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    Senior Member joy_shape's Avatar
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    Default clonidine and sleep

    I'm taking 0.2mg of clonidine for Parnate-induced insomnia. It helps with sleep onset, though I'm dreaming quite a bit and my sleep is really restless. My Parnate dose is too low to fully inhibit MAO (and therefore suppress sleep-related dreaming), though I was under the impression that clonidine did the same thing, i.e. suppresses REM, so why am I dreaming so much? Should I try raising my dose?
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    Senior Member joy_shape's Avatar
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    Just found this:

    Norepinephrine (NE) is considered to play a permissive role in the occurrence of rapid eye movement (REM) sleep. Clonidine is an NE alpha-2-receptor agonist, which has been considered to act mainly on the autoreceptors of presynaptic noradrenergic neurons to reduce their release of NE. However, previous studies of clonidine effects on REM sleep have produced controversial results and the effects of clonidine remain uncertain. To clarify the pharmacological effects of clonidine on human sleep, the sleep electroencephalograms (EEG) recorded from 15 young normal subjects after a single administration of either a low (25 micro g) or medium (150 micro g) dose of clonidine were examined, and fast Fourier transformation (FFT) spectral analyses of the C3-A2 EEG were performed. Low-dose clonidine significantly increased the amount of REM sleep and decreased the amount of non-REM (NREM) sleep during the second one-third of the drug nights compared to the corresponding hours of baseline night recordings. In contrast, medium-dose clonidine significantly decreased REM and increased NREM on drug nights compared to baseline nights in the entire night. The opposite actions of low and medium doses of clonidine on NREM-REM proportion may indicate that low-dose clonidine mainly affects the alpha-2-receptors on locus coeruleus-NE neurons presynaptically, reducing the release of NE, whereas medium-dose clonidine acts more post-synaptically.


    Anyone have any experience using clonidine for sleep?
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    Senior Member joy_shape's Avatar
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    Sorry, don't know why that came out black. Could a mod edit it?
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    I don't know about clonidine, but tizanidine, an alpha-2 receptor agonist used as a muscle relaxant gives me VERY vivid dreams.

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    O Wow. I just read that exact same article earlier today and was going to comment regarding it. If I were you I would try out a few different dosages perhaps a bit lower.
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    I take 0.1mg clonidine at night to help me sleep. I remember reading that clonidine reduces REM sleep (like the study says for medium dosages). I would say it seems to cause more dreams, for me (but maybe that is just a side product of sleeping better instead of waking up repeatedly over the night). Have you tried taking 0.1mg instead of 0.2? Or is that not strong enough?

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    Senior Member joy_shape's Avatar
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    Quote Originally Posted by superfob View Post
    I take 0.1mg clonidine at night to help me sleep. I remember reading that clonidine reduces REM sleep (like the study says for medium dosages). I would say it seems to cause more dreams, for me (but maybe that is just a side product of sleeping better instead of waking up repeatedly over the night). Have you tried taking 0.1mg instead of 0.2? Or is that not strong enough?
    I thought more dreaming was a sign of worse sleep and that suppression of REM was partially desired? I seem to be dreaming quite late .. i.e. towards the point when I'm waking up. I only tried 0.1mg once, but I didn't really find it strong enough to help with sleep onset.
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    You know, I've heard that too. I'm not really sure, but the clonidine does help me sleep better IMO. It hasn't increased my dream frequency dramatically. Lexapro, on the other hand, gave me vivid dreams when I upped the dosage.

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    Senior Member joy_shape's Avatar
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    I think it might be because I consulted with a sleep physician once (two years ago now) and was asking him about MAOI's. He said that, despite causing insomnia etc., their effect on sleep architecture wasn't adverse as far as AD's go -- and I'm aware that they completely suppress dreaming.

    I'm sure 0.1mg would be sufficient in most circumstances, but Parnate-induced insomnia seems to be a different beast altogether. So maybe I can't blame the clonidine for feeling so unrefreshed.

    How long before bed do you take your clondine dose superfob? I've been taking it an hour before bed, but I was feeling so anxious after dinner that I popped half a 0.1mg tablet and now I'm feeling kinda sleepy (3 hours later). I might try taking an extra 0.25mg - making 0.3mg total - just to see if more does help. My psychiatrist said up to 0.6mg is fine.
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    I take my clonidine dose around 10pm. I go to sleep around 11 or 12. Ideally I'd go to sleep like 30 minutes after taking the clonidine, but unfortunately I always have to eat something small before I go to bed or I sleep poorly. I also take 0.5mg ropinirole before bedtime, which seems to make me more tired before sleep. I tried 0.2mg once but it made me too tired the next day.

