Doxepin for sleep maintanence insomnia

[Ruinednose]

Tomorrow i got a doc visit i still wake up tired (som,e days better then others)
every night i wake up frequently on the second half of night and never feel that i get deep sleep.

i am coming of clonazepam 0.5 mg currecntly taking on a third of the pill (tampering very slowly)
i have researched and the use of doxepin at low doses *lower then 10 mg* can help with keepin you asleep.


Anyone have any experiecne with this medicine. its ussualy an anti depressant at hgiher does (higher then 50 mg) but poweful sleep aid below 10 mg.


ANy info welcome.
THank you.

[49er]

Tomorrow i got a doc visit i still wake up tired (som,e days better then others)
every night i wake up frequently on the second half of night and never feel that i get deep sleep.

i am coming of clonazepam 0.5 mg currecntly taking on a third of the pill (tampering very slowly)
i have researched and the use of doxepin at low doses *lower then 10 mg* can help with keepin you asleep.


Anyone have any experiecne with this medicine. its ussualy an anti depressant at hgiher does (higher then 50 mg) but poweful sleep aid below 10 mg.


ANy info welcome.
THank you.

I was prescribed this med several years ago when I was already on three other drugs and was having insomnia in spite of one of the meds being Remeron, an antidpressant commonly used for sleep. It worked decently but unfortunately caused horrendous tinnitus which led me to the decision to get off of these meds as I was experiencing other horrible side effects.

But obviously, everyone is different and you have to decide for yourself whether the benefits outweigh any potential risks.

49er

[M'ohms]

My doc started me out with a 5mg dose. After 1 month of no results, he bumped me up to 10 mg. After an initial reaction of morning headache that lasted about 2 weeks, I have adjusted to the med. Unfortunately, it has not kept me asleep as I had hoped. I have been on it for 4 months now. When my Rx is up (2 more months) I will talk to my doc about trying something else or trying a higher dosage.

With 5 years of untreated SA and 1 1/2 years of insomnia with therapy, I'm frustrated. I have followed RobySue's wonderful tips on taming the insomnia monster, changed machines from APAP to BiPAP to ASV, and now trying Doxepin. As my doc says, "I'm a complicated patient"!

[robysue]

Ruinednose,

The clonazepam you've been taking is in the class of drugs called benzodiazepines, and is typically prescribed as an anti-anxiety med or an anti-seizure med. It is frequently used off label as a prescription sleeping pill. Were you put on clonazepam because of insomnia or because of anxiety? Any particular reason that you are tapering off the clonazepam? Side affects? Or just not effective?

Doxepin is in the class of tricyclic antidepressants. The FDA has approved very low doses (3-6mg) of doxepin for insomnia. (See http://www.currentpsychiatry.com/topics ... omnia.html)

Doxepin has never been suggested to me, but then I have some genetic anomalies that can trigger some very weird and disturbing side affects to drugs that are used to treat various mood disorders. Hence there's very good reasons for me to be extra, extra careful with things like antidepressants.

If you have no history of bad reactions to tricyclic antidepressants, the doxepin may be worth a try. Even so, you will need to continue to be vigilant about the most important parts of sleep hygiene. In particular, if you do not have a regular sleep schedule where you get up at the same time every day (including weekends), you will most likely need to work on establishing that at the same time you are taking anything for sleep, including the doxepin.

[Ruined nose (lost password)]

I was given clonazepam for insomnia and while it has worked I slowly tamper off because benzo is not particularly good. I get slight anxiety but I can deal with that on my own. Clonazepam has helped that as well. It has a rep to destroy certain parts of sleep and I want to get off it. I currently take a 3rd of a 0.5 MG before bed. I will eventually be off. I never tried antidepressants, I want to give doxepin a try as under 10mg for sleep maintenance insomnia. I'm hoping for it to work for me. I read reviews and it seems 70 percent of patients respond well at low dosage for sleep maintain insomnia. I can go to bed fine. But I wake up early and I go back to sleep but I have extremely fragment sleep in the mornings. I usually keep a decent hygiene as far as going to bed on time. Plus or minus an hour. I would love for doxepin to keep me asleep so I can wake up feeling refreshed..... Tired of being tired.... Bipap is doing great and I'm complient

[ems]

Doctor prescribed Doxepin a few years ago for insomnia. It didn't work for me but can't remember exactly why.
Then prescribed Ambien (5mg) which worked much better and still does on the nights I have a difficult time falling asleep.

[avi123]

I have good experience with Zolpidem (generic Ambien). I take 5 mg tablet (half of 10 mg) at sleep time and if I don't fall asleep within 30 minutes I take the other half. It usually works 90% of the time and then I sleep for 6 to 7 hours with one to two Nocturia wakeups.

According to a 2012 survey of 8,858 responders with sleep problems by Consumer Reports on Health, Zolpidem is top rated sleep Rx for Insomnia:



"Our Best Buy picks

For the average person needing short-term help for insomnia, we have chosen only one drug—zolpidem—as a Best Buy. Zolpidem is the generic version of brand-name Ambien. The generic contains the same active ingredient as the brand-name drug and is much less expensive. At a cost of $16 to $17 for seven pills, depending on dose and strength, zolpidem is less expensive than the other brand-name sleeping pills as well.

Our choice of zolpidem is based not just on this price advantage, but also because the evidence shows it helps people fall asleep and stay asleep, and next day drowsiness is unusual (see the effectiveness table below). Thus, if you are getting a first-time prescription for one of the new sleeping pills, or if you have been taking one, we urge you to talk with your doctor about trying generic zolpidem.

The other forms of zolpidem—sustained-release (Ambien CR), dissolvable tablet (Edluar), and the oral mist spray (Zolpimist)—are more expensive and offer little if any advantage to make the higher cost worth it."







