I usually don't go off topic from Crohn's, but there's been some really significant progress in my continual battle against insomnia. And I thought some of you might find this info useful.
A few people on this forum have mentioned before that they have bad insomnia. I've had it most of my life, but as I've gotten older, it's worsened. After resisting the idea for years, I finally went out and got prescript
ion sleeping pills. These days, "sleeping pills" basically means either the benzodiazepines or the so-called Z-drugs:
These really do work well. Problem is, continuous use leads to building tolerance (requiring larger doses) and dependence (can't sleep without them). I never got to the stage of actual addiction, but I've read that can happen too, and the withdrawals are said to be terrible. So when taking these drugs, I take a minimum dose, and only use them for a few days. But after stopping, my insomnia is worse, and then I have to put up with a long period of sleepless nights, or seek alternative non-addictive drugs.
As for those "alternative non-addictive drugs," I've been doing a lot of research, and have come up with some useful info that I'd like to share.
Basically, the non-addictive drugs that can induce sleep are known as "H1 antagonists":
These can be subdivided into two important types: "first-generation antihistamines" and "first-generation antidepressants."
Both types have potential anticholinergic side-effects, but the severity differs considerably according to which drug you're taking. The ever useful Wikipedia has a page describing this phenomena:
Antihistamines are commonly used to induce sleep. They're non-addictive and most can be bought across the counter. The most sedating antihistamines I know of: hydroxyzine, meclizine and doxylamine succinate. In some countries, hydroxyzine is a prescript
ion drug. I've found that I can't take these every night, as they begin to lose affect (on me, at least) by the third or fourth night.
Antidepressants offer a rich and fertile ground for sleeping medications, which I've just begun to explore. You need to be more cautious here: the side-effects can, on occasion, be severe, even crippling. Also, not all the first-generation antidepressants are equally good for inducing sleep - some seem to be downright useless, or will even worsen your insomnia. Remember, antidepressants are being sold mainly for depression, and using them for a sleeping aid is an "off-label" use. But I have had some recent success with these drugs, which is why I'm posting this.
For myself, I've settled on Trazodone for the moment. For one thing, it's available where I live (Taiwan), not expensive, and has far fewer anticholinergic side-effects than most drugs of this class. I've been using it for only one week, but I'm very pleased with the results so far. I just hope the (very much wanted) drowsiness side-effect doesn't wear off with continual use.
Having explored the insomniacs' forums, another antidepressant that gets very good recommendations is Trimipramine:
Unfortunately, it is not available in Taiwan. I might be able to obtain it online, though that's a hassle and I hesitate to do battle with Customs. Trimipramine is a "tricyclc" drug, and as such one of the traits it has is increased appetite (and thus weight gain) as well as constipation. For many Crohn's sufferers, these side-effects might be welcome, but eating more can potentially make you more sick if your intestines are in bad shape.
So in conclusion, use with caution. Ideally, I wish I didn't need any sleeping medication. Maybe I should look forward to senility - my father-in-law is totally senile, and he sleeps like a baby.
Crohn's since 1988
Post Edited (ozonehole) : 3/23/2010 4:21:23 AM (GMT-6)