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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by AdamCanada2 on February 10, 2009, at 2:18:52
I cannot bare an average of 2 and a half hours of sleep a day as I have in the previous week or longer on parnate (initially it would not give insomnia only later on).
Today magically was the one day in a while I been able to sleep more than 5 hours. A miracle surely but I cannot be sure one day will mean this will continue.... because if that trend of 0 hours one day and 4-5 another, then 0, then 4-5, continues then I will resort to screaming at people in the emergency room if I am not prescribed a proper sleep aid.
My life is on the line here. My health.
Please inform me a bit about the risks of taking Ambien on a regular basis or if the risks are extremely minimal.
Posted by yxibow on February 10, 2009, at 2:44:28
In reply to How often can Ambien be taken??, posted by AdamCanada2 on February 10, 2009, at 2:18:52
> I cannot bare an average of 2 and a half hours of sleep a day as I have in the previous week or longer on parnate (initially it would not give insomnia only later on).
>
> Today magically was the one day in a while I been able to sleep more than 5 hours. A miracle surely but I cannot be sure one day will mean this will continue.... because if that trend of 0 hours one day and 4-5 another, then 0, then 4-5, continues then I will resort to screaming at people in the emergency room if I am not prescribed a proper sleep aid.
>
> My life is on the line here. My health.
>
> Please inform me a bit about the risks of taking Ambien on a regular basis or if the risks are extremely minimal.
There are always "unknown risks" of any sleep agent, especially after the FDA basically did some *ss protection and labelled the entire list of them as having possible effects from sleep walking and doing entire tasks in the middle of the night without knowing it. These are rare effects. Any rare effect can happen.
The greater risk though really here, is habituation. Ambien is generally labelled for about a week's use -- possibly up to four weeks.
Lunesta, whether it was a longer term trial, or for other reasons, has been marketed and approved as a longer term sleep aid.
Both of them are pseudo-benzodiazepines. They do carry a risk of habituation, when that happens is unclear and varies by person, genetics, and weight and metabolism among other things.
I would say taking Ambien beyond a month or two could be a risk for habituation.I understand sleep problems, I have a probable sleep disorder myself.
It is fairly rare to die of a lack of sleep because sooner or later the human body will adjust to some sleep cycle -- however sleep deprivation (under 5 hours or so of sleep) ultimately of course is extremely unhealthy. I didn't say it was easy and I didn't say people haven't died of other reasons because of sleep deprivation.
I have been through soporific and sleep medications, including Restoril (weak, considering I am not benzodiazepine naive) doxepin (odd chills), amitriptyline (worked but I can't take it because I take clomipramine, Anafranil), and finally doxylamine succinate (Unisom).You can take doxylamine with Parnate. You cannot take TCAs such as amitriptyline or doxepin, among others.
The diphenhydramine (Benadryl) formulation of Unisom and other similar brands potentially may have more anticholinergic effects and is believed by some to be a moderate interaction but probably not too much more than doxylamine.
I personally don't like Benadryl because it leaves me more depressed and groggy the next day than doxylamine. But this may be different for others.
-- I hope that helps
-- Jay
Posted by SLS on February 10, 2009, at 6:36:33
In reply to Re: How often can Ambien be taken?? » AdamCanada2, posted by yxibow on February 10, 2009, at 2:44:28
Would you say that there is a difference between "habituation" and "tolerance"? Is tolerance part of habituation? Is there a psychological dependence with habituation. Cravings?
- Scott
Posted by yxibow on February 10, 2009, at 7:33:41
In reply to Re: How often can Ambien be taken?? » yxibow, posted by SLS on February 10, 2009, at 6:36:33
> Would you say that there is a difference between "habituation" and "tolerance"? Is tolerance part of habituation? Is there a psychological dependence with habituation. Cravings?
>
>
> - Scott
Its all within how one personally, semantically, describes the words tolerance, habituation, and addiction.Some people use all three interchangeably which I personally believe are not, although they can occur at the same time.
One could say that tolerance is the end result of the process of habituation, I suppose.... or is habituation a form of tolerance ?
"Craving" I view differently because it implies that there is a non-therapeutic desire for a substance, which I guess would fall into the realm of "addiction", which I think is a more purposeless use of a substance, legal or otherwise outside of a care plan.
But that isn't to place a "sin" concept on addiction by any means -- though substances of addiction may be considered by the most conservative views as vice, I view quite differently.That would place the onus entirely on the individual who may not be able to stop an addiction alone (don't get me started on how we treat people who use hardcore street drugs).
And there are other things, I mean one can have "cravings" for cakes and cookies at night.
As for the psychological component, I think there could be a bit involved in habituation/tolerance but I think that is more of a chemical and transmitter overload process than the psychological reasons people become addicted to substances or "crave" them. Even coffee cravings, nicotine cravings especially, etc.
And then as I said, people can become "addicted" to a prescribed substance, especially one with a higher amount of PRN use (e.g. benzodiazepines) by increasing considerably the amount used in a manner not quite as prescribed.I suppose even people can forge a prescription of what they are taking because they have "cravings". But I'm not here to create scenarios of "illegal activity", that was just an example.
And then there's the opposite -- some people, for example, who become addicted to meth actually are using the substance because instead of placing them in orbit it calms them. Hence, when control over this is realized, often patients take legal forms of stimulants because they do have ADD/ADHD, etc.
I ramble... but its one way of looking at things anyhow.-- Jay
Posted by Phillipa on February 10, 2009, at 10:53:43
In reply to Re: How often can Ambien be taken?? » SLS, posted by yxibow on February 10, 2009, at 7:33:41
I personally took 3mg of lunesta with benzos when sleeping was really bad and just stopped it after about six month. Why I get no withdrawal I just don't understand. But I wouldn't fear something to sleep. Phillipa
This is the end of the thread.
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