PLMD — Benzos
Question:
Thanks for responding… > I tried Klonopin (clonezapam) and though it worked well for the few days I > was on it, I had a violent reaction on day 3 or 4 and had to discontinue.
What lead you to belive it was working well? Did you sleep better? Did you feel better durring the day? What was it that indicated the difference for you? > I’ve found that anything that keeps me sleeping through that sleep phase > (and the episodes) is OK. That includes prescription and OTC meds and > physical activity. I recently returned to a desk job from a highly > physically active job, so we’ll see how that effects my symptoms. We have > a > BIG bed since hubby and I both suffer, and don’t want to wake each other. > He’s untreated but his episodes don’t wake him. He refuses to believe that > waking night-time leg cramps are related, but we know better 
. Keeping > his > potassium and magnesium levels up helps significantly (Banana anyone?).
Hmm.. I know i should eat more fresh fruit… > Down thru the years we’ll see how our kids manifest symptoms…there may > be > new treatments out there by the time they are 30-40. Meanwhile the three > generations of my family that have these episodes have found that good > sleep > hygiene is a must, daily physical activity is essential for both tiring us > enough to sleep deeply and for alleviating the crampiness and other > symptoms > in severity, proper nutrition is very helpful (think minerals), and that
Yes. I am working on getting all of my vitimins and minerials… > sugar and caffeine exacerbate the problem (which doesn’t stop us from > enjoying our Cadbury’s and Coffee, but does make sure we are prepared for > the aftermath).
Thanks,,, Jamie – Hide quoted text — Show quoted text -> I really hope that is helpful. > Good Luck and keep us posted (pun intended). > Lis > "jamie dolan (AKA OCD Boy)" <ja…@ashwoodinc.com> wrote in message > news:Rz3Ad.4043$Y8.2568@newssvr17.news.prodigy.com… >> Hello; >> I have tried Ambien, Nurontin, Halcion, and Xanax, and they do not seem >> to >> work for my rls, except perhaps for high doses of xanax. >> How effecective has anyone else found xanax at treating PLMD. >> I want to start about from the dopimine drugs. >> -Jamie >> (A) Benzodiazepine medications marketed for sleeping pills >> Halcion (Triazolam) >> This drug comes in 0.125 mg and 0.25 mg tablets. Doses range from 0.125 >> mg >> to 0.5 mg. It has a fast onset of action (15-30 minutes) and a very short >> half life, so that the duration of action is only 3-4 hours. This is also > a >> popular sleeping pill and RLS medication. >> The problems with Halcion (and short acting hypnotic drugs in general) is >> that of rebound insomnia (which is much worsened insomnia the night after >> using the drug). Another problem is that of short term amnesia. This > occurs >> upon awakening, after taking Halcion, resulting in a loss of memory of >> previous recent events occurring after taking the Halcion. >> Restoril (Temazepam) >> Temazepam has a longer than usual onset of action of 45-60 minutes. It is >> therefore not as good for RLS problems that occur on going to sleep. It >> is >> good for RLS and especially PLMD that may occur after sleep onset. It has > a >> reasonable duration of action of 6-8 hours, so that it should sustain > sleep >> all night and generally not cause morning sleepiness. >> The drug comes in 15 mg and 30 mg tablets and doses range from 7.5 mg to > 30 >> mg. >> Dalmane (Flurazepam) >> This is the original benzodiazepine sleeping pill. It does have a rapid >> onset of action (15-30 min), but has a long half-life (8-10 hours) and in >> addition has active metabolites. These active metabolites (chemicals > formed >> from the metabolism of the drug) occur after the Dalmane has lost in >> original effect and continue to act a sleep inducing chemicals, thus >> prolonging the hypnotic effect of the medication. Daytime sleepiness is > thus >> a very significant problem with this medication. >> Dalmane comes in 15 mg and 30 mg capsules. Doses range from 15 – 30 mg. >> It >> is not on our recommended list of RLS medications, but has been used >> successfully in a minority of patients. >> Doral (Quazepam) >> Doral comes in 7.5 mg and 15 mg tablets. Dosage ranges from 