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About Sumatra Slim Belly Tonic

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The Science Behind Sumatra Slim Belly Tonic

A scientific breakthrough has shown a new and unknown cause of stubborn belly fat. The new alarming cause of belly fat will surprise you. If you have struggled with losing weight with little success or lost a bit and gained more later, the cause could be a new discovery.
Two scientific studies carried out in 2024 discovered one common issue in all overweight individuals, men or women. According to the studies, the new cause of stubborn weight gain and belly fat is the failure to enjoy quality sleep. Scientific studies have shown that all skinny individuals have deep and full nights of sleep.
Studies from Yale and Harvard have shown that lack of quality sleep causes negative results rather than making you feel rested. These studies have found that a lack of healthy sleep is more dangerous than smoking.
You may also think you are having a healthy sleep, but later find out that your body may not enjoy the deep restorative sleep required to maintain a toned physique and healthy weight. According to research, optimal sleep makes burning fat effortless and easy. Lack of quality sleep slows metabolism and speeds up aging and hunger.
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Key Ingredients

Sumatra Slim Belly Tonic features a unique combination of scientifically proven superfoods to address the underlying issues associated with unexplained weight and failure to have deep, restorative sleep. Some of the major ingredients of Sumatra Slim Belly Tonic:
Hops (Humulus Lupulus)
Hops are dried flowers with a bitter and grassy taste. It is the major ingredient in malts and beer. Hops have been used in traditional medicine for years because of their potential health benefits. It also supports healthy digestion, deep restorative sleep, and healthy digestion.
Studies have shown that hops may help people lose weight. A study involving 30 individuals taking hops-based supplements for three weeks twice daily significantly helped reduce hunger feelings. The supplement made them feel fuller by supporting the body to produce hormones that reduce appetite, like cholecystokinin (CCK), Glucagon-like peptide-1 (GLP-1), and Peptide YY (PYY).
Valerian Root
Valerian roots are plants that feature white and pink flowers. The plant is native to Asia and Europe but also in North America. Valerian root is used to make various forms of medicine, including pills, teas, and tinctures. The medicinal herb has been used over the years to treat insomnia and address sleeping issues. However, further research is required to back several studies claiming a mild sedative effect exists.
Studies suggest that the anxiety-reducing elements associated with valerian root may be due to the valeric acid. A preliminary study has shown that valerenic acid had anti-anxiety effects and also did not bind with benzodiazepine receptors found in the brain. According to the research, the receptors may be the underlying cause of benzodiazepine addiction.
Additionally, valerian root helps reduce the hot flashes in women in their menopause. A study revealed that taking the medicinal herb root helped reduce the frequency and severity in menopausal people. Hot flashes lead to rapid heartbeat, sudden warmth, and sweating, which some women in this stage in life find uncomfortable. The hot flashes result from hormonal changes. It also helps reduce premenstrual symptoms (PMS), which may cause food cravings, anxiety, mood swings, and depression.
Spirulina Blue
As the name suggests, this is a form of blue-green algae rich in nutrients. Consequently, it is considered a superfood and has been a food source for years, especially in Mexico, the U.S., and a few African countries. The blue-green algae has also been a key ingredient since the 1970s. Today, the ingredient comes in powder, tablet, and capsule form. I
Spirulina contains vitamins and protein, which makes it a perfect dietary supplement for individuals on vegan and vegetarian diets. According to research, it has inflammation-fighting and antioxidant properties and can control the immune system.
Berberine
Berberine is a bioactive compound found in numerous plants, including Phellodendron, European barberry, goldenseal, Oregon grape, and goldthread. The plants containing the compound have for years been used to treat various conditions, from sores to infections. Berberine was first found in barberry and related plants over 3000 years ago, and since then, the bark, leaves, and stems have been used in different ways.
Although berberine is not a magic pill for weight loss, it may help with weight gain issues and weight loss of over 30 BMI (Body Mass Index). Two scientific studies found that taking berberine supplements for three months led to notable results in weight loss. The results may be a result of how the bioactive compound aids in controlling insulin and other hormones that help regulate fat cells in your body.
Berberine is also known to help lower blood pressure, which is associated with strokes and heart disease. Taking berberine consistently for weeks or months may help lower the diastolic and systolic blood pressure, which are the bottom and top readings of the blood pressure.
Additionally, it also promotes deep restorative sleep and a healthy cholesterol profile.
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The nature and impact of antidepressant withdrawal symptoms and proposal of the Discriminatory Antidepressant Withdrawal Symptoms Scale (DAWSS)

Joanna Moncrieff , John Read , Mark Horowitz 15 March 2024
https://doi.org/10.1016/j.jadr.2024.100765

Highlights

• Antidepressant withdrawal can be severe and protracted
• It produces characteristic physical and emotional symptoms
• All symptoms were more severe after stopping than before starting antidepressants
• We identified the 15 most discriminatory withdrawal symptoms in our sample
• Withdrawal did not differ between people with physical or mental health diagnoses

Introduction

Unpleasant withdrawal effects from stopping the newer generation antidepressants (SSRIs, SNRIs and other classes of antidepressants) have been reported from the early 1990s (Fava et al., 2015), but it has only been in recent years that increased attention has been paid to the problems people have when stopping these medications (Davies and Read, 2019; Fava et al., 2018, 2015; Horowitz and Taylor, 2022, 2019). The first systematic review to quantify incidence, duration and severity of withdrawal symptoms concluded that about half of patients will experience withdrawal effects, and nearly half of patients in surveys report that their withdrawal effects are ‘severe’, with some patients reporting symptoms that persisted for months or even years after stopping antidepressants (Davies and Read, 2019; Horowitz et al., 2023). In response to this increased recognition the Royal College of Psychiatrists issued a statement identifying “the potential in some people for severe and long-lasting withdrawal symptoms on and after stopping antidepressants”(Royal College of Psychiatrists, 2019), with NICE updating its guidance similarly (Iacobucci, 2019). NHS England has published a commissioning framework calling on health authorities to provide increased services for helping people to safely stop antidepressants (England, n.d.).
Currently, 8.3 million people are given at least one prescription for antidepressants in England annually,(“Medicines Used in Mental Health – England – 2015/16 to 2021/22,” n.d.). This represents 19% of the adult population and 23% of women (England, n.d.), with even higher rates in deprived neighbourhoods (Public Health England, 2019). In the US, during 2015-2018 13.2% of adults over 18 had used antidepressants in the past 30 days, with women (17.7%) twice as likely to be prescribed as men (8.4%) (Brody and Gu, 2020). A significant proportion use these medications long-term (Johnson et al., 2012; Public Health England, 2019), even though long-term use has a weaker evidence base and is associated with significant adverse effects and complications (Dragioti et al., 2019; Horowitz and Wilcock, 2022). Therefore, a large number of people are potentially affected by problems that come with stopping antidepressants. A recent Public Health England report into the issue found that patients report current services are inadequate to help them safely stop antidepressants, and a recommendation was made for the establishment of dedicated services (Public Health England, 2019). One focus of this report was on a group of patients who experience protracted withdrawal symptoms that can last for more than months and can have severe impacts on people's lives (Guy et al., 2020; Hengartner et al., 2020), including both financial and personal losses.
However, several commentators have raised queries regarding withdrawal effects (Jauhar et al., 2019). The first is an assertion that withdrawal effects may in fact be a return of the patient's underlying condition (for example, anxiety or depression) and the patient has mistaken these symptoms for withdrawal symptoms (Jauhar et al., 2019; Jha et al., 2018). The second issue is the question of the significance of withdrawal effects on people's lives. It is still debated whether these symptoms are mostly trivial and transitory or whether they can be severely debilitating as some previous qualitative data has demonstrated (Guy et al., 2020; Marsden et al., 2019; Public Health England, 2019). This second question is of great importance because as the healthcare system is considering what investments to make in helping people to safely stop unnecessary antidepressants (England, n.d.), the scale of the difficulty caused for patients will factor into the deliberations.
We wanted to find out more about the experience of people who have trouble stopping antidepressants and to see if there are symptoms that can help to distinguish between withdrawal and the recurrence of pre-existing conditions. For this purpose we conducted a survey of people who have sought information, support or advice from peer-led online communities. Such groups now include membership of more than 150,000 people and other similar websites receive close to a million hits a month (John Read et al., 2023; J. Read et al., 2023; White et al., 2021).
Objectives:

• 1.to describe the nature, severity, duration and impact of antidepressant withdrawal symptoms
• 2.to identify the symptoms which most discriminate between withdrawal effects and patients’ pre-existing mental health symptoms
• 3.to explore predictors of severity and duration of withdrawal, including age, gender, diagnosis (physical disorder only or mental disorder), duration of use of the antidepressant prior to withdrawal, tapering speed, concomitant medication and the type of antidepressant.

​

Withdrawal symptoms

Anxiety and worsened mood were among the most common symptoms following withdrawal, but physical symptoms, including specific symptoms such as dizziness, increased sensitivity, electric shock sensations, muscle symptoms (including cramps and tics), vivid dreams, vertigo, nausea and palpitations newly occurred or worsened in more than 70% of the sample. 60.7% of patients reported an increase in suicidality after reducing or stopping antidepressants, whereas only 29.6% of respondents reported any suicidality in the weeks before starting an antidepressant.
The ten symptoms that showed the highest ‘discrimination index’ (the ratio of increase following withdrawal compared to pre-withdrawal levels) were, in order of magnitude: electric shock sensations, akathisia, dizziness, vomiting, vertigo, nausea, gait and coordination problems, increased sensitivity to light and noise, tinnitus, and psychotic symptoms. The fifteen most discriminatory symptoms that comprise the ‘Discriminatory Antidepressant Withdrawal Symptom Scale’ (DAWSS) are displayed in Table 4, which also illustrates the different pattern of these symptoms before starting and after withdrawing from antidepressants
​

Discussion

The current sample is drawn from peer-support websites designed to support people who are withdrawing from antidepressants and as such do not represent the average experience of stopping antidepressants. However, such websites have tens of thousands of members, mostly concentrated in western, English-speaking countries, and so members’ experiences are not unusual.
Prior to reducing or stopping, participants had been taking antidepressants for about the same duration as the US population in 2011-2014, when 68.0% of people taking antidepressants had used them for more than 2 years, and 44.3% had used for over five years (Pratt et al., 2017). The proportion of long-term users in our sample was slightly higher than a previous estimate for the British population in which 50% of users had used antidepressants for more than two years (Johnson et al., 2012). This is not surprising given the association between longer-term use and withdrawal effects, which is likely to have prompted joining these groups in the first place. In the current study, people wanted to stop their antidepressants due to adverse effects and fear of long-term complications, as well as preferring to manage their problems in other ways. Similarly, in a New Zealand survey, of 459 people who had successfully withdrawn from antidepressants the most common reason for wanting to stop (47%) was ‘unpleasant side effects’ (Read et al., 2014).
There has been debate in the literature, and amongst clinicians, regarding whether the symptoms people experience after stopping antidepressants are withdrawal effects or a return of an underlying condition (Jauhar et al., 2019). Our study suggests there is a distinctive pattern of new and increased symptoms following antidepressant withdrawal, including many physical symptoms not characteristic of common mental health problems, and that these can be severe and protracted for some people. Our findings are consistent with research looking at a smaller range of withdrawal symptoms (Shapiro et al 2023).
Half the participants in our study who had stopped antidepressants had experienced withdrawal symptoms that lasted for over a year, around a third for more than two years and 10% for more than five years. One in four participants had tried to stop an antidepressant in the past and had not been able to do so. Impairment of the ability to work was common, including having to reduce hours, take sick leave or stop work altogether. Family and relationship problems and having to give up social activities were also frequently reported. Free text answers revealed that some people had suffered significant disability and distress. Other studies of patients suffering with antidepressant-related protracted withdrawal also record profound impairments in social and occupational domains, but these studies have not analysed symptoms in the same detail as the current study (Guy et al., 2020; Hengartner et al., 2020). Similar impacts have been reported after benzodiazepine withdrawal (Huff et al., 2023; Reid Finlayson et al., 2022).
The withdrawal syndrome was most commonly manifested in emotional symptoms such as anxiety and worsened mood, but over 75% of respondents reported several cognitive and physical symptoms not usually associated with depression or anxiety. Dizziness, increased sensitivity to light and noise, cognitive symptoms (impaired concentration and memory problems), depersonalisation and derealisation, headache, and electric shocks (or ‘brain zaps’) were reported by over 75% of respondents during the process of withdrawal. We have proposed a ‘Discriminatory Antidepressant Withdrawal Symptom Scale’ (DAWSS) consisting of the fifteen symptoms that most strongly discriminated between symptoms experienced prior to starting antidepressants and those experienced after stopping them. These could be useful to distinguish withdrawal from relapse of the underlying condition. However, although potentially useful for discrimination in cases of uncertainty between withdrawal and relapse, it should not be considered a scale to exclude a diagnosis of withdrawal, since an increase in emotional symptoms were amongst the most common experiences in withdrawal, and so a withdrawal syndrome composed mostly of emotional symptoms may be missed if this scale is employed. Further testing of this scale is required in other samples to validate this scale.
Shapiro et al (2023) identified anxiety, brain zaps, dizziness and agitation/irritability as the symptoms that showed the greatest increase following withdrawal, but they only investigated nine pre-selected symptoms overall, and their comparison was people's symptoms prior to withdrawal, rather than their symptoms prior to starting antidepressants as we assessed. Therefore the symptoms they identified do not necessarily differentiate withdrawal from relapse, but compare withdrawal symptoms to what is presumably usually a stable mental state prior to withdrawal.
Further support for the existence of a withdrawal syndrome that is distinct from the underlying condition lies in the finding that there was no difference between people who were prescribed antidepressants for a physical health condition only and those with a mental disorder diagnosis in the severity, duration or impact of symptoms experienced on stopping antidepressants. That there was no difference in the severity of nine psychological or emotional symptoms of withdrawal – such as anxiety and depressed mood - also provides evidence that the withdrawal syndrome involves psychological symptoms. This is consistent with other studies in which either healthy volunteers or people prescribed antidepressants for reasons other than mental health conditions (e.g. for the menopause) also experienced withdrawal symptoms on stopping, including psychological symptoms of withdrawal (Bloch et al., 1995; Gallagher et al., 2012).
The current data suggests that men might be more likely to be severely affected by withdrawal than women, although an alternative explanation is that men who join such sites have particularly severe symptoms. Other analyses have found no difference between genders (Read et al., 2018, 2014), or that withdrawal symptoms are more common in women (van Os and Groot, 2023). People taking high risk antidepressants had more severe symptoms overall, which is consistent with previous analyses which have found that SNRIs and paroxetine are associated with a much greater likelihood of reporting withdrawal effects in adverse effect databases than other antidepressants (Gastaldon et al., 2022). In contrast to our finding that younger people had more severe symptoms, older people reported the longest duration of withdrawal, which may reflect that older people are more vulnerable to the physiological disruption caused by withdrawal and take longer to recover, however in other analyses age was unrelated to withdrawal effects (Read et al., 2018, 2014).
Longer duration of prior use predicted longer duration of withdrawal symptoms among those who had already stopped an antidepressant, which is consistent with other findings (Horowitz et al., 2023; Read et al., 2014). This association is plausible because longer term use leads to greater neuro-adaptations which take longer to resolve after cessation, leading to longer lasting withdrawal effects (Horowitz et al., 2023). The association between longer duration of withdrawal symptoms and not taking other drugs is difficult to interpret but may reflect the ‘buffering’ effects of taking other psychoactive substances.
The clinical implications of the present study are that antidepressant withdrawal can be a difficult process resulting in prolonged symptoms that can severely impact people's lives. The finding that more than half the sample reported increased suicidal thoughts underlines the potential risks. Slow tapering has been proposed to minimise the negative consequences of withdrawal (Cooper et al., 2023; Horowitz and Taylor, 2023; McDonald et al., 2023; Wallis et al., 2023), although there was no association between tapering speed and severity or duration of withdrawal in our data. Health professionals need to be aware of the possible outcomes of antidepressant withdrawal so that they can help people to make properly informed decisions about taking antidepressants and provide support to those who decide to stop them

Conclusion

Our findings point to the existence of a genuine withdrawal syndrome associated with antidepressants, which can cause severe symptoms, be long-lasting and have a profound impact on people's lives. The DAWSS scale can help to distinguish withdrawal from relapse of the underlying condition, but should not be considered adequate to exclude a diagnosis of withdrawal as it excludes some of the most common withdrawal symptoms. Health professionals need to be aware of the potential significance of antidepressant withdrawal to support people with clinical decision making and during the process of withdrawal itself.

