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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by SLS on January 24, 2009, at 9:28:53
Would anyone like to comment on the use of these hypnotic sleep medications? Add to the list? Personal experiences are sought with urgency. Some of these are heavy-duty and dangerous - especially the barbiturates. However, for a few individuals on certain drugs, the standards don't work. MAOIs are one group of antidepressantsl that can be tough to work with. The longer the list becomes, the more that safe alternative that will emerge.
triazolam (Halcion)
temazepam (Restoril)
lorazepam (Ativan)
zolpidem (Ambien)
zaleplon (Sonata)
zopiclone (Imovane)
ezsopiclone (Lunesta)
trazodone (Desyrel)
chloral hydrate
secobarbital (Seconal)
amobarbital (Amytal)
doxepin (Sinequan)
amitripyline (Elavil)
mirtazepine (Remeron)
quetiapine (Seroquel)
The first time I combined Parnate with desipramine (1987), I didn't sleep a single minute for almost two weeks. What worked for me was a combination of Halcion and Ativan. Halcion is the most potent hypotic benzodiazepine, and did a good job of putting me to sleep. However, with its short half-life, I would wake up at 2:00am and remain awake. Adding Ativan, a longer acting drug, allowed me to stay asleep for the rest of the night.
- Scott
Posted by shasling on January 24, 2009, at 11:48:35
In reply to Let's make a list of hypnotics - sleep medications, posted by SLS on January 24, 2009, at 9:28:53
Think your missing the most hypnotic of them all.XYREM lol,yess it is true one can get it off label,i was there seen it with my own two droppy sleep needing eyes.
The person actualy finds it better for other things but not for sleep,maybe because the sleep dose calls for such high increments such as 7-9 grams.
Also know someone who can fall asleep in a second using zanaflex,literaly.I tried it and nothing,for me the hypnotics just make me high and droppy eyed,dont get inside to my brain where my thinking is to put me to rest.
GHB/XYREM however,umm never mind wrong group lol
Posted by Phillipa on January 24, 2009, at 12:21:07
In reply to Re: Let's make a list of hypnotics - sleep medications, posted by shasling on January 24, 2009, at 11:48:35
Well if this is a list of all sleep meds for all conditions not just MAOIS mine since old consists of some not here and others repeats:
playcydl Sp? two pills nightly with two glasses red wine prescribed by pdoc and valium 5mg
chloral hydrate again with added benzos up to 20cc liquid formula
Seconal when in false labor didn't sleep two pills given by ob-gyn in hospital
seroquel one night only with benzos, chloral hydrate, l5mg remeron and still woke in four hours. Seroquel dc'd next day in hospital
Various combos of benzos now very low doses.
Phillipa oh mepbrobamate with valium first panic attacks with valium and beer. Also pdoc prescribed
Posted by SLS on January 24, 2009, at 12:24:32
In reply to Let's make a list of hypnotics - sleep medications, posted by SLS on January 24, 2009, at 9:28:53
> Would anyone like to comment on the use of these hypnotic sleep medications? Add to the list? Personal experiences are sought with urgency. Some of these are heavy-duty and dangerous - especially the barbiturates. However, for a few individuals on certain drugs, the standards don't work. MAOIs are one group of antidepressantsl that can be tough to work with. The longer the list becomes, the more that safe alternative that will emerge.
>
> triazolam (Halcion)
> temazepam (Restoril)
> lorazepam (Ativan)
> zolpidem (Ambien)
> zaleplon (Sonata)
> zopiclone (Imovane)
> ezsopiclone (Lunesta)
> trazodone (Desyrel)
> chloral hydrate
> secobarbital (Seconal)
> amobarbital (Amytal)
> doxepin (Sinequan)
> amitripyline (Elavil)
> mirtazepine (Remeron)
> quetiapine (Seroquel)
Forgot: ramelteon (Rozerem)
Posted by HyperFocus on January 24, 2009, at 14:17:39
In reply to Let's make a list of hypnotics - sleep medications, posted by SLS on January 24, 2009, at 9:28:53
one vote for amitriptyline - I had chronic insomnia because my mind is racing and buzzing 24/7. amitrip put me out and I got beautiful deep sleep no ematter how wound up I was. Depending on the dose I actually sleep less and feel more refreshed. Healthy sleep is so important to 'normal' functioning and insomnia adds immensely to the burden we have to carry
note amitrip is a TCA and very sedating and not as safe as an SSRI - if you think about trying it talk to your doctor or be cautious and do all your research.
Posted by raisinb on January 24, 2009, at 14:25:57
In reply to Let's make a list of hypnotics - sleep medications, posted by SLS on January 24, 2009, at 9:28:53
I have taken Ambien, Remeron, and Lunesta.