7.5 to 15 mg. > It >> has a fast onset of action of 15-30 minutes. It’s duration of action is > 8-10 >> hours, so that morning sleepiness may be of some concern. It also has > active >> metabolites which can lead to daytime sleepiness. This is one of the >> newer >> sleep medications and may have some benefit in a small percentage of RLS >> patients. >> Prosom (Estazolam) >> This comes in 1 mg and 2 mg tablets and is also one of the newer sleep >> medications. Dosage ranges from 0.5 mg to 2 mg. It has a rapid onset of >> action of 15-30 minutes and an intermediate duration of action of 6-8 > hours. >> It may be quite a reasonable drug for RLS in patients who have the time > and >> inclination to sleep a little longer (7-10 hours). It also has active >> metabolites which may cause increased daytime sleepiness in many >> individuals. >> (B) Benzodiazepines marketed for anxiety >> Xanax (Alprazolam) >> This medication comes in 4 strengths; 0.25 mg, 0.5 mg, 1 mg and 2 mg >> tablets. Doses range from 0.25 mg to 2 mg. The drug has fairly quick >> onset >> of about 15-30 minutes and a duration of action of about 6-8 hours. > Although >> not marketed as a sleeping pill, Xanax works quite well to control > nighttime >> RLS problems without much daytime sleepiness in most users. Xanax is a >> common choice of sleep specialists (we also like using this medication) > for >> use in RLS. >> Valium (Diazepam) >> This is one of the original sedative drugs. It has not been marketed for >> sleep but actually may work well in many patients. It has a rapid onset >> of >> action (less than 30 min). It’s duration of action can be variable from > 6-10 >> hours. >> Valium comes in 2 mg, 5 mg, and 10 mg tablets. Effective dosages range > from >> 5 mg to 10 mg. >> Klonopin/ Rivotril (Clonazepam) >> Klonopin comes in 0.5 mg, 1 mg, and 2 mg tablets. The usual dose range is >> 0.5 to 2 mg. This was the first drug used for RLS and PLMD. This is due >> to >> its previous use in myoclonic seizures. PLMD used to be called nocturnal >> myoclonus and thus this drug was tried for RLS/PLMD with great success. >> The drug has a rapid onset of action (less than 30 min) but it has a very >> long half-life (30-40 hours) causing a duration of action of 8-12 hours >> or >> longer. Daytime sleepiness can be a problem in a large percentage of >> patients on Klonopin. We therefore do not recommend this drug for most >> patients with RLS. It is, however, very commonly prescribed for RLS due >> to >> its early association with the treatment of RLS. It may work well in >> patients who do have morning RLS and do not get drowsy or sleepy due to > the >> long lasting nature of this drug (which may persist at high levels in >> the >> morning causing daytime sleepiness). >> Many physicians prescribe Klonopin, as this is the original drug used for >> RLS and is recommended by all the general medical textbooks that discuss >> RLS. Some sleep specialists (and patients) prefer to use this drug for > RLS, >> but our experience has been that the shorter acting sedatives work better >> for most RLS sufferers. >> Ativan (Lorazepam) >> Ativan is a tranquilizer that is used for stress rather than sleep. It is > a >> very common benzodiazepine drug which is used during the daytime to help >> patients control anxiety. Like all the benzodiazepines, this drug will > have >> some usefulness when taken at bedtime for sleep. >> This drug comes in 0.5 mg, 1 mg and 2 mg tablets. It has a half life of > 12 >> hours, so there is a very significant concern about daytime sleepiness >> the >> morning after the medication is taken. The long half life is more useful >> when Ativan is used for anxiety disorders, but may cause too much > drowsiness >> when used for nighttime RLS/PLMD and as a sleeping pill. >> Serax (Oxazepam) >> Serax is actually not a benzodiazepine, but is in a closely related class > of >> 3-hydroxybenzodiazepinones. This is a safer class of medication than the >> benzodiazepines (such as Valium). It has a fairly rapid onset with >> rather >> long half life of 5.7 to 10.9 hours. This is a rather long half life >> which >> might result in daytime sleepiness, but many people who have tried it for >> sleep, find that morning drowsiness is often not a problem. >> Serax