Needing a new option for insomnia

[Mises]

It has always been difficult for me to fall asleep.

The older I get, the harder it becomes to get sufficient sleep, and even more so, my ability to function without adequate sleep. I'm about 40 years old, male.

There is no 'underlying condition'. I've seen several doctors.

I've read the stickies.

I'm not looking for advice about CBT or a change of behaviour. I already know a lot about that.

For me, insomnia is not an occasional problem. I may have it every day, for many months. And sometimes, I have no serious problems for weeks or months. No obvious cause. The nature/pattern of insomnia also varies.

I have a doctor who's willing to prescribe benzodiazepines. For me benzos can work quite well, not just short term. Especially if I occasionally switch from one benzo to another. But in the long run, tolerance catches up

I can also get antihistamines for sleep, but that's also a tolerance issue.

I did some research on trazodone. Studies suggest it either works only if you are depressed as well, they work for only 1-2 weeks, or there is no evidence that it works at all, only anecdotical success stories. Depending on the studies. I tried a TCA once (for sleep), very unpleasant, I won't use antidepressants for sleep.

There is melatonin, but it doesn't work for me. The same for Seroquel.

My insomnia has little to nothing to do with not being able to relax, or stop thinking. My body just refuses to fall asleep.

I have no positive experiences with herbal stuff.

If anyone can come up with a medication that can be useful for sleep AND IS AVAILABLE it would be much appreciated.

My doctor won't prescribe barbiturates, chloral hydrate, Placidyl and other 'older' medications.

[tryp]

Since you have so few other options, I'd try the Traz.

There is also Remeron, which is also an anti-depressant, but is very good for sleep. I have taken it at 7.5 mg, 15 mg, 30 mg and 45 mg. If you want it for sleep, you'll want 15 or below, probably 7.5.

There is also the other atypicals - risperdal and zyprexa are also sedating, if I recall correctly. I've never used them, and Seroquel is the big one for sleep, but if you're at the end of your rope, it might be worth a try.

The older typicals are also used sometimes, but if your doc won't prescribe older stuff, he probably won't go for that.

Have you tried the hypnotics - Ambien and Lunesta?

Wikipedia tells me that clozapine is sometimes used for extremely refractory insomnia, but I suspect that's sort of like killing a fly with a warhead.

[dancesintherain]

the drugs that are truly designed to knock you out might be a possibility (ambien comes to mind, though I know there are more). they worked like a gem on me, though I ended up switching b/c of tolerance issues (not wanting to become dependent). I'm just not sure they're allowed for every day for an extended period of time. They might be.

[Mayteana]

This seems like a silly question but if you need something for insomnia, why not try umm prescription sleep meds like: Ambien, Ambien CR, Lunesta, Rozerem, Sonata?

When you talk about using benzodiazepine's, are we talking about the ones typically used for insomnia, Restoril, Halcion, etc?

~ May

[sorrel]

Well, you're throwing out perfectly good options based on theoretical possibilities. I couldn't tell from the way you phrased it, but did you actually experience tolerance to antihistamines or you are just afraid of it happening? That doesn't always happen, so if you are just worried about it, I'd say try it. Likewise with trazodone (I have never heard the things you cite about it and would be interested in seeing the references.) Again, you might as well try it. If it doesn't work, you're no worse off for having tried.

Like someone else mentioned, some of the standard antipsychotics are pretty sedating.

[Mises]

This seems like a silly question but if you need something for insomnia, why not try umm prescription sleep meds like: Ambien, Ambien CR, Lunesta, Rozerem, Sonata?

When you talk about using benzodiazepine's, are we talking about the ones typically used for insomnia, Restoril, Halcion, etc?

~ May

Ambien, Lunesta, Sonata: the z drugs.

Ambien seems to have no effect AT ALL. There is cross-tolerance between Lunesta and the benzodiazepines, and it seems to affect my quality of sleep (nightmares, interrupted sleep) and to fall asleep I would definitely need a much higher dose than common. True, I haven't tried zaleplon, but if it would work at all I'd probably need a high dosage.

I've used benzos 'typically used for insomnia', just not the ones with an ultra-short half life (like Halcion) or a very long half life.

