Question:
I WAS DIAGNOSED WITH PRIMARY INSOMNIA ABOUT 3 YEARS AGO- AFTER TRYING
VARIOUS NATURAL WAYS TO TREAT MY PROBLEM...HYPNOTHERAPY, BIOFEEDBACK,
MEDITATION,VARIOUS HOMEOPATHIC TREATMENTS, ETC. I FINALLY GAVE INTO THE
TRADITIONAL TREATMENT OF PRESCRIPTION MEDICATIONS. I'VE NOW BEEN
CONSISTENTLY ON SOME SORT OF DRUG FOR THREE YEARS STRAIGHT, WITH
VARYING RESULTS. I'M VERY NERVOUS ABOUT THE DAMAGE THIS MAY CAUSE MY
LIVER. IS THERE ANYONE OUT THERE WHO'S HAS HAD THE SAME PROBLEM AND
FOUND A DIFFERENT METHOD? IS THERE
ANYONE OUT THERE USING PRESCRIPTION MEDS THIS LONG? I'M CURRENTLY TAKING
15MG DALMANE AND 1 MG ATIVAN NIGHTLY.IS THIS TOO MUCH? IS THERE ANY
OTHER WAY?
Answer:
I've been rotating Xanax, Benadryl (same ingredient as Sominex) and
Ambien (and combinations of the three) for years to sleep (I switch
them periodically because they lose their effect after awhile and I'm
afraid of long-term side effects). I'm not a physician, but my feeling
regarding your situation is as follows:
1) If you can't sleep, tossing and turning all night is probably worse
for your system than meds prescribed by your doctor.
2) Prescription drugs are tested more than most "natural" remedies.
3) Get liver function tests from your internist every 6 months or so
(whatever he/she recommends).
4) Go to a shrink (if you haven't already) and check whether your
current meds are appropriate. If you already go to a shrink, check with
your internist to get a second opinion. (by the way, if you haven't
seen a psychiatrist because you think there's some sort of stigma to
it... it takes more guts to confront a problem that to ignore it. Why
live in pain?).
5) Go to one of the official sleep clinics in the US and get an
evaluation (just make sure they take your health insurance first -- if
not, they're usually willing to strike a deal). You can find a list of
accredited centers in the back of the book "The Promise of Sleep" by
William C. Dement, MD, PhD.
15mg of Dalmane, and 1mg of Atavan is a low dosage. 3 years is not that
long, I know people who take both for decades. Benzos are considered to
be quite unharmful to the liver and the kidneys (notice -quite-
unharmful, compared to other drugs, that is). But as somebody suggested,
an occasional test of your liver, and when you are on it anyway, of your
kidneys might be a good idea.
I am an insomniac since I can think (age 6 or so). I have tried so many
methods I cannot even remember them all. So I am living with drugs for
the time being. BUT I will never give up trying other things. I have
just recently heard great things about acupuncture and stress-reducing
(not sleep specifically), for example. I guess you are somebody with
alot of experience in his insomnia, so I would rather not name the
1001st way of possibly treating your insomnia. I guess you know them all
by heart. If not, just holler again, and I will try to come up with some
more ideas (and lots of others on the ng will, too, I guess)
I tried to reply directly to you backchannel, but was unable to,
so I am posting to the NG. I am taking 50 mg of Trazodone nightly for
primary insomnia. My trouble has been waking in the middle of the night and
being unable to return to sleep. I am not familiar with long term effects
of Dalmane and Ativan. I personally know that I wish I didn't need a sleep
aid, despite the fact that I am not currently having troubles from side
effects. When I take breaks from work, like over the holidays, I slept very
well. When I am thiking about work, not necessarily worrying, just thinking
a lot, I do not sleep well.
The combination of Dalmane and Ativan is unusual. Basically because
Dalmane is one of the longer acting Benzos and will build up and make
you tired during the day. Ativan usually clears out in 8-10 hours with
no active metabolites. Both Dalmane and Ativan are Benzos which are used
to treat anxiety and based on my personal experience with Ativan is a
great at inducing sleep and keeping one asleep. 2 mg about one hour
before bedtime works for me (and has continuosly for at least 2 years)
but you should start at whatever number your doc recommends. Be sure not
to eat between the time you take the Ativan and go to sleep as food (in
my experience) diminishes the hypnotic effect.
I noted John mentioned the admonition against the long-term use of
Ativan (and other benzos). I have asked several sleep docs where this
comes from and the usual answer is the PDR (package insert). I went back
to some of the original studies establishing the efficacy and the
interesting fact is that most of these studies were of very limited
duration and it may be that these warnings are more the result of the
pharmaceutical company's legal gurus than medical expertise.
John's comment about the use of either Dalmane or Ativan in conjunction
with an obstructive sleep disorder needs to be taken seriously as most
benzos are muscle relaxants. Therefore I will clearly state that I
always use a CPAP in conjunction with my Ativan.....
This NG is a great source of information and experience, but should be
used in conjunction with those who are responsible for management of
your disease.
