daridorexant looks very interesting to someone who has struggled with insomnia for years. However looks like medicare and my supplemental policy does not cover it. Looks like costs about $600 for one month supply out of pocket. What are people doing to get this cost down?
Sleep supplements are tricky, as a supplement that works for one doesnāt work for another. Just read this thread. Over the years I have tried many different supplements. Some work better than others; some do not work at all. One of the safer and cheaper ones that works quite well for me is doxepin. (Donāt confuse it with doxepine.) Cheap and available from India. It might not work for you, but since itās cheap, it would be worth a try. The dose for sleep is 6 mg. But I get mine from India, and 10 mg capsules are the smallest that I can find. This is still a very low dose compared to therapeutic doses.
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I canāt take more than 3mg of doxepine, and I donāt clear it for 16 hours. (CYP2D6, why you gotta do me like you doā¦)
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And some, like magnesium l-threonate, knock out one person and keep another wide awake for the entire night.
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Well, Iāve tried Quiviviq and it doesnāt seem to work at all for me. But, Iāve still got a bottle of it. So, Iāll give it another try.
Paraxathine? It sounds like itās better than caffeine. Do you have a brand you like?
GPT says doxepin at sleep dose doesnāt have the same risk as other antihistamine like Benadryl for early dementia, but Iād still feel a bit concerned.
Along these lines Iāve tried trazadone, and while itās better than not sleeping at all, the āhangoverā is so bad that it makes me think thereās no way this is good for our brain.
Iām very sensitive to caffeine (and reset my tolerance through breaks periodically), but I can take paraxanthine as late as 3 p.m. and have zero sleep disruption. Iām just using this.
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Get 50mg prescribed, GoodRX for $135, split the pill with a splitter that can handle odd shapes. See if 25mg is enough.
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As Desertshores said, people are different, and what works for one person may not work for another. When it comes to sleep aids, strong H1 antagonists such as Doxepin, Trazodone, Mirtazapine, Diphenhydramine, and Doxylamine all help me sleep. However, all of them except diphenhydramine cause almost intolerable side effects that persist well into the next day after I wake up.
Unfortunately, diphenhydramine (Benadryl is one brand name) is also anticholinergic, and there have been many studies suggesting an association between long-term anticholinergic use and an increased risk of early dementia. I suspect the other drugs I mentioned have not been studied as extensively for dementia risk. More broadly, I also suspect that many sleep medications in general have not been thoroughly studied for long-term cognitive effects, but that is only my opinion. So, I agree that the hangover effect you mentioned probably is not good for the brain.
For me, ways to overcome the next-day hangover effect include caffeine capsules, coffee, exercise, early morning sunlight, and occasionally Modafinil when needed. In addition, AgentSmith mentioned paraxanthine, which I plan to try as a substitute for caffeine.
My personal justification for using 50 mg of diphenhydramine for sleep is that, by morning, most of its effects have worn off. It has a shorter half-life compared with the other medications, and I do not experience nearly the same degree of hangover effects from it as I do from the others. However, I will sometimes use mirtazapine or doxepin when diphenhydramine no longer seems to work as well for me.
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3 things on my radar to try:
- Magnesium acetyl taurate Magnesium-acetyl-taurate superior to magnesium L-threonate? Recent study poinst to this being true
- Progesterone - Leads to allopregnanolone production in the brain via 5AR enzyme activity.
- Allopregnanolone - Direct exogenous free allopregnanolone or esterified allopregnanolone is very appealing to me. I made a post about it here: Parkinson's disease - #1123 by AustraliaLongevity
Iām also trialling high dose IR melatonin again.
I wasnāt sure if I was getting a cold, I went through all of the suggestions in the cold/flu remedy post and ran it through ChatGPT seeking the most up to date evidence backed remedies to kill a cold in itās infancy, I did zinc lozenges and high dose melatonin among other things.
Honestly unsure if I did have a cold coming but it seems to be completely gone haha
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