Amitriptyline?

[joeylittle]

s Prazosin just for nightmares? Is it an anti-psychotic? What class?

It's not a psychotropic med at all. It's a blood pressure medication. It regulates your blood pressure - which means, it lowers it somewhat. If taken only at night and in low doses, it helps you get to sleep. Some people end up not remembering their nightmares as much, but that has purely to do with the quality of the sleep, nothing to do with a psychotropic action.

Taking it as an actual blood pressure medication, you take it more frequently and at higher doses - which you don't need if you don't have high blood pressure.

So, that's it. It's action is to slow your heart rate a bit, which leads to a soporific (sleepy) feeling, which leads to sleep.

 

[Chava]

So NON benzo, SSRI, or sedative, remind me what the options are (whatever catergory unlike those just listed).....I want to stick the week out on amitryptilin and possible increase dose. But I'm drinking on ambien so I can really deeply sleep tonight. That's not a good long term solution.

Something in my body changed (good I think....not such stabbing cramps)...something biochemical. My Flexiril completely quit working. I feel more awake, less depressed (not bipolar, btw). But now I need to figure out what my body needs to sleep reasonably. My panic attacks are almost connected to exhaustion and I seem to need 7-8 hours of sleep. I'm glad I know this about myself....just having a hard time meeting that basic ideal...

 

[Chava]

@joeylittle would that prozasion (sp) be contraindicated by existing low blood pressure? Good, but low. ???

 

[Chava]

My doc will prescribe whatever I ask for :) Just want to know what the best options are aside from Benzos and sedatives...or other drunk-like pills.:bored::banghead:

 

[joeylittle]

So NON benzo, SSRI, or sedative, remind me what the options are (whatever catergory unlike those just listed)

Prazosin - used to treat high blood pressure. Works on the cardiac and central nervous systems. Lowers your BP, and is often prescribed for anxiety and PTSD as a sleep aid. Dosing for that is much lower and less frequent than what is needed to truly affect your blood pressure overall. Some people are now studying whether it is useful as an aid in treating alcohol addiction.

would that prozasion (sp) be contraindicated by existing low blood pressure?

Nope. I have low BP, and asked my psych the same thing. All it meant was I started with a very very low dose, and was prepared for the 'first dose' effect, where the first time you take a med it seems to hit harder than it will in the future. Honestly, it seems to tick all the boxes you are looking for, except for possible pain relief (which I know is a biggie for you).

This article is quite long, but you might really like it as a reference piece: http://www.ptsd.va.gov/professional/treatment/overview/clinicians-guide-to-medications-for-ptsd.asp

Propranolol is also prescribed for insomnia and anxiety. It is a beta-blocker, and has an off-label application as a blood pressure medication, which is what then led it to having an off-off label use as an insomnia for PTSD medication. I believe it is more frequently used in the UK.

Clonidine is the third blood pressure medication used also for sleep in PTSD and anxiety patients - but it's more frequent off-label use is for sleep problems in children with ADHD. I'll be back in a moment with information on how it works. It's an alpha-antagonist, but I don't remember more than that.

 

[joeylittle]

Here's another way to look at them: it's very over-simplified, but helps me grasp the differences -

• Prazosin works on alpha-1 receptors, found on blood vessels and inside the central nervous system. It makes blood vessels relax.
  
• Propranolol is a non-selective beta-blocker, and kind of works all over the body. It is contraindicated for people with a low heart rate, because it directly affects the cardiac muscle.
• Clonidine works inside the brain to suppress nerve impulses, which then helps relax the vascular system.

 

[Neverthesame]

@joeylittle beat me to it.

 

[Chava]

Thank you!!!!! Is clonidine a benzo?

 

[joeylittle]

Is clonidine a benzo?

No, not at all. None of these specifically work on GABA. Benzos have their effect by enhancing the GABA neurotransmitter, and the purpose of GABA is to inhibit neurons, or tell them to stop firing altogether. All the hypertenion medications listed above work more on the actual response systems in the body - benzos really only work on the response systems in the mind (if that makes sense).

(@Neverthesame, I'm just avoiding work researching other stuff by researching this stuff :p)

 

[Chava]

Okay, I sent questions about Prazosin and clonidine (I think I was confusing for clonopin) to my doctor...asking if Ishould try increasing my current amit first or try new med. I am really sleep deprived and I noted to her that this sets me up for panic attack (left out the drinking part, but yeah, it's f*cked up....I NEED SLEEP). Thank you @Neverthesame and @joeylittle ....my doc is great and will have a new idea for me tomorrow. If 30 mg amitriptyline doesn't work I'll know it's the wrong med. FEels nice, but maybe amping me up. Or maybe 30mg will be perfect. And if not...hopefully try prazosin or clonidine. (I mentioned both to her...she's totally cool with me suggesting meds because of my chemical abuse background....she recommended temazepam and I said NO...START OVER)

 

[Chava]

Li'l update: amitriptyline working okay (and no ambien or getting drunk for a couple weeks). But I'm pretty sure it's making me fat. :hungover::meh: