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Sleep: mirtazapine vs gabapentin

62milestogojoe

What's a forum then?
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221
Location
UK
Just a quick one. Mirtazapine has been my go to drug for 8 hours sleep for a couple of years, usually putting me out at a small dosage-I cut a 15mg tablet in approximately 3 pieces and take one piece (so about 5mg).

The drug does not give me refreshing N3 sleep but gets me to what I term 2.8 or 2.9.
I always take 5-HTP and l-theanine (serotonin precursors) and 500mg of Mg 1 hour before bed and did the same last night when I dosed 500mg of gabapentin and did not take mirth-as-a pea (mirtazapine).

Quick reflection on sleep quality: more 'knocked out on gaba with less dreaming. Negatives are I had to sit up in bed and not move for 20 minutes following gaba because I was so 'punch-drunk'. I remain a little spaced out 3 hours later and am moving slowly, which does not happen with 5mg mirtazapine.

Conclusion: for me working 2 days a week I would not take gaba the night before work because I would not be safe commuting by motorcycle. I would take gaba with a day off the next day.

Any thoughts on relatively safe non addictive drugs?
 

msf

Senior Member
Messages
3,650
Trazodone works well for me at 100-150mg a night (I think body weight probably has an effect on the amount you need). Since my gut has improved, I usually don´t wake up during the night if I remember to take the Trazodone.
 
Last edited:

62milestogojoe

What's a forum then?
Messages
221
Location
UK
Trazodone works well for me, at 100-150mg a night (I think body weight probably has an effect on the amount you need). Since my gut has improved, I usually don´t wake up during the night if I remember to take the Trazodone.
Hi MSF, interesting, I hadn't heard about it. Do you think you attain deep, refreshing (N3) sleep from the drug? In studies N3 is missing or depleted in ME patients.
I pinched this from 'how sleep works' website

'Stage 3 (NREM3 or N3) is also known as deep or delta or slow-wave sleep (SWS), and during this period the sleeper is even less responsive to the outside environment, essentially cut off from the world and unaware of any sounds or other stimuli. Stage 3 sleep occurs in longer periods during the first half of the night, particularly during the first two sleep cycles, and represents around 15%-20% of total adult sleep time. Stage 3 is characterized by delta brain waves with a frequency of around 0.5-4 Hz, along with some sleep spindles, although much fewer than in stage 2. Historically, what is now usually described as stage 3 (following the guidelines of the American Academy of Sleep Medicine) was split into two stages, stage 3 and stage 4, depending on the frequency of delta waves (stage 4 was initially defined as when delta waves exceeded 50% of the total).'
 

msf

Senior Member
Messages
3,650
I don´t know, but I wake up feeling okayish most days. I think the tiredness I feel these days is mostly from lactic acid build up, rather than lack of refreshing sleep.
 

bombsh3ll

Senior Member
Messages
287
I take half a 15mg tablet of mirtazapine at night, for sleep and nausea (it is a potent antiemetic used in veterinary medicine but not currently licenced for this in humans)

I have tried gabapentin not for sleep but for pain and sympathetic excess symptoms, but didn't find it helpful.

My next suggestion which I have yet to try is pregabalin. some people do use this for sleep. Have you tried this?

Benzodiazepines used sparingly also work a treat for me but are obviously neither effective nor easy to obtain on a long term basis.

I also take melatonin 3mg every night.
 

62milestogojoe

What's a forum then?
Messages
221
Location
UK
I take half a 15mg tablet of mirtazapine at night, for sleep and nausea (it is a potent antiemetic used in veterinary medicine but not currently licenced for this in humans)

I have tried gabapentin not for sleep but for pain and sympathetic excess symptoms, but didn't find it helpful.

My next suggestion which I have yet to try is pregabalin. some people do use this for sleep. Have you tried this?

Benzodiazepines used sparingly also work a treat for me but are obviously neither effective nor easy to obtain on a long term basis.

I also take melatonin 3mg every night.
Hi, haven't tried pregabalin. Didn't know mirtazapine was used as an anti emetic, interesting. Ditto diazepam sometimes.
 

jpcv

Senior Member
Messages
386
Location
SE coast, Brazil
I took Mirtazapine once and it knocked me out for almost a day.
Trazodone is a good drug and melatonin helps too.
There is one interesting drug Valdoxan, an antidepressive drug that also can help you with yoour sleep.
 

62milestogojoe

What's a forum then?
Messages
221
Location
UK
I took Mirtazapine once and it knocked me out for almost a day.
Trazodone is a good drug and melatonin helps too.
There is one interesting drug Valdoxan, an antidepressive drug that also can help you with yoour sleep.
I guess what I'm trying to say is that given evidence of highly specific damage to the left thalamic intralaminar nucleus shown in the Osaka research and highlighted in the diagram I drew on the Neurological forum-jesus -take a breath!
We need sleeping drugs that can put us into N3 sleep.

This may not be possible if the brain damage to specific functional brain loci is permanent.
 

jpcv

Senior Member
Messages
386
Location
SE coast, Brazil
I guess what I'm trying to say is that given evidence of highly specific damage to the left thalamic intralaminar nucleus shown in the Osaka research and highlighted in the diagram I drew on the Neurological forum-jesus -take a breath!
We need sleeping drugs that can put us into N3 sleep.

This may not be possible if the brain damage to specific functional brain loci is permanent.
I agree, i´m just saying what works for me.
 

pattismith

Senior Member
Messages
3,931
In studies N3 is missing or depleted in ME patients.
I pinched this from 'how sleep works' website

'Stage 3 (NREM3 or N3) is also known as deep or delta or slow-wave sleep (SWS), and during this period the sleeper is even less responsive to the outside environment, essentially cut off from the world and unaware of any sounds or other stimuli. Stage 3 sleep occurs in longer periods during the first half of the night, particularly during the first two sleep cycles, and represents around 15%-20% of total adult sleep time.

Is that right that N3 is missing in ME patient?

It's interesting to notice that it is the same with hibernation according to this site:

"Hibernation leads to the suppression of slow-wave sleep activity similar to that seen in sleep deprivation."

The question wether there is a blood messenger that switches cells into hibernation state is not yet clearly solved, but:

"Researchers have devoted much effort to the search for a possible blood-borne chemical messenger that might communicate a signal within the brain and to other body tissues, causing entry to hibernation.
Serum from hibernating animals such as the woodchuck (Marmota monax; Figure 8), when injected into active animals, can induce torpor. Partly purified serum extracts are also able to induce hibernation-like behavioural changes in a variety of mammalian species. Chemical analysis of the serum extracts reveals two components, one of high molecular mass (M r = 88 000) which has a structure closely resembling a natural protease inhibitor, and the other of low molecular mass (M r < 5000) which is a member of the family of natural morphine-like or ‘opioid’ compounds. Pure samples of an opioid called enkephalin also induce hibernation in Colombian ground squirrels (Spermophilus columbianus). Dynorphin A is another opioid present in the ground squirrel brain. It acts at so-called delta receptor sites similar to those for enkephalin and rises during hibernation to a level 15 times higher than in non-hibernating euthermia, reaching an intermediate level in euthermia between bouts of hibernation. The origin of the different hibernation-inducing trigger components is not certain, but these observations point to the possibility that the blood circulation does contribute to the transmission of the signal to enter hibernation from one tissue to another. Opioids also have remarkable properties in inducing survival of cells in the brain and other organs under anoxic conditions. This discovery has led to an interest in the chemical induction of hibernation amongst medical researchers seeking ways in which to prolong tissue survival after trauma, or during and after transplantion."