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Excedrin PM

Messages
37
Location
Berkeley, CA
(I just edited this because I;d typed Exc. AM instead of PM!)

I was reading the CFS doctors' recommendations for sleep drugs. I'm interested in prolonging sleep, because I invariably wake up within 5 hours and then it's toss and turn and misery and some dozing, but whatever it is not 8 hours of acceptable sleep. I noticed that aside from the main recommendations one doctor swears by Excedrin PM and Tylenol PM. What he doesn't say is whether it's for sleep onset or sleep prolonging. Anyone know? anyone try them?

And what have you used for prolonging sleep? Given that everyone reacts differently, I wont' assume it'll work for me). What side-effects? The most-mentioned drug for this was Trazadone. I can't talk to my doc for a couple of weeks though, but it may be something I'd like to try. Anyone use this?

Thanks you all.
 
Last edited:

SOC

Senior Member
Messages
7,849
I was reading the CFS doctors' recommendations for sleep drugs. I'm interested in prolonging sleep, because I invariably wake up within 5 hours and then it's toss and turn and misery and some dozing, but whatever it is not 8 hours of acceptable sleep. I noticed that aside from the main recommendations one doctor swears by Excedrin AM and Tylenol PM. What he doesn't say is whether it's for sleep onset or sleep prolonging. Anyone know? anyone try them?

And what have you used for prolonging sleep? Given that everyone reacts differently, I wont' assume it'll work for me). What side-effects? The most-mentioned drug for this was Trazadone. I can't talk to my doc for a couple of weeks though, but it may be something I'd like to try. Anyone use this?

Thanks you all.
My first ME specialist recommended Tylenol PM for sleep initiation and prescribed trazodone for sleep maintenance. It worked very well for me. I went from taking hours to fall asleep and waking every 1-2 hours to falling asleep within 10 minutes and sleeping through the night. It was like heaven. ;)

Later, when I improved with antiviral treatment, I was able to give up the Tylenol PM and still fall asleep, but I still need the trazodone to maintain sleep. If I wake up once in the night, which I often do, I fall asleep again immediately.

IIRC, Excedrine AM is just an analgesic with a bunch of caffeine, so I'm not sure why the doc thinks that will help unless he's figuring if the caffeine keeps you awake during the day, you might sleep better at night. o_O

I have had no apparent side effects from trazodone, but have heard other people have had some bad ones, so it's probably best to start low and work up if you're concerned about possible side effects.
 

minkeygirl

But I Look So Good.
Messages
4,678
Location
Left Coast
Why not just take the diphenhydramine and forget the Tylenol? That can kill your liver

Every one here had a different experience with sleep meds. I like trazodone but not the Teva Pliva generics. Some people hate it

Really you just have to experiment with everything.

I layer 3 or 4 things. I use benzos for sleep initiators because nothing else works. I have two otc antihistamines that I use. One is doxylamine. I use Passion flower and kava. Seroquel too

The key with sleep meds is not take the same thing every night because of tolerance.

If your doc will work with you try different things and have an assortment to alternate

There are tons of threads about sleep stuff here.
 

Sushi

Moderation Resource Albuquerque
Messages
19,934
Location
Albuquerque
Tylenol PM. What he doesn't say is whether it's for sleep onset or sleep prolonging. Anyone know? anyone try them?
These "PM" meds essentially are adding Benadryl (an antihistamine) to acetaminophen or Tylenol. You can look up the effects of Diphenhydramine Hydrochloride (Benadryl) on sleep function. There are some risks associated with continuous use of both Tylenol and Benadryl, though there also are for prescription sleep meds. We each just need to look at the pros and cons.
 

SOC

Senior Member
Messages
7,849
Why not just take the diphenhydramine and forget the Tylenol? That can kill your liver.
Good point. FWIW, I did try that and it didn't work for me at first. I had enough low-level aches that they kept me awake, so I needed the analgesic along with the diphenhydramine to fall asleep. Later, when the AVs reduced the aches, I did switch to diphen alone for a while before dropping that as well.

Every one here had a different experience with sleep meds. I like trazodone but not the Teva Pliva generics. Some people hate it.
Thanks for reminding me. I had forgotten that I have had very bad symptoms with the Teva/Pliva generic of trazodone only. The symptoms came on within hours of taking a dose and disappeared in less than 36 hours of stopping the Teva/Pliva trazodone. I have no trouble with other brands. I would do without trazodone rather than take the Teva/Pliva generic -- and that's saying a lot because I love getting a decent night's sleep after years of very little sleep.
 