A pineal hormone under the control of the biological clock located in the hypothalamus and regulated by light exposure.
The pineal gland releases melatonin in picograms.
A pleiotrophic hormone that plays an important physiologic role.
It helps synchronize the body’s daily circadian rhythms with the light-dark cycle.
Levels of melatonin slowly increase a few hours before bedtime setting the stage for the body to switch to rest and other nighttime physiological activities
Endogenous melatonin regulates the sleep-wake cycle and other circadian rhythms.
Its secretion follows a diurnal patter.
Peaks 3 to 5 hours after sleep onset when it is dark.
There is almost no production during daylight.
Regulates circadian rhythms, mood and aging.
The production of melatonin, a sleep regulator, is inhibited by light and permitted by darkness as registered by photosensitive ganglion cells in the retina.
To some degree, the reverse is true for serotonin, which has been linked to mood disorders.
Melatonin receptors are found in many issues, reflecting its effects on physiologic functions such as energy metabolism and body weight regulation.
A hormone found naturally in the body.
Commonly available in pill form, but melatonin is also available in forms that can be placed in the cheek or under the tongue, and allows the melatonin to be absorbed directly into the body.
Melatonin products are considered dietary supplements and have not been approved by the FDA for any indication and their potency impurity are suspect.
People use melatonin to adjust the body’s internal clock.
It is used for jet lag, for adjusting sleep-wake cycles in people whose daily work schedule changes , and for helping blind people establish a day and night cycle.
Used for insomnia, delayed sleep phase syndrome (DSPS); rapid eye movement sleep behavior disorder (RBD); insomnia associated with attention deficit-hyperactivity disorder (ADHD); insomnia due to certain high blood pressure medications called beta-blockers; and sleep problems in children with developmental disorders including autism, cerebral palsy, and intellectual disabilities.
There is some evidence that delayed melatonin released in children with ADHD, and some with the autism release melatonin at the wrong time of day.
Evidence success that melatonin reduces sleep onset delays in children with ADHD.
Used as a sleep aid after discontinuing the use of benzodiazepine drugs and to reduce the side effects of stopping smoking.
Up to 50% of normal children have sleep disturbances, which often decreases with age.
Up to 80% of children with attention deficit hyper activity disorder have sleep disturbances.
Use does not prevent delirium.
Some people use it for Alzheimer’s disease or memory loss (dementia), bipolar disorder, a lung disease called chronic obstructive pulmonary disease (COPD), insomnia caused by beta-blocker drugs, endometriosis, ringing in the ears, depression or seasonal affective disorder (SAD), mild mental impairment, nonalcoholic liver disease, chronic fatigue syndrome (CFS), fibromyalgia, restless leg syndrome, sarcoidosis, schizophrenia, migraine and other headaches, age-related vision loss, benign prostatic hyperplasia (BPH), irritable bowel syndrome (IBS), bone loss (osteoporosis), a movement disorder called tardive dyskinesia (TD), acid reflux disease, Helicobacter pylori (H. pylori), exercise performance, infertility, epilepsy, aging, for menopause, metabolic syndrome, for recovery after surgery, agitation caused by anesthesia, stress, involuntary movement disorder, postural tachycardia syndrome, delirium, inability to control urination, jaw pain, inflammatory bowel disease and for birth control.
May be involved in the development of neurodegenerative diseases including Alzheimer’s disease and Parkinson’s disease.
It is also used to calm people before they are given anesthesia for surgery.
Sometimes people apply melatonin to the skin to protect against sunburn.
Its main job in the body is to regulate night and day cycles or sleep-wake cycles.
Darkness causes the body to produce more melatonin, which signals the body to prepare for sleep.
Light decreases melatonin production and signals the body to prepare for being awake.
Some people who have trouble sleeping have low levels of melatonin. It is thought that adding melatonin from supplements might help them sleep.
Findings suggest it may reduce sleep latency and improve sleep duration, but randomized trials are inconclusive.
Meta-analysis does not support significant effects of melatonin on secondary sleep problems.
Reportedly alleviates anxiety and pain resulting from surgery, and reduces migraine attacks.
May improve cognitive function and and sleep maintenance in Alzheimer’s disease.
Has antioxidant and antiproliferative effects and may exhibit synergy with anticancer agents.
It is a scavenger of hydroxyl radicals
Associated with drowsiness, alterations in sleep patterns, altered mental status, disorientation, tachycardia, flushing, pruritus, abdominal cramps, headaches, trouble sleeping, bad dreams and hypothermia.
Potential consequences include glucoseintolerance and increase blood pressure and heart rate on patients currently taking melatonin and anti-hypertensive medications.
Concurrent administration with nifedipine may increase blood pressure and heart rate.
Higher doses may increase the risk of adverse effects.
Inhibits CYP1A2 activity.
Reduces levels of factor VIII and fibrinogen, and may increase bleeding when used with anticoagulants.
Melatonin products in the US are considered dietary supplements and are not approved by the FDA for any indication.Melatonin dietary supplements potency and purity are suspect.One study that analyzed 31 melatonin supplements, the melatonin content varied from -83%-+478% of the labeled content, and varied buy as much is 465% of the same product in different lots.No well controlled trial has demonstrated the efficacy of melatonin for treatment of insomnia in developmentally normal children.Daily use of melatonin may improve sleep in children with autism spectrum disorder or attention deficit/hyperactivity disorder who have chronic insomnia.
​
https://standardofcare.com/melatonin/

I am 60F with history of severe reflux, intractable migraine, mild platelet function disorder, CKD, kidney stones (passed one, another still lurking in my kidney), CPTSD with co-comittant anxiety and depression, IBS (mixed type) and ADHD. I also probably have a connective tissue disorder that has yet to be labeled (I’m sure now that MCAS has been diagnosed, this issue will be addressed as well). I have lethal allergies to shellfish and cashews so I’ve carried around epipens for decades. However these allergies are not IgE mediated ( I was allergy tested in the early 2000s,before MCAS was even discovered) but because they would kill me, I was given epipens anyway. I take an SSRI and a small dose of seroquel to manage my CPTSD and mood issues (and I have a therapist and psychiatrist), a fairly large dose of Topamax (400 mg/daily) as well as monthly injections of Emgality to control my raging migraines, a large dose of Zantac (famotidine, sp?) - (40 mg/ daily- to manage my horrific reflux (I feel like my esophagus is on fire if I don’t no matter what I eat/don’t eat) and a small dose of estrogen to manage post menopausal symptoms.
Furthermore, my daughter 25 yrs was diagnosed with MCAS six years ago. Her allergist only decided to test me because I recently took my daughter to an allergy shot appointment and she asked me to sit in the exam room with her bc it’s boring and she had forgotten that this visit coincided with a physician visit as well. While her allergist was there, I happened to mention to her doc that I had heard that MCAS could be inherited (my husband and I always thought our daughter had inherited bits and pieces of the disease from each of us). Her doc said that it only sometimes was inherited. I told her ( the doctor) that my daughter had the MCAS triad ( and no my daughter had forgotten to mention this in the five yrs she’s been a patient there): MCAS, POTS and a connective tissue disorder ( we always called her our Gumby baby). Then I told the doctor that my husband has POTS and I am allergic/ sensitive to a bunch of food (so many foods give me a migraine that my husband laminated a card that has a list of them to give to restaurant servers whenever we go out to eat [and yes we apologize and tip well]) and that I have some connective tissue issues as well bc everyone called me Gumby as a child and then I proceeded to touch my thumb to my forearm right then and there. The doctor’s eyes grew wide and she said she needed an appointment with me! She proceeded to order a CBC and an allergy panel and a tryptase test. My CBC was normal, the entire allergy panel was <10 for every single allergen tested - including shellfish and cashews, both of which I went into throat-closing analphylaxis from accidental exposure (once on a plane which almost had to make an emergency landing for me! I was able to choke down enough Benadryl to keep from using my epipen!) within the past year, so yeah still foods that are lethal to me, so clearly none of my allergies are IgE mediated! and my tryptase was 19.8. So yes, I absolutely have MCAS. 19.8 is my daughter’s tryptase level.
I obviously now will be a patient of my daughter’s allergist, but it is such a mind trip. I always knew I had weird reactions to medications (the opiates and the benzodiazepines have little to no therapeutic effect on m (or I’ve needed shockingly high doses of them to get a any effect) and I’ve long considered myself the Queen of the Rare but Reported Side Effects ). Additionally, while the differential diagnosis for MCAS didn’t exist when I sought medical help for my symptoms, the number of doctors who were dismissive of me, called me a liar to my face as well as wrote it in my chart and/or became downright hostile to me when faced with the perplexity of my physiology and symptoms is shameful

I’ll try to get to the point without writing an encyclopedia. I’ll also attempt to use the correct verbiage to obey the rules required to discuss this topic. My rat isn’t a youngster anymore. She is middle aged but she is still as adept at running through mazes and finding a small block of cheese than other rats half her age. My rat unfortunately suffered lack of experiments because of Covid and being locked in her cage in the lab, she found a way to get out and eat all the food meant for the other rats as well. While this has happened in the past, (numerous times) she always kept a slim physique, so that was part of the reason she wasn’t a suspect because she was slim enough to sneak about at night and turn off video cameras and then slip back into her cage. Then, I found out that my rat was going into menopause. This effected her body and temperament. We experimented with HRT so that she would stop biting people and acting crazy! There was talk to toss this rat because she wasn’t doing the mazes anymore and then she adapted to the HRT very well and became calm and sweet but rounder. So it was decided that she was a perfect candidate to try Semaglutide on. It was necessary because the cost of cheese doubled and she could even solve safe codes to get it. The lab physician confirmed rat was officially in menopause because it had been over 18 months since she bled, and she was kept on the HRT and had no other problems but just being chunky. All the literature we read in the lab about Semaglutide uses language that suggests it may slow gastric emptying. One study indicated that it may slow it for an hour, at most. Another legitimate study suggests it may delay it up to 4 hours. I also went on the pharmaceutical company website who owns the patent a few days ago and they extended some side effects. It indicates that Semaglutide “may” make certain individuals who already suffer with skin sensitivity or in particular, Angioedema. It’s cleverly added as possible side effects but it doesn’t give specifics. My rat started this medication in May. 5 weeks later she came down with Shingles. The timing is odd, but my rat is put in a category where it’s normal and it’s one of those things that just happens…no medication was responsible. We treated her with 3 one week doses of antivirals because she had it bad. Then we put rat on Gabapentin, which is a medication that was used for epilepsy in the 1990’s, but evidently can be prescribed for neuropathy pain. Rat also had anxiety so we put her on 1mg twice a day of a certain benzodiazepine. Another expert in the lab also put her on a sleeping pill. Rat got better and she was actually not a zombie but functioning better and she got skinny! All this took place over a 4 month period. It’s a lot for ANY rat to go through. The Shingles and the weight loss were obviously the reason she has rapid response to her intended goal of thinning down. All has been well until 3 weeks ago. Rat has been bleeding from her vagina, and equivalent to a 20 year old. We got rat medical attention and scans. Those came back normal and the cause is stress. I don’t believe stress is causing it at all. The conclusion is if rat continues to keep having this problem, she’s going to have to get a hysterectomy. She doesn’t have tumors or polyps or anything that justifies surgical intervention in my opinion. I read literature from 2019 where a study stated that Semaglutide can alter the hypothalamus. Could rat be experiencing hormonal imbalances where the HRT isn’t working? That would be an understandable and root cause probability. Rat doesn’t want surgery! Any thoughts or suggestions??

Hello everyone! If you are here and you are reading this subreddit and this post, I imagine that unfortunately you are also facing a new pain that leaves you feeling lost, scared, lonely and hopeless. A year ago I was in exactly the same place as you (you can find my story here : Secondary provoked vestibulodynia - Success story with no surgery), and with this post I would like to share all the information I have gathered over the course of this year that I would have liked to have at my disposal when I began to suspect that I was suffering from vestibulodynia. I hope this post will help you in some way and I send you lots of strength <3 even if it doesn't seem possible now, things will get better! Sending you love xx
1. Self-help tips to decrease pain/inflammation and get some relief while waiting for a doctor-prescribed treatment

• Try to remove all common vulvar irritants : (intimate) soap, scented laundry detergent, fabric softener, scented toilet paper, baby wipes, feminine hygiene products (spray, creams, powders, ..), baths oils, bubbles, douches!!!!, spermicides, condoms with lube or spermicide, fragranced menstrual pads, nylon underwear or tights.
• Also avoid : thongs, tight pants, bike riding, waxing, panties made of synthetic materials, penetrative sex, water with chlorine. Stay underwear-free in the house as much as possible. Wear cotton the rest of the time. Be sure to drink enough water : if pee is not well diluted it can cause burning to an irritated vulva. Use water-based lube only.
• Evaluate if you might allergic to any of these things : semen, latex, lanolin, parabens, preservatives, perfumes.
• Apparently benzocaine (Vagisil), neomycin (Neosporin) and Chlorhexidine (KY lube) can cause allergic reactions in some people, so if you are using them, try discontinuing them to see how your irritation evolves.
• Try ice packs or a heating pad to reduce the pain. Depending on your type of pain, either one should work.
• Try using a protective ointment like Aquaphor, especially if you feel like you have dryness and/or fissures.
• Stretch regularly to relax your pelvic floor (you can find nice videos on Youtube)
• Try a donut cushion if you have to sit down for prolonged periods.

The next two points are very important before meeting with a gynecologist. As you may have guessed, conditions affecting the vulva are not yet well known in the medical world. Therefore, unless you are lucky and happen to have a very knowledgeable and kind gynecologist right away, it is important that you also educate yourself in order be able to provide as much information as possible to your attending physician and to evaluate their work.
2. Know your pain

• Try to accurately describe where you feel pain : all over the vulva? At the entrance to the vagina (vestibule)? In the clitoris? More on the left/right side? Think about the circumference of your vulva as a clock, where 12 o'clock is situated towards your clitoris, while 6 o'clock is situated towards your anus. In which area do you feel the pain? For example : in the 5-7 o'clock area.
• Try to figure out if the pain is provoked (= you only have pain in certain parts of the vulva when they are touched) or unprovoked (= the pain is there regardless of whether contact occurs)
• Try to define your pain on a scale of 1 to 10. Try keeping track of how this number evolves over time and according to treatments.
• Think about how long you have had this pain. Is it a congenital/primary pain, i.e. Has it always been there since you tried penetration (ex: insertion of a tampon)? Or is it a secondary pain, i.e., has it arisen only in the last few months, after a period of life when you had no problem?
• Observe if there are other symptoms besides pain: itching? swelling? redness? discharge?