Ambien worked incredibly well when I first tried 10 mg tablets. But I'd have lots of experiences when I did things and couldn't remember the next day. Then it really stopped working after a year or so. I'd have to drink a good deal of alcohol and take a double dose to put me out.
Remeron knocked me out like a horse tranquilizer, but gave me intense dreams that I couldn't let go of during the day, thus negatively impacting my mood. I felt hung over constantly. I also gained 7 pounds in three weeks and thought of nothing but food all day.
Lunesta has worked well for 2 and a half years. It is more expensive and does not work if I take it too soon after eating. I take 3 mg per night. But it gives me at least 7 hours (and I can even sleep 10 or 12 if I don't have to get up early) and doesn't hang me over and doesn't seem to stop working unless there's another factor.
When I was on Wellbutrin without another AD nothing at all would make me sleep. Also, extreme stress tends to make the Lunesta less effective.
Alcohol with anything helps put me out initially, but wakes me up several times during the night, thus making any sleep med less effective in the long run.
Posted by Roslynn on January 24, 2009, at 18:30:55
In reply to Let's make a list of hypnotics - sleep medications, posted by SLS on January 24, 2009, at 9:28:53
Benedryl and other OTC antihistamines.
I personally don't like benedryl but had to take it recently when I had a cold.
Posted by yxibow on January 24, 2009, at 19:08:22
In reply to Re: Let's make a list of hypnotics - sleep medications, posted by Roslynn on January 24, 2009, at 18:30:55
> Benedryl and other OTC antihistamines.
>
> I personally don't like benedryl but had to take it recently when I had a cold.I don't like it either, that's why I use the doxylamine succinate version of Unisom. Benadryl gives me after day depression, at times. I do take it at a higher dose than noted as I took diphenhydramine, just because I tend to metabolize things faster. Don't do this without your doctor's say so.
Another one that I think wasn't on the exhaustive list of hypnotics was Dalmane (flurazepam) which is pretty strong, more than Restoril, for some people.Amitriptyline I would second as a pretty good candidate (I can't take it now because I take Clomipramine, and you don't usually mix TCAs, nasty unpredictable things happen.) Due caution with patients who are depressed, as it has no.. antidote, its just as bad and similar as a barbiturate. Don't take this line any longer than it needs to be said. Otherwise it is a good medication and an adjunct antidepressant even at the 10mg sleep dose.
Its curious, Scott, the list, because basically its the list that the FDA with *ss protection has made (all), just like the list of every antidepressant that could possibly in some astronomically small case could cause teenage suicide (all).
Outside of the US, Mogadon (nitrazepam), and related Rohypnol (flunitrazepam), and the probably not manufactured Placidyl (ethchlorvynol) -- besides its danger, I believe it uses CFCs to manufacture.In the pseudoalternative spectrum (some psychiatrists actually list this), l-tryptophan.
And then you're getting into the alternative spectrum, with Valerian (which does have some GABA properties). I found it nauseating the morning after and since I have such a serious sleep issue, it wouldn't work for me anyhow.Ditto for Kava, and all its problems, caution, caution.
-- tidings
-- Jay
Posted by desolationrower on January 25, 2009, at 11:18:45
In reply to Let's make a list of hypnotics - sleep medications, posted by SLS on January 24, 2009, at 9:28:53
well i think melatonin should be on the list, i find it helpful for sleep cycle to be kept regular and not getting into pattern of staying up late, sleeping in late, etc. also can be combined with others no problem; it is kind of a building block in getting things right, since just about everyone has unnatural levels of light after dusk. and agomeltaine would likely be useful too i think it will be seen this way after a while.
And i've mentioned cyproheptadine being the antihistamine that is sort of ideally designed for sleep.
Also, i've found clonidine to be VERY sedating.
also, as someonementioned GHB, phenibut can be helpful, although tolerance and addiction risks would keep me from using it regularly. but if you started an MAOi and need some sleep occasionally, it could be usable. I'd be doubleplus carful if you also have other hypnotics.
a basic d2 might be relevant here, as well. excess dopaminergic signalling might be involved, although i'm not sure. Certainly, DA agonists can make some people have symptoms like narcolepsy. but low dose DA agonists are likely reducing DA signalling, so an AP might work as well, and would probably be easier to explain to a pdoc. I think both d1 a d2 blockade would be good, and 5th2a would be good as well. I'm not sure which AP would be ideal.