comes in 10 mg, 15 mg and 30 mg capsules. >> NON-BENZODIAZEPINES SEDATIVES >> Ambien (Zolpidem) >> This is the first drug in this class. It is not a benzodiazepine, but it >> does work selectively on some of the benzodiazepine nerve receptors (only >> the omega 1 receptor of the 3 omega receptors). Because of this > selectivity, >> Ambien appears to have fewer side effects than other drugs in this class. > It >> is unique in sedative pills as it does not alter the sleep stages. Most >> drugs in this class decrease stages 1, 3, and 4 (and possibly even REM >> sleep) to increase stage 2 sleep. There have been as yet, no reported >> tolerance or withdrawal problems with long term usage of Ambien. There >> are >> also no problems with rebound insomnia (increased problems falling asleep >> the night after using the drug) which occurs in short acting sedative. >> Amnesia (loss of memory when awakening in the morning) does not occur as > it >> does with Halcion (see below). >> Ambien comes in 5 mg and 10 mg tablets. Doses are 2.5 to 10 mg, doses >> greater than 10 mg are no more effective than the 10 mg maximum dose. >> This >> drug has very quick onset of action (less than 30 minutes), in fact it is >> recommended that you should go to bed immediately after taking the >> medication. The half-life of the medication is about 2.5 hours, which > means >> that daytime sleepiness is extremely
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Response:
I see no one has responded, so I will, though I don’t know if it will be helpful… I tried Klonopin (clonezapam) and though it worked well for the few days I was on it, I had a violent reaction on day 3 or 4 and had to discontinue. I’ve found that anything that keeps me sleeping through that sleep phase (and the episodes) is OK. That includes prescription and OTC meds and physical activity. I recently returned to a desk job from a highly physically active job, so we’ll see how that effects my symptoms. We have a BIG bed since hubby and I both suffer, and don’t want to wake each other. He’s untreated but his episodes don’t wake him. He refuses to believe that waking night-time leg cramps are related, but we know better . Keeping his potassium and magnesium levels up helps significantly (Banana anyone?). Down thru the years we’ll see how our kids manifest symptoms…there may be new treatments out there by the time they are 30-40. Meanwhile the three generations of my family that have these episodes have found that good sleep hygiene is a must, daily physical activity is essential for both tiring us enough to sleep deeply and for alleviating the crampiness and other symptoms in severity, proper nutrition is very helpful (think minerals), and that sugar and caffeine exacerbate the problem (which doesn’t stop us from enjoying our Cadbury’s and Coffee, but does make sure we are prepared for the aftermath). I really hope that is helpful. Good Luck and keep us posted (pun intended). Lis "jamie dolan (AKA OCD Boy)" <ja…@ashwoodinc.com> wrote in message news:Rz3Ad.4043$Y8.2568@newssvr17.news.prodigy.com… – Hide quoted text — Show quoted text -> Hello; > I have tried Ambien, Nurontin, Halcion, and Xanax, and they do not seem to > work for my rls, except perhaps for high doses of xanax. > How effecective has anyone else found xanax at treating PLMD. > I want to start about from the dopimine drugs. > -Jamie > (A) Benzodiazepine medications marketed for sleeping pills > Halcion (Triazolam) > This drug comes in 0.125 mg and 0.25 mg tablets. Doses range from 0.125 mg > to 0.5 mg. It has a fast onset of action (15-30 minutes) and a very short > half life, so that the duration of action is only 3-4 hours. This is also a > popular sleeping pill and RLS medication. > The problems with Halcion (and short acting hypnotic drugs in general) is > that of rebound insomnia (which is much worsened insomnia the night after > using the drug). Another problem is that of short term amnesia. This occurs > upon awakening, after taking Halcion, resulting in a loss of memory of > previous recent events occurring after taking the Halcion. > Restoril (Temazepam) > Temazepam has a longer than usual onset of action of 45-60 minutes. It is > therefore not as good for RLS problems that occur on going to