Collect all this information and describe it precisely to your gynecologist.
Take your time to also reflect on the origin of your pain :
Can you think of any particular event after which you began to experience symptoms?
For example: an accident/fall, a sexual intercourse gone wrong, a new soap/tampon/laundry detergent, a yeast/BV infection, an allergic reaction, a traumatic emotional event?
I highly suggest you to check out the "Vulvodynia Algorithm" (link 1 in the comment), in order to identify your type of pain and its causes (hormones, inflammation, nerves proliferation, nerves damage, genes, hyperactive muscles, etc.) If you find yourself in any of the categories, do not hesitate to inform your gynecologist.
3. Ask for the necessary tests to be carried out, in order to understand the root cause(s) of your pain
Vulvodynia and vestibulodynia aren't real diagnosis per se. They only mean "unexplained pain in the vulva" and "unexplained pain in vestibule", because the medical field hasn’t cared about explaining this pain for super long. Vulvodynia and vestibulodynia only indicate a symptom, not a diagnosis. If you had pain in your foot you’d want to know if it’s the bone, the muscle or the skin right? You wouldn’t just say that you have footdynia. You deserve to find the real cause of your pain! Luckily, recent studies have allowed a deeper understanding of vulvar pain, identifying more and more possible causes.
In particular, ask for the necessary tests to understand if you might be suffering from one of the following conditions :
Bacterial/fungal/viral infections:

• yeast infection
• bacterial vaginosis
• any sexual transmittable diseases (syphilis, gonorrhoea, chlamydia, trichomoniasis, HIV, HPV, genital herpes, ...)
• ureaplasma and mycoplasma
• aerobic vaginitis
• cytolytic vaginosis
• lactobacillosis vaginosis
• group B strep

Skin conditions:

• lichen sclerosus, lichen planus, lichen simplex chronicus
• contact dermatitis
• psoriasis
• eczema
• clitoral adhesion
• keratin pearls (clitoris)

Other :

• desquamative inflammatory vaginitis (DIV)
• plasma cell vulvitis
• interstitial cystitis

If all these tests come back negative, then there are other possible sources for your pain, which are covered in the next sections : hormones, muscles and nerves.
I also saw this post Screening for Vulvar Pain: Getting to the Root Cause of Your Pain Symptoms from u/fifithechinchilla that can be very useful to understand which tests to do, and how they work. It is a little bit technical, but it might be useful for your doctor!
4. Check your hormone levels
This is especially true if you are taking the combined oral pill or if you are menopausal (but it's worth check it even if you are not part of these categories). There are several studies now that show how hormone levels can affect the health of vulvar tissue.
Simply put, when you are on birth control, your natural hormones levels are altered. This can be a problem because your vulvar tissue/skin needs these hormones in order to be healthy. When these hormones are missing, your vulvar tissue might become thinner are drier (vaginal atrophy). That way, nerves are more exposed and the skin is much more sensitive, hence the pain.
Here are some articles you can show your gynecologist in case he or she is skeptical :

• Polymorphisms of the androgen receptor gene and hormonal contraceptive induced provoked vestibulodynia
• Can oral contraceptives cause vestibulodynia?

If you think your pain may be caused by your hormone level, it is recommended that you discontinue hormonal means of contraception. At the same time, a testosterone + estradiol cream or estrogen is often prescribed. It's effective for many people : The Treatment of Vestibulodynia with Topical Estradiol and Testosterone.
If you think that you might suffer from vaginal atrophy, remember that these factors contribute to vaginal dryness :

• smoking (cigarettes, weed)
• medications like antihistamines, benzodiazepines, beta blockers, etc...

5. Check your pelvic floor health
Muscles
Vulvar pain and pelvic floor pain are often related. If the pelvic floor muscles are too contracted (hypertonic pelvic floor, vaginismus, ...) they can cause pain throughout the vulvar area.
In this cases, retraining the muscles through physical therapy is the primary treatment.
Through physical therapy you will in fact learn and use many practices that can help you overcome your pain :

• diaphragmatic breathing
• control over your pelvic floor (kegels)
• self massage
• work with dilators
• trigger point therapy
• myofascial release
• TENS therapy
• biofeedback
• relaxtion techniques
• muscles stretching

Note that people who have pain in the vulva for other reasons (skin, infection, etc) might develop a hypertonic pelvic floor as a reaction to pain. For example, although my primary source of pain was not in my muscles, I automatically started clenching my muscles before/during sex as a pain/protection response, which made my pain worse. Thanks to physical therapy I could unlearn this clenching movement.
6. Check your nerves
Pudendal nerve
Pelvic pain can also come from a damage or irritation of the pudendal nerve, a main nerve in the pelvis. This is referred to as pudendal neuralgia. This can happen if the nerve is damaged after an injury (broken bone, fall..) or after prolonged sitting/cycling/constipation or if it's compressed by muscles or tissue.
Medicines to alter the pain, painkilling injections and pelvic floor physical therapy are the main treatments.
Here's a test to understand if the pain might be coming from the pudendal nerve or not :
"Another test that can be helpful when diagnosing vestibulodynia is called a vestibular anesthesia test (VAT). The purpose of the VAT is to test if numbing the vestibule tissue makes the pain go away. Vulvar pain can also be caused by nerve pinching or damage further up in the nerve. Because sensation in the vulva comes through the pudendal nerve, vulvar pain caused by problems in the nerve is called pudendal neuralgia. In patients with nerve problems, numbing the nerve endings during the VAT does not relieve pain, and only a pudendal nerve block that acts above the damaged site to turn off all sensation through the nerve can relieve pain. It is not common for pudendal nerve issues to cause pain that is only in the vestibule. During a VAT, local anesthetic is applied topically in a cream or by injection. Once the numbing is in full effect, then the Q-tip test is redone, as well as other things that would normally cause pain, like touch or penetration. If the pain is relieved, then the test is considered positive and indicates that the pain is coming from the vestibule tissue itself."
Basically, if applying lidocaine on your vulva you still perceive pain, it is possible that the cause of pain is not superficial but deeper -> pudendal neuralgia.
Superficial nerves / neuroproliferative vestibulodynia
Sometimes the cause of pain in the vestibule is an overgrowth of nerves in the vestibule. If you had this pain since forever, it's called congenital neuroproliferative vestibulodynia. If this pain appeared only later in life after many years pain-free, then it's called acquired neuroproliferative vestibudolodynia.
Here's an explanation by Prosalya :
"Research is ongoing to further our understanding of how this happens. It is thought that the overgrowth of nerves is driven by the immune response, either to infection or allergy. In addition to finding increased numbers of nerve cells in the painful vestibule of patients with vestibulodynia, researchers also see increased numbers of immune cells. Recent findings suggests that the nerve proliferation is triggered by signaling from immune cells in the tissue".
For exemple, speaking from personal experience and also from what I have read on this blog, yeast infections and the creams used to treat them are often cited as triggers for vestibulodynia. A recent study on mice confirmed this hypothesis : Repeated Vulvovaginal Fungal Infections Cause Persistent Pain in a Mouse Model of Vulvodynia. Apparently, the inflammation caused by yeast infections can cause hyperinnervation (= growth of nerves) in the area, hence the pain.
7. Reflect on your romantic and sexual relationships (TW - mention of sexual violence)
Too often people with vulvar pain are told "there's nothing there, it's all in your head." And in no way do I condone this lack of professionalism and competence. Your pain is real and valid and you deserve appropriate treatment.
On the other hand, this does not mean that the mind-body relationship should be completely ignored. Ask yourself first and foremost if you feel safe in your relationships. Does sex makes you anxious? Does your partner(s) put pressure on you? Are you afraid that your partner(s) will leave you because they are "unsatisfied" ? Have you experienced violence in the past that you have not processed? Do you feel obligated to perform certain practices? Do you feel that you do not have the right to talk about the pain you feel? Do you feel that your partner(s) think(s) more about their pleasure than about your pain?
If there are any "yes" in your answers, consider that they may have an impact on how your body is reacting.
Finally, suffering from chronic vulvar pain means rethinking the way you have sex. And there are so many pleasurable practices that don’t involve penetration/PIV (penis in vagina): vibrators, nipple play, butt play, mutual masturbation, role play, sensation play (hot/cold, blindfolded..), neck/ears/feet kissing,… so much choice! There is no need to endure pain when you can simply experience pleasure in other ways :). Vulvodynia does not have to mean the end of your sex life. On the contrary, it could represent an opportunity to explore new things and different parts of your body and your partner's body.
If you are having a hard time seeing yourself as a sensual being and enjoying sex because of the pain, I wrote a post with some tips on how to reconnect with yourself and your partner : 30 ideas to reconnect sensually and sexually with your partner.
8. Take care of your mental health (TW - mention of su*cidal thoughts)
Dealing with this pain and the way it disrupts our lives can bring many negative emotions. I, too, felt at first that I had lost a part of me. I felt lonely, desperate and scared. If you feel that these negative emotions are too difficult to handle do not hesitate to contact a therapist, who can accompany you on this journey. Chronic pain is a serious issue and you should not be ashamed if you are feeling depressed or if you are having su*cidal thoughts. Please do not hesitate to seek help, it's worth it <3.
Also, if you have the possibility, do not hesitate to talk about this with the people around you, whether family, friends, or anyone you feel comfortable with. Because it is a condition that touches a "private" area, many people do not dare to talk about it, which can lead to feeling even more isolated. But I encourage you to break the taboo and talk about it with the people you love. It's estimated that 10% of women suffer from this kind of pain, so you're much less alone than you think. And talking about it could help someone who doesn't dare to ask for help too.
If you don't feel like talking about it with the people around you, don't hesitate to post on this forum to get in touch with people who are going through similar experiences to yours <3
9. Advocate for yourself (TW - mention of gynecological violence)
As mentioned above, unfortunately, not all gynecologists are competent and knowledgeable. To save you hassle, money, and time, I suggest you ask in this group if anyone knows a good doctor in the area where you live. That way you won't have to go through incompetent gynecologists. In general, if you have a bad time with a doctor, don't hesitate to leave and look for someone better.
Run for the hills if your gynecologist says any of the following red flags :

• "It's all in your head."
• "Your vulva is completely fine, there is nothing wrong with it"
• "I can't help you"
• "Have you tried to relax?"
• "I'll give you an anesthetic so your husband can still have sex with you"
• Or if she/he practices tests without asking you if you are in pain or uncomfortable

If you unfortunately do not have the opportunity to choose the gynecologist you prefer, do not hesitate to show up for appointments with medical papers to support your arguments and questions.
In general, the more informed you are about your condition, the more you can ask questions, monitor what the doctor is doing, and have control over your own body. This will also allow you to receive a diagnosis much faster, and therefore to start the appropriate treatment as soon as possible. I had the chance to find a good doctor and an excellent physical therapist, so in 8 months 80% of the pain was gone. I say this to show that, if treated correctly, pain doe not remain at its current level forever.
The sooner you find the cause of your pain and treat it appropriately, the less opportunity you will give the inflammation to worsen and damage your tissue and nerves.
10. Despite everything : don't forget to enjoy life
Finally, on a more personal note, I want to tell you that I know how difficult it is to accept this condition. It took me months, too. I was sad, I was angry, I was scared, and it seemed so unfair that I should hurt like this every day and that I could no longer be intimate as I wanted to be. What I learned though, was that repeating to myself every day how unlucky I was and how much this situation sucked, brought me nothing, just further mental pain and frustration. I know it is tempting to wallow in this pain, because in a way it is justified. But it is very important to know how to detach/unplug from this situation. Whether we like it or not, it is a medical condition that usually does not disappear overnight, but rather needs a few months to see a reduction in pain.
So my advice is : in the meantime, don't torture yourself! I know it is not easy because you are afraid and because you are in pain, but on the other hand, it does no good to focus all your energy all the time on the spot that hurts. Maybe it happens to you too, but personally when I am distracted because I am doing other things, I feel less pain. Therefore, keep doing activities that are good for your little heart and your mental health. Spend time with your loved-ones. Enjoy your hobbies. Meditate. Do yoga. Spend time in nature. Explore your body in a different light. Build intimacy with your partner in a new way. Allow yourself some days where you don't think/overthink about your condition.
Try to treat yourself with kindness and compassion, and not bombard you all the time with negative phrases. Give your body love, give yourself a hug. Vulvodynia can be hard enough on its own, don't add more hardness yourself <3
I hope this summary will help someone, and I send you all a virtual hug <3
If you want more in-depth information, I suggest you to consult this Self-Help Guide for Vulvodynia (link 2 in the comment) and to follow Dr. Jill Krapf on Instagram.
If you have any more tips/opinion/experiences to share, don't hesitate to write them down in the comment section!

It’s an interesting doc, mostly just personal accounts of how benzodiazepines have helped and hurt people. I don’t have much experience with the drug, so I won’t pass judgement on whether it’s a good or bad take on the issue.
But there’s a man interviewed who is dealing with a lifelong Xanax prescription, and when he tried to reduce his dosage, his body goes haywire. I’ll paraphrase, because I can’t remember word-for-word:
“It was like my skin was on fire. The brain… uh… fog, horrible fog, sounds and smells were overwhelming. Heart palpitations, horrible fatigue.”
Huh. Sounds familiar.
(There is also a comment early in the doc by one of the practitioners about how menopause is so overwhelming and women of that age were the most common users of anti-anxieties drugs).

