# Struggles and Support > Medication >  >  Sleep meds

## Equinox

I'm curious what peoples experiences with sleep medicines have been like.

In my experience Seroquel and Remeron (mirtazapine) were the most effective at inducing sleep but had a lot of unwanted side effects. On the other hand I tolerated sleep medicines such as Zolpidem (ambien) and Zopiclone better but they felt like weaker agents overall and were harder to get prescribed as the doctors I've seen generally seemed to dislike using them. Melatonin didn't do anything for me. I've also done a lot of sleep hygiene exercises in the past but they don't really help my type of sleep trouble because it was caused by chronic fatigue syndrome which interferes greatly with my sleep architecture, hence behavioral modification doesn't work for me (though it's certainly a good place to start before resorting to medications). 

Thanks

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## fordgurl_87

I took trazadone back when I was a teenager and it seemed to work good.  The only problem I had is that I would be sluggish the next day.  Not sure how I would do on it now though, since I have gotten older, all medicines seem to affect me different than they used to.  It may be because I take them for different reasons now though.

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## Equinox

That's cool, I've heard trazodone is petty good for sleep problems but it's not available in my country unfortunately.

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## whiteman

gain trazadone of lots weight

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## Dark Knight

The issue I have with sleeping medication is they make you groggy and fatigue all day. Try  Diphenhydramine HCL and  Doxylamine Succinate. These 2 are used in Over the counter sleep medications and almost without fail will put you to sleep.

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## ev0ker

i occasionally used (max. 4 times a month) diphenhydramine hydrochloride and found that when i first started taking it, it made me feel groggy for two days. after the third dosage or so, i found that the grogginess only stays for a day, sometimes even less. i didn't experienced any hallucinations or anything similar to that. the last two times i used it however, i did noticed that i kept waking up very early in the morning around 2 to 3 am. i found it difficult to fall back to sleep even though i felt very drowsy. every time i would manage to 'fall' asleep, i felt like i was falling or i was being pushed towards the edge of a seat/bed. it makes me jolt slightly and makes it hard for me to go back to sleep.

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## Equinox

> The issue I have with sleeping medication is they make you groggy and fatigue all day.



Yeah this is the biggest issue I've encountered with most of them, they left me feeling groggy and worse off the next like I hadn't slept at all. Zolpidem and Zopiclone were probably the exception for me, less hangover effect than the others.

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## metamorphosis

Doxepin at low doses (5-10 mg), is basically a antihistamine without anticholinergic properties. Trazodone is -- involving cholinergic & histamine effects. That is the main thing I try to look for to work. I will take a histamine blocker that works without effects on acetylcholine anyday. The OTC Diphen. and doxylamine are +++ in their cholinergic effects. You have the ap/aap's. And you know they affect many NT's and areas of the brain. My pdoc had me try Saphris at 2.5 mg (low) for sleep-Never Again. I woke in a daze about halfway through the night and just started eating half awake. 3  times and that was it. This is why I remind myself to steer clear of ap/aap's. Except for Abilify which effects the brain in its own separate and unique way.

If I had bi-polar or schizoid. issues, than yeah there is a fit but ap's for anxiety and unipolar depression, not for me. You also have the Z drugs. Which are basically another type of benzodiazepine with varying half-lives. Plus there is a cross tolerance. I take klonopin and ambien/ambien cr really does not affect me much. In fact I would get a better response from 10-20 mg diazepam, as that one always seems to make me tired. There is the tolerance with Z's just like benzos. Gabitril is another that some people respond to but most don't or it loses effectiveness. I would only use it occasionally/prn.

