How does Dr. Enlander rotate sleep meds?

[CBS64]

This is a question for current or former patients of Dr. Enlander. I had a Skype session with him over the summer and he said to take Klonopin and Doxipin for sleep. At the time, I was sleeping ok so I didn't need it. But I recently had to start taking it because my sleep got much worse. My local doctor said it's only for short term use, so he clearly doesn't want me taking it very long (since I haven't seen Dr. Enlander in person, he can't call in meds for me). I came across an interview with Dr. Enlander recently in which he said he rotates the sleep meds, so that patient's bodies don't get addicted to them. Can anyone tell me what he rotates with the Klonopin/Doxipin and how he does this (e.g., 3 weeks on Klonopin/Doxipin, followed by 3 weeks on something else)?

Thanks very much

 

[heapsreal]

As far as how often to rotate, its an individual thing. What to rotate with you have to search out other drug classes etc eg other sedating antidepressants like amitriptyline, mirtazapine maybe low doses of seroquel. then antihistamines like diphenhydramine, atarax, phenergan there are many more. another option is the z-drugs like zolpidem or zopiclone.

Something different but similar to what you are using would be to try zolpidem with amitriptyline. Depending on how long the doxepin/klono worked for you say 2 months, then maybe use what i just recommended for 2 months or maybe 1 month and then back to klono/doxepin or switch to mirtazapine with or without a benzo like temazapam.

Generally the benzo is to help one fall asleep and the sedating antidepressant is to help keep one asleep and asisst in reaching deeper stages of sleep.

cheers!!

 

[Living Dead]

You definetely should not use Klonopin for 3 weeks. Try something more like 1 week on 10 days off, then repeat.

 

[SanDiego#1]

You definetely should not use Klonopin for 3 weeks. Try something more like 1 week on 10 days off, then repeat.

 

[SanDiego#1]

I agree with Liv Dead- and Heapreal--My CFS Dr. puts a lot of people on Klonopin. I only took 1/4 tablet of the low mg for sleep with Mag.
I could tell in 3 days I could not stay on it. Very addictive. Also had to increase dosage very quickly for it to work.
I can see rotating anything like that would be best way to go. Just be careful-You get carry over the next day and may not know it until you drive or move around.It can be dangerous. I always start on the low end of anything sedating.

San Diego

 

[SanDiego#1]

I agree with Liv Dead- and Heapreal--My CFS Dr. puts a lot of people on Klonopin. I only took 1/4 tablet of the low mg for sleep with Mag.
I could tell in 3 days I could not stay on it. Very addictive. Also had to increase dosage very quickly for it to work.
I can see rotating anything like that would be best way to go. Just be careful-You get carry over the next day and may not know it until you drive or move around.It can be dangerous. I always start on the low end of anything sedating.

San Diego