Hi. I am making this post due to my concern for my mother’s mental health. She has changed as a person entirely over the past 6 years, and I have not been able to find an answer that properly explains her behavior after researching tirelessly. If any of you know what is going on or can offer anything to help me figure this out, I would be extremely grateful.
I will start from the beginning and do my best to be as brief as I can be. My mom was a strong, assertive, and warm woman when I was a child. She struggled a lot, however, and would cry to me when I was a child about her issues. My father was abusive, and I have heard hints that he abused her physically, sexually, and emotionally (I am unsure how accurate her claims are, however, since she often overexaggerates).
She is an alcoholic and chain-smoker and was since I can remember. She has always been extremely messy, often hoarding and buying things and letting them pile up all over the house. After my mom and dad divorced, my mom often tried to insert false memories of abuse from my father into my head and encouraged my anxieties and fears for the sake of gaining custody of us. She met my stepfather and moved in with him a year after initially separating from my father and remains with him today.
My mother’s alcoholism reached a breaking point as she was just in the early stages of menopause, and she would drink and drive frequently, eventually getting charged for a DUI. She begged and pleaded everybody around her to not be angry with her, and this is when her personality began to shift. She started telling her own version of the story, claiming that the police were abusive to her, and she was not actually drinking at all. She said that her alcoholism only lasted for a few months when I have remembered it since I was an infant.
A few months after her charge, I was assaulted by a friend, and had to go into intensive therapy for recovery. My mother was heartbroken but would release her pain by venting to me about my what had happened to me. I had requested my mom to keep the assault private, as it was very sensitive information, and she promised to do so. Members of my family began telling me overtime that my mother was telling every single person in her life and on Facebook about what had happened to me and was using it so people could give her sympathy. When I confronted my mother about this, she would burst out crying and apologize, or try and cover her tracks with white lies. My mother continued to tell everybody whenever my trauma manifested itself, such as when I had to be hospitalized, despite my disapproval.
As the years went by and I recovered, my mom’s physical health began to deteriorate. She almost completely lost feeling in her legs and is couch-ridden for most of the day, as standing is incredibly painful for her. She began to have episodes of mania, which would suddenly come on due to minor inconveniences. When in her manic episodes, she acted as if she was intoxicated. She stumbled and tripped over nothing, she made inappropriate jokes, swore constantly, and would retell stories of her past, but lie about details and stretch the truth. These episodes started as very rare at this time and would last for about half a day. After about 6 hours of mania, she would get extremely tired, and lie down to sleep. Upon sleeping, she would begin to puke and sweat, as if she had the flu, and would be bedridden for 2-3 days, returning to normal after this amount of time.
These episodes continued and happened once a month. My stepdad referred to them as PTSD episodes from the abuse she faced from my father and referred to her manic mood as “anxiety.” Her doctor put her on benzodiazepines to help ease her mania, but the episodes continued to get worse. Her episodes stopped making her bedridden for multiple days but would still make her severely exhausted once they were over. Since her episodes somewhat resembled her mood when intoxicated, my family and I would question her at points if she was still drinking. Sometimes, in response to these inquiries, she would break down and run away from home, sometimes walking along the street aimlessly, or calling her friends and begging them to pick her up and take her away from us. There were points where she threatened to call the police on me for pulling her away from the road and bringing her back into the house.
Her episodes progressed into her mispronouncing words and talking to herself, and she would sometimes randomly drive out to the store and buy massive amounts of food or junk. She would put food in the oven, and fall asleep with the oven on, or watch TV and forget that food was cooking. She no longer threw things in the garbage after using them, no longer put food back in the fridge after taking it out and stopped washing dishes properly. She would make herself something to eat or drink and forget about it and leave it in the kitchen. She would puke (or very rarely, defecate) on the bathroom floor, and not clean it up afterwards. All these things are done repeatedly when she is in manic episodes, but she has recently started to do these behaviors even when in her “normal” state.
I must clarify that my mother acts like an entirely different person when in a “normal” state. She is very self-absorbed and somewhat neutral when normal, but still displaying affection and the ability to hold normal conversation. As soon as she enters her manic state, her personality becomes like a nervous teenager. She rambles excessively, accidentally injures herself but finds it funny, and forgets everything that occurs within a minute of itself. She will ask the same questions to you every 5 minutes, forget that she has taken her pills and take even more of them, and as mentioned earlier, forget food on the stove or food that she has prepared.
She is usually in a “normal” mood when my stepdad is present, but as soon as he has left to go shopping or go to work, she enters her manic state again until he has returned. Rarely, she is normal when my stepdad is not present, but minor things may set her off into a spiral. Mentioning my father, requesting things such as cleaning dishes properly or turning off the stove after using it, literally anything will cause a manic state to begin. Upon waking up in the morning, she has no recollection of the day prior.
Now we are close to the present. A month ago, my mother was in a manic state, tripped, and cut her head open. She begged me not to call an ambulance and kept telling me she was fine. She called my stepdad and began to cry, repeatedly saying to him “I want to be a good mother. I am such a bad person.” The paramedics arrived and tried to speak with her, but she stared at them blankly, asking them where they are taking her, and claiming she is completely alright. The paramedics and I carried her to the ambulance, and she began to wail and scream, begging me not to let her go. She constantly asked why we are taking her to the hospital and would not let the paramedics put her on a stretcher. The paramedics took her to the hospital and my stepfather picked her up in the evening. When I saw her the next morning, she told me she had no memory at all getting the injury, or any of the events that unfolded afterward.
The night after the accident, she had fallen again and was thrown into another manic episode. I carried her to bed, and she began to scream my name as I left her room. She fell off the bed when trying to get up and was unable to move or pull herself up from the ground. This happened a few times, and I sat outside her room for the night, entering to help her every time she fell. She started mumbling to herself, talking about ending her own life, talking about how nobody understands her, and she began to chant my name repeatedly in the same tone of voice. She mistook me for my stepdad when I entered the room to help her up another time. Once again, the morning after, she had no recollection of anything that happened the day prior.
And now we are at the present. I am making this post out of severe concern, as I am 100% sure something is wrong with my mother. My stepfather is not taking her anywhere to get help, and doctors are only giving her more benzodiazepines when she calls them. My family and friends are all worried for her, and she seems to have no clue at all why. Every morning I wake up unsure which version of my mother I will be dealing with.
If anybody here knows anything about psychology, or knows what I am supposed to do, any kind of response would help me greatly. I am only a young adult, and I am unable to move out or take any legal action about what is going on. There are many details to this story I have missed out, so if I need to expand on anything more, please feel free to ask.
Thank you in advance.

Hi. I am making this post due to my concern for my mother’s mental health. She has changed as a person entirely over the past 6 years, and I have not been able to find an answer that properly explains her behavior after researching tirelessly. If any of you know what is going on or can offer anything to help me figure this out, I would be extremely grateful.
I will start from the beginning and do my best to be as brief as I can be. My mom was a strong, assertive, and warm woman when I was a child. She struggled a lot, however, and would cry to me when I was a child about her issues. My father was abusive, and I have heard hints that he abused her physically, sexually, and emotionally (I am unsure how accurate her claims are, however, since she often overexaggerates).
She is an alcoholic and chain-smoker and was since I can remember. She has always been extremely messy, often hoarding and buying things and letting them pile up all over the house. After my mom and dad divorced, my mom often tried to insert false memories of abuse from my father into my head and encouraged my anxieties and fears for the sake of gaining custody of us. She met my stepfather and moved in with him a year after initially separating from my father and remains with him today.
My mother’s alcoholism reached a breaking point as she was just in the early stages of menopause, and she would drink and drive frequently, eventually getting charged for a DUI. She begged and pleaded everybody around her to not be angry with her, and this is when her personality began to shift. She started telling her own version of the story, claiming that the police were abusive to her, and she was not actually drinking at all. She said that her alcoholism only lasted for a few months when I have remembered it since I was an infant.
A few months after her charge, I was assaulted by a friend, and had to go into intensive therapy for recovery. My mother was heartbroken but would release her pain by venting to me about my what had happened to me. I had requested my mom to keep the assault private, as it was very sensitive information, and she promised to do so. Members of my family began telling me overtime that my mother was telling every single person in her life and on Facebook about what had happened to me and was using it so people could give her sympathy. When I confronted my mother about this, she would burst out crying and apologize, or try and cover her tracks with white lies. My mother continued to tell everybody whenever my trauma manifested itself, such as when I had to be hospitalized, despite my disapproval.
As the years went by and I recovered, my mom’s physical health began to deteriorate. She almost completely lost feeling in her legs and is couch-ridden for most of the day, as standing is incredibly painful for her. She began to have episodes of mania, which would suddenly come on due to minor inconveniences. When in her manic episodes, she acted as if she was intoxicated. She stumbled and tripped over nothing, she made inappropriate jokes, swore constantly, and would retell stories of her past, but lie about details and stretch the truth. These episodes started as very rare at this time and would last for about half a day. After about 6 hours of mania, she would get extremely tired, and lie down to sleep. Upon sleeping, she would begin to puke and sweat, as if she had the flu, and would be bedridden for 2-3 days, returning to normal after this amount of time.
These episodes continued and happened once a month. My stepdad referred to them as PTSD episodes from the abuse she faced from my father and referred to her manic mood as “anxiety.” Her doctor put her on benzodiazepines to help ease her mania, but the episodes continued to get worse. Her episodes stopped making her bedridden for multiple days but would still make her severely exhausted once they were over. Since her episodes somewhat resembled her mood when intoxicated, my family and I would question her at points if she was still drinking. Sometimes, in response to these inquiries, she would break down and run away from home, sometimes walking along the street aimlessly, or calling her friends and begging them to pick her up and take her away from us. There were points where she threatened to call the police on me for pulling her away from the road and bringing her back into the house.
Her episodes progressed into her mispronouncing words and talking to herself, and she would sometimes randomly drive out to the store and buy massive amounts of food or junk. She would put food in the oven, and fall asleep with the oven on, or watch TV and forget that food was cooking. She no longer threw things in the garbage after using them, no longer put food back in the fridge after taking it out and stopped washing dishes properly. She would make herself something to eat or drink and forget about it and leave it in the kitchen. She would puke (or very rarely, defecate) on the bathroom floor, and not clean it up afterwards. All these things are done repeatedly when she is in manic episodes, but she has recently started to do these behaviors even when in her “normal” state.
I must clarify that my mother acts like an entirely different person when in a “normal” state. She is very self-absorbed and somewhat neutral when normal, but still displaying affection and the ability to hold normal conversation. As soon as she enters her manic state, her personality becomes like a nervous teenager. She rambles excessively, accidentally injures herself but finds it funny, and forgets everything that occurs within a minute of itself. She will ask the same questions to you every 5 minutes, forget that she has taken her pills and take even more of them, and as mentioned earlier, forget food on the stove or food that she has prepared.
She is usually in a “normal” mood when my stepdad is present, but as soon as he has left to go shopping or go to work, she enters her manic state again until he has returned. Rarely, she is normal when my stepdad is not present, but minor things may set her off into a spiral. Mentioning my father, requesting things such as cleaning dishes properly or turning off the stove after using it, literally anything will cause a manic state to begin. Upon waking up in the morning, she has no recollection of the day prior.
Now we are close to the present. A month ago, my mother was in a manic state, tripped, and cut her head open. She begged me not to call an ambulance and kept telling me she was fine. She called my stepdad and began to cry, repeatedly saying to him “I want to be a good mother. I am such a bad person.” The paramedics arrived and tried to speak with her, but she stared at them blankly, asking them where they are taking her, and claiming she is completely alright. The paramedics and I carried her to the ambulance, and she began to wail and scream, begging me not to let her go. She constantly asked why we are taking her to the hospital and would not let the paramedics put her on a stretcher. The paramedics took her to the hospital and my stepfather picked her up in the evening. When I saw her the next morning, she told me she had no memory at all getting the injury, or any of the events that unfolded afterward.
The night after the accident, she had fallen again and was thrown into another manic episode. I carried her to bed, and she began to scream my name as I left her room. She fell off the bed when trying to get up and was unable to move or pull herself up from the ground. This happened a few times, and I sat outside her room for the night, entering to help her every time she fell. She started mumbling to herself, talking about ending her own life, talking about how nobody understands her, and she began to chant my name repeatedly in the same tone of voice. She mistook me for my stepdad when I entered the room to help her up another time. Once again, the morning after, she had no recollection of anything that happened the day prior.
And now we are at the present. I am making this post out of severe concern, as I am 100% sure something is wrong with my mother. My stepfather is not taking her anywhere to get help, and doctors are only giving her more benzodiazepines when she calls them. My family and friends are all worried for her, and she seems to have no clue at all why. Every morning I wake up unsure which version of my mother I will be dealing with.
If anybody here knows anything about psychology, or knows what I am supposed to do, any kind of response would help me greatly. I am only a young adult, and I am unable to move out or take any legal action about what is going on. There are many details to this story I have missed out, so if I need to expand on anything more, please feel free to ask.
Thank you in advance.

Hi. I am making this post due to my concern for my mother’s mental health. She has changed as a person entirely over the past 6 years, and I have not been able to find an answer that properly explains her behavior after researching tirelessly. If any of you know what is going on or can offer anything to help me figure this out, I would be extremely grateful.
I will start from the beginning and do my best to be as brief as I can be. My mom was a strong, assertive, and warm woman when I was a child. She struggled a lot, however, and would cry to me when I was a child about her issues. My father was abusive, and I have heard hints that he abused her physically, sexually, and emotionally (I am unsure how accurate her claims are, however, since she often overexaggerates).
She is an alcoholic and chain-smoker and was since I can remember. She has always been extremely messy, often hoarding and buying things and letting them pile up all over the house. After my mom and dad divorced, my mom often tried to insert false memories of abuse from my father into my head and encouraged my anxieties and fears for the sake of gaining custody of us. She met my stepfather and moved in with him a year after initially separating from my father and remains with him today.
My mother’s alcoholism reached a breaking point as she was just in the early stages of menopause, and she would drink and drive frequently, eventually getting charged for a DUI. She begged and pleaded everybody around her to not be angry with her, and this is when her personality began to shift. She started telling her own version of the story, claiming that the police were abusive to her, and she was not actually drinking at all. She said that her alcoholism only lasted for a few months when I have remembered it since I was an infant.
A few months after her charge, I was assaulted by a friend, and had to go into intensive therapy for recovery. My mother was heartbroken but would release her pain by venting to me about my what had happened to me. I had requested my mom to keep the assault private, as it was very sensitive information, and she promised to do so. Members of my family began telling me overtime that my mother was telling every single person in her life and on Facebook about what had happened to me and was using it so people could give her sympathy. When I confronted my mother about this, she would burst out crying and apologize, or try and cover her tracks with white lies. My mother continued to tell everybody whenever my trauma manifested itself, such as when I had to be hospitalized, despite my disapproval.
As the years went by and I recovered, my mom’s physical health began to deteriorate. She almost completely lost feeling in her legs and is couch-ridden for most of the day, as standing is incredibly painful for her. She began to have episodes of mania, which would suddenly come on due to minor inconveniences. When in her manic episodes, she acted as if she was intoxicated. She stumbled and tripped over nothing, she made inappropriate jokes, swore constantly, and would retell stories of her past, but lie about details and stretch the truth. These episodes started as very rare at this time and would last for about half a day. After about 6 hours of mania, she would get extremely tired, and lie down to sleep. Upon sleeping, she would begin to puke and sweat, as if she had the flu, and would be bedridden for 2-3 days, returning to normal after this amount of time.
These episodes continued and happened once a month. My stepdad referred to them as PTSD episodes from the abuse she faced from my father and referred to her manic mood as “anxiety.” Her doctor put her on benzodiazepines to help ease her mania, but the episodes continued to get worse. Her episodes stopped making her bedridden for multiple days but would still make her severely exhausted once they were over. Since her episodes somewhat resembled her mood when intoxicated, my family and I would question her at points if she was still drinking. Sometimes, in response to these inquiries, she would break down and run away from home, sometimes walking along the street aimlessly, or calling her friends and begging them to pick her up and take her away from us. There were points where she threatened to call the police on me for pulling her away from the road and bringing her back into the house.
Her episodes progressed into her mispronouncing words and talking to herself, and she would sometimes randomly drive out to the store and buy massive amounts of food or junk. She would put food in the oven, and fall asleep with the oven on, or watch TV and forget that food was cooking. She no longer threw things in the garbage after using them, no longer put food back in the fridge after taking it out and stopped washing dishes properly. She would make herself something to eat or drink and forget about it and leave it in the kitchen. She would puke (or very rarely, defecate) on the bathroom floor, and not clean it up afterwards. All these things are done repeatedly when she is in manic episodes, but she has recently started to do these behaviors even when in her “normal” state.
I must clarify that my mother acts like an entirely different person when in a “normal” state. She is very self-absorbed and somewhat neutral when normal, but still displaying affection and the ability to hold normal conversation. As soon as she enters her manic state, her personality becomes like a nervous teenager. She rambles excessively, accidentally injures herself but finds it funny, and forgets everything that occurs within a minute of itself. She will ask the same questions to you every 5 minutes, forget that she has taken her pills and take even more of them, and as mentioned earlier, forget food on the stove or food that she has prepared.
She is usually in a “normal” mood when my stepdad is present, but as soon as he has left to go shopping or go to work, she enters her manic state again until he has returned. Rarely, she is normal when my stepdad is not present, but minor things may set her off into a spiral. Mentioning my father, requesting things such as cleaning dishes properly or turning off the stove after using it, literally anything will cause a manic state to begin. Upon waking up in the morning, she has no recollection of the day prior.
Now we are close to the present. A month ago, my mother was in a manic state, tripped, and cut her head open. She begged me not to call an ambulance and kept telling me she was fine. She called my stepdad and began to cry, repeatedly saying to him “I want to be a good mother. I am such a bad person.” The paramedics arrived and tried to speak with her, but she stared at them blankly, asking them where they are taking her, and claiming she is completely alright. The paramedics and I carried her to the ambulance, and she began to wail and scream, begging me not to let her go. She constantly asked why we are taking her to the hospital and would not let the paramedics put her on a stretcher. The paramedics took her to the hospital and my stepfather picked her up in the evening. When I saw her the next morning, she told me she had no memory at all getting the injury, or any of the events that unfolded afterward.
The night after the accident, she had fallen again and was thrown into another manic episode. I carried her to bed, and she began to scream my name as I left her room. She fell off the bed when trying to get up and was unable to move or pull herself up from the ground. This happened a few times, and I sat outside her room for the night, entering to help her every time she fell. She started mumbling to herself, talking about ending her own life, talking about how nobody understands her, and she began to chant my name repeatedly in the same tone of voice. She mistook me for my stepdad when I entered the room to help her up another time. Once again, the morning after, she had no recollection of anything that happened the day prior.
And now we are at the present. I am making this post out of severe concern, as I am 100% sure something is wrong with my mother. My stepfather is not taking her anywhere to get help, and doctors are only giving her more benzodiazepines when she calls them. My family and friends are all worried for her, and she seems to have no clue at all why. Every morning I wake up unsure which version of my mother I will be dealing with.
If anybody here knows anything about psychology, or knows what I am supposed to do, any kind of response would help me greatly. I am only a young adult, and I am unable to move out or take any legal action about what is going on. There are many details to this story I have missed out, so if I need to expand on anything more, please feel free to ask.
Thank you in advance.

