#14

How quickly did you notice a positive effect on sleep? Have you tested liver values (ALT/AST) multiple times, and what were they like?

#15
#16

Worked with the first dose. I don’t think it needs a “loading” period. It is melatonin agonist so it works similarly to melatonin just more effective.

Yes, I did measure ALT (baseline 28.7, two weeks 33.7, one month 29.1 U/L) and AST (baseline 25.3, two weeks 27.6, one month 25.9 U/L)

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#17

Well, melatonin doesn’t work for me at all, but maybe I should still consider this.

#18

Melatonin doesn’t work for me either.

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#19

The first night’s experience with Valdoxan was bad; I couldn’t sleep at all, and even Zopiclone didn’t work, even though it usually does (I take it very rarely). However, I will continue testing it for at least a few more days.

#20

I am sorry to hear. When I first tried it I took it at around 10.30 PM and I usually go to bed way past midnight and that first day I was sleeping like dead on the sofa some 45 minutes later, but not in a drowsy way I just naturally get sleepy about an hour later.

Hope it will work for you. As I said I tried many things and beside lorazepam (which is certainly not something you would take long term) I get a terrible “hangover” in the morning or I struggle with cognition next day or it does nothing for my sleep.

#21

Valdoxan increases dopamine and noradrenaline levels, kind of like amphetamine lol.

This is primarily an antidepressant and anxiety medication, even at the 25mg dose.
I was hoping this would also help with anxiety, but it remains to be seen if I can get any sleep with this at all.

#22

I never felt anything in this regard. I noticed my sleep is better, I feel more rested and my HRV increased slightly. But I was not anxious or depressed in any way before starting taking it. i never looked at this specific way of action as it was suggested by a colleague psychiatrist whom I complained about sleep and said it is a fantastic sleep aid. That he is using it himself too.

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#23

In conclusion, there is frequent prescribing of low-dose quetiapine, which could be due to the effect observed when treating patients with sleep disturbances. Although quetiapine can be used to treat patients with sleep issues, the results of this study suggest that the risk of metabolic consequences may outweigh the benefits. The benefits observed in the short term to aid in sleep may lead to greater complications long term and should be weighed heavily before initiating therapy. Because changes in metabolic parameters were identified, it is reasonable to suggest these outcomes are not dose-dependent. Consequently, further research needs to be conducted in order to account for the unforeseen confounding variables of this review in order to fully identify the breadth of changes in metabolic parameters with the use of low-dose quetiapine.

#24

“it is reasonable to suggest these outcomes are not dose-dependent.”
I disagree with this. It is not usual for side effects not to be dose-dependent

Most drugs prescribed for sleep disorders are not recommended for long-term use.

If you take quetiapine, you should only use it intermittently until you find the root cause of your sleep disorder. I think quetiapine is relatively benign compared to most drugs that are prescribed for sleep. Managing the side effects of quetiapine is much the same as the side effects of rapamycin. Each person has to take the risk-reward into account.

“Approximately 10.7% of patients taking quetiapine fumarate long-term experience significant metabolic disorders, such as hyperglycemia or diabetes mellitus, as indicated by an increased blood glucose level (≥ 126 mg/dL)”

“Significant dose-dependent metabolic alterations were observed.”
“The dose-dependent effect highlighted for weight gain and lipid alterations emphasizes the importance of prescribing the minimal effective dose. However, as the effect size of a dose increase on metabolic worsening is low, the potential harm of low-dose quetiapine should not be dismissed.”

#25
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#26

https://x.com/MichaelOkun/status/1957763865615212699?s=19

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#27

@John_Hemming I found the BP point interesting.

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#28

What BP point? It is known that BP goes down on sleep. At this point the brain glymphatic system flows CSF (containing melatonin) into brain interstitial fluid.

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#29

So for you high BP is mostly a risk as it impedes melatonin flow?

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#30

It would not necessarily impede melatonin flow. The issue is that when people go to sleep their BP goes down. This enables the CSF to flow into the brain and hence both the provision of melatonin and the clearing of waste. It is the change of pressure that does this.

I am not aware of any research as to what happens when people with PD go to sleep.

I am also not clear as to what BP point you are referring to.

I think hypertension is a problem because it puts a strain on the physical structures of the body. This may exacerbate endothelial problems leading to more ASCVD, but I don’t know.

There is an interesting question as to whether the vasodilative effects of acetate are a reason why many centenerians are small drinkers of alcohol. The vasodilation reduces BP.

My view is the hypertension is a problem. I am not 100% on why.

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#31

This backs up a bit of a theory I have that taking blood pressure medication before bed can improve recovery while sleeping. I just started 40mg telmistartan at night.

#32

“blood pressure control, could enhance glymphatic clearance and potentially slow progression”

Many people with PD fail to show the normal ≥10% nighttime BP fall; some even have higher BP at night (“reverse dipping”): “Dipping status was also altered often, 40.46% of patients (477/1179) being reverse dippers and 35.67% (310/869) reduced dippers.” (Blood Pressure Patterns in Patients with Parkinson’s Disease: A Systematic Review 2021)

Which makes me wonder about using an additional antihypertensive with a short half life just before sleep: Parkinson's disease - #875 by adssx

#33

That sounds potentially causative.

However, this would result in damage to the brain although reinstating it would help, it would not reverse the damage. Some other actions would be needed.

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