On Mon, 20 Mar 2006 05:48:29 -0800, Drnanjo wrote:
>
>I thought that what the current problem with Ambien
>was showing was that people misuse/abuse a drug
"even if it's proper use is clearly indicated, or perhaps
>that people should not rely on drugs to supply what
>can only be given by following the "programming"
>(for lack of a better term) suggested by nature - that
>most of us need a good 7-8 hours of sleep, regular
>exercise and a moderate diet.

I don't know if you're responding to Michael Sylvester's
original post or my follow-up but I'll say a few things here:

A NY Times article from March 14, 2006 clearly provides
guidelines concerning Ambien usage as well as when it should
be avoided:
http://www.nytimes.com/2006/03/14/business/14ambienbox.html?_r=1&oref=slogin&pagewanted=print

For those of you who don't want to register at the NY Times
website and because of the educational value of the article,
I've copied it below:

March 14, 2006
Safeguards When Using Ambien
Doctors who have researched the drug Ambien and other sleeping pills make
the following recommendations:

¨Take the lowest dosage that works. Side effects are more frequent with the
10- and 20-milligram doses than with 5 milligrams.

¨Take Ambien on an empty stomach. If you have eaten recently, the drug takes
longer to work and you might be more apt to roam around the house.

¨Put chimes on your bedroom door and exterior doors. If you start
sleepwalking, the noise might wake you up.

¨Never take Ambien when you are the sole caretaker of a small child.

¨Never take Ambien when you are a doctor on call or have a similar work
obligation.
[Palij's Note:  I guess that means we shouldn't take it
just before going to teach a class ;-)]

¨If you have ever abused a substance before, including alcohol, you probably
should not take Ambien. People with histories of addiction are more likely
to become dependent on the drug.

¨Before taking sleeping pills, try cognitive behavior therapy, a nondrug
program that helps you learn how to sleep. Some doctors think it works as
well or better than sleeping pills. Among techniques used in the therapy are
muscle relaxation and breathing exercises, as well as learning not to go to
bed unless you are tired.

This information was supplied by Dr. Daniel F. Kripke, professor of
psychiatry, University of California, San Diego; Dr. Martin B. Scharf,
director of the Tri-State Sleep Disorders Center, Cincinnati; and Dr. Mark
Mahowald, director of the Minnesota Regional Sleep Disorders Center,
Minneapolis.
Copyright 2006The New York Times Company

Also, there is an intersting article in today's Atlanta Journal-Constitution
(AJC) on the Ambien situation and this can be accessed at:
http://www.ajc.com/health/content/shared-auto/healthnews/brai/531633.html

A few points from the AJC article:

(1)  The condition that seems to be the focus of recent
reports is called parasomnia, one form of which is sleepwalking.
Sleep eating appears to be another form.  I don't know
of a cognitive explanation for parasomnia but I'd bet that
someone has come up with one.

(2) Parasomnia is listed as one of the rare side-effects
associated with Ambien and other sleep medications.
I await someone now using Ambien and placebo in
a sleep study with fMRI to study what brain structures
are involved.  Or at least a grant proposal for such.

(3) Apparently something on the order of 26 million
prescriptions for Ambien have been written (I don't
know how this would be converted into a number
that reflects episodes of actual usage but given that
most perscriptions are written for 30 days of treatment,
one might have to multiply 26 million by something
like 20-30 [because a person may take more pills per
occasion than prescribed by the physician] to get the
total number of times Ambien has actually been used).
The AJC reports that just 48 cases (apparently of
parasomnia) have been reported to the FDA.  This is
probably an underestimate but, even so, it is a tiny
percentage of total episodes of usage.  The AJC
does point out that these parasomina events appear
to have involved "inappropriate use" (the article is
unclear but I interpret this as either taking higher
than prescribed dosage and/or with alcohol).

>Or perhaps that folks are just looking for an excuse
>for their weird or unhealthy behaviors (that just when
>I am feeling particularly cynical though).

Maybe, maybe not, but one of the key points that
the AJC article makes is that stopping Ambien use
stops sleep-eating -- Michael Silber, a co-director
of the Mayo Clinic Sleep Disorders Center apparently
published an article on this about five years ago.

-Mike Palij
[EMAIL PROTECTED]
New York University

>Nancy Melucci
>Long Beach City College
>Long Beach CA




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