[OT] Antidepressant as a SLEEPING aid

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ozonehole
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Date Joined Dec 2006
Total Posts : 559
   Posted 3/23/2010 12:15 AM (GMT -7)   
Hi all,

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 prescription sleeping pills. These days, "sleeping pills" basically means either the benzodiazepines or the so-called Z-drugs:

http://en.wikipedia.org/wiki/Benzodiazepine

http://en.wikipedia.org/wiki/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":

http://en.wikipedia.org/wiki/H1_antagonist

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:

http://en.wikipedia.org/wiki/Anticholinergic

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 prescription 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.

http://en.wikipedia.org/wiki/Trazodone

Having explored the insomniacs' forums, another antidepressant that gets very good recommendations is Trimipramine:

http://en.wikipedia.org/wiki/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.

cheers,
Robert
Crohn's since 1988
3 resections

Post Edited (ozonehole) : 3/23/2010 4:21:23 AM (GMT-6)


ivy6
Elite Member


Date Joined Sep 2005
Total Posts : 10404
   Posted 3/23/2010 1:16 AM (GMT -7)   
Hi Robert,

You might be interested to know that low doses of antidepressants are often used in fibromyalgia treatment, at least partly because of their effectiveness as a sleeping aid. You might be able to learn more by reading up on fibromyalgia treatment.

It sounds to me as if you're researching these therapies themselves, and buying the medication for yourself without medical supervision or consultation? I don't like the sound of that... isn't there a professional over there who can help and advise you?

Be careful, at least, of seratonin syndrome. Please ask here or on the depression forum if you'd like to know more about SS. And PLEASE don't take Tramadol unless you know it's safe to do so with your anti-d. And don't chop and change meds too frequently without medical consultation - that can be dangerous.

All the best,

Ivy.
Co-Moderator Crohn's Forum.

Medications for Crohn's ~~ Diet and Nutritional Therapy for Crohn's ~~ Dealing with Abscesses and Fistulae ~~


getting by
Forum Moderator


Date Joined Sep 2007
Total Posts : 40602
   Posted 3/23/2010 4:40 AM (GMT -7)   
Hi Robert,

I am from the depression forum, and would like to suggest melatonin for sleep. It is a natural hormone that we stop producing in our bodies when we reach about 30. It really does work well for some people and it is over the counter medication. Another thing that I do is meditation. It works really good for falling to sleep and it is totally natural. You should think about that. No drugs with that method.

Esperimenting with different anti depressants can be dangerous. Certain ones work for certain people and I really think you should go to a doctor if you need them. Give the melatonin a try. Another good one is a tea called "sleepy time". It has natural relaxants in it and can really help with sleep.

I hope taht you get some rest soon. Check out the depression forum if you feel comfortable with that.

Hugs, Karen
  Moderator-Depression and fibromyalgia
 
fibromyalgia, Chronic fatigue, depression,allergies


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 3/23/2010 6:17 AM (GMT -7)   
I have to agree with the others here. I am also concerned about you doing this without medical supervision. Some of those drug if not used (and montitored) correctly can really cause some real issues.
Take Care,
Navy
Forum Co-moderator - Crohn's Disease/Thyroid Disorders:_All comments have the caveat contact your local health care provider.

I will find a way or make one. –Phillip Sidney 1554-1586

All that I am and all that I shall ever be, I owe to my Angel Mother.

The Bucket List- Have you found joy in your life?  Has your life brought joy to others?

Make sure your suffering has meaning…


CrohnieToo
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Date Joined May 2003
Total Posts : 9448
   Posted 3/23/2010 8:55 AM (GMT -7)   
Amen to the above. Even 1/2 the low dose of Trazodone scripted for sleep made me higher than a kite, body tingling all over and not much noticeable improvement in sleep. Pus you can NOT quit Trazodone cold turkey w/o great risk.
My computer says I need to upgrade my brain to be compatible with its new software.


Rider Fan
Veteran Member


Date Joined May 2008
Total Posts : 1445
   Posted 3/23/2010 8:59 AM (GMT -7)   
Robert, if Trimipramine isn't available in Taiwan, have you considered Amitriptyline? It's also a TCA and I've found it helpful in the past.