[Mises]

Well, you're throwing out perfectly good options based on theoretical possibilities. I couldn't tell from the way you phrased it, but did you actually experience tolerance to antihistamines or you are just afraid of it happening? That doesn't always happen, so if you are just worried about it, I'd say try it. Likewise with trazodone (I have never heard the things you cite about it and would be interested in seeing the references.) Again, you might as well try it. If it doesn't work, you're no worse off for having tried.

Like someone else mentioned, some of the standard antipsychotics are pretty sedating.

I have actually developed tolerance to antihistamines. For me, it develops very quickly.

[Mises]

Since you have so few other options, I'd try the Traz.

There is also Remeron, which is also an anti-depressant, but is very good for sleep. I have taken it at 7.5 mg, 15 mg, 30 mg and 45 mg. If you want it for sleep, you'll want 15 or below, probably 7.5.

There is also the other atypicals - risperdal and zyprexa are also sedating, if I recall correctly. I've never used them, and Seroquel is the big one for sleep, but if you're at the end of your rope, it might be worth a try.

The older typicals are also used sometimes, but if your doc won't prescribe older stuff, he probably won't go for that.

Have you tried the hypnotics - Ambien and Lunesta?

Wikipedia tells me that clozapine is sometimes used for extremely refractory insomnia, but I suspect that's sort of like killing a fly with a warhead.

I suppose it could try Remeron, but it seems that the hypnotic effect is (mostly?) mediated by its effect on the histamine receptors. Since I have developed tolerance to antihistamines, I doubt it would work. I actually discussed Remeron with my doctor once, and he said that the hypnotic/sedative effect is a temporary side effect.

As I stated, Seroquel doesn't work for me. Sedating antipsychotics like Zyprexa might work, but I'm not enthousiastic about using antipsychotics for sleep. And my doctor is reluctant to prescribe those for sleep.

Thank you for your suggestions. I'll give them some thought.

[tryp]

If it were me, I'd try Traz or Remeron, because it seems like those are the furthest away from anything you've tried before.

Or possibly combining stuff. I don't know how common it is, but right now I'm using 7.5 mg of Remeron with 150 mg of Seroquel and it's working quite well. Perhaps combining a benzo with one of the other options might work for you - a pdoc suggested benzo + seroquel to me, but I don't do well with benzos, so I never tried it.

[DarkendHour]

I take Trazodone for sleep. It still doesn't help all the time but it helps the most out of anything I've tried.

The pharmacist warned me that Trazodone could make me extremely tired after taking it.. haha ya think? Did you read what my pdoc had you put on the label..."For Insomnia"?

My pdoc won't give me actual meds made for sleep because of the dosage I would need.. she doesn't want me to become addicted.

Ummm I can't sleep without meds anyways so ummm yea why would it matter if I couldn't sleep without a certain type of med? Makes no sence to me but whatever.

Edit= forgot spellcheck

[hollywoodfreaks]

Believe you me, sometimes trazodone works VERY well for insomniacs. I've been taking it for 4 years and it usually knocks my ass right out. It kicks in quickly and keeps you asleep for many hours--perhaps too many hours, but I think it's better than sleeping shittily or not at all. Personally, I'm trying to switch over to a benzo because I'm sick of trazodone's side effects, but you never know what reaction your body will have. I know other people who felt nothing from it. It's one of those things where you just have to try it and see what happens. It's nice because you have the leeway to increase the dose a LOT if you need to because you don't have to worry about physical dependence. Try it!

[Mises]

If it were me, I'd try Traz or Remeron, because it seems like those are the furthest away from anything you've tried before.

Or possibly combining stuff. I don't know how common it is, but right now I'm using 7.5 mg of Remeron with 150 mg of Seroquel and it's working quite well. Perhaps combining a benzo with one of the other options might work for you - a pdoc suggested benzo + seroquel to me, but I don't do well with benzos, so I never tried it.

I haven't visited my doctor yet.

I wonder if someone here knows about other GABA agonists (or similar), or anticonvulsants that could be prescribed for insomnia ? (off label)

There are plenty of posts on the internet, but I couldn't find any studies, just a few anecdotes.

[Maceo]

Since you have so few other options, I'd try the Traz.