-d/r
Posted by Elanor Roosevelt on January 28, 2009, at 23:25:46
In reply to Re: Let's make a list of hypnotics - sleep medications, posted by SLS on January 24, 2009, at 12:24:32
> > zolpidem (Ambien)
after ten years of being an ambien fan i want something that knocks me out faster and has a shorter half life
> > zaleplon (Sonata)
there was something medicre about this
> > ezsopiclone (Lunesta)
lunesta takes too long for me and the secondary anxieties kick in
> > secobarbital (Seconal)
didn't know these were still around
used to take them in the 60's to get high
bought them in bags of 50--yikes
> > mirtazepine (Remeron)
the most annoying f*cking dreams that leave you not well restedwhich on your list are quick acting and have short half lives?
Posted by SLS on January 29, 2009, at 7:16:26
In reply to Re: Let's make a list of hypnotics - sleep medicat, posted by Elanor Roosevelt on January 28, 2009, at 23:25:46
Thanks for the feedback.
Halcion (triazolam) is easily the most potent hypnotic I know of in terms of sleep onset. However, its half-life is only 3 hours, and many people experience rebound awakenings. I combined it with a longer-acting drug like Ativan (lorazepam) or Restoril (temazepam) to prevent this from happening and let me sleep through the night. Restoril is really best suited for sleep maintenance. Ativan can both reduce the onset of sleep and maintain sleep.
- Scott
Posted by Elanor Roosevelt on February 1, 2009, at 22:41:54
In reply to Re: Let's make a list of hypnotics - sleep medicat » Elanor Roosevelt, posted by SLS on January 29, 2009, at 7:16:26
how quickly does restoril kick in?
Posted by SLS on February 5, 2009, at 2:32:44
In reply to Re: Let's make a list of hypnotics - sleep medicat, posted by Elanor Roosevelt on February 1, 2009, at 22:41:54
Hi E.R.
I apologize for not responding to your post earlier.
> how quickly does restoril kick in?
Maybe 30-45 minutes? My experience with Restoril is that it really didn't kick hard enough. It is a great drug for sleep maintenance, but not so much for sleep initiation. Ativan is better. If you are able to fall asleep on your own, then Restoril might be the better choice as I don't think its effects persist into the next day like they do with Ativan.
- Scott
Posted by ricker on February 6, 2009, at 13:38:54
In reply to Re: Let's make a list of hypnotics - sleep medicat » Elanor Roosevelt, posted by SLS on February 5, 2009, at 2:32:44
Crushed Tylenol. Simply place a tablet on your forehead and have a loved one crush it with a baseball bat. :-o
Ok, sorry for the err, attempt at humor.
Posted by floatingbridge on June 24, 2011, at 7:56:51
In reply to Let's make a list of hypnotics - sleep medications, posted by SLS on January 24, 2009, at 9:28:53
Wish me luck. I am requesting your combo, halcion and ativan.
fb
Would anyone like to comment on the use of these hypnotic sleep medications? Add to the list? Personal experiences are sought with urgency. Some of these are heavy-duty and dangerous - especially the barbiturates. However, for a few individuals on certain drugs, the standards don't work. MAOIs are one group of antidepressantsl that can be tough to work with. The longer the list becomes, the more that safe alternative that will emerge.
>
> triazolam (Halcion)
> temazepam (Restoril)
> lorazepam (Ativan)
> zolpidem (Ambien)
> zaleplon (Sonata)
> zopiclone (Imovane)
> ezsopiclone (Lunesta)
> trazodone (Desyrel)
> chloral hydrate
> secobarbital (Seconal)
> amobarbital (Amytal)
> doxepin (Sinequan)
> amitripyline (Elavil)
> mirtazepine (Remeron)
> quetiapine (Seroquel)
>
>
> The first time I combined Parnate with desipramine (1987), I didn't sleep a single minute for almost two weeks. What worked for me was a combination of Halcion and Ativan. Halcion is the most potent hypotic benzodiazepine, and did a good job of putting me to sleep. However, with its short half-life, I would wake up at 2:00am and remain awake. Adding Ativan, a longer acting drug, allowed me to stay asleep for the rest of the night.
>
>
> - Scott
Posted by jono_in_adelaide on June 24, 2011, at 19:20:21
In reply to Re: Let's make a list of hypnotics - sleep medications » SLS, posted by floatingbridge on June 24, 2011, at 7:56:51
Chloral Hydrate loses its effect quickly, within 2-3 weeks if used every night, so is only suitable for short term/occasional use.
Chloral and the barbiturates are no more effective than the benzos such as temazepam and flurazepam, but tollorance is more of an issue, and they are far more likely to kill in overdoseage.