Hi. I am making this post due to my concern for my mother’s mental health. She has changed as a person entirely over the past 6 years, and I have not been able to find an answer that properly explains her behavior after researching tirelessly. If any of you know what is going on or can offer anything to help me figure this out, I would be extremely grateful.
I will start from the beginning and do my best to be as brief as I can be. My mom was a strong, assertive, and warm woman when I was a child. She struggled a lot, however, and would cry to me when I was a child about her issues. My father was abusive, and I have heard hints that he abused her physically, sexually, and emotionally (I am unsure how accurate her claims are, however, since she often overexaggerates).
She is an alcoholic and chain-smoker and was since I can remember. She has always been extremely messy, often hoarding and buying things and letting them pile up all over the house. After my mom and dad divorced, my mom often tried to insert false memories of abuse from my father into my head and encouraged my anxieties and fears for the sake of gaining custody of us. She met my stepfather and moved in with him a year after initially separating from my father and remains with him today.
My mother’s alcoholism reached a breaking point as she was just in the early stages of menopause, and she would drink and drive frequently, eventually getting charged for a DUI. She begged and pleaded everybody around her to not be angry with her, and this is when her personality began to shift. She started telling her own version of the story, claiming that the police were abusive to her, and she was not actually drinking at all. She said that her alcoholism only lasted for a few months when I have remembered it since I was an infant.
A few months after her charge, I was assaulted by a friend, and had to go into intensive therapy for recovery. My mother was heartbroken but would release her pain by venting to me about my what had happened to me. I had requested my mom to keep the assault private, as it was very sensitive information, and she promised to do so. Members of my family began telling me overtime that my mother was telling every single person in her life and on Facebook about what had happened to me and was using it so people could give her sympathy. When I confronted my mother about this, she would burst out crying and apologize, or try and cover her tracks with white lies. My mother continued to tell everybody whenever my trauma manifested itself, such as when I had to be hospitalized, despite my disapproval.
As the years went by and I recovered, my mom’s physical health began to deteriorate. She almost completely lost feeling in her legs and is couch-ridden for most of the day, as standing is incredibly painful for her. She began to have episodes of mania, which would suddenly come on due to minor inconveniences. When in her manic episodes, she acted as if she was intoxicated. She stumbled and tripped over nothing, she made inappropriate jokes, swore constantly, and would retell stories of her past, but lie about details and stretch the truth. These episodes started as very rare at this time and would last for about half a day. After about 6 hours of mania, she would get extremely tired, and lie down to sleep. Upon sleeping, she would begin to puke and sweat, as if she had the flu, and would be bedridden for 2-3 days, returning to normal after this amount of time.
These episodes continued and happened once a month. My stepdad referred to them as PTSD episodes from the abuse she faced from my father and referred to her manic mood as “anxiety.” Her doctor put her on benzodiazepines to help ease her mania, but the episodes continued to get worse. Her episodes stopped making her bedridden for multiple days but would still make her severely exhausted once they were over. Since her episodes somewhat resembled her mood when intoxicated, my family and I would question her at points if she was still drinking. Sometimes, in response to these inquiries, she would break down and run away from home, sometimes walking along the street aimlessly, or calling her friends and begging them to pick her up and take her away from us. There were points where she threatened to call the police on me for pulling her away from the road and bringing her back into the house.
Her episodes progressed into her mispronouncing words and talking to herself, and she would sometimes randomly drive out to the store and buy massive amounts of food or junk. She would put food in the oven, and fall asleep with the oven on, or watch TV and forget that food was cooking. She no longer threw things in the garbage after using them, no longer put food back in the fridge after taking it out and stopped washing dishes properly. She would make herself something to eat or drink and forget about it and leave it in the kitchen. She would puke (or very rarely, defecate) on the bathroom floor, and not clean it up afterwards. All these things are done repeatedly when she is in manic episodes, but she has recently started to do these behaviors even when in her “normal” state.
I must clarify that my mother acts like an entirely different person when in a “normal” state. She is very self-absorbed and somewhat neutral when normal, but still displaying affection and the ability to hold normal conversation. As soon as she enters her manic state, her personality becomes like a nervous teenager. She rambles excessively, accidentally injures herself but finds it funny, and forgets everything that occurs within a minute of itself. She will ask the same questions to you every 5 minutes, forget that she has taken her pills and take even more of them, and as mentioned earlier, forget food on the stove or food that she has prepared.
She is usually in a “normal” mood when my stepdad is present, but as soon as he has left to go shopping or go to work, she enters her manic state again until he has returned. Rarely, she is normal when my stepdad is not present, but minor things may set her off into a spiral. Mentioning my father, requesting things such as cleaning dishes properly or turning off the stove after using it, literally anything will cause a manic state to begin. Upon waking up in the morning, she has no recollection of the day prior.
Now we are close to the present. A month ago, my mother was in a manic state, tripped, and cut her head open. She begged me not to call an ambulance and kept telling me she was fine. She called my stepdad and began to cry, repeatedly saying to him “I want to be a good mother. I am such a bad person.” The paramedics arrived and tried to speak with her, but she stared at them blankly, asking them where they are taking her, and claiming she is completely alright. The paramedics and I carried her to the ambulance, and she began to wail and scream, begging me not to let her go. She constantly asked why we are taking her to the hospital and would not let the paramedics put her on a stretcher. The paramedics took her to the hospital and my stepfather picked her up in the evening. When I saw her the next morning, she told me she had no memory at all getting the injury, or any of the events that unfolded afterward.
The night after the accident, she had fallen again and was thrown into another manic episode. I carried her to bed, and she began to scream my name as I left her room. She fell off the bed when trying to get up and was unable to move or pull herself up from the ground. This happened a few times, and I sat outside her room for the night, entering to help her every time she fell. She started mumbling to herself, talking about ending her own life, talking about how nobody understands her, and she began to chant my name repeatedly in the same tone of voice. She mistook me for my stepdad when I entered the room to help her up another time. Once again, the morning after, she had no recollection of anything that happened the day prior.
And now we are at the present. I am making this post out of severe concern, as I am 100% sure something is wrong with my mother. My stepfather is not taking her anywhere to get help, and doctors are only giving her more benzodiazepines when she calls them. My family and friends are all worried for her, and she seems to have no clue at all why. Every morning I wake up unsure which version of my mother I will be dealing with.
If anybody here knows anything about psychology, or knows what I am supposed to do, any kind of response would help me greatly. I am only a young adult, and I am unable to move out or take any legal action about what is going on. There are many details to this story I have missed out, so if I need to expand on anything more, please feel free to ask.
Thank you in advance.

Hi. I am making this post due to my concern for my mother’s mental health. She has changed as a person entirely over the past 6 years, and I have not been able to find an answer that properly explains her behavior after researching tirelessly. If any of you know what is going on or can offer anything to help me figure this out, I would be extremely grateful.
I will start from the beginning and do my best to be as brief as I can be. My mom was a strong, assertive, and warm woman when I was a child. She struggled a lot, however, and would cry to me when I was a child about her issues. My father was abusive, and I have heard hints that he abused her physically, sexually, and emotionally (I am unsure how accurate her claims are, however, since she often overexaggerates).
She is an alcoholic and chain-smoker and was since I can remember. She has always been extremely messy, often hoarding and buying things and letting them pile up all over the house. After my mom and dad divorced, my mom often tried to insert false memories of abuse from my father into my head and encouraged my anxieties and fears for the sake of gaining custody of us. She met my stepfather and moved in with him a year after initially separating from my father and remains with him today.
My mother’s alcoholism reached a breaking point as she was just in the early stages of menopause, and she would drink and drive frequently, eventually getting charged for a DUI. She begged and pleaded everybody around her to not be angry with her, and this is when her personality began to shift. She started telling her own version of the story, claiming that the police were abusive to her, and she was not actually drinking at all. She said that her alcoholism only lasted for a few months when I have remembered it since I was an infant.
A few months after her charge, I was assaulted by a friend, and had to go into intensive therapy for recovery. My mother was heartbroken but would release her pain by venting to me about my what had happened to me. I had requested my mom to keep the assault private, as it was very sensitive information, and she promised to do so. Members of my family began telling me overtime that my mother was telling every single person in her life and on Facebook about what had happened to me and was using it so people could give her sympathy. When I confronted my mother about this, she would burst out crying and apologize, or try and cover her tracks with white lies. My mother continued to tell everybody whenever my trauma manifested itself, such as when I had to be hospitalized, despite my disapproval.
As the years went by and I recovered, my mom’s physical health began to deteriorate. She almost completely lost feeling in her legs and is couch-ridden for most of the day, as standing is incredibly painful for her. She began to have episodes of mania, which would suddenly come on due to minor inconveniences. When in her manic episodes, she acted as if she was intoxicated. She stumbled and tripped over nothing, she made inappropriate jokes, swore constantly, and would retell stories of her past, but lie about details and stretch the truth. These episodes started as very rare at this time and would last for about half a day. After about 6 hours of mania, she would get extremely tired, and lie down to sleep. Upon sleeping, she would begin to puke and sweat, as if she had the flu, and would be bedridden for 2-3 days, returning to normal after this amount of time.
These episodes continued and happened once a month. My stepdad referred to them as PTSD episodes from the abuse she faced from my father and referred to her manic mood as “anxiety.” Her doctor put her on benzodiazepines to help ease her mania, but the episodes continued to get worse. Her episodes stopped making her bedridden for multiple days but would still make her severely exhausted once they were over. Since her episodes somewhat resembled her mood when intoxicated, my family and I would question her at points if she was still drinking. Sometimes, in response to these inquiries, she would break down and run away from home, sometimes walking along the street aimlessly, or calling her friends and begging them to pick her up and take her away from us. There were points where she threatened to call the police on me for pulling her away from the road and bringing her back into the house.
Her episodes progressed into her mispronouncing words and talking to herself, and she would sometimes randomly drive out to the store and buy massive amounts of food or junk. She would put food in the oven, and fall asleep with the oven on, or watch TV and forget that food was cooking. She no longer threw things in the garbage after using them, no longer put food back in the fridge after taking it out and stopped washing dishes properly. She would make herself something to eat or drink and forget about it and leave it in the kitchen. She would puke (or very rarely, defecate) on the bathroom floor, and not clean it up afterwards. All these things are done repeatedly when she is in manic episodes, but she has recently started to do these behaviors even when in her “normal” state.
I must clarify that my mother acts like an entirely different person when in a “normal” state. She is very self-absorbed and somewhat neutral when normal, but still displaying affection and the ability to hold normal conversation. As soon as she enters her manic state, her personality becomes like a nervous teenager. She rambles excessively, accidentally injures herself but finds it funny, and forgets everything that occurs within a minute of itself. She will ask the same questions to you every 5 minutes, forget that she has taken her pills and take even more of them, and as mentioned earlier, forget food on the stove or food that she has prepared.
She is usually in a “normal” mood when my stepdad is present, but as soon as he has left to go shopping or go to work, she enters her manic state again until he has returned. Rarely, she is normal when my stepdad is not present, but minor things may set her off into a spiral. Mentioning my father, requesting things such as cleaning dishes properly or turning off the stove after using it, literally anything will cause a manic state to begin. Upon waking up in the morning, she has no recollection of the day prior.
Now we are close to the present. A month ago, my mother was in a manic state, tripped, and cut her head open. She begged me not to call an ambulance and kept telling me she was fine. She called my stepdad and began to cry, repeatedly saying to him “I want to be a good mother. I am such a bad person.” The paramedics arrived and tried to speak with her, but she stared at them blankly, asking them where they are taking her, and claiming she is completely alright. The paramedics and I carried her to the ambulance, and she began to wail and scream, begging me not to let her go. She constantly asked why we are taking her to the hospital and would not let the paramedics put her on a stretcher. The paramedics took her to the hospital and my stepfather picked her up in the evening. When I saw her the next morning, she told me she had no memory at all getting the injury, or any of the events that unfolded afterward.
The night after the accident, she had fallen again and was thrown into another manic episode. I carried her to bed, and she began to scream my name as I left her room. She fell off the bed when trying to get up and was unable to move or pull herself up from the ground. This happened a few times, and I sat outside her room for the night, entering to help her every time she fell. She started mumbling to herself, talking about ending her own life, talking about how nobody understands her, and she began to chant my name repeatedly in the same tone of voice. She mistook me for my stepdad when I entered the room to help her up another time. Once again, the morning after, she had no recollection of anything that happened the day prior.
And now we are at the present. I am making this post out of severe concern, as I am 100% sure something is wrong with my mother. My stepfather is not taking her anywhere to get help, and doctors are only giving her more benzodiazepines when she calls them. My family and friends are all worried for her, and she seems to have no clue at all why. Every morning I wake up unsure which version of my mother I will be dealing with.
If anybody here knows anything about psychology, or knows what I am supposed to do, any kind of response would help me greatly. I am only a young adult, and I am unable to move out or take any legal action about what is going on. There are many details to this story I have missed out, so if I need to expand on anything more, please feel free to ask.
Thank you in advance.

Hello kava lovers!
I took quite a bit of time today to dig into this. It's been a long running issue that when you type in "Kava" in google you get some dubious results on the first page. I'm taking it upon myself to list those here, and refute them where they have issues.
Search Results for "Kava" on google in incognito window.
Result 1: Webmd

1. Overview

• Point 1: “Kava is a beverage or extract that is made from Piper methysticum, a plant native to the western Pacific islands. The name "kava" comes from the Polynesian word "awa," which means bitter. In the South Pacific, kava is a popular social drink. It is consumed as a beverage in ceremonies to promote relaxation.”

1. No issues with point one.

• Point 2: “There have been some safety concerns about kava. Cases of liver damage and even some deaths have been traced to kava use. Because of these reports, kava was withdrawn from the market in Europe and Canada in the early 2000s. However, most countries have allowed kava to return to the market since that time. Kava has never been taken off the market in the U.S.”

1. And my issues start here. “Cases of liver damage and even some deaths have been traced to kava use” is a hotly contested conclusion, and rather inflammatory when such paltry evidence exists to support it. The paragraph then goes on to state “However, most countries have allowed kava to return to the market since that time.” My issue here is; why are we not seeing these cases of liver failures and injury in countries where it’s freely available today, if it’s as liver toxic as it was said to be?

• Point 3: “Kava is most commonly used for anxiety. Some people take kava for stress, restlessness, sleeping problems (insomnia), and many other conditions. But there is no good scientific evidence to support these uses.”

1. “But there is no good scientific evidence to support these uses.” Hilariously they give quite good scientific evidence to support these uses directly in their references. Kava and kava extracts have been proven in double blind placebo controlled studies to reduce anxiety scores, and increase sleep duration/quality.
2. How does it work?