There is also Remeron, which is also an anti-depressant, but is very good for sleep. I have taken it at 7.5 mg, 15 mg, 30 mg and 45 mg. If you want it for sleep, you'll want 15 or below, probably 7.5.

There is also the other atypicals - risperdal and zyprexa are also sedating, if I recall correctly. I've never used them, and Seroquel is the big one for sleep, but if you're at the end of your rope, it might be worth a try.

The older typicals are also used sometimes, but if your doc won't prescribe older stuff, he probably won't go for that.

Have you tried the hypnotics - Ambien and Lunesta?

Wikipedia tells me that clozapine is sometimes used for extremely refractory insomnia, but I suspect that's sort of like killing a fly with a warhead.

I suppose it could try Remeron, but it seems that the hypnotic effect is (mostly?) mediated by its effect on the histamine receptors. Since I have developed tolerance to antihistamines, I doubt it would work. I actually discussed Remeron with my doctor once, and he said that the hypnotic/sedative effect is a temporary side effect.

As I stated, Seroquel doesn't work for me. Sedating antipsychotics like Zyprexa might work, but I'm not enthousiastic about using antipsychotics for sleep. And my doctor is reluctant to prescribe those for sleep.

Thank you for your suggestions. I'll give them some thought.

I am also tolerant to antihistamine sleeping pills (unisom, benadryl etc) but when I was taking Remeron 15mg I didn't build a tolerance. It still knocked me out EVERY NIGHT. Nothing else has achieved that. Not Ambien, Restoril, Halcion, Serax or any other conventional sleep med.

I also think your reason why Trazadone theoretically might not work sounds is illogical. You should be open-minded about that too. I've heard many good things and would try it if given the option.

[SofiaBT]

Hormonal changes is also a factor of having alteration in sleep pattern. And if you are consuming too much caffeine like having 3 to 5 cups of coffee a day will definitely affect your sleeping habit. Better do something about that but in case your case is really that severe, you'd better consult a health professional and ask for the right prescription.

(Deleted link to website advertising sleep aids)

[GoldCoin]

I take a combination of clopixal and seroquel it works a treat every time.

so maybe a combination of x and y is exactly what you need.

[crtclms]

I wish Trazadone had worked for me. It absolutely did not help at night, and then suddenly I would do a face plant at sometime in the late afternoon. I also had very mundane dreams, in which I could no longer be sure of what I had actually done, and what I had just dreamed.

It seems to be really helpful for most of the people I have seen on the boards, but I just wanted to throw in one contrasting experience.

[MarkP]

Yeah I tried trazodone too.. The stuff made me super drowsy, but didn't help induce sleep at all (I stayed awake for days on the stuff and just felt like a*s all the time). Same problem as you -- can't fall asleep worth a damn. But once I'm asleep..things are okay.

What I've settled on, after about a year on benzos, is breaking open a 15mg temazepam (generic Restoril) capsule, and consuming approximately half of its contents under my tongue. The fast route of administration gets me tired quickly, and the low dose doesn't leave me looking for a pot of coffee, or a six pack of Coca Cola the next day (15mg, or, gosh, 30mg was horrible that way).

I'm a 200lb, 6'1" guy. I think tolerance is the least likely to develop on the low potency benzos or benzo-look-alikes. Research shows that most people develop a tolerance within a couple weeks to triazolam, a very short acting benzo. But can go months on flurazepam without building tolerance.

Even within the benzo family, there's drastically different effects. 4mg Ativan does nothing to me. 7.5mg temaz makes me drowsy. Figure that one out... Those benzo charts might work for tapering, but they sure as heck don't describe therapeutic equivilancies. Also, you go to the benzo withdrawal internet forums (various ones), and most of the 'problems' people tend to have are with the high potency ones. You know, Ativan, Klonopin, Xanax. Rarely do you see someone have problems with temazepam, oxazepam, or even diazepam.

[Vicky]

I tried Trazadone 50 mgs for the first time last night. Wow! I took it 9 pm, dreamed my #$% off, and dragged myself out of bed about 11 this morning. Felt (more) normal after a cup of coffee, but I can see this would be a problem on days I have to get up at 7 am. However, I am not anxious about the chores I have to do this weekend as I usually am (laundry, clean guinea pig cage, etc). Might try half a pill tonight to see if I get the sweet sleep without the a.m. grogginess.

