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Titrated down on Lamictal; Ambien is not working


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Sure hope someone can give me some insight to my problem...

I recently titrated down from 400mg to 300mg, then finally to 200mg of Lamictal. This titration took about 6 weeks. I purposely did it slowly because hypersensitivity to meds.

I used to take 10mg of Ambien every night to sleep. Then about a month ago, my pdoc changed it to Ambien CR (12.5mg).

I have had to take 2 CR's (25mg) to fall asleep. I take one, get right into bed, and ruminate over everything, try relaxation techniques, still don't fall asleep. Then I cave in and take another CR.

The more Lamictal I have taken, the more difficult it was to fall asleep. So, I don't understand why I'm having problems sleeping when I have actually taken less Lamictal. I have been at the 200mg level for almost a month.

What is going on??

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Maybe ask your doc to switch it back to plain old Ambien, not the CR? I know the theory is that you'll stay asleep longer, won't have early awakening with the CR. But what good does that do if you can't get to sleep. (I have this same problem with CR, but not straight Ambien.)

The reason the pharm company came out with the CR version? Yes, in part because there was a need, people were complaining about early morning awakenings. But another part of it is that their patent is going to be running out sometime soon and will be available to other companies to produce as a generic. So they had to come up with some other version, a newer improved version too, in order to hold on to some of the market.

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Just found another site that speaks to the business reasons for the creation of AmbienCR: http://www.datamonitor.com/~6e2297340dfd45...ype=CommentWire

In part:

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Ambien CR is a new version of its top-selling Ambien sleeping drug that is due to lose US patent protection in 2007. Sanofi [sAN.PA] hopes to be able to market the product a full year before the Ambien patent expires, switching patients to Ambien CR to avoid generic competition. However this may not be enough to stave off a dramatic fall in revenues as generics take their slice of the market.

Ambien CR is a controlled release version of Ambien (zolpidem), with patent protection until 2019. It is reported to have an improved pharmacokinetic profile, with only 40-70% of the active ingredient released in the first half hour. The drug is released over a four to six hour period, providing a sustained effect and reducing awakenings to once every five hours, compared to once or twice with Ambien.

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Also found a bulletin board posting, which said the Ambien Patent Expires Oct 21, 2006. Maybe that date is accurate? Also mentioned the generic has been available in the UK for a while. Perhaps true in other countries, as well.

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