestions and opinions. Thanks!
>
Chloral Hydrate is not a benzo, it is basically a mickey finn as said with or without alcohol. It is a derivative of chloroform or carbon tetrachloride, I forget which first made in 1832. It is an agent which is largely replaced by benzodiazepines, except in certain circumstances.
Even with tolerance to benzodiazepines, 20mg of Ambien (yes, this is prescribed) or 4+ mg of Lunesta would be a far better agent. You have mentioned ineffectiveness although the dose was not mentioned -- I can no longer take the lower doses of either as well. Some doctors may be willing to prescribe these if familiar with case studies, some may not.
As for TD with Seroquel, at sleep levels it is fairly close to nil, although I would personally go with a sleep agent meant for sleep as it seems that in my opinion you have already escalated the Trazodone beyond a "normal" range anyhow -- 250mg is getting into the range of an adult dose of its original purpose, an antidepressant which is probably second only in sleep inducing in its regular dose to Seroquel and other similar sleepy agents.Sometimes one has to back off of the Trazodone and return -- I was there also. Its not the most pleasant way to go to sleep and definately not one to mix alcohol with anywhere near -- I accidentally did that once and blacked out, almost the only time in my life. It can cause priapisms more than is stated (several times for me, mildly), although I forgot to check whether you were male :) (Priapisms are not a funny thing though especially in those who are older)
And yes, I'm sympathetic to sleep issues as I am an insomniac.
The best cure for sleep issues, besides agents to help manage them, is to go to sleep at approximately the same time each day and use the sleep agent also at approximately the same time. Additionally, the bedroom should be used, well, for sleep and other human activities, shall we say. Television and other stimulative things should be left outside. But that's just one view of management of sleep
To a better night's sleep
- J
> Monte
Posted by Squiggles on July 18, 2006, at 17:34:53
In reply to Re: Desperate here..opinions on Chloral Hydrate Pl » Crazy Horse, posted by yxibow on July 18, 2006, at 17:28:35
I'm not sure if drs. use lithium as
an adjunct for sleep, but ever since
taking it (for bp treatment) my sleep
is regular almost to the minute. Before
treatment I used to have very strange
sleep cycles, sometimes lasting 12 hours,
or not being able to fall asleep until
very late and then waking up late, or
not sleeping enough, etc.
The change since lithium is amazing;
i wonder if it would work is small dosages for non-manic depressives. Of course my thyroid
level was adjusted too, so that may be
an additional factor in insomnia. I know
that derpession is.Squiggles
Posted by Declan on July 18, 2006, at 17:52:49
In reply to Re: Desperate here..opinions on Chloral Hydrate Pl » Crazy Horse, posted by yxibow on July 18, 2006, at 17:28:35
It might be fairly toxic. There is some speculation of it being carcinogenic. You can look up Pubmed (I'd do you a direct link if I knew how).
I once took 4 Noctec and stayed awake feeling gruesome, but I wasn't feeling the best before I took it either.
Posted by Colleen D. on July 18, 2006, at 19:51:46
In reply to Re: Desperate here..opinions on Chloral Hydrate Please » Crazy Horse, posted by Phillipa on July 18, 2006, at 11:31:40
Chloral Hydrate was used for my son when he had a MRI at 18 months of age. It worked great. And he slept most of the way home during our 5 hour drive back home from U of M. Kind of scary for me considering the circumstances, but if he has to have any other tests done that require sedation, they will use it again. Sorry, but I don't know if there are any interactions with EMSAM. You can go to http:\\www.drugdigest.org
and check for interactions, side effects, contraindications, etc. Great site. Good luck!Colleen
Posted by Karen44 on July 18, 2006, at 20:46:00
In reply to Desperate here..opinions on Chloral Hydrate Please, posted by Crazy Horse on July 18, 2006, at 10:23:27
> Insomnia probs...UGH. Lunesta and Ambien don't work. Serequel frightens me because of the possibility of developing TD. Current regimine is Trazodone 250 mgs. at bedtime, also take Klonopin 1.5 mgs at 6:00 and 1/4 mg of ativan at bedtime. Prob is i've developed tolerance to benzos over the past 26 years.
> Soooooooo..a friend of mine swears by Chloral Hydrate. Is it a Benzo? And what do you think of it for my EMSAM 6 mg. induced early morning wakening? This is the only side effect i am getting from EMSAM, otherwise i love it! Please offer your suggestions and opinions. Thanks!
>
> Monte
I took chloral hydrate for sleep when I was a patient at Menninger's many years ago. It tastes horrible--was given to me over ice-in liquid form. You are out like a light. Need to be near the bed when you take it. No lingering; go right to bed, and you will be out like a light. It is not habit forming, and so that is a good thing about it.
Posted by Crazy Horse on July 18, 2006, at 21:31:36
In reply to Re: Desperate here..opinions on Chloral Hydrate Please, posted by Karen44 on July 18, 2006, at 20:46:00
This is the end of the thread.
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