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[perplexed]

Hi,

Dr prescribed low dose Endep to help me sleep at night becasue of incessant pin prick/itch while waiting for mammogram results to start HRT.  Just wondering if anyone has used this? Was it any good? Any side effects? that kind of thing.

Thank 

[Dana]

Hi perplexed

I've just had a read of your previous posts and I see you are from Australia. So am I.

I'm not sure how much feedback you will get here about Endep because it's not an AD that I've ever seen other ladies on MM refer to (who are predominately from the UK), so it might not be a commonly known one there. However, it is a very good sedating AD when used at low doses. Certainly it will be a whole lot better for you to use than Temazepam (is a benzodiazepine), which I see you take on occasions. Please avoid benzos as much as you can because they are highly addictive, and if you have a particular sensitivity to them (which I do) weaning yourself off them can be an extremely long and unpleasant experience. I could tell you a whole sorry tale about how and why I ended up taking diazepam (valium), but it's all a bit boring. However, I did lose about 4 years of my life to it, so I tend to be a bit outspoken when I see people talking about taking benzos in general because I have first hand experience of how insidious these drugs are.

Anyway, during that weaning process I would have to quite regularly use Endep to help me sleep and I never had any issues with it, provided I took a low dose. I'm not sure what dose you have been prescribed, but you probably shouldn't need much more than about 10mg-25mg (less is better for sedation). On the odd occasion where I did take a higher dose (say 50mg) I usually just ended up with restless legs, so there was no benefit in taking more at all.

However, because my insomnia was so chronic during that time, and I already had a problem with a benzo, I was very nervous about becoming dependent on something else. So when I was going through a longer period of insomnia I would take Endep for about 4-5 nights and then I would switch to doxylamine (a sedating antihistamine available over the counter in chemists) for another 4-5 nights and then back again if necessary. My preferred brand was Restivit because doxylamine tablets tend to be quite soft and crumble a bit on cutting, but I found Restivit to be harder and easier to cut.

The good news though is that I rarely have to use either now because I finished my benzo taper 2.5 years ago and I have healed from the experience, and HRT solved my menopausal insomnia issue.

I see also from your previous post that you've been using Remifemin. Some women may find it helps (my cousin swears by it), but you do have to be very careful about these alternative remedies, because things that are "natural" aren't always natural for us ingest. You sound like you are in the early-ish stages of meno, so these things can offer some relief, but they tend to lose their effectiveness as your hormone levels continue to drop. They are also extremely expensive. I looked at the price of Remifemin once and was shocked at the price. You will pay a fraction of that for HRT.

Also, HRT will address the actual problems of menopause, unlike these alternative things that have never really been proven to work long term, and they also don't help with all the other more hidden negatives of menopause like HRT does (eg bone, heart and brain health).

One more thing, I personally wouldn't take the BCP for menopause because that's not what it's designed for. BCP is designed for birth control. HRT is designed for peri-meno and meno. You might as well use the right medication from the start.

[perplexed]

Hey Dana,

Thanks for your reply, I did notice it is a predominantly UK forum, but t's the only one I've found to post things on, so I guess here I am.  That was why I added Amitriptyline becasue that's the name of the actual drug, Endep I guess is the manufacturing name it's sold under here in Australia.  I understand that benzos are not ideal and have used them in the past for various reasons, I'm ok with them and generally prefer to not take anything, but in certain circumstances they are good.  I've not had issues with addiction or anything like that, I've actually never had issues sleeping! and don;t still, it's just pretty hard to get to sleep and stay asleep when you have constant itching and pin pricking sensations all over your body! My GP actually suggested remifemin, and I looked into it, black cohosh is one of the only alternative therapies that has actually been scientifically proven to have some effect on menopause symptoms, and the Remifemin is produced in Germany which I think from what I read has guidelines for herbal remedies etc. which we don;t here in Australia.  So it is a controlled and proven dose.  I can't be put on HRT until the results of my mammogram come back which will take two weeks, I was crestfallen when they told me that I thought it would be the day after.  Anyway, I guess till then Endep will have to do.  It's good to hear other people's thoughts and reactions to things.  I've always had reservations on antidepressants bu, if i can sleep and not itch at this pint in time I don;t care anymore.  And yes from what I've read on HRT it looks like there are certain other benefits to it as well, which kind of makes sense, as hormone production slowly stopping results in degenerative disease, so it makes sense that if you replenish hormones those degenerative diseases will be kept at bay a little.

