Ambien
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My husband has been taking it for over a year, though this is longer then the 1-2 weeks I believe they recommend. At the beginning he was getting the full 7-8 hours sleep, but now gets 4-6 straight. He does not feel any kind of drug hangover when he gets up. To the best of my knowledge, I believe he would have some withdrawal problems if he choose to stop taking it at any time.
I hope this is of some help for you.
terri
I hope this is of some help for you.
terri
G
Guest
·Hola,
When my DP first started, I was also suffering from lack of sleep. I got an RX for Ambien and BOY...DID I SLEEP! I know that you can only take it for a short while, at least thats what the Dr.'s say, and I can understand why.
I know for myself after a few weeks on Ambien, I began to look forward to my evening "dosage" perhaps a little too much. However if you need sleep, Ambien is the way to go. Good Luck.
Tony
When my DP first started, I was also suffering from lack of sleep. I got an RX for Ambien and BOY...DID I SLEEP! I know that you can only take it for a short while, at least thats what the Dr.'s say, and I can understand why.
I know for myself after a few weeks on Ambien, I began to look forward to my evening "dosage" perhaps a little too much. However if you need sleep, Ambien is the way to go. Good Luck.
Tony
G
Guest
·I didn't notice any intensity with DP, very mild side efx if any.
Tony
Tony
ambien is very similiar to booze and benzos. It also works on gaba and in time can cause tolerance/addiction. Tho all of these substances will knock you out, they also inhibit deep, restorative sleep and will eventually work against you. Thats why its not recommended for any extended period of time. Id talk to your doctor about a prescription to trazadone first. Just my opinion.
Joe
Joe
I agree with Joe that hypnotics/sedatives/anxiolytics can be abused and can cause tolerance and should be used with caution. Of course I had to go look up both. I've seen these ads on TV for Lunesta, Ambien and a few other meds like this and feel odd about them, but they serve a critical purpose, particularly for the elderly who often have trouble sleeping.dakotajoe said:
I was curious about your recommending Desyrel (trazodone) however as it is an antidepressant.
What I understood in looking these up is:
1. Insomnia is a symptom and in and of itself requires a very particular type of medication. A hypnotic. And apparently Ambien has few negative side effects as long as the individual has time for a proper night's rest.
2. Depression is a disorder, which could include the symptom of insomnia, but not necessarily.
The choice of Ambien or any hypnotic is to initially address insomnia in and of itself. There is an indication that if the insomnia persists (I believe no more than a month's worth of Ambien should be prescribed) one should look into a medical or psychiatric cause for the insomnia which may be part of a larger disorder -- a constellation of symptoms -- such as depression, or as noted a medical condition
Insomnia is a single specific symptom.
Depression is a disorder comprised of a variety of symptoms.
It seems a hypnotic is the drug of choice for someone with ONLY a problem sleeping. This is where I get a tad concerned about those of us here who have general disorders -- of which insomnia is only one symptom. This is where I have a problem with it.
Using myself as an example. I have GAD, mood dysregulation/depression, HYPERsomnia, and the symptoms of DP/DR. I personally would be leery of taking a sleeping pill. If I had ONLY insomnia and it was interfering with my daily routine/functioning, I'd consider it.
Two completely different scenarios.
*Detailed information on both drugs at http://www.rxlist.com *
Information below from RXLIST.COM
Read at your leisure, LOL.
Best,
D 8)
Sheesh I should have been a pharmacist. If it weren't for hideous DP in highschool, I may have done rather well in Chemistry. HELL. I could have some money saved up at this point ... and a house.
Again, insomnia ALONE is a symptom.
Having insomnia as a symptom that is part of a greater disorder such as GAD, depression, mania, etc. must be treated separately.
*Note a major depressive episode can have EIGHT symptoms and one must fit a minimum of four ... using Desyrel for one symptom of insomnia doesn't seem to be indicated.
--------------------------------------------------------------------------------
Brand Name: Ambien
Class: Miscellaneous Sedatives/Hypnotics
Zolpidem tartrate is a non-benzodiazepine hypnotic of the
imidazopyridine class and is available in 5 mg and 10 mg strength
tablets for oral administration.
While zolpidem is a hypnotic agent with a chemical structure
unrelated to benzodiazepines, barbiturates, or other drugs with
known hypnotic properties, it interacts with a GABA-BZ receptor
complex and shares some of the pharmacological properties of the
benzodiazepines.
In contrast to the benzodiazepines, which non-selectively bind to
and activate all three omega receptor subtypes, zolpidem in vitro
binds the (w1) receptor preferentially.
The(w1) receptor is found
primarily on the Lamina IV of the sensorimotor cortical regions,
substantia ***** (pars reticulata), cerebellum molecular layer,
olfactory bulb, ventral thalamic complex, pons, inferior
colliculus, and globus pallidus.
This selective binding of zolpidem on the (w1) receptor is not
absolute, but it may explain the relative absence of myorelaxant
and anticonvulsant effects in animal studies as well as the
preservation of deep sleep (stages 3 and 4) in human studies of
zolpidem at hypnotic doses.
Since sleep disturbances may be the presenting manifestation of a
physical and/or psychiatric disorder, symptomatic treatment of the
insomnia should be initiated only after a careful evaluation of the
patient.
The failure of insomnia to remit after 7 to 10 days of treatment
may indicate the presence of a primary psychiatric and/or medical
illness which should be evaluated. Worsening of insomnia or the
emergence of new thinking or behavior abnormalities may be the
consequence of an unrecognized psychiatric or physical
disorder.
Such findings have emerged during the course of treatment with
sedative/hypnotic drugs, including zolpidem tartrate. Because some
of the important adverse effects of zolpidem tartrate appear to be
dose related (see PRECAUTIONS and DOSAGE AND ADMINISTRATION), it is important to use the smallest possible effective dose, especially
in the elderly.
---------------------------------------------
Brand Name: DESYREL
Class: Antidepressants
Trazodone HCl
The mechanism of DESYREL?s antidepressant action in man is not
fully understood.
In animals, DESYREL selectively inhibits serotonin uptake by brain
synaptosomes and potentiates the behavioral changes induced by the
serotonin precursor, 5-hydroxytryptophan. Cardiac conduction
effects of DESYREL in the anesthetized dog are qualitatively
dissimilar and quantitatively less pronounced than those seen with
tricyclic antidepressants.
DESYREL is not a monoamine oxidase inhibitor and, unlike
amphetamine-type drugs, does not stimulate the central nervous
system.
DESYREL is indicated for the treatment of depression. The
efficacy of DESYREL has been demonstrated in both inpatient and
outpatient settings and for depressed patients with and without
prominent anxiety. The depressive illness of patients studied
corresponds to the Major Depressive Episode criteria of the
American Psychiatric Association?s Diagnostic and Statistical
Manual, III.a
Major Depressive Episode implies a prominent and relatively
persistent (nearly every day for at least two weeks) depressed or
dysphoric mood that usually interferes with daily functioning, and
includes at least four of the following eight symptoms: change in
appetite, change in sleep, psychomotor agitation or retardation,
loss of interest in usual activities or decrease in sexual drive,
increased fatigability, feelings of guilt or worthlessness, slowed
thinking or impaired concentration, and suicidal ideation or
attempts.
---------------------------------------------------------
P.S. -- in re: terri's husband's case, it is my understanding he has a medical condition, not a psychiatric condition, and needs help sleeping. Again this is a quality of life decision.
I would be hesitant as someone with a psychiatric disorder to take something like Ambien. It seems treating the main problem whatever it is -- Panic, GAD, depression, bipolar, OCD, etc. is first and foremost.
Ambien is very specifically for one symptom -- insomnia.
I would be hesitant as someone with a psychiatric disorder to take something like Ambien. It seems treating the main problem whatever it is -- Panic, GAD, depression, bipolar, OCD, etc. is first and foremost.
Ambien is very specifically for one symptom -- insomnia.
PPPS, LOL
Disclaimer:
"I don't necessarily agree with everything I say."
Marshall McLuhan
Crumbles, I'm neither discouraging nor encouraging you to take Ambien. In your case, I recall your DP/DR is less bothersome and you have higher anxiety.
Case by case basis. Risk benefit. Very confusing. Glad I'm not a doctor. I've been watching Discovery Health Channel -- the new REAL E.R. doctors. Holy Tomatoes what a job.
Disclaimer:
"I don't necessarily agree with everything I say."
Marshall McLuhan
Crumbles, I'm neither discouraging nor encouraging you to take Ambien. In your case, I recall your DP/DR is less bothersome and you have higher anxiety.
Case by case basis. Risk benefit. Very confusing. Glad I'm not a doctor. I've been watching Discovery Health Channel -- the new REAL E.R. doctors. Holy Tomatoes what a job.
G
Guest
·Love the Marshall McLuhan quote, lol
Personally, I think sleeping pills are a LONG term bad idea for dp patients.