• Point 1: “Kava affects the brain and other parts of the central nervous system. The kavalactones in kava are believed to be responsible for its effects.”

1. No issues with this. This has been demonstrated repeatedly in research.
2. Possibly Effective for

• Point 1: “Anxiety. Most research shows that taking kava extracts that contain 70% kavalactones can lower anxiety and might work as well as some prescription anti-anxiety medications. Most studies have used a specific kava extract (WS 1490, Dr. Willmar Schwabe Pharmaceuticals). It seems that kava supplements containing at least 200 mg kavalactones daily should be taken for at least 5 weeks for symptoms to improve.”

1. Strangely, they just got finished saying there is no good scientific information on which to support these theories. Extra note: WS-1490 is an extract that has been embroiled in controversy. The extract is contested on the grounds that it was changed several times throughout the research periods from an ethanolic extract to an acetonic extract with no indication. You can see this by noting how the kavalactone percentage changes arbitrarily from 30% to 70%.
2. Possibly Ineffective for

• Point 1: “A type of persistent anxiety marked by exaggerated worry and tension (generalized anxiety disorder or GAD). Several early studies show that taking kava doesn't improve symptoms in people with GAD.”

1. They conveniently don’t mark their sources in the article, but this one comes from Dr. Sarris in Australia in 2020. This research concluded that kava was more suitable for the reduction in stress and tension related to ‘situational’ anxiety, than it was for direct treatment of G.A.D.
2. Insufficient Evidence for

• Point 1 “Withdrawal from drugs called benzodiazepines. Early research suggests that slowly increasing the dose of kava extract over the course of one week while decreasing the dose of benzodiazepines over the course of two weeks can prevent withdrawal symptoms and reduce anxiety in people who have been taking benzodiazepines for a long period of time.”

1. It can reduce anxiety, but the actual physical withdrawal is not treated by any action of the kavalactones themselves. It’s likely that the steady tapering of the BZP drug was what allowed these participants to cease their use with less acute withdrawal. Kava definitely helps, but it has different actions at the GABA-A receptor that are not similar to that of benzodiazepine drugs. Benzos target the BZP allosteric site on the GABA-A receptor where they exert their effect. Kava and flumazenil (a very potent anti-benzo or BZP antagonist) were administered at the same time in studies, and the effect of kava was not blocked.

• Point 2 “Cancer. There is some early evidence that taking kava might help to prevent cancer.”

1. I would say this “insufficient evidence” is actually an order of magnitude more studied and documented than the “liver damage” at the very beginning of this article. I’ve added additional citations below this papers citations, and I stopped citing at 12 research studies that show anti-cancer effects.

• Point 3 “Insomnia. Research on the effectiveness of kava in people with sleeping problems is inconsistent. Some research shows that taking kava extract daily for 4 weeks reduces sleeping problems in people with anxiety disorders. But other research suggests that taking kava three times daily for 4 weeks does not reduce insomnia in people with anxiety.”

1. The World Health organization monograph (2002) describes insomnia as a state supported by clinical data. This is generally accepted, however there were participants in studies on kava that dropped out due to insomnia complaints. While kava is overall a good fit for sleep issues, it likely won’t present that way to 100% of the people who drink it. We actually do see people complain about not being able to get to sleep after a strong kava. I say this to agree with the above paragraph where it states the research is inconsistent. It helps me with sleep, but that doesn’t mean it will be the same for everyone.

• Point 4 “Symptoms of menopause. Early research shows that taking kava daily for 3 months might reduce depression, anxiety, and hot flashes.”

1. While maybe insufficient, there is good evidence to support this. Two individual studies found improvement in mood, reduction in depression, and reduction in anxiety in perimenopausal individuals.

• Point 5 “Stress. Early research suggests that taking a single dose of kava by mouth might reduce symptoms associated with mentally stressful tasks.”

1. This is an odd one to say has insufficient evidence. A number of researchers including Münte, Sarris, Cropley, and Aporosa have found kava reduces symptoms associated with mentally stressful tasks.

• Point 6 “Seizure disorder (epilepsy).”

1. This is in line with reality. We only see glimpses into kava’s ability to modulate glutamate. Kavain was shown to inhibit veratridine-activated sodium channels. It’s possible that kava may help reduce seizures, but as said, there is insufficient evidence to say it precisely.

• Point 7 “Muscle pain.”

1. This I don’t agree with, and it’s a strange one to be saying there’s insufficient evidence for. Kava has marked antinociceptive (pain relieving) and muscle-relaxing properties. A good number of independent research studies have confirmed this.

• Point 8 “Other conditions”

1. I’m not really sure what to say here. I suppose it’s quite accurate to say that there is insufficient evidence for kava causing superhero-like powers to emerge.
2. Side Effects

• Paragraph 1 “When taken by mouth: Kava is POSSIBLY SAFE when taken for up to 6 months. Using kava can make you unable to drive or operate machinery safely. Do not take kava before you plan on driving. "Driving-under-the-influence" citations have been issued to people driving erratically after drinking large amounts of kava tea.”

1. This is good, and goes pretty far based on the double blind placebo controlled studies. The one issue I have is the 6 month limit. There really isn’t any indication that taking kava beyond this time frame causes issues, it’s just when they cut the time limit of the study. Empirical evidence suggests kava, when consumed as a beverage, is safe indefinitely as shown by the South Pacific people who drink kava on a daily basis and have for generations. In regards to driving, I fully agree. If you’re consuming anything that makes you question your abilities with driving, call an ubelyft.The risk is simply not worth it.

• Paragraph 2 “People may have heard that use of kava can cause liver damage. The use of kava for as little as 1-3 months has resulted in the need for liver transplants and even death in some people. Early symptoms of liver damage include yellowed eyes and skin (jaundice), fatigue, and dark urine. But these cases appear to be relatively rare. Most people who have used kava have not experienced liver toxicity. Also, some experts believe that the liver toxicity seen in these cases cannot be directly linked to kava. Other factors may have contributed to these toxic effects. To be on the safe side, people who choose to use kava can get liver function tests.”

1. That’s pretty honest, however the phrase “The use of kava for as little as 1-3 months has resulted in the need for liver transplants and even death in some people” really understates “some people”. The number of individuals allegedly harmed by kava is limited to less than 10. There has been no intrinsic (unable to be separated) toxicity seen in kava or any kava extracts, however idiosyncratic reactions of the immunologic type have occurred. This is extremely rare. I can’t say that enough. We’re talking on the scale of winning the lottery, being hit by lightning, and finding Jimmy Hoffa all at the same instant. If we turn our attention to things such as green tea extracts or acetaminophen we see intrinsic, predictable toxicity to the liver. This does not exist with kava.
2. Special Precautions and Warnings

• Point 1 “Pregnancy and breast-feeding: Don't use kava if you are pregnant or breast-feeding. Kava is POSSIBLY UNSAFE when taken by mouth. There is a concern that it might affect the uterus. Also, some of the dangerous chemicals in kava can pass into breast milk and might hurt a breast-fed infant.”

1. They’re speaking about kavalactones, and they’re not “dangerous chemicals” however we don't fully understand the function of GABAergic substances on the developing brain. Kavalactones are known as lipophilic, meaning they tend to combine or dissolve in fats. This means they could likely also pass on through breastfeeding. There is no data confirming this suspicion, however with no experience available, kava is not recommended for use by pregnant or breast-feeding women. It’s much better to err on the side of caution. In regards to kava affecting the uterus, I’m afraid there is absolutely nothing confirming this. It’s an old myth from Fiji that kava stimulates the uterus, this doesn’t happen, and shouldn’t be listed as a precaution. Histopathology was performed on rats at 2.0g/kg of kavalactones and found no-effect level on the uterus. (2012. “Toxicology and Carcinogenesis Studies of Kava Kava Extract (CAS No. 9000-38-8) in F344/N Rats and B6C3F1 Mice (gavage Studies).” National Toxicology Program 571 (1): 1–186. https://ntp.niehs.nih.gov/publications/reports/t500s/tr571/index.html)

• Point 2 “Liver disease: Kava might cause liver problems, even in healthy people. People who have a history of liver problems should avoid kava.”

1. Well this sounds familiar. This will be the 3rd time this website has decided it was pertinent to warn us of liver damage. What they’ll throw at you sometimes is the instance of GGT elevation in metabolism tests seen in kava users in the late 80s and early 90s in Australia's Northern Territory. This is NOT indicative of liver damage. It indicates liver adaptation and is seen in kava drinkers that consume about a pound of dried kava per week. AST and ALT increases are not seen. I would even go as far to say here that kava is not even detrimental to those with liver problems. Kava is not intrinsically toxic to the liver in any way.

• Point 3 “Parkinson disease: Kava might make Parkinson disease worse. Do not take kava if you have this condition.”

1. This one is interesting. You have research on one side saying kava has no or very little activity at dopamine, then you have other research indicating that some kavalactones drop dopamine levels considerably. The one kavalactone in question here is Yangonin. Yangonin has shown in research to lower dopamine to below detectable levels. I personally believe that this is happening evidenced by the extrapyramidal movements seen in kava drinkers that went way overboard. They end up looking like they have parkinsons. If you are on medication such as levodopa that is specifically meant to increase free dopamine levels in the brain, kava can counteract this effect and cause the resurgence of parkinson's symptoms. So yes, I agree with this statement. If you have parkinsons it’s best to skip the kava.

• Point 4 “Surgery: Kava affects the central nervous system. It might increase the effects of anesthesia and other medications used during and after surgery. Stop using kava at least 2 weeks before a scheduled surgery.”

1. This is not talked about very much but should be taken into close consideration when approaching a surgery. Kava has many properties that haven’t been studied all that intensively. Kava has shown to have some mild antithrombotic actions. This means it may be able to prevent, to a degree, blood clotting. Give yourself at least a week if not two before any surgery to let your system flush out. Kava has also been shown to increase the sedation of anesthetic drugs. You’ll want to observe this just to be on the safe side.
2. Major Interactions

• Point 1 Alprazolam “Kava can cause drowsiness. Alprazolam (Xanax) can also cause drowsiness. Taking kava along with alprazolam (Xanax) may cause too much drowsiness. Avoid taking kava and alprazolam (Xanax) together.”

1. Agreed

• Point 2 “Kava might cause sleepiness and drowsiness. Medications that cause sleepiness are called sedatives. Taking kava along with sedative medications might cause too much sleepiness.Some sedative medications include clonazepam (Klonopin), lorazepam (Ativan), phenobarbital (Donnatal), zolpidem (Ambien), and others.

1. Agreed as well. Sedation seems to be the pharmacodynamic interaction here.
2. Moderate Interactions

• Point 1 “Levodopa interacts with KAVA - Levodopa affects the brain by increasing a brain chemical called dopamine. Kava might decrease dopamine in the brain. Taking kava along with levodopa might decrease the effectiveness of levodopa.”

1. I believe this to be correct. Levodopa is a medication meant to increase the levels of dopamine in the brain. Yangonin can decrease dopamine levels in the brain and counteract this medication.

• Point 2 “Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates) interact with KAVA - Some medications are changed and broken down by the liver.- Kava might decrease how quickly the liver breaks down some medications. Taking kava along with some medications that are changed by the liver might increase the effects and side effects of some medications. Before taking kava talk to your healthcare provider if you take any medications that are changed by the liver. Some of these medications that are changed by the liver include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, zileuton (Zyflo), zolmitriptan (Zomig), and others.

1. This is also correct. CYP1A2 is the pathway of metabolization for caffeine. Kava causes inhibitory actions at this pathway and as such causes caffeine to appear in serum levels for much longer than without kava in the system. The individual effect of this combination may differ from person to person. CYP1A2 activity has a range of 40% between individuals. As such it’s quite difficult to make predictions of which drugs will do what when this pathway is inhibited.

• Point 3 “Medications changed by the liver (Cytochrome P450 2C19 (CYP2C19) substrates) interact with KAVA - Some medications are changed and broken down by the liver Kava might decrease how quickly the liver breaks down some medications. Taking kava along with some medications that are broken down by the liver can increase the effects and side effects of your medication. Before taking kava talk to your healthcare provider if you take any medications that are changed by the liver. Some of these medications changed by the liver include amitriptyline (Elavil), clomipramine (Anafranil), cyclophosphamide (Cytoxan), diazepam (Valium), lansoprazole (Prevacid), omeprazole (Prilosec), lansoprazole (Protonix), phenytoin (Dilantin), phenobarbital (Luminal), progesterone, and others.

1. Correct as well; however, issues at this cytochrome with drugs that use this pathway are not heavily researched in regards to kava. They generally encompass the sedative effects and their increase when in combination with the drugs above. Caution should still be taken when combining these drugs with kava as it will likely make them stay in your system for considerably longer periods of time. DMY seems to be the most potent inhibitory kavalactone in this regard.

• Point 4 “Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates) interacts with KAVA - Some medications are changed and broken down by the liver. Kava might decrease how quickly the liver breaks down some medications. Taking kava along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking kava talk to your healthcare provider if you take any medications that are changed by the liver. Some medications that are changed by the liver include amitriptyline (Elavil), diazepam (Valium), zileuton (Zyflo), celecoxib (Celebrex), diclofenac (Voltaren), fluvastatin (Lescol), glipizide (Glucotrol), ibuprofen (Advil, Motrin), irbesartan (Avapro), losartan (Cozaar), phenytoin (Dilantin), piroxicam (Feldene), tamoxifen (Nolvadex), tolbutamide (Tolinase), torsemide (Demadex), warfarin (Coumadin), and others.

1. This inhibition was seen strongest with methysticin, the number 6 on chemotypes. The effect seen with methysticin was low, with only 1% of the strength of their positive control (Sulfaphenazole). I truly believe this would not have a strong impact on drugs that also use this pathway being kava/kavalactones have such a low affinity for it.

• Point 5 “Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates) interact with KAVA - Some medications are changed and broken down by the liver. Kava might decrease how quickly the liver breaks down some medications. Taking kava along with some medications that are change by the liver can increase the effects and side effects of your medication. Before taking kava talk to your healthcare provider if you take any medications that are changed by the liver. Some medications that are changed by the liver include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.

1. This is incorrect. Kava has no inhibition property at this cytochrome even at absurdly high concentrations, and as such this is wrong.

• Point 6 “Medications changed by the liver (Cytochrome P450 2E1 (CYP2E1) substrates) interact with KAVA - Some medications are changed and broken down by the liver. Kava might decrease how quickly the liver breaks down some medications. Taking kava along with some medications that are change by the liver can increase the effects and side effects of your medication. Before taking kava talk to your healthcare provider if you take any medications that are changed by the liver.Some medications that are changed by the liver include acetaminophen, chlorzoxazone (Parafon Forte), ethanol, theophylline, and drugs used for anesthesia during surgery such as enflurane (Ethrane), halothane (Fluothane), isoflurane (Forane), and methoxyflurane (Penthrane).

1. Again methysticin is the only kavalactone shown to interact with this cytochrome and it does it quite weakly. I wouldn’t suspect any immediate issues with drugs that use this pathway combined with kava.

• Point 7 “Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) interact with KAVA - Some medications are changed and broken down by the liver. Kava might decrease how quickly the liver breaks down some medications. Taking kava along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking kava, talk to your healthcare provider if you are taking any medications that are changed by the liver. Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.

1. This effect, if present, will be very light. Kava has shown very slight inhibitory properties at CYP3A4 with methysticin being the most potent inhibitor. Methysticin has shown to be about 1% the inhibitory properties of their positive control, Ketoconazole. I would not expect major interactions with pharmaceuticals along this pathway with kava.