There is basicly no place for them in modern theraputics
Posted by Lamdage on July 4, 2011, at 9:57:15
In reply to Re: Let's make a list of hypnotics - sleep medications » SLS, posted by floatingbridge on June 24, 2011, at 7:56:51
Ill throw in trazodone (if it wasnt mentioned yet).
Gabapentin can be helpful, the same with baclofen.I like seroquel, diphenhydramine and pipamperon(anyone know this? its good! weak but sedating antipsychotic)
I rotate them a little to steer away from tolerance
Posted by floatingbridge on July 4, 2011, at 11:11:59
In reply to Re: Let's make a list of hypnotics - sleep medications, posted by Lamdage on July 4, 2011, at 9:57:15
Are you getting some decent sleep Lamdage?
Posted by Lamdage on July 6, 2011, at 17:13:29
In reply to Re: Let's make a list of hypnotics - sleep medications » Lamdage, posted by floatingbridge on July 4, 2011, at 11:11:59
Hell yeah!
Im pretty well equipped. Today i had only 4 hours (i woke up at 0430 am pretty much ready to go lol). Today i will knock myself out if this happens again. Like i said, as a rule of thump, if i wake up and didnt get 5 hours i will enforce more sleep.
Also, today, for like 1-2 hours at a time i had hints of not too bad mood and feeling of being "at ease". Might be something going on there!
Posted by floatingbridge on July 6, 2011, at 20:44:21
In reply to Re: Let's make a list of hypnotics - sleep medications, posted by Lamdage on July 6, 2011, at 17:13:29
I like the robust reply :-)
Keep working it safely!
fb
> Hell yeah!
>
> Im pretty well equipped. Today i had only 4 hours (i woke up at 0430 am pretty much ready to go lol). Today i will knock myself out if this happens again. Like i said, as a rule of thump, if i wake up and didnt get 5 hours i will enforce more sleep.
>
> Also, today, for like 1-2 hours at a time i had hints of not too bad mood and feeling of being "at ease". Might be something going on there!
Posted by mtdewcmu on July 9, 2011, at 13:06:26
In reply to Re: Let's make a list of hypnotics - sleep medications, posted by desolationrower on January 25, 2009, at 11:18:45
> also, as someonementioned GHB, phenibut can be helpful, although tolerance and addiction risks would keep me from using it regularly. but if you started an MAOi and need some sleep occasionally, it could be usable. I'd be doubleplus carful if you also have other hypnotics.
I second phenibut. I have been using it for the past couple weeks to good effect. It's very good for sleep maintenance, yet you feel pretty normal in the morning. Just a little tired. It's not like the other weak junk that's sold as supplements. I tried valerian before this, and the difference is enormous. It's more comparable to a benzo than to something like 5-htp. I have read that the quality varies between brands, though. I've been using SNS.
This is because my doctor refused to prescribe ambien. But I don't miss it now that I've found phenibut. I just wish I had something else to rotate to.
Posted by floatingbridge on July 9, 2011, at 17:13:49
In reply to Re: Let's make a list of hypnotics - sleep medications, posted by mtdewcmu on July 9, 2011, at 13:06:26
MtDew,
What's up with ambien? My (ex) doc refused me, too. After years of lunesta and sonata...?
I had to go down to the walk in docs to get ambien. It works. Isn't provoking anxiety. Am I missing something?
Posted by mtdewcmu on July 9, 2011, at 17:51:44
In reply to Re: Let's make a list of hypnotics - sleep medications » mtdewcmu, posted by floatingbridge on July 9, 2011, at 17:13:49
> MtDew,
>
> What's up with ambien? My (ex) doc refused me, too. After years of lunesta and sonata...?
>
> I had to go down to the walk in docs to get ambien. It works. Isn't provoking anxiety. Am I missing something?
>I don't know. Maybe they feel like they're not doing their jobs if they let you have everything you ask for.
Posted by desolationrower on July 15, 2011, at 20:48:05
In reply to Re: Let's make a list of hypnotics - sleep medications » floatingbridge, posted by mtdewcmu on July 9, 2011, at 17:51:44
> > MtDew,
> >
> > What's up with ambien? My (ex) doc refused me, too. After years of lunesta and sonata...?
> >
> > I had to go down to the walk in docs to get ambien. It works. Isn't provoking anxiety. Am I missing something?
> >
>
> I don't know. Maybe they feel like they're not doing their jobs if they let you have everything you ask for.haha. maybe you should ask for some weird shit, like tiagabine or some old neuroleptic or something (not anything abusable, or they will catogorize it as 'wants to get high') every once in a while, so they can turn down that instead.
-d/r
This is the end of the thread.
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