    As I understand, clonidine will make you sleepy if taken during the day. Why do you feel anxious after dinner? Is it from the parnate? I think with higher doses, you will have to watch out for excessive drops in blood pressure upon standing. Also, Dr. Mariano (my current doctor) has written about clonidine's use here: http://definitivemind.com/forums/showthread.php?t=83

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    Senior Member joy_shape's Avatar
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    Yeah, since Parnate primarily acts like a stimulant at lower doses, I tend to suffer a 'withdrawal' effect at night, not unlike that I've experienced on more classic stimulants, i.e. Dexedrine.

    Thanks for the post from Dr. Mariano ... very interesting! Especially the point about paradoxical reactions at higher doses; I'll have to watch out.

    What I don't understand is why clonidine is dosed several times a day in cases of hypertension (is that correct?) when the half-life is so long. I notice that I still become mentally stimulated on Parnate, but that the physical anxiety is completely abolished the next day, and I'm wondering if it's a carry-over effect of clonidine.
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    Senior Member joy_shape's Avatar
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    Tried 0.3mg last night. Sleep wasn't great and I woke up in the middle of the night and found it hard to fall back asleep, but I don't feel as tired today .. also, less dreaming ... so, go figure?
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    I guess that is what Mariano is talking about when he says it acts as a stimulant at higher dosages.

    Sorry, I'm not knowledgeable enough to understand what's going on. Did you ask your psychiatrist about this problem? Or send a PM to Ex Dubio - he should know =)

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    Senior Member joy_shape's Avatar
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    No, I only see my psychiatrist again at the end of next week, but I worry he's probably growing weary of me since I have paradoxical/adverse reactions to everything I try ..
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    Senior Member joy_shape's Avatar
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    I rarely smoke, but am staying with some friends and had a cigarette before bed last night. Anyway, same thing happened .. despite 0.3mg clonidine, my sleep was extremely refreshing and I dreamt vividly the entire night. I'd also had a cigarette before bed the last night I described sleeping badly in this thread. So I'm wondering if nicotine withdrawal (particularly as a non-smoker) is also accounting for the worsened sleep ..?
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    It looks as though clonidine inhibits melatonin and thus might interfere with one's natural sleep architecture. I'm guessing if you are taking it at night it is probably best to keep the dosage low.

    Effect of clonidine on plasma ACTH, cortisol and melatonin in children.


    Muñóz-Hoyos A, Fernández-García JM, Molina-Carballo A, Macías M, Escames G, Ruiz-Cosano C, Acuña-Castroviejo D.
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    Departamento de Pediatría, Hospital Universitario de Granada, España.

    Abstract

    An interaction between melatonin and adrenocorticotropin (ACTH) seems to occur in humans and both hormones respond to beta-adrenergic stimulation. As in lower animal species, human pineal gland also contains alpha2-adrenergic receptors as does the hypothalamus-pituitary axis. In this study the response of the pineal gland and of the hypothalamus-pituitary-adrenal axis to alpha2-adrenergic stimulation was assessed. Twenty-nine children (21 males, mean age 11.2 +/- 0.6 yr and eight females, mean age 9.1 +/- 1.1 yr) from the University of Granada Hospital were studied. The children were diagnosed as having growth problems but with a normal response of growth hormone (GH) to clonidine test. Changes in plasma levels of ACTH, cortisol and melatonin were evaluated in these children after oral administration of the alpha2-adrenoceptor agonist clonidine (100 microg/m2) or a placebo. Plasma ACTH, cortisol and melatonin were measured before (basal) and at 30, 60 and 90 min after oral clonidine or placebo administration. Hormonal determinations were carried out by commercial radioimmunoassay kits, previously standardised in our laboratory. The results show a significant decrease in plasma ACTH, cortisol and melatonin 30 min after clonidine administration (P < 0.001), reaching lowest values at 90 min after the drug was administered. The reduction in the levels of these hormones is independent of their normal circadian decay since the control group showed a significantly different pattern of behaviour. These data support the existence of an inhibitory alpha2-adrenergic influence on both the pineal gland and the hypothalamus-pituitary-adrenal in children and further support the presence of alpha2-adrenoceptors in the human pineal gland.


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