Can anybody explain this?

[jim_morrison]

Originally Posted by meyaj

The SSRIs helped my overall sleep quality and stopped the constant dreaming, but I still needed more zopiclone to FALL asleep. I found that with the nortriptyline, I was able to use only half as much zopiclone to fall asleep.

I've had to double up again though as I taper though not because of trouble with sleep onset but because all the dreaming and awakening was coming back. Just the dreaming alone is actually really exhausting...

Interesting, has zopiclone caused much of a dependancy issue for you? It's anoying (even if its true) that the GABA-acting sleep drugs say for short term use only, because the reality is that some people suffer from long term chronic insomnia.

[meyaj]

Originally Posted by jim_morrison

Interesting, has zopiclone caused much of a dependancy issue for you? It's anoying (even if its true) that the GABA-acting sleep drugs say for short term use only, because the reality is that some people suffer from long term chronic insomnia.

I don't know if it's caused a dependency issue, to be honest. The relief from the long nights of not being able to sleep, constantly waking up, and bizarre dreaming has just been too amazing for me to even think about going more than a night or two without it in the last 5 months or so.

I DO suspect that I may be experiencing some rebound anxiety from it in the afternoon, but it hasn't been too bad. These last few weeks of tapering from the nortriptyline have been way worse.

Dependence usually goes hand in hand with tolerance though, and I haven't really had any issues with that so far. It might feel slightly less sedating than when I first started taking it, but as long as I actually go to bed, I still fall asleep fairly quickly.

I've actually started having bizarre hallucinations on it in the last month or so, though only in very low light. The best I can describe it as is black lines of electricity shooting out of everything. Sometimes it creates the illusion of insects swarming my room, which was really disturbing for 1 or 2 nights, but I can deal with it now. I suspect this has partially something to do with the nortriptyline as I've read about similar hallucinations in the delirium following anticholinergic overdose.

It might seem odd to still want to take the drug despite the intense hallucinations I've been having every night lately, but compared to the vivid dreaming that often seemed to blend with reality for me, it's not a really big deal. I keep forgetting to bring it up with my psychiatrist so maybe somebody else can shed some light on what's happening.

I agree with you that it's unfortunate these drugs are really only indicated for short term use, but there's often cause for concern. I tried remeron and trazodone, which I do think should be tried first, and I also tried seroquel and zyprexa, and I REALLY disagree with the practice of treating antipsychotics as preferable to GABA agonists in the treatment of insomnia. Yeah, dependence is an issue, but the antipsychotics can have some really bad long-term implications - diabetes, movement disorders, etc - that psychiatrists don't seem to keep in mind a lot of the time. Either way, none of those worked for me, despite the fact that the antipsychotics are generally seen as being heavier drugs, and they only left me really groggy in the morning. The effectiveness of zopiclone and temazepam for me seems to lie partly in the gentleness of the whole experience.

[jim_morrison]

Originally Posted by meyaj

I've actually started having bizarre hallucinations on it in the last month or so, though only in very low light. The best I can describe it as is black lines of electricity shooting out of everything. Sometimes it creates the illusion of insects swarming my room, which was really disturbing for 1 or 2 nights, but I can deal with it now. I suspect this has partially something to do with the nortriptyline as I've read about similar hallucinations in the delirium following anticholinergic overdose.

It might seem odd to still want to take the drug despite the intense hallucinations I've been having every night lately, but compared to the vivid dreaming that often seemed to blend with reality for me, it's not a really big deal. I keep forgetting to bring it up with my psychiatrist so maybe somebody else can shed some light on what's happening.

I agree with you that it's unfortunate these drugs are really only indicated for short term use, but there's often cause for concern. I tried remeron and trazodone, which I do think should be tried first, and I also tried seroquel and zyprexa, and I REALLY disagree with the practice of treating antipsychotics as preferable to GABA agonists in the treatment of insomnia. Yeah, dependence is an issue, but the antipsychotics can have some really bad long-term implications - diabetes, movement disorders, etc - that psychiatrists don't seem to keep in mind a lot of the time. Either way, none of those worked for me, despite the fact that the antipsychotics are generally seen as being heavier drugs, and they only left me really groggy in the morning. The effectiveness of zopiclone and temazepam for me seems to lie partly in the gentleness of the whole experience.

I have read quite a few reports on erowid of ambien causing hallucinations, so I'm not wholey suprised, however didnt you say that you took lsd recently? could you be mistaking it for that?

I know that the Z drugs and the hypnotic benzos such as temazepam generally have a higher affinity for the sedating GABA subunits compared to the anxiolitic benzos, (which for me stop working for sleep after about the first week of use) do you find that tolerance builds up to the sedative effects of ambien or temazapem much less than to the anxiolitic benzos ie valium, klonopin and xanax?