There is something about the "half awake/half asleep" phase, the transition from sleeping to waking and vice versa that is oddly-activated in dp states. Partly, that's why napping is so freaky to us, and why we have such odd thoughts, etc. before falling asleep.
That normal "transition" needs to be strenghtened, not ignored. Sleeping pills push the mind FAST into sleep, i.e., 'knock you out' (sort of) and that removes the problem. However, it also removes the needed "exercise" of having to navigate the transition.
Again, my own personal theory. I am not a doctor. I don't even date one. grin
But I have seen DP/DR people use sleeping pills and then have a slow increase in episodic dp during the day. I also had personal bouts of it many many years ago and traced it to the kinds of problems above. NOT true for everyone. However, it is a theory that makes sense to me.
Personally, I think sleeping pills are a LONG term bad idea for dp patients.
There is something about the "half awake/half asleep" phase, the transition from sleeping to waking and vice versa that is oddly-activated in dp states. Partly, that's why napping is so freaky to us, and why we have such odd thoughts, etc. before falling asleep.
That normal "transition" needs to be strenghtened, not ignored. Sleeping pills push the mind FAST into sleep, i.e., 'knock you out' (sort of) and that removes the problem. However, it also removes the needed "exercise" of having to navigate the transition.
Again, my own personal theory. I am not a doctor. I don't even date one. grin
But I have seen DP/DR people use sleeping pills and then have a slow increase in episodic dp during the day. I also had personal bouts of it many many years ago and traced it to the kinds of problems above. NOT true for everyone. However, it is a theory that makes sense to me.
Trazadone is an old trycyclic that is now only used as a sleep aid. The dosage required to give an anti-depressant effect is so high that the patient would be put to sleep. Its prescribed over benzos/ambien because it is NOT ADDICTIVE. Benzos,booze, ambien all work on gaba. Trazadone does not negatively effect sleep stages like booze/benzos/ambien(all of these substances inhibit deep restorative sleep that is critical for mental and physical health). Lastly, Trazadone works on the serotogenic system which is the system in the brain that deals with sleep. This is the way it was explained to me by all of my doctors.
Id give trazadone a shot or maybe even 5htp. Ive read that melatonin levels increase dramatically when a person takes 5htp. I know since Ive taken it, Im ready for bed by 10.
Joe
Id give trazadone a shot or maybe even 5htp. Ive read that melatonin levels increase dramatically when a person takes 5htp. I know since Ive taken it, Im ready for bed by 10.
Joe
Joined
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723 Posts
i take l-tryptophan (which is the same as 5-htp) and it puts me right to sleep. if i'm really having a hard time i take the l-tryptophan and a shwig of nyquil.
Trazodone for Insomnia
Trazodone has consistently been found to significantly improve insomnia, with little tolerance developing to its hypnotic effect.22 Its actions on sleep have been hypothesized to be mediated through 5-HT2 serotonergic receptor antagonism23,24 or through alpha-adrenergic antagonism.25 Polysomnographic studies of patients with various kinds of insomnia have found that trazodone's main effect on sleep architecture is an increase in slow-wave (stages 3 and 4) sleep.26,27 Trazodone improves sleep not only in major depressive disorder28 and dysthymic disorder26 but also in chronic primary insomnia27 and in insomnia associated with other antidepressant medications such as SSRIs and monoamine oxidase inhibitors (MAOIs).2
The specific efficacy of trazodone in elderly patients' insomnia has received only limited systematic study. The report of Montgomery et al of trazodone in nine "poor sleepers" apparently included some elderly individuals,27 because their subjects' mean age was 61 years. These investigators found that trazodone improved subjective sleep quality, increased slow-wave sleep, and decreased arousal frequency by half. Kunik and colleagues found trazodone to be efficacious and well tolerated in 21 elderlypsychiatric inpatients treated for insomnia;21 in particular, there were no significant problems with daytime sedation or orthostatic hypotension. These findings are consistent with another group's results with normal geriatric subjects, in whom an acute dose of trazodone produced no impairment on most components of a battery of cognitive tasks.29
For treating insomnia in elderly patients, an appropriate starting dose of trazodone is 25 mg at bedtime, which can be increased if necessary by 25 mg per week. Most patients respond to 50 to 75 mg, and there is little need to increase the dose above 100 mg for this indication.