sleep. It is > good for RLS and especially PLMD that may occur after sleep onset. It has a > reasonable duration of action of 6-8 hours, so that it should sustain sleep > all night and generally not cause morning sleepiness. > The drug comes in 15 mg and 30 mg tablets and doses range from 7.5 mg to 30 > mg. > Dalmane (Flurazepam) > This is the original benzodiazepine sleeping pill. It does have a rapid > onset of action (15-30 min), but has a long half-life (8-10 hours) and in > addition has active metabolites. These active metabolites (chemicals formed > from the metabolism of the drug) occur after the Dalmane has lost in > original effect and continue to act a sleep inducing chemicals, thus > prolonging the hypnotic effect of the medication. Daytime sleepiness is thus > a very significant problem with this medication. > Dalmane comes in 15 mg and 30 mg capsules. Doses range from 15 – 30 mg. It > is not on our recommended list of RLS medications, but has been used > successfully in a minority of patients. > Doral (Quazepam) > Doral comes in 7.5 mg and 15 mg tablets. Dosage ranges from 7.5 to 15 mg. It > has a fast onset of action of 15-30 minutes. It’s duration of action is 8-10 > hours, so that morning sleepiness may be of some concern. It also has active > metabolites which can lead to daytime sleepiness. This is one of the newer > sleep medications and may have some benefit in a small percentage of RLS > patients. > Prosom (Estazolam) > This comes in 1 mg and 2 mg tablets and is also one of the newer sleep > medications. Dosage ranges from 0.5 mg to 2 mg. It has a rapid onset of > action of 15-30 minutes and an intermediate duration of action of 6-8 hours. > It may be quite a reasonable drug for RLS in patients who have the time and > inclination to sleep a little longer (7-10 hours). It also has active > metabolites which may cause increased daytime sleepiness in many > individuals. > (B) Benzodiazepines marketed for anxiety > Xanax (Alprazolam) > This medication comes in 4 strengths; 0.25 mg, 0.5 mg, 1 mg and 2 mg > tablets. Doses range from 0.25 mg to 2 mg. The drug has fairly quick onset > of about 15-30 minutes and a duration of action of about 6-8 hours. Although > not marketed as a sleeping pill, Xanax works quite well to control nighttime > RLS problems without much daytime sleepiness in most users. Xanax is a > common choice of sleep specialists (we also like using this medication) for > use in RLS. > Valium (Diazepam) > This is one of the original sedative drugs. It has not been marketed for > sleep but actually may work well in many patients. It has a rapid onset of > action (less than 30 min). It’s duration of action can be variable from 6-10 > hours. > Valium comes in 2 mg, 5 mg, and 10 mg tablets. Effective dosages range from > 5 mg to 10 mg. > Klonopin/ Rivotril (Clonazepam) > Klonopin comes in 0.5 mg, 1 mg, and 2 mg tablets. The usual dose range is > 0.5 to 2 mg. This was the first drug used for RLS and PLMD. This is due to > its previous use in myoclonic seizures. PLMD used to be called nocturnal > myoclonus and thus this drug was tried for RLS/PLMD with great success. > The drug has a rapid onset of action (less than 30 min) but it has a very > long half-life (30-40 hours) causing a duration of action of 8-12 hours or > longer. Daytime sleepiness can be a problem in a large percentage of > patients on Klonopin. We therefore do not recommend this drug for most > patients with RLS. It is, however, very commonly prescribed for RLS due to > its early association with the treatment of RLS. It may work well in > patients who do have morning RLS and do not get drowsy or sleepy due to the > long lasting nature of this drug (which may persist at high levels in the > morning causing daytime sleepiness). > Many physicians prescribe Klonopin, as this is the original drug used for > RLS and is recommended by all the general medical textbooks that discuss > RLS. Some sleep specialists (and patients) prefer to use this drug for RLS, > but our experience has been that the shorter acting sedatives work better > for most RLS sufferers. > Ativan (Lorazepam) > Ativan is a tranquilizer that is used for stress rather than sleep. It is a > very common benzodiazepine drug which is used during the daytime