Also I agree with you that antipsychotics are a big no no for just insomnia, and I agree that mirtazapine, trazadone and mianserin, or antihistamines should be first line and GABA acting hypnotics, whilst second line, should also be greatly favoured over antipsychotics. As for the new melatonergic drugs...time will tell, but they look somewhat promising.

[meyaj]

Originally Posted by jim_morrison

I have read quite a few reports on erowid of ambien causing hallucinations, so I'm not wholey suprised, however didnt you say that you took lsd recently? could you be mistaking it for that?

Qualitatively the hallucinations couldn't be farther apart. Aside from the fact that they are both visual hallucinations, I can't really see any similarities between the two experiences. When I start hallucinating after two nights of not sleeping in a row, the visuals are pretty similar even if they're not the same. These hallucinations though, are just so bizarre and far and away from the hallucinations that I'd attribute to psychedelics.

Besides... the LSD dose I took was so low I wasn't getting any hallucinations, although it made me feel just really damn good about myself and the world, kind of allowing me to love myself, so to speak, in a fashion very similar to the way MDMA does the exact same thing.

But the real reason I know that can't be it is because I took the LSD less than a week ago I believe, and this has been going on for quite a bit longer.

Originally Posted by jim_morrison

I know that the Z drugs and the hypnotic benzos such as temazepam generally have a higher affinity for the sedating GABA subunits compared to the anxiolitic benzos, (which for me stop working for sleep after about the first week of use) do you find that tolerance builds up to the sedative effects of ambien or temazapem much less than to the anxiolitic benzos ie valium, klonopin and xanax?

I've only been on clonzepam 15 x 2mg's per month, so I really can't say, that's the most consistent I've been on a benzo for daytime anxiolysis. I've found to tolerance problems though (as little as that means) but it's my understanding that tolerance to the anxiolytic effects develop really slowly, if at all, with the benzos. It's the sedation that they associate with anxiety relief which one quickly becomes tolerant to, and leads to thinking they need to escalate their dose.

Originally Posted by jim_morrison

Also I agree with you that antipsychotics are a big no no for just insomnia, and I agree that mirtazapine, trazadone and mianserin, or antihistamines should be first line and GABA acting hypnotics, whilst second line, should also be greatly favoured over antipsychotics. As for the new melatonergic drugs...time will tell, but they look somewhat promising.

Oh, forgot to mention I tried the antihistamines too. Benadryl and hydroxyzine, the latter of which is actually also an anxiolytic. Doesn't help, but makes me groggy in the morning anyways. Although I still use the hydroxyzine quite often to deal with seasonal allergies.

My allergies are weird in that I don't get the puffy eyes or runny nose or anything like that... just full-body itching that drives me crazy. And hydroxyzine is such an effective itch killer compared to benadryl. Which is half of the reason I take them with opioid painkillers (my noses gets insanely itchy on them). The other half of the reason I take it is that it's know as a good potentiator of opiates, making them somewhat stronger and much more pleasantly sedating. Not much medical reason for that second one though

[jim_morrison]

Originally Posted by meyaj

Qualitatively the hallucinations couldn't be farther apart. Aside from the fact that they are both visual hallucinations, I can't really see any similarities between the two experiences. When I start hallucinating after two nights of not sleeping in a row, the visuals are pretty similar even if they're not the same. These hallucinations though, are just so bizarre and far and away from the hallucinations that I'd attribute to psychedelics.

I assume your suggesting that the hallucinations associated with not sleeping for a few nights are similiar to psychedelics? Oddly enough i've never hallucinated, even from being awake for 2-3 days straight. I just get a little bit more absent minded and forgetful at best.

[meyaj]

Originally Posted by jim_morrison

I assume your suggesting that the hallucinations associated with not sleeping for a few nights are similiar to psychedelics?

Right. It's like explaining the difference between a mushroom trip and an acid trip and a mescaline trip. They're all somewhat different in their own right, but they all share the same psychedelic quality. If you had given me a sugar pill right before the first time I had hallucinations from sleep deprivation, I would have been convinced it's another psychedelic.

Not with zopiclone though... the experience couldn't be further apart. and that's why I'm curious.

Anyways I've took the zopiclone a while a go and should have gone to be already. Even with just the monitor lighting up my room (well actually, two 22" inch monitors), I'm not getting hallucinations, but as soon as I jump into bed and turn the lights off I KNOW I'll be getting a show tonight.

