Melatonin not working?

[kaypeeoh]

For three years I've taken melatonin 10mg every night. Last night it didn't work. I was still awake at 2AM so I found some Ibuprofen PM in the medicine cabinet. I took two and was able to sleep for 10 hours. Ibuprofen PM is ibuprofen with an antihistamine. I know constant use of any medication can cause less sensitivity to the dose and might require a larger dose. Is that better than adding an antihistamine to the nightly regimen?

[MarionP]

Shouldn't make any difference either method, but if your experience, or perceived experience, is better than the other, and you're not troubled by particular side effects of one or the other, go with it. You add the typical known risks to your stomach and other effects when you add Advil, I wouldn't do it.

Antihistamines with a soporific effect are quite often used and marketed as sleeping aids, such as sominex for example. Particular side effects vary quite a bit from formulation to formulation and Brant to brand and among generics, so you can experiment around. Expense wise, generics are better if you can find one that you like, but make sure it is not manufactured in India because it will have nothing in it (personal experience, store brands are the risk, Eg, topco... But the genericof diphenhydramine they sell at Target is really quite good).

Because the last generation (we are now in the third generation) have engineered out the soporific or drowsy side effect and have specific intended differential effects on the now known numerous different receptor subtypes, it's mostly the oldest medications that make use of the side effect for drowsiness as their main marketed intended effect... including generic Benadryl (diphenhydramine) or Dramamine (active ingredient dimenhydrinate) for that matter. Your original generics (mostly now generic variants of Benadryl) are very easy to dose and distribute across time, has a nice three to four hour effect and short half life so you can experiment around safely. If you have concern about antihistamines and dementia, really the history of those have to more to do with long-term high dose use, or typical use from the much more potent antipsychotic antihistamine cousins like thorazine. If money is not a concern at all, then I'd prefer to go with the branded formulation.

Unless you want to deal with anticholinergic side effects, especially strong constipation, I would avoid tricyclic antidepressants for sleep.

Any concern you might have should probably be easily addressed by seeing your physician or any neurology or psychiatry specialist and having them look at your history and discuss with you, and do a current mental status. Of course you'll get a more particular mental status exam from psychiatrist. Mental status or "mini" mental status exams are really very common and very well understood in medicine and psychiatry so that shouldn't be a problem.. they've been around for almost a hundred years in one form or another. I'm rather less salient about people without an MD or a DO degree, you get what you pay for there.

Pretty easy stuff to use and relatively low risk. Antihistamines don't typically complicate other medications, at least not very much. The older ones will dry you out a bit. You would have more concern about dementia coming from anxiolytics, meaning benzodiazepines, that's a different conversation but not impossible either.

In case you were thinking about your old specialty, if you're going to try animal sedatives and you live through them, I'd love to know what you find. ☺️

[JewelryGal in reply to MarionP]

MarionP

Thank you for the insight on Diphenhydramine! I am a retired RN (USA) and I also take 10mg of Melatonin (Gummies) at bedtime.... if that doesn't work I add the Benadryl 25mg. That seems to work for me. It does give me a little hangover in the morning though. I do worry that the Benadryl will cause the dementia but who the heck really knows? I do not take it every night and only 25mg. You are correct about getting what you pay for when it comes to most everything!

[MarionP in reply to JewelryGal]

True enough, but it is really hard to say with confidence which medication will affect which patient, without without unwarranted assumptions regarding how much use for how long and numerous other assumptions one has to make. Brief clinical experimentation really is the only way to proceed because it is fairly safe to do and you will get more and more information. Also minimum use, at least effective dose, etc.

Ever hear of daridorexant? It's a new wrinkle might be worth exploring. I'm actually going to talk to my own neurologist about it because I don't think he's heard about it and it might fit my own problem situation with problematic insomnia which really has not had much of a solution despite numerous efforts. But this molecule is one of three similar new ones that have a very different action and might just fit the bill with the rest of my condition and treatment variables so I'm suggesting everybody else who has a serious problem with insomnia look into it too, can't hurt. But bloody expensive because they're new. This is one of three which has the shortest half-life, & good medium strength of effectiveness not necessarily interfering with other medications I have to take, at least it's worth discussing. They are called orexant inhibitors.