Anyway, the joys of being a female.....

[Dana]

Just be careful that you never take a benzo for any longer than a couple of weeks. There is a thing called 'kindling' which means that the more you take and stop a benzo the more sensitivity you can build up to it, and it can become harder and harder to stop. I spent a few years mentoring on a benzo support forum and some of the stories about how quickly people became severely dependent on them would shock you. Someone on the forum, who became a very good friend of mine, was prescribed klonopin for just a short period of time to help her sleep while she had bronchitis. She then had to spend the next 18 months very slowly weaning off it. So please never underestimate benzos.

Benzos are actually becoming harder and harder to get in Australia, which is a really good thing. Medical students are now being taught about the dangers of benzos, which they never used to be, and a lot won't or can't even prescribe them at all. For example, Xanax can no longer be prescribed by a GP. Only specialists can prescribe it.

I'm afraid I'm very dubious about any of the alternative remedies, pretty much because I did the whole naturopath thing and found everything she gave me to be useless for my symptoms, and it cost me a fortune. I find that most of the practitioners or manufacturers play on the whole "HRT is dangerous" nonsense, scaring and financially gouging women, when HRT will actually do the job a whole lot better because it's designed for the job, it's safe for most women, and because most of it is covered by PBS it will cost very little.

Anyway, I hope all goes well with your mammogram. I'm surprised that this is a requirement of your doctor though. I think most would prescribe without needing one done. I assume you're getting one of the free ones done? They do take longer to get the result. I get mine done at the Wesley Hospital in Brisbane and I verbally get my result then and there, and the report is sent to my doctor at the same time. I do have to pay for it of course, but by the time I get the rebate from my insurance it only costs about $50, so I would rather do that than have to sit around for days/weeks wondering what the result will be.

[daisie]

hi perplexed...iv been taking amitriptyline for over 7 years now im on 50mg 1 at night it does help with sleep i take it round about 7 o clock at night .i do get drowsyness in the morning on waking but does wear off ..there is also weight gain with it ,,i have tried a few times to come off it ..with no luck at all ..i cannot tolerate the other class of antidepressants the ssri ones they make me feel sick ..so iv always stuck to the amitriptyline ..i was put on them for anxiety and depression ..its worth giving them a go and see ..you need your sleep.to be able to function.amytriptyline is the one for me ..x daisie

[Otes73]

I've used anitriptyline in the past for pain caused by endometriosis. It's quite often prescribed at a low dose for pain. It did help me sleep and as I was on a low dose I didn't get any side effects. For depression a much higher dose is prescribed and I'm sure much more likely to get side effects then.
X

[perplexed]

still haven't figured out how to reply to each person! so I'll just do a mass reply

Dana, yes I know re: mamogram but I guess my GP is just like that, she's pretty thorough and I trust her.  I have no qualms or hesitation in starting HRT whatsoever, I've done some reading and by all studies it seems to be good.  The remifemin was only as a sterating point and as i've said I did notice that it does seem to cut the hot flushes down to a minimum, the itch nothing.  I won;t be visiting a naturopath or taking anything else, as it's all pretty much unproven bunk.  If i had known the free mammogram was going to take two weeks I would have happily gone somewhere else and paid for it so I could have gotten the results the next day, you live and learn I guess.

'm not taking the endep for depression though I 'm ok in that department and the anxiety department just this god awful itch pin prick that just makes me want to rip my skin off really....you can say I'm uncomfortable in my own skin, ha ha...which figuratively speaking I'm not just literally speaking!...'m just concerned about the tiredness the
 next day there's nothing I hate more than that feeling of lethargy through the day, but then if I don't sleep I'll be pretty lethargic anyway, so it's a lose lose win win...

anyway thank you all so much for your stories

[Dana]

The groggy feeling in the morning is the only thing I didn't like about endep, even though in most cases I didn't take much more than about 10mg. I'm usually a fairly early riser, but I often found it hard to get up after taking Endep.

Mind you I would usually end up taking it later (like around 10-11pm) when I found I couldn't sleep. If I'd taken it earlier it might not have had the same effect, but I wasn't prepared to take it earlier without actually knowing if I needed it or not.

