Back when I used zolpidem, I found that it is best to use it as a reset button, not as a daily crutch.
I do take 300mcg melatonin but I found it has no diminishing returns and in fact it has a negative feedback -- after 3 days of melatonin, I don't need it for at least another week. I keep the zolpidem for "recreational" usage, but I don't want to use it with my wife and daughter in the house in the remote possibility I get sleepwalking(never actually happened, I just get amazing auditory hallucinations before I fall asleep).
What would happen if you took a month off work and all your obligations and stayed home and didn't take anything for a whole month? My understanding is the human body can't go more than about 10 days without sleep [1].
So I assume at that point you would fall asleep, and then over the coming ~20 days hopefully you could normalize it and get back to some kind of unassisted "regular" sleeping.... ?
[1] https://www.healthline.com/health/healthy-sleep/how-long-can...
For the past year, I would roughly take 90mg of either Zolpidem/Zopiclone in a single night. On average, I roughly go through 100 pills a week (I have pharmacies that sell to me...I know sketch).
It wasn't always like this, when I first started taking medication after going to Stanford Sleep Clinic, I would just take a pill or two a night and have fantastic sleep. It was like this for several years but eventually my tolerance increased and my work stress/insomnia got worse with age.
I want to reiterate that I've destroyed/damaged every meaningful relationship in my life. I state this all out because I've realized that people have a strange fascination with Ambien.
It also sounds like there are some treatments that can help fight an auction, including other medications that bind to some of the same receptors. Or very slowly weaning someone off (but then you have to figure out something else for the insomnia.)
This isn’t really an option anymore as a father of young kids
Benzodiazepines on the other hand I've had no issues with (no desire/need to increase the dose, no withdrawal even when I've been taking them for prolonged periods, no side effects), but I don't find them as effective. I have seen the destructive effects they can have though - a family member had to taper off them over six months, and at the end she was cutting the smallest dose tablets into quarters as she still couldn't quite get off them.
Also (from wikipedia) on Seroquel / Quetiapine: "Despite being widely used as a sleep aid due its sedating effect, the benefits of such use do not appear to generally outweigh the side effects."
https://pdfs.semanticscholar.org/8812/afd4bc713c03435b68f2bb...
Personally I would only take antipsychotics when absolutley necessary. Nasty stuff.
I went on them in my early twenties due to a nervous breakdown, and while they stopped the endless loops of thought and insomnia (I ended up sleeping ten hours a night without breaking a sweat), they reduced my libido, made me gain weight, and worst of all, robbed me of my natural sharpness and creativity. It was as if my brain had been wrapped in a layer of bubble wrap, and my ability to come up with those sparks of inspiration that you need to do intellectual work was almost extinguished. I'm 100% now, fully recovered, but it took me about 3-4 years to get back where I was before it all happened. If your doctor thinks you're right for them, go for it, but only as a last resort.
They do work, but they're the last tool in the box that you only want to use when everything else has failed.
No consent given or asked for, let alone informed consent. You are told "take this".
This is not in circumstances of hospitalization, let alone involuntary hospitalization, but regular outpatient treatment.
People who are in a bad place generally don't research meds, and if they are not extremely uncooperative, or paranoid, will take them and the doctors' words at face value.
Consequences are severe and long-lasting.
Absolutely shameful and despicable. These doctors should be shamed by the scientific community for [almost] using prehistoric notions of "hysteria" to mistreat ilness by basically showing "see, he's not crying anymore! PROGRESS!" while pointing to a barely awake, sedated patient.
Any and all progress is usually SSRIs and psychotherapy, if available. Why do they give these antiquated meds that are not appropriate for the situation (i.e. CPZ) is beyond me. These are not psychoses, this is Episodium depressivum, gradus moderati .
Sorry, had to get that out. This is from personal experience.
The dose makes the poison. A small dose e.g. of seroquel, for a few days, has a great risk:reward profile for panic disorder
Learning a skill from the ground up I couldn't bullshit from random esoterica I'd picked up from high school forced me to confront my lifelong hubris and put aside my ego. Eventually I got decent enough at it that it became my career. It was a slow, grinding, painful process, but it taught me a lot about humility and the value of incremental progress.
A man, 29-year old, with a history of alcohol abuse suffered from hypoxic-ischemic brain injury after choking on a piece of meat. After an initial, though slow neurological recovery, spontaneous movement and speech disappeared. The patient developed such a severe impairment of arousal that he required intensive auditory and tactile stimulation to maintain a wakeful state. No structural lesions were found using a computerized tomography (CT) scan to explain this secondary deterioration, and conventional EEG-recordings showed no evidence of epilepsy. After a stay in the ICU and neurology department, the patient was transferred to a nursing home without a formal diagnosis explaining his hyporesponsive state. A structural MRI at follow-up showed signs of diffuse atrophy without hydrocephalus.
Eight years passed without any further improvement and neurological follow-up. Eventually, a new nursing home physician with experience in hyporesponsive disorders took over the patient's treatment and performed a new neurological examination to find directions to improve his care. Upon clinical assessment, the now 37-year old patient seemed awake, but showed a complete lack of voluntary movement (akinesia) and absence of speech (mutism). More specifically, the patient showed no affective reactions, initiation of eating or drinking, and remained incontinent. Although the patient showed no signs of spontaneous speech or vocalization on request, he was able to respond to questions or commands with movements with a significant delay (usually a couple of seconds) and with evident ataxia and muscle rigidity. Despite his intact awareness, the patient's initiative was so severely impaired that he remained wheelchair-bound and entirely dependent on nursing care for all daily activities, including the need for enteral tube feeding.
