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Is there anything that I can talk to my pdoc about taking that would prevent dreaming? I need to be fully functional during the day, but at night I want zero dreams.

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I second prazosin (Minipress) if they're trauma-related, and/or they are nightmares.

Otherwise, since dreams occur mainly during REM sleep, you could be given a medicine that suppress REM sleep, like antidepressants, MAOIs in particular, I believe.

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7 hours ago, dancesintherain said:

are they trauma-related?  if so, prazosin's a gem.

 

3 hours ago, mikl_pls said:

I second prazosin (Minipress) if they're trauma-related, and/or they are nightmares.

Otherwise, since dreams occur mainly during REM sleep, you could be given a medicine that suppress REM sleep, like antidepressants, MAOIs in particular, I believe.

Thanks guys. I hesitate to call them trauma related because I struggle with using that term for my experiences, which don’t seem to be “bad enough”. But yes, nightmares about or relating to bad things that happened to me, from which I wake up anxious, in a cold sweat and can’t get back to sleep.

I’ll ask my pdoc about prazosin when I see her tomorrow. I just recently argued against an MAOI and am now on Prozac, but maybe I’ll reconsider. Long washout with Prozac though. :( 

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10 hours ago, Geek said:

 

Thanks guys. I hesitate to call them trauma related because I struggle with using that term for my experiences, which don’t seem to be “bad enough”. But yes, nightmares about or relating to bad things that happened to me, from which I wake up anxious, in a cold sweat and can’t get back to sleep.

I’ll ask my pdoc about prazosin when I see her tomorrow. I just recently argued against an MAOI and am now on Prozac, but maybe I’ll reconsider. Long washout with Prozac though. :( 

Prazosin is said to enhance sleep quality and decrease nightmares in those with PTSD, not saying you have PTSD, but it could be that you have a mild form of it. Certainly sounds as though you do.

DAT 5 WEEK WASHOUT THO... You could bridge it with something like nortriptyline, which has low CYP2D6 interaction, where as Prozac is a potent CYP2D6 inhibitor. You may find that you like the potent inhibition of serotonin and norepinephrine together (this wouldn't be like taking an SNRI, this would be totally different--the inhibition of the SERT and NET would be totally customizable via modulation of the dosages of each individual medicine). Nardil is said to be very good for "PTSD"-like symptoms, but just watch out for weight gain! Parnate is good too, but can be stimulating! (VERY stimulating! You will have insomnia for about the first 3 months of taking it! You'll likely need something to help with sleep, like trazodone or something...) Marplan is kinda like Nardil but way more expensive and less sedation and weight gain. Emsam is a hassle to me because of the skin patch, and it is pretty stimulating like Parnate. Didn't help with anxiety much unlike Parnate though.

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I took Parnate for 2 years and yes - stimulating. I did need Trazodone for sleep to happen at all. It helped for a while but I guess pooped out and I ended up coming off it shortly after starting ECT. A couple months ago pdoc brought up Nardil and I talked her out of it. I didn't want the hassle, and I'm very wary of weight gain. Might be worth reconsidering though. sigh.

Genetic testing says I won't metabolize tricyclics including nortriptyline very well. I took Imipramine for a while (I know, it's not really a tricyclic). It didn't do a thing for my mood but it sure made it easy to sleep.

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Posted (edited)
44 minutes ago, Geek said:

A couple months ago pdoc brought up Nardil and I talked her out of it. I didn't want the hassle, and I'm very wary of weight gain. Might be worth reconsidering though. sigh.

You might consider Marplan if your insurance covers it. It has a copay coupon. It's related to Nardil but has less weight gain. In fact, I lost weight on it (that I gained on Parnate, which is paradoxical in and of itself).

44 minutes ago, Geek said:

Genetic testing says I won't metabolize tricyclics including nortriptyline very well. I took Imipramine for a while (I know, it's not really a tricyclic). It didn't do a thing for my mood but it sure made it easy to sleep.

Aww, that's unfortunate... So what do you mean about imipramine not really being a tricyclic? Because my pdoc has referred to nortriptyline as a "bicyclic" before, and saying that it isn't a TCA... I'm wondering if that has anything to do with what you're talking about.