• Point 8 “Medications moved by pumps in cells (P-Glycoprotein Substrates) interacts with KAVA - Some medications are moved by pumps in cells. Kava might make these pumps less active and increase how much of some medications get absorbed by the body. This might increase the amount of some medications in the body, which could lead to more side effects. But there is not enough information to know if this is a big concern. Some medications that are moved by these pumps include etoposide, paclitaxel, vinblastine, vincristine, vindesine, ketoconazole, itraconazole, amprenavir, indinavir, nelfinavir, saquinavir, cimetidine, ranitidine, diltiazem, verapamil, corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.”

1. A single dose of 800mg kavain gave a serum concentration level of 40ng/ml or .1um. This plasma level is unlikely to cause any significant inhibition of P-gp in vivo. Also, 800mg of kavain is quite unlikely to be consumed at once in a typical kava consuming session. The likelihood of inhibition here is very low. Results obtained in vitro vs in vivo were contradictory.

• Point 9 “Medications that can harm the liver (Hepatotoxic drugs) interact with KAVA - Kava might harm the liver. Taking kava along with medication that might also harm the liver can increase the risk of liver damage. Do not take kava if you are taking a medication that can harm the liver. Some medications that can harm the liver include acetaminophen (Tylenol and others), amiodarone (Cordarone), carbamazepine (Tegretol), isoniazid (INH), methotrexate (Rheumatrex), methyldopa (Aldomet), fluconazole (Diflucan), itraconazole (Sporanox), erythromycin (Erythrocin, Ilosone, others), phenytoin (Dilantin), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and many others.”

1. It should be obvious to limit the intake of liver toxic compounds, however some of them are rather ubiquitous. Acetaminophen, also known as APAP, Panadol, Paracetamol, and Tylenol is a potent hepatotoxic drug due to its metabolites. Kava likely does not interact with these drugs other than APAP. There is research leaning to indicate that the combination of APAP and kava should be avoided on the issue of glutathione degradation. IF kava does indeed reduce glutathione levels, mixing it with APAP would increase its toxicity.
2. Dosing
3. Paragraph 1 “By Mouth: For anxiety: 50-100 mg of a specific kava extract (WS 1490, Dr. Willmar Schwabe Pharmaceuticals), taken three times daily for up to 25 weeks, has been used. Also, 400 mg of another specific kava extract (LI 150, Lichtwer Pharma) taken daily for 8 weeks has been used. Five kava tablets each containing 50 mg of kavalactones have been taken in three divided doses daily for one week. One to two kava extract tablets has been taken twice daily for 6 weeks. Calcium supplements plus 100-200 mg of kava taken daily for 3 months have also been used.”
4. This really doesn’t tell us anything to go by for our own personal dosing. In truth, there is no recommended dosage for powdered kava. These dosage recommendations come from several studies as well as the German Commission E. I take it that these numbers indicate the minimum amount of kavalactones it requires to see any effect without seeing intoxication. Seeing that many of us aim for intoxication these numbers are simply meaningless.

Citations Removed for length. See kavaforums post for full citations.
Kavaforums Discussion Thread: https://kavaforums.com/forum/threads/webmds-article-on-kava.19070/

Melatonin is a hormone that regulates the sleep–wake cycle. It is primarily released by the pineal gland. As a supplement, it is often used for the short-term treatment of trouble sleeping such as from jet lag or shift work. Evidence of benefit, however, is unclear. One review found onset of sleep occurred 6 minutes faster with use but found no change in total time asleep. It may work as well as the medication ramelteon. It is typically taken by mouth.

Overview Information

Melatonin is a hormone found naturally in the body. Melatonin used as medicine is usually made synthetically in a laboratory. It is most commonly available in pill form, but melatonin is also available in forms that can be placed in the cheek or under the tongue. This allows the melatonin to be absorbed directly into the body.
Some people take melatonin by mouth to adjust the body’s internal clock. Melatonin is most commonly used for insomnia and improving sleep in different conditions. For example, it is used for jet lag, for adjusting sleep-wake cycles in people whose daily work schedule changes (shift-work disorder), and for helping people establish a day and night cycle.

How does it work?

Melatonin’s main job in the body is to regulate night and day cycles or sleep-wake cycles. Darkness causes the body to produce more melatonin, which signals the body to prepare for sleep. Light decreases melatonin production and signals the body to prepare for being awake. Some people who have trouble sleeping have low levels of melatonin. It is thought that adding melatonin from supplements might help them sleep.

Uses & Effectiveness?

Likely Effective for

• Trouble falling asleep at a conventional bedtime (delayed sleep phase syndrome). Taking melatonin by mouth appears to reduce the length of time needed to fall asleep in young adults and children who have trouble falling asleep. However, within one year of stopping treatment, this sleeping problem seems to return.
• Non-24-hour sleep wake disorder. Taking melatonin at bedtime seems to improve sleep in children and adults who are blind.

Possibly Effective for

• Sleep disturbance caused by certain blood pressure medicine (beta blocker-induced insomnia). Beta-blocker drugs, such as atenolol and propranolol, are a class of drugs that seem to lower melatonin levels. This might cause problems sleeping. Research shows that taking a melatonin supplement might reduce problems sleeping in patients taking beta-blocker drugs.
• A painful uterine disorder (endometriosis). Taking melatonin daily for 8 weeks seems to reduce pain and painkiller use in women with endometriosis. It also reduces pain during menstruation, intercourse, and while going to the bathroom.
• High blood pressure. Taking the controlled-release form of melatonin before bedtime seems to lower blood pressure in people with high blood pressure. Immediate-release formulations do not seem to work.
• Insomnia. For primary insomnia (insomnia that is not related to a medical or environmental causes), melatonin seems to shorten the amount of time it takes to fall asleep, but only by about 12 minutes. Melatonin does not appear to improve “sleep efficiency,” the percentage of time that a person actually spends sleeping during the time set aside for sleeping. Some people say melatonin makes them sleep better, even though tests do not agree. There is some evidence that melatonin is more likely to help older people than younger people or children. This may be because older people have less melatonin in their bodies to start with.There is also interest using melatonin for “secondary insomnia.” Secondary insomnia is sleeping trouble that is related to other conditions. Research suggests that melatonin might improve sleeping trouble related to conditions such as depression, schizophrenia, epilepsy, autism, developmental disabilities, intellectual disabilities, and other conditions. It’s unclear if melatonin improves sleep problems in people with Alzheimer disease, dementia, Parkinson disease, traumatic brain injury, substance use disorders, or those undergoing dialysis.
• Jet lag. Most research shows that melatonin can improve certain symptoms of jet lag such as alertness and movement coordination. Melatonin also seems to slightly improve other jet lag symptoms such as daytime sleepiness and tiredness. But, melatonin might not be effective for shortening the time it takes for people with jet lag to fall asleep.
• Anxiety before surgery. Melatonin used under the tongue seems to be as effective at reducing anxiety before surgery as midazolam, a conventional medication. It also seems to have fewer side effects in some people. Taking melatonin by mouth also seems to reduce anxiety before surgery, although some conflicting evidence exists. Furthermore, some evidence suggests that taking melatonin before sevoflurane anesthesia reduces agitation after surgery.
• Tumors without cysts or liquid (solid tumors). Taking high doses of melatonin with chemotherapy or other cancer treatments might reduce tumor size and improve survival rates in people with tumors.
• Sunburn. Applying melatonin gel to the skin before sun exposure seems to prevent sunburn. Applying melatonin cream to the skin before sun exposure seems to help people that are very sensitive to sunlight. But melatonin cream might not prevent sunburn in people with less sensitive skin.
• A group of painful conditions that affect the jaw joint and muscle (temporomandibular disorders or TMD). Research suggests that taking melatonin at bedtime for 4 weeks reduces pain by 44% and increases tolerance to pain by 39% in women with jaw pain.
• Low levels of platelets in the blood (thrombocytopenia). Taking melatonin by mouth can improve low blood platelet counts associated with cancer, cancer treatment, and other disorders.

Possibly Ineffective for

• Athletic performance. Taking melatonin shortly before resistance exercise or cycling doesn’t appear to improve performance.
• Involuntary weight loss in people who are very ill (cachexia or wasting syndrome). Research shows that taking melatonin each evening for 28 days does not improve appetite, body weight, or body composition in people with wasting syndrome from cancer.
• Diseases, such as Alzheimer disease, that interfere with thinking (dementia). Most research shows that taking melatonin does not improve behavior or affect symptoms in people with Alzheimer disease or other forms of memory loss. But taking melatonin might reduce confusion and restlessness when the sun goes down in people with these conditions.
• Dry mouth. Taking melatonin by mouth and using melatonin as a mouth rinse doesn’t prevent dry mouth in people with head and neck cancer being treated with cancer drugs and radiation.
• Inability to become pregnant within a year of trying to conceive (infertility). Taking melatonin does not appear to improve fertility or pregnancy rates in women undergoing fertility treatments.
• Sleep disorder due to rotating or night shifts (shift work disorder). Taking melatonin by mouth does not seem to improve sleeping problems in people who do shift work.

Likely InEffective for

• Withdrawal from drugs called benzodiazepines. Some people take benzodiazepines for sleep problems. Long-term use can lead to dependence. Taking melatonin at bedtime doesn’t help people stop taking these drugs.
• Depression. Although melatonin might improve sleeping problems in people with depression, it does not seem to improve depression itself. There is also some concern that melatonin might worsen symptoms in some people. It is not clear if taking melatonin can prevent depression.

Insufficient Evidence for

• An eye disease that leads to vision loss in older adults (age-related macular degeneration or AMD). Early research shows that taking melatonin might delay the loss of vision in people with age-related vision loss.
• Eczema (atopic dermatitis). Early research shows that melatonin can reduce the symptoms of eczema in children. However, although melatonin improves sleep quality it does not always can shorten the time it takes for these children to fall asleep.
• Attention deficit-hyperactivity disorder (ADHD). Limited research shows that melatonin might reduce insomnia in children with ADHD who are taking stimulants. However, improved sleep does not seem to decrease symptoms of ADHD.
• Enlarged prostate (benign prostatic hyperplasia or BPH). Taking melatonin may reduce excessive urination at night in some men with enlarged prostate. But it’s not clear if this improvement is clinically meaningful.
• Bipolar disorder. Early research shows that taking melatonin at bedtime increases sleep duration and reduces manic symptoms in people with bipolar disorder who also have insomnia. But there are also concerns that taking melatonin might make symptoms worse in some people with bipolar disorder.
• Tiredness in people with cancer. Taking melatonin short-term doesn’t seem to improve tiredness or quality of life in people with cancer. It’s unclear if it would be beneficial if used for a longer time.
• Cataracts. Taking melatonin by mouth before cataract surgery seems to reduces the pain during surgery. It might also reduce pressure in the eye before and during cataract surgery.
• Chronic fatigue syndrome (CFS). Some early research shows that taking melatonin in the evening might improve some symptoms of CFS, including fatigue, concentration, and motivation. However, other early research shows that taking melatonin by mouth does not improve CFS symptoms.
• A lung disease that makes it harder to breathe (chronic obstructive pulmonary disease or COPD). Some evidence shows that taking melatonin improves shortness of breath in people with COPD. However, it does not seem to improve lung function or exercise capacity.
• Cluster headache. Taking melatonin 10 mg by mouth every evening might reduce the frequency of cluster headaches. However, lower doses don’t seem to work.
• Memory and thinking skills (cognitive function). Early research shows that a single dose of melatonin taken by mouth does not improve thinking skills in healthy adults. Other early research shows that applying a cream containing melatonin to the skin for 2 days does not change mental function in healthy adults.
• Problems with mental function. Taking a mixture of docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), vitamin E, soy, phospholipids, melatonin, and tryptophan appears to slightly improve mental function and sensitively to smell in older people with some problems with mental function.
• A mental state in which a person is confused and unable to think clearly. Evidence shows that taking melatonin nightly for 14 days reduces the risk of delirium in older people.
• Indigestion (dyspepsia). Taking melatonin nightly might reduce indigestion in some people. But it doesn’t seem to work as well in people with prior H. pylori infection.
• Seizure disorder (epilepsy). There is some evidence that taking melatonin at bedtime may reduce the number and length of seizures in children with epilepsy. But higher quality research is needed to confirm.
• Fibromyalgia. Melatonin might decrease the severity of pain and stiffness in people with fibromyalgia.
• Persistent heartburn. Taking melatonin daily at bedtime might improve symptoms of acid reflux, including heartburn. However, taking conventional medication seems to be more effective.
• A digestive tract infection that can lead to ulcers (Helicobacter pylori or H. pylori). Evidence shows that taking melatonin together with the drug omeprazole improves healing in people with ulcers caused by H. pylori infection.
• A long-term disorder of the large intestines that causes stomach pain (irritable bowel syndrome or IBS). Early research shows that taking melatonin might improve some, but not all, symptoms of IBS. Some research shows that melatonin works better in people with IBS in which constipation is the main symptom.
• Symptoms of menopause. Limited research shows that melatonin does not relieve menopausal symptoms. However, taking melatonin in combination with soy isoflavones might help psychological symptoms associated with menopause.
• A grouping of symptoms that increase the risk of diabetes, heart disease, and stroke (metabolic syndrome). Early research shows that taking melatonin reduces blood pressure as well as low-density lipoprotein (LDL or “bad”) cholesterol in people with metabolic syndrome.
• Migraine. There is some evidence that taking melatonin before bed can prevent episodic migraine headache in adults and children. When headaches do occur, they are milder and pass more quickly. However, other evidence shows that taking melatonin does not reduce the frequency of migraine attacks.
• Multiple sclerosis (MS). Early research shows that taking melatonin doesn’t improve MS symptoms such as fatigue and disability.
• Heart attack. Early research shows that melatonin injected directly into the vein within 2.5 hours after a heart attack, might decrease damage to the heart.
• Brain damage in infants caused by lack of oxygen. Early research shows that giving melatonin in addition to cooling-therapy might improve outcomes in infants with brain damage caused by lack of oxygen.
• Swelling (inflammation) and build up of fat in the liver in people who drink little or no alcohol (nonalcoholic steatohepatitis or NASH). Some evidence shows that taking melatonin improves markers of liver function in the blood of people with nonalcoholic steatohepatitis.
• Swelling (inflammation) and sores inside the mouth (oral mucositis). Taking melatonin by mouth and using melatonin as a mouth rinse seems to delay mouth ulcers from forming in people getting cancer drugs and radiation. But it might not reduce the number of these people who get mouth ulcers.
• Low bone mass (osteopenia). Early research in women with low bone mass after menopause suggests that taking melatonin slightly increases bone thickness in the spine and shin but not in other areas.
• A hormonal disorder that causes enlarged ovaries with cysts (polycystic ovary syndrome or PCOS). Melatonin might improve irregular menstruation in women with PCOS. Taking melatonin seems to increase the number of menstrual cycles over 6 months from 2.5 to 4.
• Recovery after surgery. Some evidence shows that taking melatonin the night before and one hour before undergoing surgery might reduce pain and drug use after surgery.
• Changes in heart rate when you move from laying down to sitting up (postural tachycardia syndrome). Early research shows that taking a single dose of melatonin reduces heart rate when you change from sitting to standing. But melatonin does not seem to affect blood pressure or other symptoms.
• A pregnancy complication marked by high blood pressure and protein in the urine (pre-eclampsia). Taking melatonin with vitamin B6 might sometimes reduce the need for blood pressure medicines. But it doesn’t seem to improve pre-eclampsia overall.
• Prostate cancer. Taking melatonin by mouth together with conventional medications might reduce the growth of prostate cancer.
• Skin damage caused by radiation therapy (radiation dermatitis). In women with breast cancer, applying a specific melatonin emulsion cream to the skin during radiation treatment seems to reduce radiation dermatitis.
• A sleep disorder in which people act out dreams while sleeping. Some evidence shows that taking melatonin before bed reduces muscle movement during sleep in people with a sleep disorder that involves acting out dreams.
• A disorder that causes leg discomfort and an irresistible urge to move the legs (restless legs syndrome or RLS). Early research shows that taking melatonin before bedtime might make symptoms worse in people with restless legs syndrome.
• A disease that causes swelling (inflammation) in body organs, usually the lungs or lymph nodes (sarcoidosis). Early evidence shows that taking melatonin daily for one year followed by a reduced dose for a second year improves lung function and skin problems in people with an inflammatory condition called sarcoidosis.
• Schizophrenia. There is conflicting evidence about the effects of melatonin on schizophrenia symptoms and side effects related to medications. Some research shows that taking melatonin by mouth for 8 weeks reduces weight gain associated with the use of the drug olanzapine and improves symptoms of schizophrenia. But other research shows that it might not have any benefits and might worsen the side effects of second-generation antipsychotic medications.
• Seasonal depression (seasonal affective disorder or SAD). Some early research shows that taking melatonin by mouth might reduce depression during the winter in people with SAD. But giving melatonin under the tongue does not seem to improve symptoms.
• Quitting smoking. Taking melatonin 3.5 hours after quitting smoking seems to reduce anxiety, restlessness, and cigarette cravings.
• Blood infection (sepsis). There is conflicting research about the effect of melatonin on sepsis in neonates. While some early research shows that giving melatonin in addition to antibiotics improves severity of blood infection, other research shows that melatonin has no effect.
• Headache characterized by sudden sharp pain (stabbing headache). Some evidence shows that taking melatonin daily might prevent sudden stabbing headaches.
• Stress. There is some evidence that taking melatonin might improve memory while under stress.
• A movement disorder often caused by antipsychotic drugs (tardive dyskinesia). Some evidence shows that taking melatonin by mouth decreases symptoms of a movement disorder called tardive dyskinesia. However, other evidence shows that taking melatonin daily does not reduce involuntary movements in these patients.
• Ringing in the ears (tinnitus). Some evidence shows that taking melatonin at night reduces ringing in the ears and improves sleep quality. However, other research shows that it does not reduce ear ringing.
• A type of inflammatory bowel disease (ulcerative colitis). Taking melatonin daily in combination with conventional medication seems to help control a type of inflammatory bowel disease called ulcerative colitis.
• Loss of bladder control (urinary incontinence). Early research shows that taking melatonin before bed does not reduce how much children wet their beds at nighttime.
• Aging.
• Birth control.
• Osteoporosis.
• Other conditions.

