desertshores, I don’t notice much anticholinergic effect at 3 mg to 6 mg of Doxepin. It’s the antihistamine effect I refer to when talking about Doxepin and next-day sleepiness. It’s just a constant feeling most of the day that I would like to lie down and take a nap. However, my thinking seems to be pretty clear when using Doxepin. An additional note is that it seems to diminish my physical stamina noticeably.
On the other hand, a strong anticholinergic effect like that from Doxylamine gives me “foggy brain” much of the next morning. My thinking and actions are slow, like that of a sloth! Well, maybe not a sloth. But, that’s what I compare it to until it wears off.
Well, I just ordered 10mg doxepin tablets to give it a shot starting at ~2.5mg and to be able to stop using that evil anticholinergic doxylamine (aka Costco sleeping pills) waaay too frequently. Here’s hoping!
With you on this 100%. LDN for me is the ONLY med that I can say has had the most effect (positive) in overall health and wellbeing (mainly pain and inflammation but helped me with sleep also) of all meds I’ve ever taken. I take or have taken in the past many other meds (rapa, metformin, SGLT2i, Statin etc.) but no med has had such a profound effect as LDN (3mg). The best part is the fact that it works immediately. I didn’t bother to start low and titrate, started at 3mg (3 months ago) and been there since and works great for me.
As a side note, I was having somewhat mid to high level muscle and joint pain (which clearly affected my sleep) and that is all gone on LDN. Not sure it is doing anything else, and not sure if it will do anything for those that have no pains and aches.
Melatonin, Trazodone, or Doxepin for Sleep Disorders
A 6-month study compared trazodone (50mg), doxepin (10mg), and melatonin (3mg) as alternatives to benzodiazepines for insomnia in 175 psychiatric patients. All improved sleep quality, with trazodone showing slightly better efficacy but more morning grogginess than the others.
I took low-dose Doxepin (3 mg to 6 mg) nightly for two weeks. The next-day sleepiness effect did not go away. And, the reduced stamina while taking it did not diminish. Caffeine and modafinil helped some, but did not resolve the problem. So, I will go back to my old plan of using it only when necessary.
Yes, I found the same effect from using doxepin. It does differ from trazodone in that it has “hypnotic” effects, and when coupled with galantamine or donepezil, produces effects that are very similar to lucid dreaming, in that you are aware and have some control and guidance of the dream.
Unfortunately, this does not result in a good night’s sleep. (Of course, results may vary.)
And also, unfortunately, at the rate that I will be using it, I have more than a lifetime’s supply.
My go-to stack when I have a disturbing day or activities that make me restless and mind racing at bedtime is:
100 mg melatonin ~ 1hr before sleep (tells the body it’s time to go to sleep)
2 grams l-tryptophan ~ 1/2 hr before sleep (shortens sleep onset)
10 mg trazodone ~ 1/2 hr before sleep (shortens sleep onset)
50 mg quetiapine ~ 1/2 hr before sleep (shortens onset and maintains longer sleep times)
This combo for my particular physiology works great and feels “clean” with no morning-after effects.
Dr Frasers AD thread got me interested in DORA’s so I asked by new best friend Perplexity a few questions about the opportunity to use peptides for this function.
One of my questions was if the sleep improvement was the key to the benefit, it is definitely part of the benefit but may not be the entire benefit from DORA’s
Since my current obsession is peptides I asked about that and found some interesting info on DSIP, my new fav peptide for increasing the quality of my sleep. One thing is does, it “concentrates” sleep patterns. We go in and out of the various stages of sleep in what looks like random cycles. It helps to concentrate deep sleep phases earlier in the sleep cycle and increase the duration of deep sleep, for me it was a significant improvement.
Deep sleep is important for clearing out the physical aspects of the brain.
@Jay, Well… I did get capsules even tho’ I ordered tablets Oh well, I have a scale, and this is just an experiment to see if I can improve my sleep-maintenance. Sort of like what you did, I took one 10mg capsule opened it. There is 120mg of media (active ingredients + fillers) in each capsule. A white powder. Presuming the active ingredients are uniformly distributed in the filler, to get 3mg of doxepin would be 40mg of media. But there will be some loss in the capsule-making process, so I’m starting with making 3 capsules and tossing out the residual … starting below 3mg and going slow. I didn’t taste it to see if your method was tolerable.
jjrap1, If 3 mg helps you get a good night’s sleep, then that is the right dose for you. I found that around 5 mg worked better for me. The scale method sounds precise and I have tried it. I also tried mixing the capsule contents with a specific amount of liquid using an oral syringe. With a 1 ml oral syringe I drew tap water and put it into a small dropper bottle 2 times for a total of 2 ml of water. (In your case it would be 3 times to get 3 doses.) I then poured the contents of the capsule in, closed the bottle and swirled the contents trying to keep the mixture near the bottom of the bottle. I let it set for a few hours for the Doxepin HCL to dissolve in the water. At that point I drew 1 ml of liquid out of the bottle as the first dose using the oral syringe. I placed the bottle in the fridge for a 2nd dose if needed. Of course, the bottle needs to be swirled before use each time. With this method some of the ingredients that are mixed with the Doxepin won’t dissolve and will coat the inside of the bottle with a white film. Assuming some of that white film to be Doxepin I thought swirling would be better than shaking in order to reduce the total amount of the white film.
