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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by jerrympls on October 9, 2004, at 1:03:42
I've been on and off various benzos for the past 13 years. When they first put me on Klonopin I couldn't stay awake - same with Xanax, Ativan, etc. Same with Ambien (even tho it really *isn't* a benzo).
Now, I take 5mg of Xanax XR at night and nothing. I'm still up until 4am. I was on 50 mg of Valium - but nothing - could barely tell I was taking it.
My friend who is being treated for depression and has been for about 10 years - takes 2mg of Xanax and is OUT COLD 20mins later. I'm SO full of envy!!
So what's the deal? Is my brain just too used to benzos? Does my body metabolize them very very rapidly? I want to be able to take 2mg of Xanax and be able to sleep soundly all night!!!
Anyone have any insight???
Jerry
Posted by Shadowplayers721 on October 9, 2004, at 1:38:20
In reply to I no longer respond to benzos. Need some insight., posted by jerrympls on October 9, 2004, at 1:03:42
It sounds like your body has built a tolerance to the medication.
Posted by Daniel Woodfield on October 9, 2004, at 3:32:11
In reply to I no longer respond to benzos. Need some insight., posted by jerrympls on October 9, 2004, at 1:03:42
You could try the proper hypnotics if you want to use the medication for sleep issues.
The benzos you mention are used for anxiety and wouldn't really be prescribed as first line sleeping pills (except ambien, but ambien has never worked for me either).
In the UK there is a sleeping pill called Zopiclone, (i forget the generic name), and that used to knock me for six. Unfortunately i used to have a bit of a hangover in the morning with those, but i do with the anxiety Benzos also so.....
Posted by Racer on October 9, 2004, at 10:12:19
In reply to I no longer respond to benzos. Need some insight., posted by jerrympls on October 9, 2004, at 1:03:42
I don't have any real insight into why this happened with me, but I have a similar story to tell, which might shed some light.
I was taking Xanax for sleep for about six months or so, and it worked a charm -- except for leaving me more depressed the next day, which I didn't really realize until later, since my depression was not even close to being controlled at the time. Then I had a reaction to another medication, and the Xanax stopped working entirely. I was up most of every night, racing thoughts, jerking muscles, really miserable. I tried taking more Xanax, but it didn't help, so I stopped all meds.
A while later, the Xanax worked again, but the next time something happened that left me overstressed, I took some Xanax -- and, again, nothing. So, I took more. Well, something happened then: it was like an alcoholic blackout. My mind was just gone, but I was up and about and hysterical. It was terrible! (Because I was so out of it in a marriage counseling session, our counselor called the police who took me to the psych ward, where they nearly put me in restraints. I had gone from "out of it" to yelling and swearing by the time they got me there -- I think because of being grabbed and handcuffed by the police.) At any rate, I don't remember much of any of this, because I had taken so much Xanax.
I was told that the Xanax was working -- thus the blackout -- but that it was not calming me down. Xanax is apparently a very clean drug, in that it hits one receptor in the brain, and that's it. So, in my case, it hit that receptor, did it's little bit there, shut down my brain. The problem is, that part of my brain wasn't part of the whole upset in my system from the stress. My adrenaline was up so high, hitting a receptor in the brain to reduce anxiety wasn't going to make much difference.
If you, like me, have a more physical -- and less psychological -- reaction to anxiety, and experience insomnia as a result, then benzos may not be the best way to go. After that incident, I was prescribed propranalol for anxiety, and it's been a great choice for me. It reduces the physical symptoms enough that I can function much better. Doesn't do a thing about sleep, although the reduction in anxiety helps a bit.
As for sleep, I can't tell you what might help. I haven't really found anything yet myself, although I also haven't asked about it yet. One option, by the way, is Benadryl. It will make you drowsy. In the past, I've taken cyproheptidine for SSRI induced anorgasmia, and that worked well for sleep, too. (Just meant no morning or afternoon sex unless I could nap...)
