Ambien and ESLD Question

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Angie1953
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Date Joined Jul 2011
Total Posts : 933
   Posted 9/15/2011 11:25 PM (GMT -7)   
Hi   First of all, I appreciate this forum and those on it have been and continue to be so supportative and informative.  Thanks for being here.
  Secondly, I have a question that has come up.  My hubby with ESLD went to Dr. on Monday and told the GP Dr. that he can't sleep (although it appears to me he sleeps alot, mostly in the daytime then he isn't too tired at night).  Dr. gave him a prescription for 10 mg of Ambien and he took one yesterday(I counted pills and he did only take one) at 9:00PM went to sleep and slept til 4:00AM (7 hours) when he came wildly stubbling out of the bedroom and went to the front door for no reason, all wild eyed and back to bed, then up 2 hours later..didn't make it to potty(first time ever), then back to bed until 2:00 this afternoon, up an hour and then asleep until about 2 hours ago (9 more hrs of sleep).  He is puffy in the face, not eating, bad tremors and weak.  Prior to taking the Ambien he was doing quite well, making his own meals, going for walks reading and now he just is in bed almost all day.
  The only thing that is different is the Ambien sleeping pill.  I took the bottle and until we figure out what happened and I talk to the Dr, I'm not giving him anymore.  Do any of you take Ambien to sleep?  Has anyone had a bad experience with Ambien?  Could he be allergic to it?  Hubby says he hallusinated and is so so very weak.  Any feedback or ideas would be helpful.  Thanks
Angie1953

hep93
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Date Joined Jul 2005
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   Posted 9/15/2011 11:56 PM (GMT -7)   

Ambien is a controlled substance, a Class IV drug.  It is a hypnotic and sedative.  It should be taken with caution in those with liver disease.  I had asked my GP for it and she refused (now I'm glad.)  She suggested Melatonin (over-the-counter) which occurs naturally in the body.  It was fine for couple of weeks and then I had to start taking more for it to work.  That resulted in really bad dreams.  She then put me on Trazodone, an antidepressant, though it doesn't have that effect in low doses.  I would recommend that he call the doctor's office, explain that he can't tolerate the Ambien, and ask if Melatonin or Trazodone would be better for him.  Meanwhile, ditch the Ambien.

Hugs,

Connie


hep93
Forum moderator - Hepatitis


"But that was yesterday, and I was a different person then."

Lewis Carroll, Alice in Wonderland

SadWife
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Date Joined Jan 2011
Total Posts : 321
   Posted 9/16/2011 2:40 PM (GMT -7)   
It's funny how everyone reacts differently to medications. My husband was on Librium 25 mg, Ambien 10 mg, and melatonin (5 pills) I think they are 5 mg each (can't remember) and it took all that to just get him to sleep every night. Most of the time it was 2 or 3 am before he would get sleepy and he took all these pills by 9:30 every night. The Doctor will probably try him on different things before he finds what will work for him. In the meantime, I agree with Connie, no Ambien. Sounds like it's definitely not for him!
Good Luck!

Angie1953
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Date Joined Jul 2011
Total Posts : 933
   Posted 9/17/2011 5:44 PM (GMT -7)   
Connie & Sadwife,
Thanks for the input regarding the Ambien. Will take your advise and contact the Dr. and no more of this for hubby.
Angie1953

blonde504
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Date Joined Aug 2011
Total Posts : 449
   Posted 9/17/2011 7:31 PM (GMT -7)   
Yikes ..I've heard of healthy people having bad reactions to to that med ....I know many people who take melatonin ..which is more natural . Luckily my husband hadn't had any major problems with sleeping..hope doc can find something that works for your husband.
Blonde504 aka Elle

cable poodle
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Date Joined May 2011
Total Posts : 491
   Posted 9/17/2011 7:39 PM (GMT -7)   
Angie,
Contacting the doctor is the best idea. With medications, my husband has to be very careful. He has been prescribed histamine blockers, for the itching . . strong benadryl, and for 2 days he is out of it, groggy, sleepy, just blah. His liver processes so slowly that the meds stay in his system alot longer. He doesn't get much sleep at night either, and it does seem like he sleeps alot during the day. He is either cramping or itching all night. He won't take the anithistamine . . he hates the way it makes him feel, and it doesn't stop the itching!!

Ambien has alot of side affects, sleep walking and nightmares are a few of them. Hopefully the doctor can find something to help without all the side affects.

Good Luck!!

Debbie

**David**
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   Posted 9/18/2011 9:29 AM (GMT -7)   
Now for the other side... I had problems sleeping (for years) when my liver was failing. I was prescribed Ambien. It was like magic. I slept wonderfully and never had any bad effects from it. I know that many people have had problems with it, but for me, it was the difference between sleeping all night and barely sleeping.
Have a nice day!

mer
Veteran Member


Date Joined Aug 2008
Total Posts : 613
   Posted 9/18/2011 9:51 AM (GMT -7)   
My hubby was prescribed Ambien to help him sleep and I will say that it contributed to his HE issues, so the doctor refuses to give it to him any more.