Trazodone has consistently been found to significantly improve insomnia, with little tolerance developing to its hypnotic effect.22 Its actions on sleep have been hypothesized to be mediated through 5-HT2 serotonergic receptor antagonism23,24 or through alpha-adrenergic antagonism.25 Polysomnographic studies of patients with various kinds of insomnia have found that trazodone's main effect on sleep architecture is an increase in slow-wave (stages 3 and 4) sleep.26,27 Trazodone improves sleep not only in major depressive disorder28 and dysthymic disorder26 but also in chronic primary insomnia27 and in insomnia associated with other antidepressant medications such as SSRIs and monoamine oxidase inhibitors (MAOIs).2
The specific efficacy of trazodone in elderly patients' insomnia has received only limited systematic study. The report of Montgomery et al of trazodone in nine "poor sleepers" apparently included some elderly individuals,27 because their subjects' mean age was 61 years. These investigators found that trazodone improved subjective sleep quality, increased slow-wave sleep, and decreased arousal frequency by half. Kunik and colleagues found trazodone to be efficacious and well tolerated in 21 elderlypsychiatric inpatients treated for insomnia;21 in particular, there were no significant problems with daytime sedation or orthostatic hypotension. These findings are consistent with another group's results with normal geriatric subjects, in whom an acute dose of trazodone produced no impairment on most components of a battery of cognitive tasks.29
For treating insomnia in elderly patients, an appropriate starting dose of trazodone is 25 mg at bedtime, which can be increased if necessary by 25 mg per week. Most patients respond to 50 to 75 mg, and there is little need to increase the dose above 100 mg for this indication.
Ambien and Lunesta, Sonata, yada are much newer and better and developed specifically for the treatment of insomnia.
Joe, my point is the med should fit the VERY specific diagnosis.
Insomnia ALONE in and of itself is now best treated by AMBIEN and
similar new meds you see on the market... i.e. of Rx drugs. See
the note under benzodiazepines. Ambien and the like have specific
properties. Antidepressants can disrupt the sleep cycle. Benzos
are for anxiety and cause extra symptoms as well.
I don't like the idea of AMBIEN, etc. or any "sleeping pill"for those of us here, however.
On Sleepdisorder Channel, a whole host of routine
changes, exercise and other homeopathic remedies are suggested
first before ANY medical treatment is instigated.
If I sneeze one more time I am going to jump off my balcony!!!
http://www.sleepdisorderchannel.net/insomnia/treatments.shtml#anti
Pharmacological Therapy
Current pharmacological therapy may include over-the-counter sleep
medications, antidepressants with sedative effects, and
benzodiazepines. Treatments specific to the conditions for which
they are indicated are discussed in their respective sections. A
general description follows.
Over-the-counter sleep medications
The vast majority of over-the-counter sleep aids contain
antihistamines, which are associated with drowsiness.
Unfortunately, they also tend to cause decreased memory and
concentration, dry mouth, morning sickness, blurred vision,
extended sedation, and constipation.
They are generally not recommended for the treatment of insomnia that is severe enough to require attention of a physician. And they should be avoided, especially, in cases of chronic insomnia.
Over-the-counter
medications, including the subvarieties of legal uppers and
stimulants that are typically available in gas stations and truck
stops, only provide temporary relief, if any, and may further
disrupt sleep over the long term.
Antidepressants
Many antidepressants have sedative side effects. These side
effects may be utilized in patients with depression and insomnia.
In fact, many widely used antidepressants, like Prozac?, actually
regulate sleep onset and duration for those who take them. Some
antidepressants may cause significant sedation in the morning.
Others, however, may affect rapid eye movement sleep (REM) and
disrupt sleep quality. Generally, they are used to treat the
depression causing insomnia; the side effect of causing drowsiness
is used to an advantage in helping with the insomnia.
Benzodiazepines
Benzodiazepines have been the most popularly prescribed hypnotic
(sleeping pill) for some time. There are a variety of them
currently available. The main difference among benzodiazepines is
length of effectiveness, or half life, in the body.
Longer-acting benzodiazepines cause a lot of carry-over morning
sedation, and shorter-acting benzodiazepines cause a higher
incidence of rebound insomnia after discontinuation. There is a
risk for developing drug dependency with long-term use in some
patients. Benzodiazepines can cause fatigue, dizziness, confusion,
falls, and blurred vision, especially in older people. Operating a
motor vehicle or heavy machinery may be hazardous when using this
type of medication.
****There are new drugs such as SONATA (zaleplon) and AMBIEN
(zolpidem) which interact with one of the benzodiazepine receptors
on cells that induce sleep. These two drugs are increasingly
being used to treat insomnia because of their rapid onset,
decreased residual effect the next morning, and low number and
severity of side effects.*****
Best,
D
The recommended treatment for INSOMNIA alone are the new Anti Insomnia medications. Anti-depressants in general affect sleep quality and are for insomnia secondary to depression. Benzos have the negative effects you note, Joe. More side effects as well.