to help > patients control anxiety. Like all the benzodiazepines, this drug will have > some usefulness when taken at bedtime for sleep. > This drug comes in 0.5 mg, 1 mg and 2 mg tablets. It has a half life of 12 > hours, so there is a very significant concern about daytime sleepiness the > morning after the medication is taken. The long half life is more useful > when Ativan is used for anxiety disorders, but may cause too much drowsiness > when used for nighttime RLS/PLMD and as a sleeping pill. > Serax (Oxazepam) > Serax is actually not a benzodiazepine, but is in a closely related class of > 3-hydroxybenzodiazepinones. This is a safer class of medication than the > benzodiazepines (such as Valium). It has a fairly rapid onset with rather > long half life of 5.7 to 10.9 hours. This is a rather long half life which > might result in daytime sleepiness, but many people who have tried it for > sleep, find that morning drowsiness is often not a problem. > Serax comes in 10 mg, 15 mg and 30 mg capsules. > NON-BENZODIAZEPINES SEDATIVES > Ambien (Zolpidem) > This is the first drug in this class. It is not a benzodiazepine, but it > does work selectively on some of the benzodiazepine nerve receptors (only > the omega 1 receptor of the 3 omega receptors). Because of this selectivity, > Ambien appears to have fewer side effects than other drugs in this class. It > is unique in sedative pills as it does not alter the sleep stages. Most > drugs in this class decrease stages 1, 3, and 4 (and possibly even REM > sleep) to increase stage 2 sleep. There have been as yet, no reported > tolerance or withdrawal problems with long term usage of Ambien. There are > also no problems with rebound insomnia (increased problems falling asleep > the night after using the drug) which occurs in short acting sedative. > Amnesia (loss of memory when awakening in the morning) does not occur as it > does with Halcion (see below). > Ambien comes in 5 mg and 10 mg tablets. Doses are 2.5 to 10 mg, doses > greater than 10 mg are no more effective than the 10 mg maximum dose. This > drug has very quick onset of action (less than 30 minutes), in fact it is > recommended that you should go to bed immediately after taking the > medication. The half-life of the medication is about 2.5 hours, which means > that daytime sleepiness is extremely unusual. Time will tell, but Ambien may > be an excellent choice for long term use in patients who get relief with > this drug. > Sonata (Zaleplon) > This is a new non-benzodiazepine drug from the pyrazolopyrimidine class of > drugs. It is similar in many ways to Ambien in that there is no > tolerance/addiction or withdrawal problems demonstrated yet and it acts on > the same omega 1 receptors in the brain. It also does not affect the sleep > stages. It works very quickly and should be taken as one goes to bed. There > are also no problems with amnesia
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Response:
Hello; I have tried Ambien, Nurontin, Halcion, and Xanax, and they do not seem to work for my rls, except perhaps for high doses of xanax. How effecective has anyone else found xanax at treating PLMD. I want to start about from the dopimine drugs. -Jamie (A) Benzodiazepine medications marketed for sleeping pills Halcion (Triazolam) This drug comes in 0.125 mg and 0.25 mg tablets. Doses range from 0.125 mg to 0.5 mg. It has a fast onset of action (15-30 minutes) and a very short half life, so that the duration of action is only 3-4 hours. This is also a popular sleeping pill and RLS medication. The problems with Halcion (and short acting hypnotic drugs in general) is that of rebound insomnia (which is much worsened insomnia the night after using the drug). Another problem is that of short term amnesia. This occurs upon awakening, after taking Halcion, resulting in a loss of memory of previous recent events occurring after taking the Halcion. Restoril (Temazepam) Temazepam has a longer than usual onset of action of 45-60 minutes. It is therefore not as good for RLS problems that occur on going to sleep. It is good for RLS and especially PLMD that may occur after sleep onset. It has a reasonable duration of action of 6-8 hours, so that it should sustain sleep all night and generally not cause