Sushi

Moderation Resource Albuquerque
Messages
19,934
Location
Albuquerque
I had forgotten that I have had very bad symptoms with the Teva/Pliva generic of trazodone only. The symptoms came on within hours of taking a dose and disappeared in less than 36 hours of stopping the Teva/Pliva trazodone.
Gee, I just got a script for trazodone (haven't tried it yet) and the pill says Pliva. I guess Teva and Pliva are the same company? What were the side effects and how do you get another brand when that is what the major pharmacies dispense?
 

minkeygirl

But I Look So Good.
Messages
4,678
Location
Left Coast
@Sushi. Teva bought Pliva a few years ago. Teva used to use Barr Apotex recipe. Now Apotex sells on their own and the brand I prefer. Teva now uses Pliva.

Last I heard Apotex was stopping production. They had problems with the fda a few years ago so maybe some hold with them. I couldn't get an answer from them nor could my pharmacist

I tapered off too vs using Teva or Pliva. I had side effects although I can't remember what

Qualitest makes one and so does Mutual. There is another, Major but they use Teva.

Many people say that Teva Pliva doesn't even work if you can take it. Most places I called only carry the junk brand but I also think there might be regional variations.

I like trazodone when I wake up around 3-4 am. No drug hangover and about 3 more hours sleep. I never slept through the night with it
 

SOC

Senior Member
Messages
7,849
Gee, I just got a script for trazodone (haven't tried it yet) and the pill says Pliva. I guess Teva and Pliva are the same company? What were the side effects and how do you get another brand when that is what the major pharmacies dispense?
Yes, Pliva and Teva are the same... or they're produced in the same factories, at least.

I get very severe suicidal ideation and I am not at all suicidal, or even depressed, otherwise. It comes on suddenly and disappears almost as suddenly. Since I know it's medication-induced, I know better than to take it as my genuine emotional state or act on it in any way, but it feels awful and takes a lot of mental energy to put aside and get on with life until it wears off.

I can't tell you how much I hate it when I wake up the next morning with That Feeling and think, "Damn! I forgot to check that new bottle of trazodone to see if the pharmacy gave me the wrong one." I know I'm going to be miserable for the next day or two and there's nothing I can do about it except survive until the med wears off.

I told my doc about the rxn and so I usually get a script that says "No Pliva or Teva generic". The pharmacy has to order another generic if they usually carry Pliva/Teva, but that's what they're supposed to do. I've even had luck, when the doc forgot to write No Pliva/Teva, telling the pharmacy I have a bad rxn to that brand and need another. I've never had a problem with an in-person pharmacy. Mail-order pharmacies are a different matter. They are apparently not equipped to deal with those kind of 'special' requests.
 

minkeygirl

But I Look So Good.
Messages
4,678
Location
Left Coast
Only one pharmacy in my area carries anything other than Pliva or Teva. Many are at the whim of their wholesalers. So even if your doc writes no Pliva or Teva, the pharmacy may not be able to accommodate you.
 

*GG*

senior member
Messages
6,389
Location
Concord, NH
And what have you used for prolonging sleep? Given that everyone reacts differently, I wont' assume it'll work for me). What side-effects? The most-mentioned drug for this was Trazadone. I can't talk to my doc for a couple of weeks though, but it may be something I'd like to try. Anyone use this?

Thanks you all.

Yes, I was on Trazadone for a few years, been on Remeron since 2009, woke up feeling more refreshed in the morning/day. Might not be the same for you, which I know you figured :)

GG
 
Messages
37
Location
Berkeley, CA
My first ME specialist recommended Tylenol PM for sleep initiation and prescribed trazodone for sleep maintenance. It worked very well for me. I went from taking hours to fall asleep and waking every 1-2 hours to falling asleep within 10 minutes and sleeping through the night. It was like heaven. ;)

Later, when I improved with antiviral treatment, I was able to give up the Tylenol PM and still fall asleep, but I still need the trazodone to maintain sleep. If I wake up once in the night, which I often do, I fall asleep again immediately.

IIRC, Excedrine AM is just an analgesic with a bunch of caffeine, so I'm not sure why the doc thinks that will help unless he's figuring if the caffeine keeps you awake during the day, you might sleep better at night. o_O

I have had no apparent side effects from trazodone, but have heard other people have had some bad ones, so it's probably best to start low and work up if you're concerned about possible side effects.

@I don't see your username. Huge typo-- I meant Excedrine PM, not AM. Is there a way to edit a post?
Probably, since the doc I'm quoting mentioned Tyl. & Exced. PM in the same breath, they are BOTH for initiation of sleep. I was wondering whether to bother trying it, but I won't. Thanks for the info.
 