Don't know if you have used melatonin and/or valerian along with some mag. glycinate pwd.
People seem to have good responses to 5-htp or tryptophan. Of course being on a serotonergic/5-HT drug would rule those two out.
Re-reading your OP, Remeron= 'Shaun Of The Dead'.
I find it bizarre that one of the more benign medications-Trazodone, is not used in your country. I mean it is also a + that you can play with the dose. Anywhere from 25-100 mg can work. I can use 25 or 50 mg to fall asleep and stay asleep for 8 hrs. Higher the dose=higher morning grogginess. Quite funny how they originally thought this was going to be The AP/anxiolytic of the future. That was until they realized that, for it to have any therapeutic effect in monotherapy;It would have to be dosed at somewhere around 400 mg. As it is for sleep it blocks a1 and is a 5HT2a antagonist at the lower doses.  Most impressive about it is that it is both a weak antihistamine and has no anticholinergic effects. It lacks affinity to mACh receptors. Also, it doesn't screw with sleep architecture like many other sleep agents, in other words the 5 stages of sleep ,including REM.

Last, I forgot Agomelatine. Which to me looks like a weak antidepressant with it's effects on MT1 & MT2 easily replaced by melatonin supplement. I just haven't heard very good feedback on it. More like it being relatively benign!

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## VickieKitties

Drink my Warm Milk!  :banana guy:

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## Equinox

> Doxepin at low doses (5-10 mg), is basically a antihistamine without anticholinergic properties. Trazodone is -- involving cholinergic & histamine effects. That is the main thing I try to look for to work. I will take a histamine blocker that works without effects on acetylcholine anyday. The OTC Diphen. and doxylamine are +++ in their cholinergic effects. You have the ap/aap's. And you know they affect many NT's and areas of the brain. My pdoc had me try Saphris at 2.5 mg (low) for sleep-Never Again. I woke in a daze about halfway through the night and just started eating half awake. 3  times and that was it. This is why I remind myself to steer clear of ap/aap's. Except for Abilify which effects the brain in its own separate and unique way.



Thanks for the in-depth response. Yeah remeron and seroquel (not at the same time) do quite literally make me feel like I could be an extra in a zombie film! Both also give me quite vivid dreams which I dislike. I've tried Doxepin @ 25mg - 50mg. By memory 25mg wasn't that bad but I don't really recall, might be worth re-investigating though. As for OTC antihistamines, Doxylamine (Unisom) didn't really put me to sleep, it just made me feel really bad the next day, which makes sense as apparently pure antihistamines have a detrimental effect on sleep quality (by memory anithistaminergic psych meds such as remeron, aps, and so on aren't quite as bad because they have 5-HT2a blockade which enhances sleep quality.) 





> You also have the Z drugs. Which are basically another type of benzodiazepine with varying half-lives. Plus there is a cross tolerance. I take klonopin and ambien/ambien cr really does not affect me much. In fact I would get a better response from 10-20 mg diazepam, as that one always seems to make me tired. There is the tolerance with Z's just like benzos. Gabitril is another that some people respond to but most don't or it loses effectiveness. I would only use it occasionally/prn.



My finding with ambien cr was similar to yours. I didn't notice much of an effect at the standard dose aside from feeling kind of 'drunk', and as you said, years on clonazepam may have contributed to the tolerance. Zopiclone helps me sometimes, I prefer it to ambien. I'd say that zopiclone is my most favoured sleep med overall, it's smooth and subtle (not a knock out), but if I go to bed on it I can fall asleep more easily. Unfortunately it's quite hard to get prescribed here in my experience as my doctor says it's addicting. I don't personally find that to be the case with it nor any psych med I've ever tried but I don't have an addictive personality.





> Don't know if you have used melatonin and/or valerian along with some mag. glycinate pwd.
> People seem to have good responses to 5-htp or tryptophan. Of course being on a serotonergic/5-HT drug would rule those two out.
> 
> Last, I forgot Agomelatine. Which to me looks like a weak antidepressant with it's effects on MT1 & MT2 easily replaced by melatonin supplement. I just haven't heard very good feedback on it. More like it being relatively benign!



I've tried both melatonin and agomelatine, neither helped me but I'm not sure if my sleep issues are body clock related so I wouldn't expect it too. Melatonin is a good antioxidant though. 
I've also tried an OTC valerian/lemon balm preparation but didn't notice any effect, the one supplement which seems to have potential which I haven't tried is phenibut.

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