Saturday, June 13, 2015

Of Ambien Zombies and Altered States of Consciousness

Saturday, June 13, 2015

There is now less than a month of calendar time before I make the leap and completely titrate off the last of the medications I have taken at some point in the last two years. The only medication I now take on a regular basis is sertraline. And I have not been taking what would be considered a therapeutic dosage in a number of months now. This will not be the first time I stop taking sertraline. But I do hope it is the last time I feel the need to take it. I believe it likely will be. Unlike past forays I have made into the realm of psychotherapy I believe my recent two year exploration of the terrain of my inner world has proven much more effective than my past efforts. I attribute my success to a number of factors. I have been willing to try healing methods I previously had never tried. I also have been very diligent in my recent efforts. And being willing to no longer interact with people who express no desire to change their dysfunctional or disrespectful behaviors has also proven immensely helpful.

Not until this most recent 'psychotherapeutic trip' did I appreciate the impact sertraline evidently has on my dream life. I keep much more thorough notes about my health and the journey of psychotherapy as compared to earlier in my life. Like a gardening enthusiast who, in exasperation with the repeated reappearance of unwanted plants, decides to conduct a strategic and thorough - almost painstaking - exploration of his garden (to prevent having to attend to the same issue over and over again) I decided two years ago that if I were going to go back to therapy (yet again!) I would do everything in my power to maximize my prospect of 'success'. My thorough note-taking helped me to discern an apparent correlation between sertraline and my dream-life.

I am certainly no expert on how the pharmaceutical industry assesses the potential side effects of drugs. I do not know if there is a commonly accepted standard as to the length of time that a study should be conducted to determine the potential or likely side-effects of a certain class of drugs. I have no doubt there are certain policy standards but I do not know their details. What I find interesting is how drugs may impact your sleep and, more specifically, your dream-life.

If you want to really appreciate how bad the side effects of some drugs can be consider the story of ambien. Ambien belongs to a class of drugs known as hypnotics. It was approved by the FDA in 1992.  There was a time when ambien dominated the sleep aid market. French manufacturer Sanofi made $2 billion in sales on ambien about ten years ago. Then the strange stories involving ambien began.

You know you are in for a real 'treat' of bizarre stories when you enter the google search term 'ambien horror stories', find a number of search results and, in reading through the first search result you select, discover such phrases as 'ambien defense' and 'crazy ambien sex'. The good primer of Ambien horror stories I allude to can be found in a Huffington Post article from early 2014. The article notes people have been done any number of strange and dangerous things while ambien has been at work in their bodies. Some of the most noteworthy have been murderous rampages, unremembered meal preparation and loss of memory! Consider the contents of the potential side effects warning noted in one particular anecdotal story within the article:

"After taking Ambien, you may get up out of bed while not being fully awake and do an activity that you do not know you are doing. The next morning, you may not remember that you did anything during the night...Reported activities include: driving a car ("sleep-driving"), making and eating food, talking on the phone, having sex, sleep-walking."

It seems to me that the number of drugs that make it possible to have sex and later have no memory of it  is fairly small. The Huffington Post article notes that this side effect of ambien may make it an alluring drug of choice for those who wish to commit date rape. If you can drug someone with ambien and subsequently rape that person without any realistic expectation of punishment it is no wonder the drug would be popular among would-be rapists.

I find it interesting that the impact of a medication on your dream-life does not seem to be an issue of significant concern to the pharmaceutical industry. I will grant that I have occasionally heard 'unusual dreams' articulated as a potential side effect when I have seen television commercials advertising some drug. Of sleep related phenomena insomnia seems to be a common potential side-effect that may prove of concern to many. But I have to wonder about the reality of people's dream lives. If drug studies do not include a means to assess how a drug may impact a person's dream-life how could you even gather any data to make an informed conclusion? You can't create data for something you are not measuring.

I feel fortunate that the side-effects of sertraline are nowhere near as noteworthy as those of ambien. The National Institute of Mental Health notes that there are two FDA approved drugs for the specific treatment of PTSD. These are zoloft (sertraline) and paxil (paroxetine). So apparently I didn't exactly have a large number of choices for a medication that could work well in the treatment of PTSD. And from what I know the potential side effects of sertraline are less significant than those associated with paroxetine.

I personally would like to see more research conducted on how medications may impact a person's dream life. I feel this is a worthy focus given how some conditions (like PTSD) can feature nightmares as one of their signature symptoms. Not wanting to go to sleep because you fear having nightmares can put a serious crimp in your quality of life. There have been moments when I have awoken from a horrifying dream and been subsequently consumed by a (thankfully fleeting) feeling of never wanting to sleep again. But depriving myself of sleep as a means of reducing the risk of having nightmares simply creates other risk. For example, research suggests the symptoms of sleep deprivation may mimic psychosis. I would rather have some troubling dreams at night on occasion than be psychotic during the day!

As a student of Naropa University I engaged in the survey of a variety of disciplines that don't often stand alone as their own majors in many university settings. One topic I delved into was dream analysis. There was a time when I was quite dutiful about recording my dreams. Then I drifted away from that practice. More recently I have again moved in the direction of recording my dreams. Dreams are but another way we express our understanding of ourselves and the world around us.

As I move in the direction of titrating off sertraline I look forward to the wisdom of my dreams becoming more intelligible and vivid to me.

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I invite you to accompany me as I document my own journey of healing. My blog is designed to offer inspiration and solace to others. If you find it of value I welcome you to share it with others. Aloha!