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To Take Sleep Meds Or Not? That Is The Question.

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#1 magenta

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Posted 25 March 2012 - 05:23 AM

"The Case for Sleep Medicine," an opinion piece that ran in the New York Times.

Edited by Blue Heron, 30 March 2012 - 11:58 AM.
embedded the link

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#2 Simba Cub

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Posted 28 March 2012 - 12:42 PM

In my opinion, sleep medications (or "Z drugs" such as Zopiclone) should be used sparingly. Strictly speaking they should NOT be taken for more than a week as their efficiency wanes and habituation increases dramatically. If you really need more than a week of sleeping blitz, you'd probably have to switch meds half way through.

Respect these meds.



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Diagnosed with: Schizoaffective Disorder of the Depressive Type; Panic; GAD; OCD; PTSD; Transient Ischaemic Attacks

Experience in: Alprazolam, Aripiprazole, Bupropion, Chlordiazepoxide, Citalopram, Clonazepam, Clozapine, Dothiepin, Duloxetine, ECT, EMDR, Fluoxetine, Imipramine, Lamotrigine, Lithium, Lorazepam, Mirtazapine, Moclobemide, Olanzapine, Paroxetine, Procyclidine, Propranolol, Quetiapine, Reboxetine, Risperidone, Sertraline, Sodium Valproate, Tranylcypromine, Trifluoperazine, Venlafaxine, Zolpidem, Zopiclone.



#3 Claire

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Posted 30 March 2012 - 11:32 AM

I am Rx'd either Zopiclone or Tamazepam then a night off as a cycle. I've been taking it for nearly a year now with no increase in dosages or wane in efficacy. I am trying to have two nights off per cycle for the last two months as I have been frequently told here that they are for short term use and I'll suffer dreadfully coming off them - indeed my pdoc wants me off them as soon as I am stable. I don't see why - honestly. I don't abuse them, I just get 6-7 hours of sleep which goes a long way to making me as stable as possible. Surely this is a better option than using copious amounts of antihistamines or nytol etc?
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Somedays, it's simply not worth chewing through the restraints...



Previously Rx'd
Moclobemide - Pooped out on second attempt.
Abilify - Flipped me out X2
Zopiclone - mmmmm sleep...
Prozac/Fluoxetine - Mania
Effexor/Venaflaxine - Migraines and Mania
Lofepramine - Ridiculous sweating, but did work Pdoc says all tricyclics will have same effect
Lithium
Sodium valproate
Cymbalta - sugar pills
Tegretol (UGH!!)

#4 notfred

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Posted 30 March 2012 - 11:52 AM

I have 5 years under my belt with taking 6 mg Lunesta every night. It still works as well as it did when I started. I find it easy to get off of, I have had to do this a few times due to insurance problems.
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I am in full remission (296.36) from Depression. Insomnia, ADHD-PI, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.

 

Psyc Meds: Forfivo XL 450 mg (Wellbutrin XL), Abilify 15 mg, Eszopiclone 6 mg (Lunesta), Vyvance 70 mg, Levetiracetam 2,000 mg (Keppra), Propranolol ER 60 mg (Inderal)
PRN: Lorazepam 1-4 mg (Ativan), Alprazolam 1-2 mg (Xanax), Dextroamphetamine 10-40 mg (Dexedrine), Propranolol 20-40 mg (Inderal)

Supps: Multi-vitamin/mineral, Vitamin D 2,000 IU, Fish oil 7.2 g

Dx: Depression, Insomnia, ADHD-PI, Epilepsy, Dyspraxia, Tremor

I also take allergy and diabetes + it's complications meds.

All doses are a daily total.


#5 VAL

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Posted 30 March 2012 - 01:05 PM

Notfred,

I've always wondered why you're not fred but putting that aside, does Lunesta have the same reputation as Ambien for the sleep walking, eating, driving, etc.? I'm considering it as a possibility as I'll probably be coming off Saphris soon
and I don't know if going back on trazodone is going to do it for me and I'll definitely need something. Ambien made me quite depressed very rapidly after starting it and I was wondering if Lunesta is likely to do the same thing or if it's different enough to give it a try if the Traz doesn't work out.
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Current Meds: Lamictal 325mg, Wellbutrin XL 450mg, Neurontin 900mg, Klonopin 1.5mg, Saphris 10mg, Trazodone up to 200mg, Prozosin 2mg, Zyprexa 5mg PRN and Inderal 20mg PRN
Past Meds: Siniquan, Elavil, Imipramine, Zoloft, Seroquel, Abilify, Nardil, Emsam, Rozerem and Ambien
Current Non-psych: Soma 350mg PRN, Norco 10mg/325 PRN, Percocet 10mg/325 PRN, Advair, Nasonex, Ventolin PRN, Allegra, Avalide, Dexilant, Levothroxine, Pravachol


#6 notfred

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Posted 30 March 2012 - 01:41 PM

does Lunesta have the same reputation as Ambien for the sleep walking, eating, driving, etc.?