It's incredible how little we still know about some things. They couldn't pin down a cause and this is apparently a significant detail as to why this patient was basically warehoused in a nursing home with no real treatment for literally years until they tried this new thing, which had some short-lived effects.
There's a lab at UCSF[1] that actually specializes in doing genome sequencing of cerebrospinal fluid specifically for cases like this. They're talked about pretty extensively in Adam Savage's "Still Untitled" podcast[2] and all the crazy weird things they managed to diagnose this way.
We all have the impression that medicine is a solved problem, but we've still got a way to go. We're still making progress though.
[1] https://nextgendiagnostics.ucsf.edu/
[2] https://www.tested.com/podcasts/adam-savage-project/854328-s...
We just have a few pieces of a puzzle and no idea what the overall image actually is. Neuroplasticity and adaptivity make this even harder because often you can't just take a part away like in a car and pinpoint issues due to the absence or disturbance of these parts.
If you knockout an area and a patient loses smell, will you say that you found the "center" of smell? We are still poking at the brain and figuring out its responses.
treatment effective in the short term, but only in a small proportion of cases (estimated at around 5%)
It's absolutely incredible! You can read as much in the paper of course, but seeing it with your own eyes is somehow very different.
Immediately following the accident, we saw other patients in the same condition as her and tracked their progress for comparison sake. The common theme was that patients either made significant progress (with motor skills, talking, etc) within the first 0-3 weeks, or not really at all. It seemed like once scar-tissue started forming in the brain, critical brain connectivity began to get blocked (not necessarily broken). If we can better understand the underlying mechanism behind the "signal blocking" vs "signal un-blocking" aspect seen using this drug in TBI patients, it would be a huge win for all brain related conditions.
New cell types or pathways to become cell types are observed more often than you would think and it feels like we are still at the very foundation of understanding <insert field of biology>. It's scary how much we don't know while publically acting as if we figured out 99.98% of biology.
Explaining allergies and their origin is a good example here. It's just people throwing guesses around.
This would be game changing to the Tourette's community. It is so much more than just a speech or tic disorder, and to give the worst affected sufferers their lives back (by reducing the impact of disinhibition, etc) is a fucking miracle.
Two incredible actors, and one very touching movie.
Got basically told off with denial and laughs.
Experts often get stuck on this point where their ego supercedes any notion of new science, exploration and potentially disruptive information.
I've recently started taking it a few times a month to help out when I am having poor sleep, in an attempt to kick me back into a decent rhythm.
Reading the experiences in this thread of people using Seroquel or Zolpidem and their negative reactions - I am feeling a little sketchy about my crutch.
it helps 'slow down my thinking' and just kind of nod out to nothingness when taken alone. and combining with other drugs/alcohol amplifies
I feel like it has permanently worsened my memory. For sure brain fog is definitely noticeable for weeks after stopping.
There are also a few scary articles I've read linking to alzheimer's/dementia. It kind of makes sense from my limited wikipedia understanding of brain chemistry that blocking Acetylcholine would have long term effects. amped up version of this action is used to kill people vx seren etc
im sober from everything now. but every once and a blue moon i'll take diphenhydramine if i'm having serious insomnia.
one night feels restful. after that it just exasperates & continues the cycle. It also is hard to take just one, I literally have to buy a travel pack, take one, throw the rest away or i will keep taking them until they are gone. annnnd now i want one to zone out. don't abuse drugs kids!
> Two hours after zolpidem administration, he gradually fell back into his diminished motivational state.
here is just a list of shit to be prepared for when you take them for more than a few short weeks:
please be VERY careful. ive been on then for years and it is a nasty and very long detox process.
Even though I haven't had any side effects, I still hide my car keys before taking it after having read stories of people driving while asleep on Ambien.
Hydroxyzine works ok for me. Not great. Flexirol + hydrocodone work fantastic for me, but that's not a viable option.
Zolpidem may cause serious or possibly life-threatening sleep behaviors. Some people who took zolpidem got out of bed and drove their cars, prepared and ate food, had sex, made phone calls, sleep-walked, or were involved in other activities while not fully awake. After they woke up, these people were unable to remember what they had done. Tell your doctor if you have ever had an unusual sleep behavior while taking zolpidem. Be sure that your family or caregiver are aware that these symptoms are serious and to call your doctor if they occur. Stop taking zolpidem and call your doctor right away if you find out that you have been driving or doing anything else unusual while you were sleeping.
That said, without the medication I'd be miserable and might not even be alive.
One of these is better than the other, so it's the choice I make.
Now, if one is dealing with something really serious like psychosis or acute mania, maybe it is a preventing a short-term harm which outweighs the risk of this long-term harm. But if it is just trouble sleeping, considering this risk, I think one should explore other options first.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476840/
https://www.sciencedirect.com/science/article/abs/pii/S09249...
https://pubmed.ncbi.nlm.nih.gov/30191724/
(I used to take Seroquel for insomnia and anxiety myself. I stopped when I discovered this research. It also contributed to our decision to get our son off risperidone.)