I have hydroxyzine and zopiclone by prescription and find them helpful, but I don't usually use them for more than a few days in a row.

Have considered trying cycling? That's when you use hydroxyzine for a few days, then say Amitriptyline for a couple and then a z-drug for a couple and then throw a day or two of using nothing if you're able. In this way some people are able to avoid dependence, since the TCA's and the z-drugs work in different ways. I'm not totally sure if anti-histamines and TCA's work different pathways with regards to sleep induction though. You can even throw a couple days of melatonin in there if it works for you.

I've never used Trazodone but it's also a popular one.

Of course you should discuss a plan such as this WITH A DOCTOR, since I'm not one! :)
33 y/o male. Dx'ed in 1999. No surgeries.

Current meds: Humira 2/27/09. Proferrin iron pills.

Tried SCD, didn't work, now avoiding gluten and dairy.


Go Saskatchewan Roughriders!


ozonehole
Veteran Member


Date Joined Dec 2006
Total Posts : 559
   Posted 3/23/2010 6:43 PM (GMT -7)   
Thanks to all for their comments. I guess I wasn't clear that I AM seeing a doctor. Apologies for that.

Yes, all these drugs have potential for side effects. Mixing them together is really dangerous, so its never good to be on more than one at a time. Ivy, I want to particularly thank you for bring up "seratonin syndrome", a term I hadn't heard before but I looked it up. The Wiki on that mentioned tramadol (a pain medication for which I have a prescription, though I seldom use it) as one drug that, when mixed with antidepressants, can trigger this dangerous reaction. I think I'll make it a hard rule now that I won't use tramadol as long as I'm using Trazodone - it's got to be one or the other.

I do know about melatonin. It's very safe, and can even be mixed with other drugs. Unfortunately, it's not very effective for me.

CrohnieToo said:
Amen to the above. Even 1/2 the low dose of Trazodone scripted for sleep made me higher than a kite, body tingling all over and not much noticeable improvement in sleep. Plus you can NOT quit Trazodone cold turkey w/o great risk

I don't doubt you. I've read several of the sleep/depression forums, and some people do react badly to these drugs. It seems to be a fairly small minority of people, but it happens. That's true for the drugs to treat us Crohnies - some people have terrible reactions, and there seems to be no way to predict this outcome until you've tried.

best regards,
Robert
Crohn's since 1988
3 resections


ivy6
Elite Member


Date Joined Sep 2005
Total Posts : 10404
   Posted 3/23/2010 7:37 PM (GMT -7)   
You also need to be very careful when switching from one med to another. I've been told that sometimes it can take a week or two for one antid to clear the system before it's safe to try another one. I think the clearance time depends on the med being stopped and the med being started, and whether the two are likely to react to one another.

My gastro specialist was very clear on the Tramadol. He said to NEVER ever let anyone give me one, even if in hospital, because he has seen people get into an awful, awful state with seratonin syndrome. In other words, Robert, don't even have one tablet, no matter how bad the pain gets. You might like to ask if you can switch to Endone or some other pain med instead.

Hope this helps,

Ivy.
Co-Moderator Crohn's Forum.

Medications for Crohn's ~~ Diet and Nutritional Therapy for Crohn's ~~ Dealing with Abscesses and Fistulae ~~


Grandpato2
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Date Joined Dec 2009
Total Posts : 681
   Posted 3/23/2010 10:16 PM (GMT -7)   
I was on non-addictive zioplicone for 8 years and when I finally detoxed off of it I couldn't get more than 3-4 hours sleep for 4 months. Thank you Dr. for that one, you idiot! Eventually a new family Dr. proscribed trazadone and I have not noticed any side effects from it yet. It only lasts a short time up to maybe 4 hours so you don't wake up groggy at all but it's great if you have trouble falling asleep. The trick is to take it then 10 minutes later eat something small like a few cookies and it triggers it quickly. I wasn't aware of the tramadol link though so thanks for that.