Goodnight

[jim_morrison]

Originally Posted by meyaj

Not with zopiclone though... the experience couldn't be further apart. and that's why I'm curious.

Heres some reports of hallucinations caused by Z drugs that I've come across, you might find these interesting;

http://www.erowid.org/experiences/exp.php?ID=8240

http://www.erowid.org/experiences/exp.php?ID=3915

http://www.erowid.org/experiences/exp.php?ID=54338

http://www.erowid.org/experiences/exp.php?ID=45543

"The three 'Z's are zolpidem, zopiclone, and zaleplon, and I ended up trying them all. Each selectively activates certain GABA receptor subtypes (I can't remember which), thus, they produce 'reverse trips': perceptual distortions that in some ways mirror those produced by other psychedelics even though their mechanisms of action are quite different from those of other psychedelics. "

"By now I had tried various other psychedelics, and I believe that it was these which caused the visual experiences I have with the three 'Z's to change: no longer do I see figures and realistic images with any of these drugs. Instead, the visuals generally consist of 'layering': a two-dimensional image, such as a computer monitor, a painting, or a pattern in wallpaper or on a rug, may appear three-dimensional and move without any notable change in coloration or detail, this seems to result from an alteration in the way afterimages are perceived when they overlap with various objects in my field of vision. The plainer an image or surface is, the less likely it is that it will produce visual effects. For me, this is very unlike the psychedelics which work by selectively activating 5HT2 receptors for me, since with most of them (psilocybin, LSD, 2c-i, 2c-e, mescaline, 2c-t-2, 5-MeO-DMT, blah, blah, blah) I see complex patterns even in total darkness. "

"90 minutes later, I thought I saw glitter falling everywhere, and my computer screen looked like glowing, rippling gelantous fluid. I wasn't 'out of control' which is what acid does to me.. it wasn't nearly as chaotic or intense, but it was quite pleasant! I could easily visualize into a hallucination anything I imagined, for instance, I wondered what it would look like for a stream to be running through my apartment, and whoosh, there I could glowingly see it. "

[jim_morrison]

Originally Posted by meyaj

Antidepressants + zopiclone (or temazepam, when I was using that) have made my sleep quality a lot better, and I've never felt more refreshed in the morning, although lay-people usually tell me I'm supposed to feel groggy, which personally I find is only the case with sleep aids that get a lot of their effect from antihistamine action (eg benadryl, seroquel, zyprexa, remeron).

Could I ask why did you change from temazepam to zopiclone? Did the temazepam lose its effectiveness or something?

Btw I think zopiclone/eszopiclone probly have the most optimal half life for a hypnotic, 6-8 hours.

[meyaj]

Originally Posted by jim_morrison

Could I ask why did you change from temazepam to zopiclone? Did the temazepam lose its effectiveness or something?

Btw I think zopiclone/eszopiclone probly have the most optimal half life for a hypnotic, 6-8 hours.

My GP had my on temazepam (at my own request). When I finally got into the mental health clinic, my psychiatrist felt more comfortable prescribing zopiclone for longer-term use. The temazepam was more enjoyable, but they both worked for sleep where MANY other drugs failed, so I can't complain.

[jim_morrison]

Originally Posted by meyaj

My GP had my on temazepam (at my own request). When I finally got into the mental health clinic, my psychiatrist felt more comfortable prescribing zopiclone for longer-term use. The temazepam was more enjoyable, but they both worked for sleep where MANY other drugs failed, so I can't complain.

Thats good to hear, I'm actually considering asking my pdoc to switch me from mirtazapine to zopiclone/eszopiclone to help me sleep. I'm getting sick of mirtazapines side effects.

[meyaj]

Originally Posted by jim_morrison

Thats good to hear, I'm actually considering asking my pdoc to switch me from mirtazapine to zopiclone/eszopiclone to help me sleep. I'm getting sick of mirtazapines side effects.

It might not be too hard. For all functional purposes, zopiclone pretty much IS a benzo, but many psychiatrists seem to think it has a lower abuse/dependence liability, as it's marketed as such, despite a number of studies suggesting it is at LEAST as bad as typical benzos in this regard.

My psychiatrist had actually taken me off the temazepam, and had me try remeron, trazodone, seroquel, and zyprexa. None worked for me, and in fact most had me feeling restless. All of them left me groggy in the morning, which wasn't acceptable for me. So I asked about benzos or zopiclone, and she wasn't comfortable with the benzos, but she said that, given the fact that I've never had dependence issues (despite the fact that I was a poly-drug abuser), she was comfortable giving me a prescription for zopiclone for at least a few months (I'm now in the middle of month 6, I believe.) To my surprise she even started me on the highest approved dose - 15mg. So I think it may have a lot to do with your particular psychiatrist, but the fact that it leaves me refreshed in the morning, feels more gentle for the other drugs, and probably for this reason is much more effective for me, it's really been a wonder drug for me.