I hope that helped some. Best luck.
Posted by jerrympls on October 9, 2004, at 16:21:05
In reply to Re: I no longer respond to benzos. Need some insight., posted by Daniel Woodfield on October 9, 2004, at 3:32:11
> You could try the proper hypnotics if you want to use the medication for sleep issues.
>
> The benzos you mention are used for anxiety and wouldn't really be prescribed as first line sleeping pills (except ambien, but ambien has never worked for me either).
>
> In the UK there is a sleeping pill called Zopiclone, (i forget the generic name), and that used to knock me for six. Unfortunately i used to have a bit of a hangover in the morning with those, but i do with the anxiety Benzos also so.....
Hi Daniel-Docs over here think that .5mg of Ativan is just fine for sleep. They underprescribe benzos mostly. I think my receptors are just too saturated from chronic use of benzos over the past 13 years. However, I haven't been on them constantly for 13 years - but it seems certainly enough to have grown quite a tolerance.
Zopiclone is soon to be released in the US under the name ESTORRA. Ambien used to work SO well for me for sleep. I've been taking time off of it to see if a drug holiday will allow it to work for me again. I can't stand Trazadone! UGH - the WORST AD used for sleep - nightmares and terrible hangover.
Thanks!
Jerry
Posted by zeugma on October 10, 2004, at 7:40:19
In reply to I no longer respond to benzos. Need some insight., posted by jerrympls on October 9, 2004, at 1:03:42
Tolerance to the sedative effects of benzodiazepines is a well-known phenomenon. That is one reason (not the only one) that they are not recommended for long-term insomnia.
The other reason they are not ideal for long-term sleep use is that they block slow wave sleep. There is apparently some controversy over this, and Dr. Paul Cheney, who is a great advocate of klonopin, says this is a myth. (Sorry, I am writing this from memory and too tired to dig up a link.) Cheny treats fibromyalgia patients who often experience chronic sleep difficulties. If I understand Cheney's practice, however, as opposed to his false claim about clonazepam, it is this: He advocates simulatneous use of low doses of doxepin, which enhances restorative sleep and would counteract the block on SWS from Klonopin. The articles I have read on long-term treatment of insomnia all come to a similar conclusion: "although more study is needed" (everything in psychiatry comes with this irritating disclaimer), TCA's such as doxepin or amitriptyline induce little tolerance and actually seem to correct the hypothesized HPA axis dysregulation that causes the insomnia in the first place. The reason these studies are buried in obscure academic journals is because they have been off patent for decades and psychiatry is more business practice than medicine. Have you tried TCA's for your sleep problems?
-z
Posted by jerrympls on October 10, 2004, at 14:15:27
In reply to Re: I no longer respond to benzos. Need some insight. » jerrympls, posted by zeugma on October 10, 2004, at 7:40:19
I'm sorry y'all - my original post wasn't correct. I meant the point to be that even if I take benzos during the day for anxiety I can't feel any effect - or if they're working. I take the Xanax at night not for a sleeping pill, but for night anxiety. I'm trying to discover if my benzo receptors are too saturated or too "used to" benzos - so they don't effect me as well or if I metabolize them too quickly after having been on and off of them for over 112 years.
Does that help clarify? Sometimes I have trouble getting to the point. However, yes, I do still have terrible insomnia and the example I gave about my friend falling asleep on 2mg of Xanax and me being awake all night on 5mg was just and example of how tolerant I must have become to benzos.
Thanks for all of your replies thus far!!!
Jerry
Posted by Guy on October 10, 2004, at 22:06:20
In reply to I no longer respond to benzos. Need some insight., posted by jerrympls on October 9, 2004, at 1:03:42
If you have terrible insomnia and feel the benzos are no longer working, why not try switching to Zyprexa. This should help you sleep and let you wean comfortably off the benzos.
This is the end of the thread.
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