Tbh this is the first time I've heard of Trazodone helping against nightmares. I've always learned that Trazodone makes dreams more vivid, which made me understand that it would actually be bad for nightmares. Thanks for the insight!
I find there's a wide range of responses to trazodone. Seems as though for most, it helps with nightmares. Though I also have seen what you're describing in a small percentage. pubmed.ncbi.nlm.nih.gov/11518472/
This stuff is great to listen to as a research PhD b/c literature consistently states hydroxyzine has barely any affinity for mAChr, and this is actually a pretty consistent pattern for a lot of agents w/ observed putative anticholinergicity. Whether the observed anticholinergic effects are the result of an indirect mechanism or just that the assays used aren't so good, what actually matters is the observed effects, for certain purposes.
@@PsychoFarm Hey look, I hope the cast/channel get big enough you get MORE behind-there's def a big audience not yet awared. My comments are 85% stream of consciousness 10% tomfoolery 5% science usually anyway. Appreciate all the information and insight you share!
@@kenhaze5230 You can tell from your comments that the filter from brain to keyboard is minimal, and it makes for great and weird connections that an average brain wouldn't have access to. Let the tom foolery flow.
I've wondered this as well. The extent of anticholinergic effects reported anecdotally by patients and clinicians alike don't scale like what would be expected given the multiple magnitude difference in IC50 between the two.
Note: this comment is not from the voice in the video. You'll see them recommended first line by ASAM, and in things like Up To Date. If I do use a benzo or Z-drug, it’s typically with a patient I feel will be able to use them short-term (little addiction risk) and situation-specific (e.g., acute stressors, severe anxiety-induced insomnia) where I need something fast-acting to get someone over a hump. The one exception might be in severe bipolar disorder, where stabilizing sleep quickly can prevent a manic or depressive episode. Even then, I’ll plan to taper off once the mood stabilizer kicks in.
I respect your approach to other psych topics but you truly neglect the DORA class even if it’s the most efficacious way of treating insomnia. It seems like money is the primary barrier but this is an outdated view. Daridorexant is $135/month on GoodRX now. $135 is nothing in 2024 with inflated salaries
Love the extensive use of cats in the teaching material
I’m more of a dog person, but since Dr. Fu is a cat, it just seemed to make sense
I like how they actually move their mouths as if they're the ones speaking 😂
Tbh this is the first time I've heard of Trazodone helping against nightmares. I've always learned that Trazodone makes dreams more vivid, which made me understand that it would actually be bad for nightmares. Thanks for the insight!
I find there's a wide range of responses to trazodone. Seems as though for most, it helps with nightmares. Though I also have seen what you're describing in a small percentage.
pubmed.ncbi.nlm.nih.gov/11518472/
This stuff is great to listen to as a research PhD b/c literature consistently states hydroxyzine has barely any affinity for mAChr, and this is actually a pretty consistent pattern for a lot of agents w/ observed putative anticholinergicity. Whether the observed anticholinergic effects are the result of an indirect mechanism or just that the assays used aren't so good, what actually matters is the observed effects, for certain purposes.
Thanks Ken. Sorry I'm a little behind on commenting back on your comments, but I'll get to them eventually. Always appreciate your perspective.
@@PsychoFarm Hey look, I hope the cast/channel get big enough you get MORE behind-there's def a big audience not yet awared. My comments are 85% stream of consciousness 10% tomfoolery 5% science usually anyway.
Appreciate all the information and insight you share!
@@kenhaze5230 You can tell from your comments that the filter from brain to keyboard is minimal, and it makes for great and weird connections that an average brain wouldn't have access to. Let the tom foolery flow.
I've wondered this as well. The extent of anticholinergic effects reported anecdotally by patients and clinicians alike don't scale like what would be expected given the multiple magnitude difference in IC50 between the two.
Extremely informative, thank you
Glad it was helpful!
Amazing video! One thing I don't like in the Hydroxyzine is that it builds up a tolerance really quickly
Thanks!
Wow perfect! Thanks!
You're welcome!
Great video
Thanks!
Avatar cuteness escalation results are in: 🥰
I found Olanzapine great for great nights sleep. You have to take it around 5:00PM same time everyday.
Olanzapine is under the histamine category.
That’s so early, super long half life too. You don’t mind being impaired during the day at work? 💼 😬
Thank you for the video! What is primary role of benzos and Z-drugs in your vision of sleep disorders treatment?
Note: this comment is not from the voice in the video.
You'll see them recommended first line by ASAM, and in things like Up To Date. If I do use a benzo or Z-drug, it’s typically with a patient I feel will be able to use them short-term (little addiction risk) and situation-specific (e.g., acute stressors, severe anxiety-induced insomnia) where I need something fast-acting to get someone over a hump. The one exception might be in severe bipolar disorder, where stabilizing sleep quickly can prevent a manic or depressive episode. Even then, I’ll plan to taper off once the mood stabilizer kicks in.
@@PsychoFarm understood, thank you again!
Is the stuff you say about gabapentin also applicable for pregabalin? Or are there aby important differences?
No doxepin mention, no Zaleplon wow
Cat
🐈
I respect your approach to other psych topics but you truly neglect the DORA class even if it’s the most efficacious way of treating insomnia. It seems like money is the primary barrier but this is an outdated view. Daridorexant is $135/month on GoodRX now. $135 is nothing in 2024 with inflated salaries