Yes, some people have that reaction. I think it is common to all the Z meds. Still it is different enough that it is worth a try. Unlike most of the Z meds Lunesta is longer acting and is more effective for those who can't stay asleep or wake up too early. The main drawback is that insurance generally does not cover it and it is hideously expensive at retail. It is also relatively weak, I would not worry with the 1mg and 2 mg tablets.

I have severe complex sleep apnea which causes numerous awakenings per hour. Conventional treatments have failed so sleep meds have become reasonable treatments. I have especially no stage 3 sleep due to the apnea, just stage 1,2 and REM sleep. Still I wake up feeling rested with no hangover from the Lunesta.
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I am in full remission (296.36) from Depression. Insomnia, ADHD-PI, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.

 

Psyc Meds: Forfivo XL 450 mg (Wellbutrin XL), Abilify 15 mg, Eszopiclone 6 mg (Lunesta), Vyvance 70 mg, Levetiracetam 2,000 mg (Keppra), Propranolol ER 60 mg (Inderal)
PRN: Lorazepam 1-4 mg (Ativan), Alprazolam 1-2 mg (Xanax), Dextroamphetamine 10-40 mg (Dexedrine), Propranolol 20-40 mg (Inderal)

Supps: Multi-vitamin/mineral, Vitamin D 2,000 IU, Fish oil 7.2 g

Dx: Depression, Insomnia, ADHD-PI, Epilepsy, Dyspraxia, Tremor

I also take allergy and diabetes + it's complications meds.

All doses are a daily total.


#7 VAL

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Posted 31 March 2012 - 12:28 PM

There are no free meds available but there is a patient assistance program with reasonable prices $20-40 for 90 days. I can also get a free 7 day prescription if I decide to try it. Thanks for replying.
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Current Meds: Lamictal 325mg, Wellbutrin XL 450mg, Neurontin 900mg, Klonopin 1.5mg, Saphris 10mg, Trazodone up to 200mg, Prozosin 2mg, Zyprexa 5mg PRN and Inderal 20mg PRN
Past Meds: Siniquan, Elavil, Imipramine, Zoloft, Seroquel, Abilify, Nardil, Emsam, Rozerem and Ambien
Current Non-psych: Soma 350mg PRN, Norco 10mg/325 PRN, Percocet 10mg/325 PRN, Advair, Nasonex, Ventolin PRN, Allegra, Avalide, Dexilant, Levothroxine, Pravachol


#8 notfred

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Posted 31 March 2012 - 01:06 PM

I have insurance that covers it with a pre-auth. It can be a fight as I take twice the max dosage. I always win, though.
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I am in full remission (296.36) from Depression. Insomnia, ADHD-PI, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.

 

Psyc Meds: Forfivo XL 450 mg (Wellbutrin XL), Abilify 15 mg, Eszopiclone 6 mg (Lunesta), Vyvance 70 mg, Levetiracetam 2,000 mg (Keppra), Propranolol ER 60 mg (Inderal)
PRN: Lorazepam 1-4 mg (Ativan), Alprazolam 1-2 mg (Xanax), Dextroamphetamine 10-40 mg (Dexedrine), Propranolol 20-40 mg (Inderal)

Supps: Multi-vitamin/mineral, Vitamin D 2,000 IU, Fish oil 7.2 g

Dx: Depression, Insomnia, ADHD-PI, Epilepsy, Dyspraxia, Tremor

I also take allergy and diabetes + it's complications meds.

All doses are a daily total.


#9 facelessbelief

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Posted 31 March 2012 - 02:06 PM

I'm one of those that has problems sleeping no matter what cycle i am in. Up, Down, or Squirrelly I can never sleep well. I also have sleep apnea. Trazodone never did anything for me sleep wise. Even at 200mg. So now my pdoc has prescribed Ambien. Even with that wonderous sleep apnea machine. It is incredibly difficult for me to fall asleep. Hence the sleep meds. I will have to talk to my pdoc about what to do with the long-term of ambien.
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This is my fight. The disorder may have won a few battles. But I will and have to win the war. For it is a war against the worst kind of enemy..... Myself.

Previous Meds: Lamictal 200mg, Tegretol 200mg, Paxil, Trazodone 200mg, Wellbutrin, Prozac 20mg, Geodon 120mg.

#10 brainworms

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Posted 13 July 2012 - 10:24 PM

People who espouse the "sleeping medications should be used sparingly" school of thought never seem to have a concrete plan for what those of us who live with chronic, severe insomnia (and deal with the resulting damage to our mental and physical health) are supposed to actually do. Good sleep hygiene and herbal supplements don't even touch the side for most hardcore insomniacs. I agree with you that long term use of prescription sleeping medication isn't an ideal situation, but sleep is actually a vital need for humans to function. If the only way you can get it is to take a carcinogenic drug of dependance... well, sometimes the best option is actually a pretty cruddy one.
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Current crazymeds: 300mg Solian, 50mg Lamotrigine, 50mg Topiramate, 5mg Valium as needed.
Proposed crazymeds: 10mg Saphris, 50mg Lamotrigine, 50mg Topiramate, 5mg Valium as needed.
Current non crazymeds: Melatonin, Thyroxine, Levlen.
Past crazymeds: Epilim, Seroquel, Zoloft, Luvox, Aropax, Effexor, Edronax, Cypramil, Cymbalta, Xanax.