I hope you can find a good balance

Mer

DDMom
Regular Member


Date Joined Apr 2010
Total Posts : 165
   Posted 9/18/2011 10:07 AM (GMT -7)   
My husband has taken Ambien for years and he has definitely had sleeping problem since treatment. We just talked to the doctor on the 6th of this month about his sleeping problem. He said it is normal for liver patients to have problems with there sleep and that encephalopathy is why the sleeping is backward, as in sleep all day and up all night. His doctor said that most patients are prescribed Trazadone but unfortunately my husband is allergic to it.

Maybe try cutting down the ambien to 1/2 of what he was prescribed and see how he does but Ambien can cause sleep walking and eating and not remembering it in some people. Like David Ambien has worked great until this last year when it doesn't seem to work as well but if he doesn't take it he won't sleep for days. Any sleeping pills or Xanan or any drug in that same field will be hard on a liver patient and can cause encephalopathy to become worse if you have it.

Last night my husband was up till 6 this morning but went to bed at 12:30, he read a book and it didn't help. He went to sleep at 7 A.M. and will sleep until 2 or 3 p.m. We don't like this at all but we have tried everything. You name it we've tried it. We went to the sleep doctor and he said there isn't much we can do but let him sleep when he can....he does sleep sooner or later but it sucks!!

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 9/18/2011 12:08 PM (GMT -7)   
"...encephalopathy is why the sleeping is backward."

I don't have encephalopathy, so that explanation doesn't hold up. But it does seem that most people with liver disease have sleep problems and days and nights mixed up.

Hugs,
Connie
hep93
Forum moderator - Hepatitis


"But that was yesterday, and I was a different person then."

Lewis Carroll, Alice in Wonderland

MamaLama
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Date Joined Oct 2010
Total Posts : 4030
   Posted 9/18/2011 12:31 PM (GMT -7)   
Sometimes I think the notion of the sleeping being backwards isn't 100% right.
 
For Mike it seemed to HIM he was backwards...sleeping much of the day and wakeful at night.
 
But I think he napped 24/7...often long deep naps during the day, and long deep naps at night also. But every few hours he was up for some time.  Minutes or hours.   In the middle of the night those wakeful periods must have felt like being "up all night!"
 
During this set back Mike seemed to be sleeping in bed about 16 hours a day.  He was awake from 6-8 AM, 11AM - 1PM, 4PM - 8PM...but he was likely up a bit in the night while I was sawing zzzzz's also.
 
Carol

Post Edited (MamaLama) : 9/18/2011 12:35:03 PM (GMT-6)


DDMom
Regular Member


Date Joined Apr 2010
Total Posts : 165
   Posted 9/18/2011 12:32 PM (GMT -7)   
I know Connie that sounded a little strange to me as well but that is what he said.....maybe he meant people who have encephalopathy usually have the sleep problem as well but that isn't how he said it. Who knows I feel like I walk around in a haze most of the time.....and I don't have encephalopathy:)

DDMom
Kathy and Dennis

cable poodle
Regular Member


Date Joined May 2011
Total Posts : 491
   Posted 9/18/2011 4:58 PM (GMT -7)   
Carol. I agree. My husband tells me "I got no sleep last night, i was cramping and itching all night" I get up several times a night to check on him and he is asleep, and he sleeps during the day. Naps, like you said. Strong snoring naps. I won't wake him unless he has an appointment or something very important, because I know he feels like he is getting no sleep, and he is exhausted.

Debbie

Pink Grandma
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Date Joined Nov 2006
Total Posts : 2445
   Posted 9/18/2011 5:14 PM (GMT -7)   
That's probably part of the issue.....they are exhausted all the time so it feels like to them that they are not sleeping at all at night. Same thing with my husband.......swore up and down that he didn't sleep but his snoring kept me awake so I know he was sleeping at least most of of the night. He had Trazadone also but didn't take it but a couple of times. He wouldn't take anything for pain either until the end.

Thoughts and prayers......
Pink Grandma
Forum moderator-Hepatitis

When the going gets tough....the tough get going! Don't always know where I going but I get there anyways.