morning sleepiness. The drug comes in 15 mg and 30 mg tablets and doses range from 7.5 mg to 30 mg. Dalmane (Flurazepam) This is the original benzodiazepine sleeping pill. It does have a rapid onset of action (15-30 min), but has a long half-life (8-10 hours) and in addition has active metabolites. These active metabolites (chemicals formed from the metabolism of the drug) occur after the Dalmane has lost in original effect and continue to act a sleep inducing chemicals, thus prolonging the hypnotic effect of the medication. Daytime sleepiness is thus a very significant problem with this medication. Dalmane comes in 15 mg and 30 mg capsules. Doses range from 15 – 30 mg. It is not on our recommended list of RLS medications, but has been used successfully in a minority of patients. Doral (Quazepam) Doral comes in 7.5 mg and 15 mg tablets. Dosage ranges from 7.5 to 15 mg. It has a fast onset of action of 15-30 minutes. It’s duration of action is 8-10 hours, so that morning sleepiness may be of some concern. It also has active metabolites which can lead to daytime sleepiness. This is one of the newer sleep medications and may have some benefit in a small percentage of RLS patients. Prosom (Estazolam) This comes in 1 mg and 2 mg tablets and is also one of the newer sleep medications. Dosage ranges from 0.5 mg to 2 mg. It has a rapid onset of action of 15-30 minutes and an intermediate duration of action of 6-8 hours. It may be quite a reasonable drug for RLS in patients who have the time and inclination to sleep a little longer (7-10 hours). It also has active metabolites which may cause increased daytime sleepiness in many individuals. (B) Benzodiazepines marketed for anxiety Xanax (Alprazolam) This medication comes in 4 strengths; 0.25 mg, 0.5 mg, 1 mg and 2 mg tablets. Doses range from 0.25 mg to 2 mg. The drug has fairly quick onset of about 15-30 minutes and a duration of action of about 6-8 hours. Although not marketed as a sleeping pill, Xanax works quite well to control nighttime RLS problems without much daytime sleepiness in most users. Xanax is a common choice of sleep specialists (we also like using this medication) for use in RLS. Valium (Diazepam) This is one of the original sedative drugs. It has not been marketed for sleep but actually may work well in many patients. It has a rapid onset of action (less than 30 min). It’s duration of action can be variable from 6-10 hours. Valium comes in 2 mg, 5 mg, and 10 mg tablets. Effective dosages range from 5 mg to 10 mg. Klonopin/ Rivotril (Clonazepam) Klonopin comes in 0.5 mg, 1 mg, and 2 mg tablets. The usual dose range is 0.5 to 2 mg. This was the first drug used for RLS and PLMD. This is due to its previous use in myoclonic seizures. PLMD used to be called nocturnal myoclonus and thus this drug was tried for RLS/PLMD with great success. The drug has a rapid onset of action (less than 30 min) but it has a very long half-life (30-40 hours) causing a duration of action of 8-12 hours or longer. Daytime sleepiness can be a problem in a large percentage of patients on Klonopin. We therefore do not recommend this drug for most patients with RLS. It is, however, very commonly prescribed for RLS due to its early association with the treatment of RLS. It may work well in patients who do have morning RLS and do not get drowsy or sleepy due to the long lasting nature of this drug (which may persist at high levels in the morning causing daytime sleepiness). Many physicians prescribe Klonopin, as this is the original drug used for RLS and is recommended by all the general medical textbooks that discuss RLS. Some sleep specialists (and patients) prefer to use this drug for RLS, but our experience has been that the shorter acting sedatives work better for most RLS sufferers. Ativan (Lorazepam) Ativan is a tranquilizer that is used for stress rather than sleep. It is a very common benzodiazepine drug which is used during the daytime to help patients control anxiety. Like all the benzodiazepines, this drug will have some usefulness when taken at bedtime for sleep. This drug comes in 0.5 mg, 1 mg and 2 mg tablets. It has a half life of 12 hours, so there is a very significant concern about daytime sleepiness the morning after the medication is taken. The long half life