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Temazepam to Mirtazepin?
I am reading the posts here on this subject but in the interest of speed I am asking a question before I finish:
74yo man with a variety of health issues and limited access to quality care.
Before I go into any more complex details, the basics.
I have usually been able to keep depression and anxiety at bay without meds or therapy, except during triggers life events, for which Temazepam has been
effective (15mg 2-3 days, few times/year).
A recent trigger has induced insomnia. Even though I have decent sleep hygiene, I walk briskly 1hr/day and do not sleep/nap during the day, for the last two weeks am unable to fall asleep without at least 7.5mg Temazepam daily and that gives me
only 3-5 hours of sleep.
My GP recommends the tetracyclical Mirtazepin for its dual action on both depression and sleep, I researched it and:
* don't like what I read about it;
* I took a tricyclical decades ago and hated it
* withdrawal and rebound.
I researched all AD and sedative options available and found none attractive, to put it mildly.
I realize it's no substitute for medical advice, but it may take time to get access to a good specialist -- if at all -- so I would appreciate any help/comments.
* How long can I expect daily Temazepam 7.5mg to be effective and safe?
* Is Mirtazepin the least bad option?
Thanx.
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I only take Klonopin in the daytime. A low dose of .25mg twice a day. I don’t take it before bed. I’m on so many other pills at night.!
I am on 16-17 pills, but not all at night.
Klonopin for depression?
No prob, thanx.
Klonopin for anxiety.
Works well for you? Side effects?
It’s just barely ok for anxiety. Biggest side effect is tiredness. And I’m probably dependent on them.
Any other med you tried for anxiety?
While I don't know much about temazepam specifically, it's a benzo, and I do know a lot about benzos, from lived experience and much research. If you are taking a benzo daily, you will become dependent on it, within weeks to months. Though some claim not to, in my and many experiences, you will become tolerant to its effects, also within weeks to months, longer for some. It will stop working unless you raise the dose, vicious cycle. And if you are dependent on it and tolerant to its effects, you will need a slow taper, and may experience withdrawal from mild to severe, depending a lot on your individual constitution, the same withdrawal and rebound that unfortunately comes with just about every drug with the capacity to sedate. Your body seeks homeostasis and will overcome the sedating effects of meds you put in it every day over time. I don't want to play doctor to your doctor, but I have a little experience with mirtazapine, and a bunch of others I tried while trying, ultimately unsuccessfully to get off the benzo. At a dose of 7.5 - 15 mirt is supposedly sedating but does not have an antidepressant effect. At higher doses, where it may have an antidepressant effect, it is not sedating. Wish there was better news. I found this drug to be evil, not sedating but made me feel ill, but I am super sensitive to drug side effects, you may have better luck. Also watch for metabolic changes, weight gain with or without increased food consumption, higher blood lipids, again, this probably varies from individual to individual. I know it's hard, I understand the stress of sleeplessness, I live it, but the best advice I can give to you is get off the benzo, or at least stop taking it more than occasionally, before it's too late. Yes, insomnia is life altering, but you aint seen nothing until you've experienced benzo withdrawal. It's extreme insomnia in addition to a host of other symptoms. Been there, you don't want to go there. This is hard to hear: there is not a single drug in existence that is safe to take daily and will address your insomnia over the long term, bodies adjust to every single one - just my experience and my obsessively researched conclusion. Try some non-pharm options: CBT-I or a similar therapy, abdominal breathing, meditation, relaxation, there's a lot out there that doesn't involve drugs. The effect is likely not as immediate or significant as a benzo/drug, but much safer and can help in long run if you buy into it. Belief that something will help you sleep is probably as powerful as the drug or method itself, since most insomnia has its roots in anxiety about sleeping.
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2 ReactionsI’m on Pregabalin , off label for anxiety. Don’t notice much difference. My best medicine is exercise. For sure.
Many thanx for the extended reply.
Wrt to benzos, you are not telling me anything I dk. What I did not know -- and asked a separate question here -- is how long tolerance and withdrawal takes.
I needed to know how much time I can use it as a temp solution until I find an alternative (which does not seem to exist).
About Mirta I knew nothing. Did you try it for sedation or depression? It did neither for you? What do you mean by "evil"? Addiction, tolerance, withdrawal as bad as benzos? MY GP pushes it and if he believes that's the solution that shuts me up, he won't be very helpful with the insomnia. And I don't have the luxury of changing drs.
Aside from the fact that that I tried them non-meds throughout my 74 years and I KNOW they don't work for me, there is a good chance that my insomnia is not due to just anxiety and depression that requires investigation by knowledgeable experts and I don't have access to quality care.
Believe me I would love it if those non-med worked for me, but