Angie1953
Veteran Member


Date Joined Jul 2011
Total Posts : 933
   Posted 9/18/2011 10:10 PM (GMT -7)   
This is very helpful.  I really didn't think of hubby's complaints of "not sleeping" could be because he feels so tired all the time.  When he told the Dr. he couldn't sleep, I was stunned because to me that seems like that is all he does do.  But, now that I think about it, it does make sense that he feels tired all the time and assumes he isn't sleeping...also my hubby's memory is failing and getting worse all the time and he likely can't remember one day (or night) from another and can't recall if he sleep....all he knows is that he is so tired.
  Also, because of his years of taking care of elephants, (way before he was ill) his nightly schedule was to get up at midnight, and 3:00 and 6:00 to check the elephants.  He has always continued to follow that schedule even though he hasn't cared for elephants for 7-8 years.  But he has forgotten that was always his schedule.  I remind him, but by the next day, he has forgotten again.
  Thanks for the insight.  This is helpful for us as we stagger down this road we wish we didn't have to take. 
Angie1953

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 9/18/2011 11:27 PM (GMT -7)   
I don't usually nap during the day, unless I've had to get up really early and just can't keep my eyes open by 6 or 7 PM. I am exhausted 24/7. On nights wjere I am up every hour or two, I feel as though I haven't slept at all. I've been lucky lately to get a straight 6 hours...get up and go to bathroom, and back to sleep for another 4-6 hours. When I've slept for uninterrupted periods of time, the fatigue is much less....but it's always there. It's not like a normal person would feel after only 8-9 hours of uninterrupted sleep.

Hugs,
Connie
hep93
Forum moderator - Hepatitis


"But that was yesterday, and I was a different person then."

Lewis Carroll, Alice in Wonderland

Post Edited (hep93) : 9/19/2011 1:25:11 PM (GMT-6)


bostonmike
Regular Member


Date Joined Jan 2010
Total Posts : 166
   Posted 9/19/2011 12:55 PM (GMT -7)   
cool  My doc prescribed me 10, 1 mg. Ativan to use when Anxiety would set in when laying down and trying to sleep. It used to happen to me once in a while. Ativan is supposed to be easier on the cirrhotic liver than other benzos. I was worried about the ammonia build-up so I switched to Trazadone which is non-addicting. It may dry you out, especially the next morning, but if your desperately seekiing SNOOZING, Traz might be the safe bet. I use 25 mg.'s when I am having sleeping problems. On the other hand, when you have this disease it can be very stressful physdically, mentally, psychologically and spiritually for the person who has it and the caretaker. I prefer not to sleep during the day, so I will not be up all night. Others sleep just to cope with this nightmare. There is nothing wrong with that, but abusing benzos might cause one to spiral into the ER. BostonMike.

hep93
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Date Joined Jul 2005
Total Posts : 12014
   Posted 9/19/2011 1:31 PM (GMT -7)   

Mike, Ativan is highly addictive, so I'm glad you changed to Trazodone.  I'm amazed, though, that you get by on 25 mg.  I take 100 mg and sometimes 125.  I started out at 50 mg, but quickly built up a tolerance.  However, as you said, it's not addictive.  I also take 10 mg of Flexeril at night.

Hugs,

Connie

 


hep93
Forum moderator - Hepatitis


"But that was yesterday, and I was a different person then."

Lewis Carroll, Alice in Wonderland

bostonmike
Regular Member


Date Joined Jan 2010
Total Posts : 166
   Posted 9/19/2011 2:49 PM (GMT -7)   
Flexeril, does that help with cramping? Connie, that was going to my next question. The hospital gave that to my girl when she was in a minor fender bender with her car. Is Flexeril O.K. to take with liver disease? Then why is my doc prescribing Quinnalon (Quinine)  for my cramps? I would rather take Flexeril if it is less harmful and works better. I have been taking Quinnalon for 1.5 years or longer and lately I still wake up with cramps in the middle of the night.I called my hepatologist this morning. He usually calls me after 6:00 P.M. for non-emergency calls. I,m going to ask him about the Fexeril. Plus my insurance does not want to pay for the Quinnalon, so every 3 or 4 months there is a refill, there is a problem.

**David**
Veteran Member


Date Joined Nov 2009
Total Posts : 3404
   Posted 9/19/2011 3:45 PM (GMT -7)   
I no longer take Ambien, as BC/BS only pays for 14 pills a month, meaning I had nothing for the other 14 days. I changed to trazadone, which worked well at 50 mg. for a while, then I needed 100 mg.. Now I take 150 mg. and it sort of helps. The quinalon sp. is very expensive, so that's why they're hassling you every few months. When I took it, my co pay was the same as that of xifaxin. Only one company makes quinalon, so they charge whatever they want. My pharmacist said that when it was over-the-counter, it cost less than $20 a month. Now it lists at over $200 a month and it's prescription. Typical drug company rip off.

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 9/19/2011 6:55 PM (GMT -7)   
Mike, Flexeril is a muscle relaxant. It is usually taken 3 x a day. My hep doc and transplant team are fine with me taking it, though I only take 1 and sometimes 2 a night. You could try it along with the Trazodone and it might help you. Ask Veysey about it.

Hugs,
Connie
hep93
Forum moderator - Hepatitis


"But that was yesterday, and I was a different person then."

Lewis Carroll, Alice in Wonderland
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