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Re: clomipramine insomnia - does it ever go away? » TriedEveryMedication

Posted by SLS on January 28, 2023, at 11:28:14

In reply to Re: clomipramine insomnia - does it ever go away? » undopaminergic, posted by TriedEveryMedication on January 27, 2023, at 16:56:02

>
> > What about alprazolam? There is some evidence that it has antidepressant effects.
> >
> > How do you react to antihistamines? Or melatonin?
> >
> > -undopaminergic
> >
>
> It's funny, antihistamines like hydroxyzine do not put me to sleep. They used to, but it seems like I have a permanent tolerance to them now. I've noticed nothing with melatonin. I'll ask my doc about alprazolam. Thank you

1. If the problem you are addressing is severe anxiety, then alprazolam is a good choice. If, however, your anxiety is no worse than moderate, lorazepam (Ativan) might be a better choice. It is rather neutral with respect to mood, and allows for clearer thinking. Clonazepam is sometimes used. If the anxiety is provoked by social situations, Nardil is probably the most effective medication. However, it comes with risks for which one must follow dietetic and drug restrictions. Paroxetine (Paxil) is usually the SSRI best suited to treating chronic anxiety, including Generalized Anxiety Disorder (GAD).

2. If insomnia is the problem you are addressing, there are several medications that would probably give favorable results.

zolpidem (Ambien) - Z-drug
lorazepam (Ativan) - benzodiazepine
temazepam (Restoril) - benzodiazepine
clonazepam (Klonopin) - benzodiazepine
quetiapine (Seroquel) - antipsychotic
mirtazepine (Remeron) - antidepressant
doxepin (Sinequan) - antidepressant (TCA) - Extremely antihistaminergic
amitriptyline (Elavil) - antidepressant (TCA)
trimipramine (Surmontil) - antidepressant (TCA)
prazosin (Minipress) - Specific for PTSD nightmares.

I prefer Z-drugs. If you ever need to discontinue Ambien, you can do so abruptly without having typical benzodiazepine withdrawal reactions. Insomnia can be a withdrawal reaction. For me, I had only partial insomnia as a withdrawal reaction to Ambien discontinuation. This might not be true of everyone. Zolpidem and triazolam (Halcion) are good for initial-insomnia while temazepam is good for sleep-maintenance. Many people like low-dosage quetiapine for both types of insomnia.

About melatonin:

1. Melatonin can make depression somewhat worse.

2. The optimum timing of melantonin dosing varies between individuals. Most people find that 1 hour before bedtime works well. Yet, there are people who sleep much better when melatonin is given in the afternoon.

3. Herbal teas. Valerian is mentioned often. Chamomile, lemon grass, and eleuthero are others with reputations as being sleep-aids.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.

 

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