Male, 54 years old with Crohn's since 15 years old, diagnosed at age 46. Terminal ileum resected 2002. 5 months of remission. Crohn's has now been active since early 2003. Had a gall bladder removed Nov. of 2009. Currently on Remicade every 8 weeks, Nexium, Iron, B-12 injection every 4 weeks,5-asa Asacol, Morphine Sulfate as needed for pain. Cymbalta for long term pain control. 5-asa Salofalk, Entecort, Imuran and Prednisone in the past.


artist guy
Veteran Member


Date Joined Jan 2010
Total Posts : 1373
   Posted 3/23/2010 11:36 PM (GMT -7)   
I hate to confess to this but I take restoril 30mg x2 if i need to per nite i also take serax for anti anxiety, but i'll say this I know they are addicting but right now my sleep is so important to me that i willing to risk the addiction thing. later in my life i'll address it when i get close to retiring, but lack of sleep worsens my cd

artist guy


Howlyncat
Elite Member


Date Joined Jan 2005
Total Posts : 24909
   Posted 3/24/2010 5:11 AM (GMT -7)   
I also take trazadone 50 mgs at bedtime..i hv hot milk with it....lyn
Long Time Member of da Family

Crohns..Fibromyalgia,,Neuropathy...Deaf...Seizures Pyoderma gangrenosum


Co mod for Crohns...Anxiety/Panic and Alzheimers

lyn


artist guy
Veteran Member


Date Joined Jan 2010
Total Posts : 1373
   Posted 3/24/2010 11:37 AM (GMT -7)   
what family is trazadone in

artist guy


Rider Fan
Veteran Member


Date Joined May 2008
Total Posts : 1445
   Posted 3/24/2010 11:46 AM (GMT -7)   
Grandpato2 said...
I was on non-addictive zioplicone for 8 years and when I finally detoxed off of it I couldn't get more than 3-4 hours sleep for 4 months. Thank you Dr. for that one, you idiot! Eventually a new family Dr. proscribed trazadone and I have not noticed any side effects from it yet. It only lasts a short time up to maybe 4 hours so you don't wake up groggy at all but it's great if you have trouble falling asleep. The trick is to take it then 10 minutes later eat something small like a few cookies and it triggers it quickly. I wasn't aware of the tramadol link though so thanks for that.

Ya I was also addicted to this non-addictive drug at one point because my GP told me to use it every night.  Then when I tried to stop my dr insisted I couldn't be addicted.  That's when I learned there's a difference between 'addicted' and 'dependant'.  Oh well, live and learn.
33 y/o male. Dx'ed in 1999. No surgeries.

Current meds: Humira 2/27/09. Proferrin iron pills.

Tried SCD, didn't work, now avoiding gluten and dairy.


Go Saskatchewan Roughriders!


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 3/25/2010 6:05 AM (GMT -7)   
Shu Kei,
What are you training for?
Forum Co-moderator - Crohn's Disease/Thyroid Disorders:_All comments have the caveat contact your local health care provider.

I will find a way or make one. –Phillip Sidney 1554-1586

All that I am and all that I shall ever be, I owe to my Angel Mother.

The Bucket List- Have you found joy in your life?  Has your life brought joy to others?

Make sure your suffering has meaning…


ozonehole
Veteran Member


Date Joined Dec 2006
Total Posts : 559
   Posted 3/25/2010 7:04 AM (GMT -7)   
Moderator:

I believe "Shu Kei" (who created his character yesterday, has zero details in his profile, and only made one post) is a spammer. Google "G monster sleep aid" and the identical post appears all over the place, though most of the sites have already deleted the post (which of course contains a web address for buying the stuff, which I believe you've already deleted).

Example: identical post that has survived thus far:
http://www.videojug.com/user/michelfirth/discussions
Crohn's since 1988
3 resections


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 3/25/2010 7:15 AM (GMT -7)   
I have deleted her post as you are correct it is spam. Thx
Gail*Nanners* Co-Moderator for Crohns Disease & Anxiety/Panic
Crohn's Disease for over 34 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium, Vit D, and Xanax prn. Resections in 2002 & 2005. Also diagnosed w/ Fibromyalgia, Osteoarthritis, & Anxiety. Currently my Crohns is in remission, but my joints are going crazy!
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*
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