Melatonin

Melatonin for Information

This is an old research paper on Melatonin which may explain why less is more with this drug. I’m not promoting it’s use but I do get asked a lot of questions about what to do for insomnia. There’s no further research as to what the long term effects of using this drug are so it’s only recommended in the short term and should only be tried in a small dose when in benzo withdrawal if absolutely necessary. It could prevent natural sleep returning and impact on the natural production of this hormone by the pineal gland. It can only be got on prescription in the UK in 2mg tablets (1mg for children) and only in an extended release formula. 0.3mg is the recommended dose for the older age group. 

If you are using melatonin for sleep and have done so for more than a few days and suffering bad withdrawal symptoms it may be worth looking into the dose you take and whether this should be reduced and stopped. I’m not sure if melatonin needs tapering, I don’t think so but perhaps someone else could help with their own experiences. It’s always worth remembering that any hormones will subdue our own hormonal systems over time and lower the output of natural hormones. Hope the article helps.

http://news.mit.edu/2001/melatonin-1017

‘Melatonin also inhibits the secretion of dopamine, which makes it bad news for restless legs syndrome patients. It might increase RLS symptoms in the evening and night, according to researchers at Sacre-Coeur Hospital in Montreal.’

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Melatonin 2

Some quick information with regards to Melatonin

This is to add to our supplements Unit 4 as many people seek help for insomnia and turn to melatonin. All previous information still stands but this may be helpful as well.

🛌 Melatonin is considered to be more effective when the dose taken is under 1mg.
🛌 A good quality liquid melatonin that doesn’t contain fillers may prevent negative reactions.
🛌 Once sleep routine has been re-established then stop the melatonin, it doesn’t appear to be necessary to taper.
🛌 If you have daytime lethargy after using this at night then try a low dose one hour before bed and don’t retake during the night.
🛌 If liquid melatonin doesn’t keep you asleep all night then try a low, extended release option but no more than 1mg.
🛌 Don’t take melatonin if you are taking any other drugs to avoid interactions and never take with a benzo.
🛌 Don’t take if you have an autoimmune problem as it could worsen this.
🛌 Better not to take if receiving HRT as it may interfere with this as it is also a hormone and HRT increases natural melatonin levels.

I am not supporting taking this or any other supplements for sleep as trying to let your natural sleep return is always best but when suffering for long periods without sleep it is seemingly the most natural solution. Always remember it won’t be for everybody.

This information comes from various sources but seems to be that generally accepted. In the UK melatonin is only available on prescription so doctors can monitor its effects. For some people a low dose does help sleep once completely off Benzos and recovering.

I would be interested in comments of anybody’s experiences with this.

Over the Counter Medications

OVER-THE-COUNTER (OTC) MEDICATIONS:

Whenever an over-the-counter item is taken with a prescription medication, there is a chance that there will be an interaction between them. The interaction may increase or decrease the effectiveness and/or the side effects and might also result in a new side effect that is not generally seen with the medications individually. The likelihood of drug interactions increases as the number of combinations increases. Most drug interactions are due to altered absorption in the intestine and can change the blood flow to the intestines, metabolism of the drug by the intestine, increased movement in the intestines resulting in diarrhea or constipation, alterations in the acidity of the stomach and a change in the bacteria of the gut region. The liver and kidney are where most drugs are eliminated and therefore are important sites of drug interactions. Drug interactions can be complex and unpredictable, so minimizing the risk is essential.


Antihistamines (Benadryl, Dimetapp, NyQuil, Alka-Seltzer Night-Time Cold, Thera Flu, etc).

Over-the-counter (OTC) antihistamines are drugs that temporarily relieve a runny nose, or reduce sneezing, itching of the nose or throat, and itchy watery eyes. However, antihistamines increase the effect of benzodiazepines and sleeping pills and can cause cognitive deficits, dangerous drops in blood pressure, suppression of the lungs and extreme sedation. Antihistamines also alter the metabolism of many SSRIs, increasing blood levels of the Antidepressant and increasing their side effects.  Combining antihistamines with hypertension medication may cause an increase in heart rate and blood pressure.

Nasal Decongestants (Afrin, Neosynephrine, Sudafed, ect.):

Most nasal decongestant sprays will cause increased adrenaline and norepinephrine, which can worsen anxiety and depression. Use of decongestants for longer than 3-5 days can damage the nasal tissue and lead to chronic congestion. Nasal decongestants may decrease the effectiveness of some blood pressure medications, and the most common side effects are stomach upset, trouble sleeping, dizziness, lightheadedness, headache, nervousness, fast heartbeat, loss of appetite and shaking.