SOC

Senior Member
Messages
7,849
@I don't see your username. Huge typo-- I meant Excedrine PM, not AM. Is there a way to edit a post?
Probably, since the doc I'm quoting mentioned Tyl. & Exced. PM in the same breath, they are BOTH for initiation of sleep. I was wondering whether to bother trying it, but I won't. Thanks for the info.
You can click the Edit button at the bottom of your post and correct it, but that might just lead to more confusion. :) Since you've corrected your statement later in the thread, that's probably sufficient. We've all got some degree of cognitive dysfunction and understand that those kinds of typos happen. :hug:
 
Messages
37
Location
Berkeley, CA
Why not just take the diphenhydramine and forget the Tylenol? That can kill your liver

Every one here had a different experience with sleep meds. I like trazodone but not the Teva Pliva generics. Some people hate it

Really you just have to experiment with everything.

I layer 3 or 4 things. I use benzos for sleep initiators because nothing else works. I have two otc antihistamines that I use. One is doxylamine. I use Passion flower and kava. Seroquel too

The key with sleep meds is not take the same thing every night because of tolerance.

If your doc will work with you try different things and have an assortment to alternate

There are tons of threads about sleep stuff here.
@minkeygirl I've been around this block dozens of times myself. Right now I'm using Xanax for anxiety every day and it will make me groggy so it's good for sleep. But I wanted not to be taking it all the time. So I switched back to Klonopin for getting to sleep, partly because it doesn't metabolize so quickly and I had hoped it would help me sleep longer. It doesn't. I might give Trazadone a try. I seem to react to everything, though, and am not crazy about adding another drug. But if it works it would be a blessing... The other thing I tried for a while was Ambien, but it didn't give me a full night; it was good when getting to sleep initially was the problem. But within a few days I had intolerable dry mouth, which, aside from being uncomfortable, is really bad for your teeth.
 
Messages
37
Location
Berkeley, CA
@Sushi. Teva bought Pliva a few years ago. Teva used to use Barr Apotex recipe. Now Apotex sells on their own and the brand I prefer. Teva now uses Pliva.

Last I heard Apotex was stopping production. They had problems with the fda a few years ago so maybe some hold with them. I couldn't get an answer from them nor could my pharmacist

I tapered off too vs using Teva or Pliva. I had side effects although I can't remember what

Qualitest makes one and so does Mutual. There is another, Major but they use Teva.

Many people say that Teva Pliva doesn't even work if you can take it. Most places I called only carry the junk brand but I also think there might be regional variations.

I like trazodone when I wake up around 3-4 am. No drug hangover and about 3 more hours sleep. I never slept through the night with it
@minkeygirl About getting another few hrs. with Trazadone---how quickly does it work?
 

minkeygirl

But I Look So Good.
Messages
4,678
Location
Left Coast
@skiesareclearing I think it's different for everyone even with what it says. For example it's supposed to last 6 hours but for me it's only 3 or 4. That's why I can take it at 3 a.m. and not feel drugged when I wake up at 6 a.m. I used to take it nightly but always with other stuff. I stopped when I couldn't get the generic I used.

Like I said, it's all about experimenting and layering stuff. And alternating so you don't build tolerance. No matter what anyone says, everything has the potential for tolerance and dependence.

Everyone is different, meds work differently and all you can do is try stuff and see how it works for you. And I can take the same thing 2 nights and have a completely different outcome.

I use a small amount of antihistamine with my 3 a.m waking. I just don't take something that will leave me drugged. I experiment to find out what works.


  1. Trazodone has biphasic elimination with a redistribution half-life of about one hour and an elimination half-life of 10-12 hours. Onset of action.
    Antidepressant effect: it takes about 1-3 weeks to notice effects. Sleep aid effect: 1-3 hours.
 

A zombie

Senior Member
Messages
197
Cannibis oil. It gets you to sleep and KEEPS you asleep with no harsh rx. I do need a small amount of xanax (.25 mg- i was taking 3 plus mg prior to CO)
 
Messages
37
Location
Berkeley, CA
Cannibis oil. It gets you to sleep and KEEPS you asleep with no harsh rx. I do need a small amount of xanax (.25 mg- i was taking 3 plus mg prior to CO)
I tried CBD oil (from hemp) and it did nothing. Before that I tried some m.j. and the THC was way too much for me; it was like tripping; I lay there all night and couldn't move and couldn't sleep; it was so weird, and very unpleasant. CBD oil also hasn't helped my anxiety. But it's possible I wasn't taking enough. It's great you could use it; I've been told by others how well it helped them sleep.