Though Ambien, Lunestra, Sonata (don't those sound lovely and sleepy?, LOL) are apparently the choice for insomnia, I still don't recommend them for folks on the Board.
DP/DR are SYMPTOMS, not a specific disorder save for a few people.
The overall CAUSE THAT CAUSES DP/DR SYMPTOMS should be treated, and someone here with insomnia needs to be evaluated for the proper med. I have a problem with the anti-insomnia meds. Again other natural remedies are recommended first, including no napping, exercise, a set routine, etc.
IMHO and YMMV 8)
Best,
D
Joe, my point is the med should fit the VERY specific diagnosis.
Insomnia ALONE in and of itself is now best treated by AMBIEN and
similar new meds you see on the market... i.e. of Rx drugs. See
the note under benzodiazepines. Ambien and the like have specific
properties. Antidepressants can disrupt the sleep cycle. Benzos
are for anxiety and cause extra symptoms as well.
I don't like the idea of AMBIEN, etc. or any "sleeping pill"for those of us here, however.
On Sleepdisorder Channel, a whole host of routine
changes, exercise and other homeopathic remedies are suggested
first before ANY medical treatment is instigated.
If I sneeze one more time I am going to jump off my balcony!!!
http://www.sleepdisorderchannel.net/insomnia/treatments.shtml#anti
Pharmacological Therapy
Current pharmacological therapy may include over-the-counter sleep
medications, antidepressants with sedative effects, and
benzodiazepines. Treatments specific to the conditions for which
they are indicated are discussed in their respective sections. A
general description follows.
Over-the-counter sleep medications
The vast majority of over-the-counter sleep aids contain
antihistamines, which are associated with drowsiness.
Unfortunately, they also tend to cause decreased memory and
concentration, dry mouth, morning sickness, blurred vision,
extended sedation, and constipation.
They are generally not recommended for the treatment of insomnia that is severe enough to require attention of a physician. And they should be avoided, especially, in cases of chronic insomnia.
Over-the-counter
medications, including the subvarieties of legal uppers and
stimulants that are typically available in gas stations and truck
stops, only provide temporary relief, if any, and may further
disrupt sleep over the long term.
Antidepressants
Many antidepressants have sedative side effects. These side
effects may be utilized in patients with depression and insomnia.
In fact, many widely used antidepressants, like Prozac?, actually
regulate sleep onset and duration for those who take them. Some
antidepressants may cause significant sedation in the morning.
Others, however, may affect rapid eye movement sleep (REM) and
disrupt sleep quality. Generally, they are used to treat the
depression causing insomnia; the side effect of causing drowsiness
is used to an advantage in helping with the insomnia.
Benzodiazepines
Benzodiazepines have been the most popularly prescribed hypnotic
(sleeping pill) for some time. There are a variety of them
currently available. The main difference among benzodiazepines is
length of effectiveness, or half life, in the body.
Longer-acting benzodiazepines cause a lot of carry-over morning
sedation, and shorter-acting benzodiazepines cause a higher
incidence of rebound insomnia after discontinuation. There is a
risk for developing drug dependency with long-term use in some
patients. Benzodiazepines can cause fatigue, dizziness, confusion,
falls, and blurred vision, especially in older people. Operating a
motor vehicle or heavy machinery may be hazardous when using this
type of medication.
****There are new drugs such as SONATA (zaleplon) and AMBIEN
(zolpidem) which interact with one of the benzodiazepine receptors
on cells that induce sleep. These two drugs are increasingly
being used to treat insomnia because of their rapid onset,
decreased residual effect the next morning, and low number and
severity of side effects.*****
Best,
D
The recommended treatment for INSOMNIA alone are the new Anti Insomnia medications. Anti-depressants in general affect sleep quality and are for insomnia secondary to depression. Benzos have the negative effects you note, Joe. More side effects as well.
Though Ambien, Lunestra, Sonata (don't those sound lovely and sleepy?, LOL) are apparently the choice for insomnia, I still don't recommend them for folks on the Board.
DP/DR are SYMPTOMS, not a specific disorder save for a few people.
The overall CAUSE THAT CAUSES DP/DR SYMPTOMS should be treated, and someone here with insomnia needs to be evaluated for the proper med. I have a problem with the anti-insomnia meds. Again other natural remedies are recommended first, including no napping, exercise, a set routine, etc.
IMHO and YMMV 8)
Best,
D
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