Pain Relievers (Acetaminophen - Tylenol, Excedrin, ect. / Ibuprofen - Motrin, Advil, ect.):

Painkillers such as Acetaminophen and Ibuprofen are called analgesics, which numb pain. Both can have a profound effect on other medications, the absorption of nutrients and therefore to our general health. Acetaminophen, also known as Paracetamol, is widely used in over-the-counter pain reliever and fever reducer derived from coal tar and has been shown to reduce glutathione production (the body’s master antioxidant). Acetaminophen is metabolized primarily in the kidneys with a lesser amount traveling through the liver, where a toxic by-product called N-acetyl-p-benzoquioneimine (NAPQI) is produced in response to the acetaminophen, and is extremely harmful to the liver. The side effects of acetaminophen include nausea, vomiting, loss of appetite, diarrhea, sweating, irritability, abdominal pain (particularly near the liver), yellow eyes or skin, liver or kidney failure, heart problems and seizures. Ibuprofen reduces melatonin levels and may affect sleep if taken at bedtime. Other drugs that interfere with melatonin production are Valium, Xanax, diuretics, beta-blockers, calcium channel blockers, alcohol and caffeine. Ibuprofen may also exacerbate anxiety and depression by causing a disruption in the hormone system that participates in the contraction and relaxation of the muscles, blood vessels and modulates inflammation. Side effects include rash, riming of the ears, headaches, dizziness, abdominal pain, nausea, diarrhea, constipation, heartburn, bruising, tingling, numbness, nervousness, depression and insomnia.

Stomach Relievers (Maalox, Tums, Tagamet, Prilosec OTC, Pepcid, Zantac, ect.):

Over-the-Counter medications that reduce the production of stomach acid can upset the natural balance of healthy bacteria required for good health, and allow unhealthy bacteria to proliferate. Proton-pump inhibitors block stomach acid production AND increase the risk of a common infectious form of diarrhea. Taking a heartburn medication (Nexium, Losec) significantly increase the risk of diarrhea from the Clostridium difficile bacteria. Frequently prescribed anti-heartburn drugs called H2 antagonists (Zantac, Prevacid) double the risk of the bacterial diarrhea. PPIs and H2 antagonists reduce gastric acid, allowing for bacteria to multiply in the digestive system. While antibiotics formerly blamed for outbreaks of the illness have declined in use, the acid-blocking drugs have become steadily more popular to treat ulcers and conditions such as gastric reflux disease. Additionally, stomach medications can slow the absorption of benzodiazepines and sleeping pills and lead to increased anxiety and insomnia. Antacids taken with antibiotics, heart and blood pressure or thyroid medications can decrease their absorption up to 90 percent, and may pose a concern with certain antidepressants. Antacids also bind to nutrients and prevent proper absorption.

Medications for GERD and acid reflux can potentiate the benzodiazepines in your system.  The  proton pump inhibitors (PPIs) are the most effective antisecretory  agents used to treat acid-related disorders. As such, they are  frequently prescribed for patients who are concurrently using other  medications. PPIs may interact with other drugs through  numerous mechanisms. The most important include competitive inhibition  of hepatic cytochrome P (CYP) 450 enzymes involved in drug metabolism,  and alteration of the absorption of other drugs via changes in gastric  pH levels. Poor metabolizers, who lack CYP2C19, may be particularly  predisposed to drug interactions. Although the potential for drug  interactions is high, few clinically significant interactions have been  reported for the PPIs. Nevertheless, caution is indicated when certain  drugs are co-prescribed with these agents. The incidence of clinically  significant drug interactions increases proportionately with the number  of drugs taken and with the age of the patient. The drug interaction  with the greatest clinical importance is the reduction in benzodiazepine  clearance by omeprazole. 

--Division of Gastroenterology, Stanford University School of Medicine, CA, USA. MAY 

 

ANTIBIOTICS:

DO NOT TAKE ANY ANTIBIOTIC THAT IS IN THE FLOUROQUINOLONE FAMILY. These usually have "flox" in the name-levafloxacin (Levaquin), ciprofloxacin (Cipro), ect. This family of antibiotics cause a SEVERE adverse reaction when taken with benzodiazepines.

Added information and noted contraindications:

Activated Charcoal:

Activated charcoal can cause an acute withdrawal reaction when used while on benzodiazepines.

Detox:

Detoxification can strip the active ingredients of medications from your body and blood stream putting you at risk for a cold turkey reaction that can be difficult to pinpoint since you may be still taking your medication daily. Please be mindful that detox will rid the body of good nutrients, medications, and in some cases even your intestinal flora and yeasts that can cause major side effects to even someone who is very healthy.

