Posted by dan16 on October 04, 2005 at 07:35:18:

In Reply to: Sinking fast losing hope posted by hendo on October 03, 2005 at 21:31:37:

Some years ago I was given Elavil, (Amitriptylin) for a spastic colon, to be taken 3x daily. After a while, I noticed that it was taking me 2 1/2 hours to fall asleep, and I would wake up after 4 hours. I told this to the doctor, who told me that people didn't need much sleep and increased the dose to 4x daily. (This was many years ago). I then began waking up after only 2 1/2 hours, and I began feeling extremely irritable, so I discontinued it. I couldn't sleep for two nights, and afterwards, only 2 1/2 hours nightly, with extremely frequent diarrhea, far worse that it had ever been before. The doctor didn't understand why, and protested that it was only a small dose. I had read that niacinamide could alleviate diarrhea, and purchased some. I found that I needed 2000 mg to moderate but not cure it. I wrote to Merck telling them of the problem and they advised another doctor I saw to use prednisone, and 5 mg of that helped improve the sleep to 4 hours nightly, and I was able to function better, but a long way from a cure.
I read of a discovery of a hormone (melatonin)that was released at night, so I figured out that excess cortisol blocked the release of this hormone, causing insomnia. I thought that takeing this hormone would help me sleep better, so when it became available, I purchased some, but found that it did not help at all.
I read on this board that some people were helped by using Remeron. I found out that Remeron significantly reduced levels of cortisol, so I thought that this would be helpful. A doctor gave me some 30 mg samples, and I found I was able to sleep 5-6 hours nightly on that amount. I tried 15 mg, but could only get 3-4 hours on that amount, so I went higher, to 45 mg, and could get 7-8 hours on that amount. I had to used that amount several months befor I was able to reduce it, then went to 30 mg for several more monthe, and am now down to 22 1/2 mg. I have had insomnia for more than 20 years since being given the Amitriptylin.
I thing that it overstimulated the adrenal gland, to produce more cortisol that the body requires. I believe that taking the generic equivalent of Remeron (mirtazapine) the adrenals gradually become less active, leading to a reduction of cortisol, eliminating insomnia.
The amount of mirtazapine required varies with each person. Some people do well on 7 1/2 mg, another posted said he had to use 60 mg to get 8 hours sleep. The cost of generic mirtazapine in aroung $42 for 30 pills, less than ambien. If 15 mg does not work, try 30 mg and see what happens.
Other antidepressants that may work are trazodone, and doxepin, which also reduce cortisol, but mirtazpine seems to be the most effective. Read up on these medications, and see what you can find out.

Good luck.

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