Is this website any good:

http://www.allsleep.com/sleep-aids/slee ... r-doxepin/

Who stands behind it? At the "Consumer Reports on Health" the Neurologist Orly Avitzur, MD, {Google her name} is the adviser.

[MINItron]

I was prescribed Silenor (the low dose sleep aid version of Doxepin). I am a narcoleptic, and have a hard time staying asleep for more than 4-4.5 hours at a time.

It worked quite well for me, but there are some caveats that go along with it. You are not supposed to eat ANYTHING for three hours before taking it, and are supposed to expect to sleep for eight hours after you take it. I quickly learned that if I did not follow the three hour no eating rule I would be down for the count for 11 hours or more. It did not work for me because there just were not enough hours in the day for me to get home, cook, eat, take the Silenor, and still be up for work on time. On the days that I could manage to eat early enough to take it, and get to bed 8 hours before I needed to be up I slept straight through, 8 hours on the dot.

[Carmen]

I take a low dose of Amitriptyline, also an antidepressant, because I have trouble maintaining sleep due to menopause. It does work--I still wake up at night, but not nearly as often.

[MINItron]

I take a low dose of Amitriptyline, also an antidepressant, because I have trouble maintaining sleep due to menopause. It does work--I still wake up at night, but not nearly as often.

I was prescribed Amitriptyline and later Nortriptyline for nerve pain long before any of my sleep issues were ever being treated. Both of them turned me into the walking dead. I also gained a ton of weight.

[robysue]

I was given clonazepam for insomnia and while it has worked I slowly tamper off because benzo is not particularly good. I get slight anxiety but I can deal with that on my own. Clonazepam has helped that as well. It has a rep to destroy certain parts of sleep and I want to get off it. I currently take a 3rd of a 0.5 MG before bed. I will eventually be off.

Sorry for being dense, but:

If the clonazepam is working for you in terms of both the insomnia and the anxiety AND you are NOT experiencing any adverse side affects, why are you wanting to change things?

Is it just the reputation of clonazepam? In that case, I'd recommend a chat with the prescribing doc and the pharmacist about your concerns about long term treatment with clonazepam.

After all NO drug is completely free of adverse side affects. A quick look at the Drugs.com entry for Silenor (a low dose name brand for doxepin) shows that the Silenor (like all other sleeping medicines, including Ambien and ) should be used with caution in patients with OSA and Silenor has several common side effects including: drowsiness and strange dreams, including nightmares.

Still, if the clonazepam is not working as well as you and your doctor think it should, then a switch to a different sleeping medication such as doxepin might be worth considering.

I usually keep a decent hygiene as far as going to bed on time. Plus or minus an hour.

Bedtime is only a small part of sleepy hygiene. And describing your bedtime as "Plus or minus an hour" means that you actually
have up to a two hour variability in bedtimes from night to night. And that much difference can be very significant for some people's ability to manage their insomnia.

And you said nothing at all about whether you maintain a consistent wake up time. And that can be more important than a consistent bedtime when it comes to sleep hygiene and conquering insomnia. Yes, I understand that your insomnia is "wake too soon" and "wake too many times in the second half of the night". But what I'm wondering is this: If you have a rough night, do you stay in bed trying to "get more sleep" on some mornings? Do you intentionally try to sleep later on weekends and holidays than you do on ordinary week days?

In other words, even with the sleeping medication, it's worthwhile for you to honestly evaluate all aspects of your sleep habits when compared to a standard list of good sleep hygiene tips.

Here are some links to "tips for good sleep hygiene" from a number of well respected sites:

American Sleep Association
Mayo Clinic
National Sleep Foundation
University of Maryland Medical Center
University of Washington

[Pugsy]

I take a low dose of Amitriptyline, also an antidepressant, because I have trouble maintaining sleep due to menopause. It does work--I still wake up at night, but not nearly as often.

I was prescribed Amitriptyline and later Nortriptyline for nerve pain long before any of my sleep issues were ever being treated. Both of them turned me into the walking dead. I also gained a ton of weight.

I am just curious. What dose were you taking when you had the zombie status with Amitriptyline?
I also take it now to help sleep through arthritis pain but in a very small 10 mg dose without zombie status...but some years ago in the middle of a divorce I did take it for depression in the bigger 150 mg 3 times a day dose and I was a zombie.

[MINItron]

I am just curious. What dose were you taking when you had the zombie status with Amitriptyline?
I also take it now to help sleep through arthritis pain but in a very small 10 mg dose without zombie status...but some years ago in the middle of a divorce I did take it for depression in the bigger 150 mg 3 times a day dose and I was a zombie.

I don't remember what the dose was exactly. That was several years ago, and quite frankly that period is quite blurry. I'm pretty sure it was a pretty small dose though. I was taking Protriptyline for its REM suppressing properties, and had no problems with sedation.

[Ruinednose]

Went to doc today, he told me to keep taking clonazepam in the middle of the day for anxiety im on a minor dose of (0.17mg) just a third of a 0.5 mg (apox) just to keep anxiety at bay.

i was give sample pak of 3mg Silenor. honestly im very exited to try it now and see how it works for me. if i can get restful full nights sleep without the countless interuptions in the second half of the night.

i will try 3mg tonight and i hope that dose will work for me.
i read review (mostly good and a few fails)

i will report tomorrow on how it worked for me. wish me luck and thanks to all that read and replied.
im happy my bipap is keeping my minor apnea or UARS at bay.

anyone else have any suggestions for sleep maintenance insomnia?

[MINItron]

I actually started CPAP for sleep maintenance insomnia. My hypopnea is quite mild, and was not able to continue with any of the other nighttime meds when I switched to Adderall as my daytime med. I am sleeping 6-7 hours a night now. That's a lot better thats 4-4.5.