[michelagvolpe]

to help me sleep, I rotate between melatonin (3mg), zolpidem, lemon balm + passion flower + chamomile herbal tea. 1 sinemet ir at 8pm helps me sleep. when I wake up at night (at 2 or 3am) to go to the bathroom, I take 1/2 sinemet so I can get back to sleep. sinemet makes me a little drowsy.

Ibuprofen is bad for the stomach.

[MarionP in reply to michelagvolpe]

Ever hear of this one: daridorexant.

[LAJ12345]

what brand out of interest? Hubby has been also not sleeping with his 10mg melatonins, awakening at 2 having racing dreams where he has to solve murder mysteries and the like and chase criminals. I wonder if it’s something in that batch.

[00Mark]

Maybe one night of insomnia doesn't mean melatonin has stopped working altogether. Either way, I would avoid taking ibuprofen regularly because it can lead to stomach ulcers.

I'm sure you are aware of sleep hygiene and the benefits of exercise. There are also numerous supplements and bedtime teas you can try.

I take one controlled release C/L pill at bedtime and then, if I wake up in the early hours, I take a second pill. Usually works for me, although sometimes I am awake for a while.

[Pixelpixie]

I will occasionally use a nibble of a CBD gummy. Works for me

[docjleonard55]

Antihistamines like diphenhydramine (Benadryl) can lead to increased dementia risk

health.harvard.edu/blog/com...

[MarionP in reply to docjleonard55]

Ever hear of daridorexant?

[docjleonard55]

Maybe try valerian

[SilentEchoes]

Benadryl is bad for the brain, ibuprofen is bad for the kidneys. The therapeutic dose for melatonin is 50 mg. I'd up my dose of melatonin and skip the pharmaceuticals.

SE

[DianeF]

I notice that melatonin has the opposite effect on me as well after a night or two. It actually keeps me awake even if I increase the dose to 10 mg. I believe someone else reported this on this site sometime ago.

[MarionP in reply to DianeF]

New bed to look into, prescription, completely different, unique mechanism: daridorexant

[rhyspeace12]

I'm 83 and take melatonin. I recently added 1/3 of a Unisom that is an antihistimine , Doxylamine succinate. It totally zonks me. The first time using it I took a whole one the first time and couldn't wake up all the next day.

[MarionP]

Forgot to mention something that's relatively new and a unique mechanism, but it is very pricey and maybe since it is still new might have some complications, plus need a prescription, but on insomnia it is very strong: it is called daridorexant.

[chartist]

You can try a melatonin break to see if that will help return the benefit of sleep from 10 mg of melatonin. Perhaps something has happened recently in your life that has caused the sleep disruption via possibly elevated anxiety? Keep in mind that melatonin levels decline with age and even more so in people with PD. This could potentially be a reason why more melatonin might be required now than 3 years ago.

The antihistamine / ibuprofen combo does help with sleep, but NSAIDS such as ibuprofen can be hard on the gut and liver. Diphenhydramine (Benadryl) has also shown potential to negatively affect the liver in longer term use as discussed here :

pmc.ncbi.nlm.nih.gov/articl....

Here is a relevant quote from the link :

' Diphenhydramine undergoes extensive first-pass metabolism, whereby 50–60% of ingested medication is metabolized by the liver before reaching the systemic circulation. Nearly all the available drug is metabolized by the liver within 24–48 hours, thus increasing risk for liver injury.'

Diphenhydramine is also suggested to possibly contribute to dementia risk as discussed here :

health.harvard.edu/blog/com....

Melatonin, on the other hand is thought to help work against dementia or AD as discussed here :

healthunlocked.com/cure-par...

Melatonin is also known for its liver protective effects as discussed here :

pmc.ncbi.nlm.nih.gov/articl....

Here is a relevant quote from the above link :

' Melatonin is a well-known natural antioxidant, and has many bioactivities. There are numerous studies investigating the effects of melatonin on liver injuries and diseases, and melatonin could regulate various molecular pathways, such as inflammation, proliferation, apoptosis, metastasis, and autophagy in different pathophysiological situations. Melatonin could be used for preventing and treating liver injuries and diseases. Herein, we conduct a review summarizing the potential roles of melatonin in liver injuries and diseases, paying special attention to the mechanisms of action. '

Art