However, the Restivit never had that effect on me. I could take it at the same time, but wake feeling quite refreshed in the morning. For that reason if I need something to sleep now I will usually take the Restivit in preference to the Endep - and you don't need a prescription for it.

[perplexed]

Thanks Dana, I might give the Restivit a go first then.

[Dana]

Try a low dose first. The pack says you can take up to 2 x 25mg tablets, but when I took that amount it totally knocked me out for about 12 hours. I found that I would easily get away with just a quarter of one 25mg tablet.

[Peroxideblader]

Hi Dana...I've messaged you at length before wirh regard to my chronic long term insomnia and me using zopiclone small dose every night. Well I stopped totally 3 weeks ago after reducing right down and I've been fine..not sleeping but no worse off them which was a relief but I've just read your recommendation of restavit...is this a safe non addictive one it's just  we don't have it over the counter in the UK it's an antihistamine but we use different ones here and none of them help at all..but this one I can get online on Biovea website called  doxylamine  it's the same used in restavit so is this safe to use..thanks

[Dana]

Hi Peroxide

I'm really pleased to hear you've managed to come off the zopi without any problems. Where are you now with the hrt?

You might have other brand names in the UK. The active ingredient is doxylamine, so you might just need to ask for that.

When I was mentoring on the benzo support forum, which had people from all over the world, a large proportion of them used doxylamine to help their insomnia, and I don't recall hearing many negative reviews. These were people who already had a dependency problem with a benzo so were very wary of using anything that could cause more problems.

There are other brand names that I'm aware of. In Australia we have Sleep Aid, Dozile and Unisom, as well as Restivit. Unisom seems to be the major brand in the US, but you do have to be sure you use the one containing doxylamine, because apparently there's another Unisom that contains something else (the name escapes me at the moment), but apparently it's not as good as doxylamine.

I don't like to say whether people should take various meds or not. I can only say that I've never had any problems with it, and the worst I've heard other people say is that it didn't work very well for them.

Like any sleep med, I am personally not keen on continuous use. I'm not aware of any particular dependency problems with doxylamine, but continuous use could cause tolerance issues which means it might lose its effectiveness.

However, i am aware of a lot of people who used it continuously throughout their benzo taper without any problems, but I was always a bit too nervous to do that. That's why my preferred method of use was to take it for 4-5 days, then switch to the Endep for 4-5 days, then switch again. Doing it that way meant I never had any dependency or tolerance problems. I could stop and start both without any problems at all.

At the end of the day though most sleep issues are just a symptom of something else, so that's the thing that really needs to be addressed. If it's hormonal insomnia, then it's the hormones that need sorting out, usually with hrt. Any kind of sleep med, whether prescription or OTC, should never be used as a long term treatment.

[Dana]

The other type of Unisom ingredient I was trying to think of is diphenhydramine, but I never hear the same positive comments on that like I did the doxylamine.

Here is some information on doxylamine...  https://en.wikipedia.org/wiki/Doxylamine

[Peroxideblader]

Dana...thanks for your reply..I'm not yet on hrt I'm seeing the doctor Monday coming to start on femoston as I'm still having periods etc just all the signs of peri for last 3 years about the tone my sleep disappeared actually.  About the restavit and it's active ingredient doxylamine.asked my chemist today they don't have anything with it in just the other antihistamine you mentioned which I've already tried and it doesn't work at all in fact makes me worse by increasing my restless legs so I'll order the doxylamine on line I've never done that before but it seems a genuine site.  I just want to get more sleep at least during the week because my fella goes to bed at 1030 during the week and it's a long sad night on my own til 3 or 4 o'clock when I eventually get some sleep.  I'll give it a try I don't hold much hope as the 3 different antihistamines I've tried have done nothing.  Thanks again

[Dana]

It's strange that you don't have doxylamine, but have the other one. I've only ever used the doxy, and what I've gathered from those who have used the other one, they say the doxy is better.

I hope it works for you, but just start with a low dose as these things can bring on restless legs if you take too much. Even Endep would do that to me if I took a higher dose.

I'd suggest half a 25mg tablet first off and take it about an hour before your normal bedtime. See how that works before deciding if you need to take more, or hopefully take less. A quarter of a 25mg tablet is usually enough for me, but then I'm already on HRT which definitely helps insomnia. Without the HRT you might need a higher dose.