I must admit when my GP prescribed me zopiclone before I met my psychiatrist, I did try abusing them, but found little recreational value. This seems to be the case for me for benzos as well... I don't get the euphoria that other people seem to report. But used as intended, it's easily the most effective drug for me (tied with temazepam) of any drug I've tried in the list in my signature.

[jim_morrison]

Originally Posted by meyaj

It might not be too hard. For all functional purposes, zopiclone pretty much IS a benzo, but many psychiatrists seem to think it has a lower abuse/dependence liability, as it's marketed as such, despite a number of studies suggesting it is at LEAST as bad as typical benzos in this regard.

As far as I'm aware zopiclone (and eszopiclone) is an atypical Z drug because it binds unselectively to the GABA-A α1, α2, α3, & α5 subunits (as do all of the benzodiazapines) whereas the other Z drugs bind selectively only to α1.
Although from what I understand, the way in which it binds to those subunits is slightly different to how a benzo does, but nevertheless a similair outcome occurs.
So yes, for all functional purposes it's pretty similair to a benzo, so the supposed lowered abuse potential thing is a mystery to me also.

[crayzyMed]

Originally Posted by jim_morrison

As far as I'm aware zopiclone (and eszopiclone) is an atypical Z drug because it binds unselectively to the GABA-A α1, α2, α3, & α5 subunits (as do all of the benzodiazapines) whereas the other Z drugs bind selectively only to α1.
Although from what I understand, the way in which it binds to those subunits is slightly different to how a benzo does, but nevertheless a similair outcome occurs.
So yes, for all functional purposes it's pretty similair to a benzo, so the supposed lowered abuse potential thing is a mystery to me also.

I tought the Z drugs dont cause a physical addiction.

[meyaj]

Originally Posted by crayzyMed

I tought the Z drugs dont cause a physical addiction.

The most definitely do...

[jim_morrison]

Originally Posted by crayzyMed

I tought the Z drugs dont cause a physical addiction.

Yeah, they definitely do, when they were first released onto the world market they were thought not to be, but the addiction potential soon became evident as they became more widely used. Ontop of that some toxicology studies show that Z drugs may be carcinogenic. So pick your poison I guess.

[meyaj]

Originally Posted by jim_morrison

Yeah, they definitely do, when they were first released onto the world market they were thought not to be, but the addiction potential soon became evident as they became more widely used. Ontop of that some toxicology studies show that Z drugs may be carcinogenic. So pick your poison I guess.

The carcinogenic effects of Z drugs, as far as we know, apply to ALL hypnotics, including benzos. Our best guess at the moment is that it has something to do with suppression of the immune system. Either way the increased risk is still remarkably low, and I find the relief of my severe insomnia worth that slight increase in risk. I know that if I do wind up with cancer, the chances are low enough that I certainly won't be blaming the Z-drugs for it.

[jim_morrison]

I guess the major question with next day grogginess seems to be, is it Antihistaminergic vs GABAergic thats defines it, or is it half life that plays a bigger role, regardless of the mechanism.

[meyaj]

Originally Posted by jim_morrison

I guess the major question with next day grogginess seems to be, is it Antihistaminergic vs GABAergic thats defines it, or is it half life that plays a bigger role, regardless of the mechanism.

I feel just as groggy from diphenhydramine, which has a fairly short half-life, so I imagine it's principally the antihistaminergic effects. It's just conjecture but perhaps they affect sleep quality is a way that is not as restorative.

[jim_morrison]

Originally Posted by meyaj

I feel just as groggy from diphenhydramine, which has a fairly short half-life, so I imagine it's principally the antihistaminergic effects. It's just conjecture but perhaps they affect sleep quality is a way that is not as restorative.

Good point, I can even take clonazepam (which has a really long half life) before bed, and it will help me sleep without causing excess grogginess the next day, though I've never taken temazepam.
Subjectively, how do the hypnotic benzos like temazepam feel compared to clonazepam or alprazolam in terms of sleep?

[meyaj]

Originally Posted by jim_morrison

Good point, I can even take clonazepam (which has a really long half life) before bed, and it will help me sleep without causing excess grogginess the next day, though I've never taken temazepam.
Subjectively, how do the hypnotic benzos like temazepam feel compared to clonazepam or alprazolam in terms of sleep?

That's very difficult to describe. Temazepam just feels really warm and comfortable. Much better for sleep than any of the other benzos I've tried.