Yeah imipramine was actually a nightmare for me. Nortriptyline actually didn't do much for me until I got to the max dose at 150 mg, and it barely affected me. Desipramine seems to be the magic pill for me. Protriptyline didn't do anything except make my mouth dry and make it hard to pee.

Edited by mikl_pls

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55 minutes ago, mikl_pls said:

You might consider Marplan if your insurance covers it. It has a copay coupon. It's related to Nardil but has less weight gain. In fact, I lost weight on it (that I gained on Parnate, which is paradoxical in and of itself).

Aww, that's unfortunate... So what do you mean about imipramine not really being a tricyclic? Because my pdoc has referred to nortriptyline as a "bicyclic" before, and saying that it isn't a TCA...

Yeah imipramine was actually a nightmare for me. Nortriptyline actually didn't do much for me until I got to the max dose at 150 mg, and it barely affected me. Desipramine seems to be the magic pill for me. Protriptyline didn't do anything except make my mouth dry and make it hard to pee.

Hmm, I was mis-remembering. I thought Imipramine was a "tetracyclic" but it's not. 

The other hard thing, frankly, about taking a TCA is my pdoc wouldn't give me more than a week of Imipramine at a time. I have chronic suicidal thoughts and while she mostly trusts me... she didn't with that.

Thanks for the tip about Marplan. My insurance just changed, so I don't even have access to their formulary yet, but I'll look into it once I do.

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On 8/2/2018 at 10:26 PM, Geek said:

Hmm, I was mis-remembering. I thought Imipramine was a "tetracyclic" but it's not.

Ah! The tetracyclics are amoxapine and maprotiline. Mirtazapine is technically a tetracyclic too.

On 8/2/2018 at 9:26 PM, Geek said:

The other hard thing, frankly, about taking a TCA is my pdoc wouldn't give me more than a week of Imipramine at a time. I have chronic suicidal thoughts and while she mostly trusts me... she didn't with that.

Oh I see, since the OD of TCAs can be deadly.

On 8/2/2018 at 9:26 PM, Geek said:

Thanks for the tip about Marplan. My insurance just changed, so I don't even have access to their formulary yet, but I'll look into it once I do.

Absolutely! Best of luck to you! If I find anything else about anything that can suppress REM sleep and thereby dreams, I will.

Also, if I can find anything that can actually just reduce nightmares and "calm" the content of your dreams down, I'll let you know too.

Speaking of which, when I was withdrawing from Cymbalta in an (unsuccessful) attempt to get on Parnate the first time, I was having a lot of vivid nightmares. I had a cocktail of supplements I was taking at the time that seemed to actually do quite a decent job at reducing the nightmares... I dunno, i know every time someone is like "I took this [insert supplement here] and it CURED MY [insert ailment here]!" it is an instant turn off, but I figured I'd at least share this with ya. This is the combination that helped me calm my sleep down (rid my sleep of so many night mares):

  • chamomile
  • lemon balm
  • skull cap

You would definitely want to avoid melatonin. It can cause dreams to become more vivid and can cause nightmares.

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I'm not sure that suppressing dreams is healthy. Any drug that suppresses dreams is going to mess with your sleep architecture. 

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Posted (edited)
1 hour ago, jt07 said:

I'm not sure that suppressing dreams is healthy. Any drug that suppresses dreams is going to mess with your sleep architecture. 

Most antidepressants suppress REM sleep; however, there are a few that actually enhance sleep architecture. I think trazodone and nefazodone are two that enhance, for instance (but don't quote me on that). Agomelatine (of course, not available in the US), is another.

So while most of us taking psych drugs aren't aiming to suppress dreams or REM sleep, we are already doing so and altering our sleep architecture, most of us without even knowing it.

Also, narcoleptics actively are prescribed antidepressants to suppress REM sleep. They have abnormal REM sleep in that they enter REM sleep at the beginning of sleep instead of having a period of NREM sleep at the beginning of sleep followed by REM sleep. Also, the characteristics of REM sleep such as lack of muscular control can occur during wakefulness--cataplexy, which antidepressants can aid in suppressing such events.

People with REM sleep behavior disorder would also want to suppress REM sleep because they do not have the typical paralysis that occurs during REM sleep, and thus they will act out their dreams, often becoming violent during their sleep.

Edited by mikl_pls

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