The sleep is good when needed, but the unfortunate problem is that the next-day lingering sleepiness and reduced energy and stamina may hit you as it has other people on the forum. So, I try to limit use to only when needed and for a short period of time. It usually takes me a few days after this for energy and stamina to come back up to normal.
I believe hospitals commonly use Trazodone, Tempazepam and possible Silenor (Doxepin) as sleep aids, but I wonder about nursing homes. Doxepin would seem to be a good choice in a nursing home for an elderly invalid who needs good sleep and calming of nerves when next-day physical activity and alertness is not a big priority. I’m just thinking ahead about possibilities in case that’s in my future!
@desertshores, @Jay: doxepin is a bust for me; tho’ mildly effective as a sleep even at 3mg, the next day haze is a show-stopper; no amount of caffeine cuts through the fog… it’s really unpleasant! Time to move on!
@desertshores can you tell me what quetiapine pharma co and size tablets you are buying? Just the 50mg tablets, or something larger and cutting them into pieces? I see they are available up to 300mg. How did you arrive at the 50mg dose? Trial and error? Thanks much!
The only reason I tried doxepin is because it has a slightly better safety profile for long-term use.
My daughter has been using 100 mg tablets for many years with no obvious ill effects.
She gave me a few to try. The 100 mg tablets were a little too strong for me. I think the 300 mg tablets would be way too much for most people. 50 mg is the dose I use, and it seems just right for me. Too high of a dose is too much of a good thing.
The pills are very cheap from India. I would order the 50 mg tablets.
These are the ones I ordered, and they work quite well.
jjrap1, Yes the next-day sleepiness effect is the big problem with Doxepin. Otherwise, it would be a winner for me.
You noted quetiapine. I ordered some a couple of weeks ago.
Lots of sleep products, both OTC and prescription have been failures (for me) in the past, but maybe quetiapine will work. Or, maybe it will work for you.
Thanks @desertshores for suggesting this. I tried last night 25mg (cut 100mg into four) and it was the first night in three years that I slept for 8.5 hours straight. REM was over 2 hours (24%) and it has never been over 12% before. Deep sleep was always good about 30% and so was last night. Surprisingly I feel more sluggish this morning (with 8.5 hours sleep) than when I’d usually get only five hours sleep but I’m sure I’ll start feeling better as day goes on.
Edit: Two nights in a row of 8.5 hour of uninterrupted sleep (first time in three years) thanks to Quetiapine 25mg.
Curious how you compare the potential downside of quetiapine vs ambien?
Ambien works really well for my husband, but I’m always looking for healthier alternatives for him. When I google quetiapine, it appears it’s also no free lunch.
I am assuming you all are choosing this over ambien for a better health profile, but I wanted to double check.
Virtually every sleep aid has its downsides. Ambien is never recommended for long-term use. doxepin would be the safest bet long-term, but unfortunately, it doesn’t work for everybody, nor does quetiapine.
The main downsides of quetiapine are long-term weight gain and metabolic effects, and some people experience low blood pressure at night, which can cause dizziness.
Personally, n=1. I have not experienced these side effects, even after taking quetiapine for ~2 years. My current BMI is 21, and as an old person, I have virtually no appetite, so if quetiapine caused a little weight gain, it wouldn’t matter to me; that would be okay.
Things that quetiapine is supposed to affect (mine are okay):
Williams et al., 2010 (Pharmacotherapy) – “low-dose quetiapine” and weight gain
Retrospective study; showed progressive weight gain over time: about +5.56 lb at 6 months and +10.58 lb at 12 months compared with baseline (both statistically significant at 6 and 12 months)
Conclusion: Despite limited generalizability, these findings suggest that, even at low doses, quetiapine has an impact on metabolism. Further research is needed to clarify its role in metabolic dysregulation. This study was registered in the international database of prospectively registered systematic reviews
Oh well, I have a scale, and this is just an experiment to see if I can improve my sleep-maintenance. Sort of like what you did, I took one 10mg capsule opened it. There is 120mg of media (active ingredients + fillers) in each capsule. A white powder. Presuming the active ingredients are uniformly distributed in the filler, to get 3mg of doxepin would be 40mg of media. But there will be some loss in the capsule-making process, so I’m starting with making 3 capsules and tossing out the residual … starting below 3mg and going slow. I didn’t taste it to see if your method was tolerable.