PPIs…Protein Pump Inhibitors

PPI

Proton Pump Inhibitors (PPIs)

These drugs, such as Prilosec (omeprazole), Nexium (esomeprazole), Prevacid (lansoprazole), and Protonix (pantoprazole), are used to treat acid reflux. They can increase blood levels of benzodiazepines by interacting with the same liver enzymes that clear them from the body. This can result in worsening side effects of benzodiazepines, including confusion, sedation, dizziness, falls, and impaired driving.

The most common offenders are Prilosec and Nexium. Mary Hall, a retiree living in North Carolina, was prescribed Prilosec by her doctor while taking clonazepam.

“The clonazepam started to build up, and I started feeling stoned like I was taking more doses of a benzo. I had to skip my night dose of the clonazepam and stop taking the Prilosec after three days.” She also developed a “horrible headache” that lasted for several days. She notified her doctor, and he was unaware of the potential interaction. ‘

Read also if still on benzos…….

https://medium.com/@Drug_Justice/top-three-most-dangerous-acid-reflux-drug-interactions-5fef509f991f

Buspirone

Information on Buspirone

From the American Journal of Psychiatry….

‘Fifteen patients with 146 cumulative years of tranquilizer use were withdrawn from their benzodiazepine (nine gradually and six abruptly), and buspirone, a new nonbenzodiazepine anxiolytic, was substituted. The addition of buspirone did not appear to lessen the intensity of the withdrawal state. This finding supports preclinical studies indicating that buspirone has no clinically significant benzodiazepine receptor activity.’

From the U.K. NICE Guidelines for Doctors….

Buspirone
‘Buspirone hydrochloride is thought to act at specific serotonin (5HT1A) receptors. Response to treatment may take up to 2 weeks. It does not alleviate the symptoms of benzodiazepine withdrawal. Therefore a patient taking a benzodiazepine still needs to have the benzodiazepine withdrawn gradually; it is advisable to do this before starting buspirone hydrochloride. The dependence and abuse potential of buspirone hydrochloride is low; it is, however, licensed for short-term use only (but specialists occasionally use it for several months).’

From the Ashton Manual…..

‘Other drugs which have been found to be of little or no value in withdrawal trials over 4-6 weeks include buspirone (BuSpar, an anti-anxiety drug), carbamazepine (Tegretol, an anticonvulsant), clonidine (Catapres, an anti-anxiety drug sometimes used in alcohol detoxification), nifedipine (Adalat) and alpidem.’

Full Information on the Actions of Buspirone….

https://en.wikipedia.org/wiki/Buspirone

Gabapentin

Statement on GABAPENTIN a drug that comes up again and again on this group. Sources used come from David Healy and Heather Ashton.

“Another “fake” hypnotic option has been pregabalin and gabapentin. These drugs, which act on the same GABA system as the benzodiazepines, and are addictive, have crept into use as hypnotics on the back of their marketing for pain-management. They have a limited use in a small number of neuropathic pains but are now being prescribed widely in primary care for pain in general. As some patients seem initially happy when they take them, doctors have loosened up about using them especially at night when pain has been cast as one of the main reasons people can’t get to sleep.”
(This was written by David Healey a high profile psychiatrist who is well aware of the damage drugs can do.)

Heather Ashton also noted this drug in her Manual....
“There have been some reports that gabapentin (Neurontin), tiagabine (Gabitril) and possibly pregabalin (yet to be licensed) help with sleep and anxiety in withdrawal. However, there have been no controlled trials and it is not clear whether these drugs themselves cause withdrawal effects. In practice additional drugs are seldom needed with very slow benzodiazepine tapering. Only in special situations there might be a place for an antidepressant, beta blocker, sedative antihistamine or anticonvulsant. There is no need to avoid ordinary pain killers such as Tylenol, Feldene etc. for pain.”

Your brain has already suffered the onslaught of Benzos and another hypnotic drug is merely going to extend the time it takes to recover so always consider this and then the possibility of another long taper before making your decision. Also that it may worsen symptoms. There are several Facebook Groups for Gabapentin and other Psychiatric drugs to help with this decision.

The lesson was learnt with benzos and the problems they cause but there are other drugs that cause similar problems and should be avoided if possible. Always research fully and make up your own mind before adding anything at all.

A link but read only for information as it can be triggering...
If you’re not able to read the full text take this fact alone from it..........
“This is what I have since learned about the drug: Stanford University did a study on gabapentin in 2009 and found that it prevents the formation of new synapses in the brain. Many who take it long-term eventually develop cognitive impairment and short-term memory loss. Gabapentin affects GABA (gamma-aminobutyric acid—a “calming” element) in the body. When taking the drug, one’s body will adjust to the artificially induced GABA and start to produce less of its own. (That fact is similar to benzodiazepines except that gabapentin affects GABA through calcium receptors rather than GABA receptors.).”

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https://www.madinamerica.com/2020/04/gabapentin-horror/