Eight days ago, my doctor prescribed a brand new insomnia drug called Lunesta. Lunesta seemed like a dream to me. It had very few side effects (mostly dry mouth), showed little signs of tolerance build-up, almost no chance of physiological addiction and was the first drug ever produced that was safe to use indefinitely for the treatment of insomnia. And for the first five days, it was my miracle. I took the pill by9:30 and was out by 10 am. I was waking up at 9 am on the weekend and 6:13 am on the weekday with little drag. Then slowly, like all other medications, it quit working. Friday night saw me awake until 4:30 am (despite getting up at 5:13 am the previous day) and I woke up on Sunday morning at noon:45 while going to bed a 9 pm the following night. I did fall asleep on Sunday night (probably due to sheer exhaustion) but here I am again facing another sleepless night followed by a day with 7.5 hours worth of meetings scheduled which I cannot miss.

I’m in trouble folks. This crap is getting worse by the month and is consuming my life. Yes, I have tried all the medication ways and looking back, I might have just been better off without trying anything but I can’t go back now. I don’t even know if I can go back to see the doctor because it would just be to damn embarrassing. Something’s gotta give here.

Read Part I

My recent battle with pneumonia made me finally get off my ass and find a GP doc. I ended up going with the one I first saw at the urgent care center but I really liked her and her location in Issaquah is convenient so it all worked out. On a side note, I’ve always preferred female doctors for some reason and generally trust their advice more than a male’s.

Anyway, doc had me come in every couple of days for checkups (my lungs were really bad) and she had me fill out the cursory five page, medical history. Insomnia was on the list and I checked it not thinking too much of it. Doc noticed it and we talked for a long time about my struggles with sleeping. I told her I had tried Ambien but didn’t like it and she knew exactly why, lol. She didn’t prescribe me anything then because I was already on a truckload of crap already but she’d have something for me when I came back on the following Friday.

On the nights before the appointment, I found myself anxious for Friday like it was Christmas morning. Hell, I didn’t care if she prescribed me Ambien because I was so desperate for anything that could help. Please, please, please let her give me something good, I thought.

On Friday, she gave me a one month’s prescription for Trazodone, an anti-depressant. Here are some interesting things I’ve found out about Trazodone:

General:
Trazodone, is a modified cyclic antidepressant. Trazodone belongs to the group of medicines known as antidepressants or “mood elevators.” It is used to relieve mental depression and depression that sometimes occurs with anxiety.

Pharmacology:
n animals, trazodone HCl selectively inhibits serotonin uptake by brain synaptosomes and potentiates the behavioral changes induced by the serotonin precursor, 5-hydroxytryptophan.

Peak plasma levels occur approximately one hour after dosing when trazodone HCl is taken on an empty stomach or two hours after dosing when taken with food.

For those patients who responded to trazodone HCl in clinical trials, one-third of the inpatients and one-third of the outpatients had a significant therapeutic response by the end of the first week of treatment. Three-fourths of all responders demonstrated a significant therapeutic effect by the end of the second week. One-fourth of responders required 2-4 weeks for a significant therapeutic response.

Warnings/ Side effects:
Trazodone has been associated with the occurrence of priapism (inappropriate and excruciatingly long erections). In approximately 1/3 of the cases reported, surgical intervention was required and, in a portion of these cases, permanent impairment of erectile function or impotence resulted. Male patients with prolonged or inappropriate erections should immediately discontinue the drug and consult their physician. If the condition persists for more than 24 hours, it would be advisable for the treating physician to consult an urologist or appropriate specialist in order to decide on a management approach.

Insomnia. Trazodone has been associated with the occurrence of insomnia. (WHAT?)

I know drug makers have to warn about every possible side effect but I was concerned that almost every website warned about the drug causing insomnia, though they also said that Trazodone is often used to treat insomnia.

Make no mistake though, I’m not anywhere near depressed, it’s just that serotonin reuptake inhibitors often help insomniacs “turn off” their brain at night and allow them to sleep.

So how has it helped me? I’m on my third night and I have to say that the only difference I’ve noticed are incredibly vivid dreams (and not the good kind either, lol). I haven’t fallen asleep any earlier than I would have normally but most of the research I read on Trazodone said that it takes 8-10 days for the drug to become effective. We’ll see.

I should have known that if I wrote about insomnia, I would be awake all night and I was. My body finally gave up and turned off my brain around 7:37 am dammit. I woke up around 2 pm and it will be oh so easy to fall asleep tonight…

I’ve suffered from varying degrees of insomnia as long as I can remember. Even when I was little when all the neighborhood kids got up early on the weekends to see the cartoons, I was still sound asleep because I was awake at 3 am. I first noticed I had a problem around 10 years old. My friend Tommy and I had a sleep over every weekend and always had “a plan.” The plan always had something to do with staying up very late to do something we weren’t supposed to do and invariably, Tommy was always sound asleep by midnight and I was forced to lie awake in my cot for several hours.

Then I remember not being able to sleep at all or very, very little while at week long summer Boy Scout camps when I was in junior high. These camps terrified me because it meant that after Wednesday, I’d be a zombie until my parents picked me up on Sunday. I went to three of those and none were particularly pleasant.

By high school, I’d learned to deal with it and it only became a problem when my lack of sleep adversely affected my cycling performance. It was irritating, but manageable.

In college, I was a mess. My new found freedom let me stay up as long as I wanted and it made things worse. See, I just don’t get tired. When I lie down and turn off the lights, my brain turns on. I’m not anxious nor a worrier, I just think about all sorts of things. I quickly realized that I had two choices for classes. Either take 6:30 am classes or take the 6:30 pm classes. If I scheduled any classes between 9:30 am and 5 pm, I was just going to end up skipping too many to be successful. And we don’t need Paul Harvey to tell us “the rest of the story” on this one…

After college, every night became the same. Around 7-8 pm, I’d start to think about mitigation plans around sleep. Could I make it through tomorrow if I didn’t get a wink? Could I somehow leave early if I really had to? All this crap really affected my social and sex life. Thinking about sleep almost became an obsession for me. Tylenol PM type products (anything containing at least 25mg of Diphenhydramine hydrochloride) worked for a few weeks but then lost their effectiveness so I quit. I figured I just had to live with it. Despite insomnia being a pretty common problem, I had met very few individuals who had it and absolutely nobody who suffered like I did. In 2002, I met Amy’s best friend Cami who was also a chronic insomniac who was actually worse than me. This actually made me feel a ton better, especially when she was prescribed the anti-depressant Zoloft and her symptoms went away. Cami was anything but depressed but the Zoloft helped her “turn her brain off” when she got in bed. She urged me to see a doctor. The doctor I saw prescribed Ambien which made me hallucinate, gave me very long and inappropriate erections, made me forget everything that happened about 20 minutes after taking it and promptly quit working just four days later. I went back to that doctor but she accused me of trying to “scam her” into getting more Ambien (even though I brought back four pills I still had) so I just gave up.

Tomorrow I’ll continue with this story and tell you what my new doc says about the problem.

(Read Part II)