#11 notfred

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Posted 13 July 2012 - 10:56 PM

People who espouse the "sleeping medications should be used sparingly" school of thought never seem to have a concrete plan for what those of us who live with chronic, severe insomnia (and deal with the resulting damage to our mental and physical health) are supposed to actually do. Good sleep hygiene and herbal supplements don't even touch the side for most hardcore insomniacs. I agree with you that long term use of prescription sleeping medication isn't an ideal situation, but sleep is actually a vital need for humans to function. If the only way you can get it is to take a carcinogenic drug of dependance... well, sometimes the best option is actually a pretty cruddy one.


I agree. Despite a lot of people here who take them regularly without loosing efficiency people repeat the same stuff. It totally ignores people real experiences and reason for needing long term sleeping meds.
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I am in full remission (296.36) from Depression. Insomnia, ADHD-PI, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.

 

Psyc Meds: Forfivo XL 450 mg (Wellbutrin XL), Abilify 15 mg, Eszopiclone 6 mg (Lunesta), Vyvance 70 mg, Levetiracetam 2,000 mg (Keppra), Propranolol ER 60 mg (Inderal)
PRN: Lorazepam 1-4 mg (Ativan), Alprazolam 1-2 mg (Xanax), Dextroamphetamine 10-40 mg (Dexedrine), Propranolol 20-40 mg (Inderal)

Supps: Multi-vitamin/mineral, Vitamin D 2,000 IU, Fish oil 7.2 g

Dx: Depression, Insomnia, ADHD-PI, Epilepsy, Dyspraxia, Tremor

I also take allergy and diabetes + it's complications meds.

All doses are a daily total.


#12 sircuit

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Posted 09 October 2012 - 07:38 PM

Sleep is everything in the world if bipolarity. If you can`t sleep naturally, you must take something to knock you out. Plain and simple.
I have the luxury of taking Seroquel as a mood stablizer but it has a side benefit of knocking me out . I really have no choice. For me, no sleep brings on Mother Mania and that simply fucks up my life, big time. So you be the judge. Just how badly do you need to sleep ??
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#13 alittleunwell

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Posted 10 October 2012 - 04:37 AM

Good sleep hygiene and herbal supplements don't even touch the side for most hardcore insomniacs.


Tell me about it! Sometimes I feel like it must be my fault, like I should be able to go to sleep if I do everything they tell us to. I've been reading a lot lately about all the damage not getting enough sleep can cause. Not only making mental illnesses worse (or even causing depression), but causing weight gain and disrupting hormones. And once one hormone is out of whack, it affects others. This can lead to all sorts of illnesses. So now I'm trying to make a serious effort at getting enough sleep most nights, even if it means taking drugs. In past I've always used them as sparingly as I could, often going without sleep rather than take them, but sleep is way too important.
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Current meds: Paxil, Klonopin, Ambien
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#14 Velthir

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Posted 10 October 2012 - 04:52 AM

Tell me about it! Sometimes I feel like it must be my fault, like I should be able to go to sleep if I do everything they tell us to. I've been reading a lot lately about all the damage not getting enough sleep can cause. Not only making mental illnesses worse (or even causing depression), but causing weight gain and disrupting hormones. And once one hormone is out of whack, it affects others. This can lead to all sorts of illnesses. So now I'm trying to make a serious effort at getting enough sleep most nights, even if it means taking drugs. In past I've always used them as sparingly as I could, often going without sleep rather than take them, but sleep is way too important.


Yeah, speaking as someone who hasn't slept at all properly for months it's causing all sorts of physical issues. IBS type stuff + nausea in the mornings, pretty sure it's causing weight gain, when I get incredibly bad sleep for days I tend to develop a temporary cough until I start sleeping more. Probably some other weird shit I can't remember/don't notice anymore :P
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Dx: Dysthymia, recurrent treatment resistant depression, Bipolar II/III (antidepressant induced mixed states/hypomania)
Rx: 400 mg lamotrigine, 800 mg carbamazepine (Tegretol XR), 600 mg of bupropion SR (Wellbutrin)
Failed meds: Citalopram (Celexa), agomelatine (Valdoxan), lofepramine, mirtazapine (Remeron), sertraline (Zoloft), quetiapine (Seroquel), trimipramine (Surmontil)
Partial-success: duloxetine (Cymbalta), nortriptyline, moclobemide, aripiprazole (Abilify), reboxetine



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