Oh, and the stuff only costs $3.50 at the drugstore, but a month of Lunesta would have cost over $200!!! So I am hoping the good old cheap traz will work out!!!

Vicky

[notfred]

I tried Trazadone 50 mgs for the first time last night. Wow! I took it 9 pm, dreamed my #$% off, and dragged myself out of bed about 11 this morning. Felt (more) normal after a cup of coffee, but I can see this would be a problem on days I have to get up at 7 am. However, I am not anxious about the chores I have to do this weekend as I usually am (laundry, clean guinea pig cage, etc). Might try half a pill tonight to see if I get the sweet sleep without the a.m. grogginess.

Oh, and the stuff only costs $3.50 at the drugstore, but a month of Lunesta would have cost over $200!!! So I am hoping the good old cheap traz will work out!!!

Vicky

You can't judge a med on one nights use. You get used to the excessive sedation over time.

nf

[Vicky]

Yes NotFred,

You are absolutely right about not judging a med after one night--I will try the 50 mg for a while. I'm not complaining, that was the best sleep I've had in a while!!!!

[notfred]

Yes NotFred,

You are absolutely right about not judging a med after one night--I will try the 50 mg for a while. I'm not complaining, that was the best sleep I've had in a while!!!!

Smart thinking to try Traz on the weekend. I have taken it b4 and it can knock you on your ass at first !

nf

[Guest ldo not signed in]

This is probably a stupid comment, but I suppose you've tried all the standard non med stuff like heavy exercise in the afternoon or early evening, bright light early, etc? (I find going outside mid day for a long time very useful but hard to fit in.) Sleep study? They must learn something with all those wires they put on your head!

I've found clonidine helpful, but that's more for calming my brain down, I think, and you say you don't have that issue.

[Shannie]

I suppose it could try Remeron, but it seems that the hypnotic effect is (mostly?) mediated by its effect on the histamine receptors. Since I have developed tolerance to antihistamines, I doubt it would work. I actually discussed Remeron with my doctor once, and he said that the hypnotic/sedative effect is a temporary side effect.

Yes, I think that its sedative effects are mediated via histamine - but it still might be worth a try. I took it for a year and it made me sleep like a log every night (9-11 hours if left to my own devices), after long-standing problems with insomnia. For the first few weeks I felt like I was wading through treacle in the daytime after taking it the night before, but thankfully that wore off after a while. Its ability to make me sleep never wore off though - I would still feel utterly sedated and need to go to bed within a maximum of two hours after taking it, without fail. And I'd be out like a light within minutes of getting into bed. I think that it might be worth you giving it a go!

[Maceo]

Since you have so few other options, I'd try the Traz.

There is also Remeron, which is also an anti-depressant, but is very good for sleep. I have taken it at 7.5 mg, 15 mg, 30 mg and 45 mg. If you want it for sleep, you'll want 15 or below, probably 7.5.

There is also the other atypicals - risperdal and zyprexa are also sedating, if I recall correctly. I've never used them, and Seroquel is the big one for sleep, but if you're at the end of your rope, it might be worth a try.

The older typicals are also used sometimes, but if your doc won't prescribe older stuff, he probably won't go for that.

Have you tried the hypnotics - Ambien and Lunesta?

Wikipedia tells me that clozapine is sometimes used for extremely refractory insomnia, but I suspect that's sort of like killing a fly with a warhead.

I suppose it could try Remeron, but it seems that the hypnotic effect is (mostly?) mediated by its effect on the histamine receptors. Since I have developed tolerance to antihistamines, I doubt it would work. I actually discussed Remeron with my doctor once, and he said that the hypnotic/sedative effect is a temporary side effect.

At one point I was considering Remeron and believed that I'd have the same issue as with antihistamines but in practise it just did not happen. I took it for months with no tolerance. I was groggy the next day but I definitely slept every night for a long time.

[Guest twinkletoes]

i tried trazedone and it worked for many yrs. Then it wore off. the hypnotics make me sleep-walk and i eveen drove in a blackout! what i'x taking now is clonodine, related to a beta blocker and it really works. (i'm bipolar adhd)