Anyone tried combining ramelteon and doxepin?
I've been trying to fix the irregularities in my sleep due to insomnia -- unable to fall asleep, waking up in the middle of the night and not getting back to sleep, waking up too early or too late -- because irregular sleep is a migraine trigger for me. I started using zolpidem to help with this problem years ago. Initially, I only needed it when travelling. Now, it's up to several times a week, and I'm staring the possibility of daily usage in the face. Pretty sure that at that point, I'm going to wind up with dosage issues, because with a migraine history, I lean toward central sensitization problems anyway.
Been through the CBTi wars, and have fixed all the behavioral/environmental stuff. Also tried sleep compression, which hit the migraines too badly for me to sustain it. Melatonin and doxepin have been mildly helpful, but only barely.
So far, stacking daily ramelteon and daily doxepin has been working surprisingly well -- in the last month, I've only taken zolpidem twice, which is amazing. However, although stacking is a thing in the migraine world, I haven't found any trials or studies that usefully deal with this particular insomnia combination. Individually, the two drugs seem to be notoriously low risk. I'm thinking about keeping this up for about six months, and then pausing them to see if this has retrained my brain.
Anyone have any insight into or experience with combining these drugs?
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