is more useful when Ativan is used for anxiety disorders, but may cause too much drowsiness when used for nighttime RLS/PLMD and as a sleeping pill. Serax (Oxazepam) Serax is actually not a benzodiazepine, but is in a closely related class of 3-hydroxybenzodiazepinones. This is a safer class of medication than the benzodiazepines (such as Valium). It has a fairly rapid onset with rather long half life of 5.7 to 10.9 hours. This is a rather long half life which might result in daytime sleepiness, but many people who have tried it for sleep, find that morning drowsiness is often not a problem. Serax comes in 10 mg, 15 mg and 30 mg capsules. NON-BENZODIAZEPINES SEDATIVES Ambien (Zolpidem) This is the first drug in this class. It is not a benzodiazepine, but it does work selectively on some of the benzodiazepine nerve receptors (only the omega 1 receptor of the 3 omega receptors). Because of this selectivity, Ambien appears to have fewer side effects than other drugs in this class. It is unique in sedative pills as it does not alter the sleep stages. Most drugs in this class decrease stages 1, 3, and 4 (and possibly even REM sleep) to increase stage 2 sleep. There have been as yet, no reported tolerance or withdrawal problems with long term usage of Ambien. There are also no problems with rebound insomnia (increased problems falling asleep the night after using the drug) which occurs in short acting sedative. Amnesia (loss of memory when awakening in the morning) does not occur as it does with Halcion (see below). Ambien comes in 5 mg and 10 mg tablets. Doses are 2.5 to 10 mg, doses greater than 10 mg are no more effective than the 10 mg maximum dose. This drug has very quick onset of action (less than 30 minutes), in fact it is recommended that you should go to bed immediately after taking the medication. The half-life of the medication is about 2.5 hours, which means that daytime sleepiness is extremely unusual. Time will tell, but Ambien may be an excellent choice for long term use in patients who get relief with this drug. Sonata (Zaleplon) This is a new non-benzodiazepine drug from the pyrazolopyrimidine class of drugs. It is similar in many ways to Ambien in that there is no tolerance/addiction or withdrawal problems demonstrated yet and it acts on the same omega 1 receptors in the brain. It also does not affect the sleep stages. It works very quickly and should be taken as one goes to bed. There are also no problems with amnesia or next day sleepiness. Sonata comes in 5 and 10 mg tablets. It can be taken up to 20 mg, but the starting dose is 10 mg for most adults, and 5 mg for elderly patients or very small people. It should not be taken after a meal that is high in fat, as that will delay absorption and cause a significant decrease in its effectiveness. Care should be taken when used with Tagamet (cimetidine), as it will cause higher levels of Sonata (therefore, start with 5 mg for patients on Tagamet). One major difference from Ambien is that this drug has a half life of only 1 hour (compared with 2..5 hours for Ambien), which makes this the fastest metabolized sedative that is prescribed. It is suggested that due to this short half life, that Sonata will only result in about 4 hours of sleep. Some clinical studies suggest that the actual sleep times with this drug will only be minimally shorter than with Ambien. This may be a good drug to take in the middle of the night when quick relief is need for RLS insomnia, but when one needs to be awake and alert a few hours later (there are no studies yet to show whether or not this will be the case). As this drug is quite new, only time will tell how well it works for RLS and for sleep in general. Imovane (Zopiclone) Available only in Canada – can not get this in the USA Zopiclone, a cyclopyrrolone derivative, is a short-acting hypnotic agent. Imovane belongs to a novel chemical class which is structurally unrelated to existing hypnotics. This drug is similar to Ambien (which is not available in Canada). The half-life of zopiclone ranges from 3.5 to 6.5 hours. In the elderly, the elimination half-life is prolonged to approximately 7 hours and in patients with liver insufficiency it was substantially prolonged to11.9 hours. Compounds which … read more »
