Today I give you some thoughts on 4 topics.
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There’s a new sleeping pill in town. It’s called Belsomra. This new medication has a lot of promise for being a medication that doesn’t cause dependence. It works by blocking Orexin. Orexin is a brain chemical that makes you awake and alert.
Sleep happens when the sleep chemicals turn on and the wake chemicals turn down or off. Trouble sleeping can happen when the wake chemicals don’t turn down and instead intrude on your sleep state.
This is the first sleeping pill we have that works to keep wakefulness from interrupting your sleep. Belsomra accomplishes this by blocking Orexin.
Why does this matter?
The reason this may be a better way to help you sleep is because the clinical trials for the medication showed that people could take it for 3 months without developing a tolerance. That is, it worked just as well at 3 months as it did the first night.
If this bears out to work the same for most people, this is huge. In my experience treating many people with medications like Ambien and Lunesta, these drugs would often stop working fairly quickly. Some people could take Ambien for months and have it work well, while for others it stopped working after the third night.
But that’s the nature of sleeping pills. They are not a good long-term solution for sleep.
Another problem with the traditional sleeping pills is you can get rebound insomnia when you take them regularly (nightly or almost nightly) then try to stop. Rebound insomnia means when you try to stop your sleep is worse from stopping the medicine than it was before you ever took the medicine.
Supposedly, you don’t have this problem with Belsomra. That’s another huge scoring point in my opinion. The rebound effect can keep people taking Ambien for months to years because they can’t deal with horrible sleep they have when they try to stop.
I’m not against Ambien. I still think it’s a good solution for very short-term sleep problems. You can avoid the rebound issue if you don’t take it every night for a long period of time (like more than a few weeks).
The clinical trials with Belsomra lasted up to three months. So we still don’t know what happens after that period of time, whether or not the rebound issue arises or if tolerance develops. We’ll have to see what happens in real practice.
So far I’ve seen good results with it. If you are having trouble with sleep, talk to your doctor about this medication. If you are currently taking Ambien or Lunesta and you are trying to switch over to Belsomra, you still may have the rebound effect from stopping the Ambien. This means that you could start Belsomra and still have trouble sleeping because you are withdrawing from Ambien. If this is the case, you may need to taper the Ambien first before trying the Belsomra.
Vyvanse for Binge Eating Disorder
This is a disorder that has been newly defined in the DSM-V manual that was published in 2013. I think this is significant because I think more people have this problem than it would seem.
This is not binging and purging as in bulimia. This is in a nutshell, eating too much while feeling out of control and having guilt about the overeating. This guilt effects how you feel about yourself. That’s the English translation. Here’s the actual criteria from the DSM-V:
“A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
- Eating, in discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
- A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
B. The binge-eating episodes are associated with three (or more) of the following:
- Eating much more rapidly than normal.
- Eating until feeling uncomfortably full.
- Eating large amount of food when not feeling physically hungry.
- Eating alone because of feeling embarrassed by how much one is eating.
- Feeling disgusted with oneself, depressed, or very guilty afterward.
C. Marked distress regarding binge eating is present.
D. The binge eating occurs, on average, at least once a week for 3 months.
E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.”
This not the occasional packing down of food like you may do for Thanksgiving or another holiday celebration. This is regular bingeing on food with a sense of lack of control and some sense of shame about it. You can ask yourself these questions to get a sense of whether or not you have this problem.
- Do you feel out of control when you’re eating?
- Do you think about food all the time?
- Do you eat in secret?
- Do you eat until you feel sick?
- Do you eat to escape from worries, relieve stress, or to comfort yourself?
- Do you feel disgusted or ashamed after eating?
- Do you feel powerless to stop eating, even though you want to?
Why am I talking about this now?
The FDA recently approved Vyvanse for this disorder. Vyvanse has been used for the treatment of ADHD. Now it is also used for binge eating disorder. If you think you may have this problem talk to your doctor about getting medication treatment.
Speaking of food…
I’ve been experimenting with using the company Blue Apron to help me with meal planning. I hate having to think about what to make for dinner. This company sends you fresh ingredients for two or four meals for the week.
I’m choosing the plan for 4 people, which costs $140/week (shipping included). This is not cheap, but I have to take into account I’m also paying for someone to shop for me and deliver the goods to my house.
So far I’m enjoying the meals. They taste like restaurant quality because of the fresh spices.
A downside is the preparation. At the end of a long work day, I don’t always feel like chopping onions and picking parsley leaves off the stems. I’m working on doing all the prep ahead of time on a Saturday. I’ll see if that makes things a little easier and shortens the preparation time – which is currently around 45 minutes per meal.
I’ll keep you posted on how this goes. Here are a few meals.
This is an app that allows you to do high or low intensity workouts at home. I spoke about high intensity interval training in a previous article, here.
I like this app because the video shows you how to do the exercise. You can choose how long you want to exercise. So the net effect is like having a personal trainer guide you through the exercises. I like to do a 20 minute workout consisting of a 5 minute warm up, 5 minutes of cardio, 5 minutes of strength training and 5 minutes of yoga or pilates.
I’m used to doing 45 minutes on an elliptical bike at the gym, so I thought I would want to do a minimum of 10 minutes of cardio. But shamefully I found the cardio exercises to be very strenuous. Ten minutes of it was brutal. So word of warning – if you are out of shape (and I didn’t think I was), you should take it easy with the cardio.
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