More evidence is needed to rate melatonin for these uses.

Side Effects & Safety

When taken by mouth: Melatonin is LIKELY SAFE for most adults when taken by mouth short-term. Melatonin is POSSIBLY SAFE when taken by mouth appropriately, long-term. Melatonin has been used safely for up to 2 years in some people. However, it can cause some side effects including headache, short-term feelings of depression, daytime sleepiness, dizziness, stomach cramps, and irritability. Do not drive or use machinery for four to five hours after taking melatonin.
When applied to the skin: Melatonin is LIKELY SAFE for most adults when applied directly to the skin short-term.
When given by IV: Melatonin is POSSIBLY SAFE when injected directly into the body under the supervision of a health care professional.

Special Precautions & Warnings:

Pregnancy: Melatonin is POSSIBLY UNSAFE for women when taken by mouth or injected into the body frequently or in high doses when trying to become pregnant. Melatonin might have effects similar to birth control. This might make it more difficult to become pregnant. There’s not enough reliable information to know if melatonin is safe in lower doses when trying to become pregnant. Some evidence suggests that low doses (2-3 mg daily) might be safe, but additional research is needed to confirm. Not enough is known about the safety of melatonin when used during pregnancy. Until more is known, it’s best not to use melatonin while pregnant or trying to become pregnant.
Breast-feeding: Not enough is known about the safety of using melatonin when breast-feeding. It is best not to use it.
Children: Melatonin is POSSIBLY SAFE when taken by mouth, short-term. Melatonin is usually well tolerated when taken in doses up to 3 mg per day in children and 5 mg per day in adolescents. There is some concern that melatonin might interfere with development during adolescence. While this still needs to be confirmed, melatonin should be reserved for children with a medical need. There isn’t enough evidence to know if melatonin is safe in children when taken by mouth, long-term.
Bleeding disorders: Melatonin might make bleeding worse in people with bleeding disorders.
Depression: Melatonin can make symptoms of depression worse.
Diabetes: Melatonin might increase blood sugar in people with diabetes. Monitor your blood sugar carefully, if you have diabetes and take melatonin.
High blood pressure: Melatonin can raise blood pressure in people who are taking certain medications to control blood pressure. Avoid using it.
Seizure disorders: Using melatonin might increase the risk of having a seizure.
Transplant recipients: Melatonin can increase immune function and might interfere with immunosuppressive therapy used by people receiving transplants.

Interactions?

Major Interaction

Do not take this combination!

• Sedative medications (CNS depressants) interacts with MELATONINMelatonin might cause sleepiness and drowsiness. Medications that cause sleepiness are called sedatives. Taking melatonin along with sedative medications might cause too much sleepiness.
  Some sedative medications include clonazepam (Klonopin), lorazepam (Ativan), phenobarbital (Donnatal), zolpidem (Ambien), and others.

Moderate Interaction

Be cautious with this combination!

• Birth control pills (Contraceptive drugs) interacts with MELATONINThe body makes melatonin. Birth control pills seem to increase how much melatonin the body makes. Taking melatonin along with birth control pills might cause too much melatonin to be in the body.
  Some birth control pills include ethinyl estradiol and levonorgestrel (Triphasil), ethinyl estradiol and norethindrone (Ortho-Novum 1/35, Ortho-Novum 7/7/7), and others.
• Caffeine interacts with MELATONINCaffeine might decrease melatonin levels in the body. Taking melatonin along with caffeine might decrease the effectiveness of melatonin supplements.
• Fluvoxamine (Luvox) interacts with MELATONINTaking fluvoxamine (Luvox) can increase the amount of melatonin that the body absorbs. Taking melatonin along with fluvoxamine (Luvox) might increase the effects and side effects of melatonin.
• Medications for diabetes (Antidiabetes drugs) interacts with MELATONINMelatonin might increase blood sugar. Diabetes medications are used to lower blood sugar. By increasing blood sugar, melatonin might decrease the effectiveness of diabetes medications. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
  Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
• Medications that decrease the immune system (Immunosuppressants) interacts with MELATONINMelatonin might increase the immune system. Taking melatonin along with medications that decrease the immune system might decrease the effectiveness of medications that decrease the immune system.
  Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.
• Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with MELATONINMelatonin might slow blood clotting. Taking melatonin along with medications that also slow clotting might increase the chances of bruising and bleeding.
  Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.
• Nifedipine GITS (Procardia XL) interacts with MELATONINNifedipine GITS (Procardia XL) is used to lower blood pressure. Taking melatonin might decrease the effectiveness of nifedipine GITS for lowering blood pressure.
• Sedative medications (Benzodiazepines) interacts with MELATONINMelatonin might cause sleepiness and drowsiness. Drugs that cause sleepiness and drowsiness are called sedatives. Taking melatonin along with sedative medications might cause too much sleepiness.
  Some of these sedative medications include clonazepam (Klonopin), diazepam (Valium), lorazepam (Ativan), and others.
• Verapamil (Calan, Covera, Isoptin, Verelan) interacts with MELATONINThe body breaks down melatonin to get rid of it. Verapamil (Calan, Covera, Isoptin, Verelan) can increase how quickly the body gets rid of melatonin. Taking melatonin along with verapamil (Calan, Covera, Isoptin, Verelan) might decrease the effectiveness of melatonin.

Minor Interaction

Be watchful with this combination!

• Flumazenil (Romazicon) interacts with MELATONINFlumazenil (Romazicon) might decrease the effects of melatonin. It is not yet clear why this interaction occurs yet. Taking flumazenil (Romazicon) along with melatonin might decrease the effectiveness of melatonin supplements.

Dosing

The following doses have been studied in scientific research:
ADULTS
BY MOUTH:

• For disorders that affect when a person sleeps and when they are awake: 0.5 mg to 5 mg of melatonin taken daily before bedtime for up to 6 years has been used in blind people. Also in blind people, high dose of 10 mg taken an hour before bedtime for up to 9 weeks has also been used. 2-12 mg of melatonin taken at bedtime for up to 4 weeks has been used.
• For trouble falling asleep at a conventional bedtime (delayed sleep phase syndrome): 0.3 to 5 mg of melatonin daily for up to 9 months has been used.
• For sleep disturbance caused by certain blood pressure medicine (beta blocker-induced insomnia): 2.5 mg of melatonin taken daily for up to 4 weeks has been used. Single doses of 5 mg of melatonin have also been used.
• For endometriosis: 10 mg of melatonin taken daily for 8 weeks has been used.
• For high blood pressure: 2-3 mg of controlled-release melatonin for 4 weeks has been used.
• For insomnia:For primary insomnia: 2 mg to 3 mg of melatonin before bedtime for up to 29 weeks has been used in most research. Higher doses of up to 12 mg daily have also been used for shorter durations (up to 4 weeks).
• For secondary insomnia:2-12 mg for up to 4 weeks has been used. Lower doses have also been used for up to 24 weeks.
• For jet lag: 0.5-8 mg of melatonin at bedtime is commonly taken on the day of arrival at the destination, continuing for 2 to 5 days. Low doses of 0.5-3 mg are often used to avoid the side effects of the higher doses.
• For reducing anxiety before surgery: 3-10 mg of melatonin taken 60-90 minutes before surgery has been used.
• For tumors without cysts or liquid (solid tumors) in combination with conventional therapy: 10-40 mg of melatonin daily, along with radiotherapy, chemotherapy, or interleukin 2 (IL-2), has been used. Melatonin is typically started 7 days before the start of chemotherapy and continued throughout full treatment course. 20 mg of melatonin intravenously daily for 2 months, followed by 10 mg of oral melatonin daily, has also been used.
• For a group of painful conditions that affect the jaw joint and muscle (temporomandibular disorders or TMD): 5 mg of melatonin at bedtime for 4 weeks has been used.
• For low levels of platelets in the blood (thrombocytopenia) associated with cancer chemotherapy: 20-40 mg of melatonin daily beginning up to 7 days before chemotherapy and continuing throughout chemotherapy cycles has been used.

INTRAMUSCULAR (into the muscle):

• For tumors without cysts or liquid (solid tumors) in combination with conventional therapy: 20 mg of melatonin intramuscularly daily for 2 months, followed by 10 mg of oral melatonin daily, has been used.

APPLIED TO THE SKIN:

• For sunburn: A gel containing 0.05% to 2.5% melatonin, applied either 15 minutes before or up to 4 hours after sun exposure, has been used. A cream containing 12.5% melatonin, applied to the skin before sun exposure, has been used.

UNDER THE TONGUE:

• For reducing anxiety before surgery: 5 mg or 0.05-0.2 mg/kg of body weight taken 90-100 minutes before anesthesia has been used.

CHILDREN
BY MOUTH:

• For disorders that affect when a person sleeps and when they are awake: 0.5-4 mg of melatonin daily for up to 6 years has been used in blind people. 0.5-12 mg of melatonin daily for up to 12 weeks has been used in children and adolescents 3 months to 18 years-old.
• For trouble falling asleep at a conventional bedtime (delayed sleep phase syndrome): 1-6 mg of melatonin before bedtime for up to one month has been used.
• For insomnia:For primary insomnia, 5 mg or 0.05-0.15 mg/kg of body weight taken at bedtime for 4 weeks has been used in children 6-12 years-old with primary insomnia.
• For secondary insomnia: 6-9 mg of melatonin taken before bedtime for 4 weeks, has been used in children with seizures 3-12 years-old.
• For reducing anxiety before surgery: 0.05-0.5 mg/kg of body weight has been taken before anesthesia in children 1-14 years-old.

Natural Sleep Aids: Home Remedies to Help You Sleep
Are you having trouble drifting into a peaceful, nourishing slumber? You’re not sitting up at night alone: More than 60 million Americans suffer from poor sleep quality.
Disturbed sleep is more than an inconvenience that leaves you dragging the next day: it can affect your emotional and physical health. It negatively affects your memory, concentration and mood, and it boosts your risk for depression, obesity, type 2 diabetes, heart disease and high blood pressure.
Happily, there are easy, natural fixes that can improve your sleep, says Charlene Gamaldo, M.D. , medical director of Johns Hopkins Center for Sleep at Howard County General Hospital.
“It’s not always necessary to get a prescription for a sleep aid,” she says. “There are natural ways to make adjustments to your sleeping habits.”

Five tips for better sleep

Drink up. No, not alcohol, which can interfere with sleep. Gamaldo recommends warm milk, chamomile tea and tart cherry juice for patients with sleep trouble.
Though there isn’t much scientific proof that any of these nighttime drinks work to improve your slumber, there’s no harm in trying them, Gamaldo says. She recommends them to patients who want treatment without side effects or drug interactions.
“Warm milk has long been believed to be associated with chemicals that simulate the effects of tryptophan on the brain. This is a chemical building block for the substance serotonin, which is involved in the sleep-wake transition,” Gamaldo says.
Chamomile tea can also be helpful. “It’s believed to have flavonoids that may interact with benzodiazepine receptors in the brain that are also involved with the sleep-wake transition,” she says.
Plus, chamomile tea doesn’t have caffeine, unlike green tea or Earl Grey. Finally, tart cherry juice might support melatonin production and support a healthy sleep cycle.
Exercise . Physical activity can improve sleep, though researchers aren’t completely sure why. It’s known that moderate aerobic exercise boosts the amount of nourishing slow wave (deep) sleep you get.
But you have to time it right: Gamaldo says that aerobic exercise releases endorphins, chemicals that keep people awake. (This is why you feel so energized after a run.)
It can also raise core body temperature; this spike signals the body that it’s time to get up and get going. If you’re having trouble sleeping, try to avoid working out within two hours of bedtime.
Use melatonin supplements . “Melatonin is a hormone that is naturally released in the brain four hours before we feel a sense of sleepiness,” Gamaldo says. It’s triggered by the body’s response to reduced light exposure, which should naturally happen at night.
These days, though, lights abound after it’s dark outside—whether it’s from your phone, laptop or TV. This exposure to unnatural light prevents melatonin release, which can make it hard to fall asleep. Luckily, melatonin is available in pill form at your local pharmacy as an over-the-counter supplement.
Just make sure that you consistently buy the same brand. “Because melatonin supplements are unregulated by the FDA, the per-pill dosages and ingredients may differ from manufacturer to manufacturer. Stick with one brand, and don’t buy it online from an unknown source,” Gamaldo cautions.
Keep cool. “The ideal temperature for your thermostat is between 65 and 72 degrees,” Gamaldo says. Women who are going through menopause and experiencing hot flashes should keep the room as cool as possible and wear cotton or breathable fabrics to bed.
Go dark. It’s known that the light from a smartphone interferes with sleep. But what about your bathroom light? If you have the urge to go at night, don’t flick on the lights. “The latest recommendation is to use a flashlight if you need to get up at night,” Gamaldo says, because it offers less visual disruption. And remember: If you do wake up for a bathroom break, it might take up to 30 minutes to drift back off. This is completely normal, she says.
Source: http://www.hiwamag.com/health/melatonin-sleep-supplement/

Monthly MAMMJ Threads

MMMMM - June 2019
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Monthly Dispensary Discussions - July 2019
Weekly Dispensary Power Rankings
Weekly Dispensary Request Thread

Monthly Ailment-Specific Threads July 2019:

[[Working on the bot to automate these threads, but it is being a jerk. Manual entry for now.]]
Acne
ADHD / ADD
ALS
Alzheimer’s Disease
Anhedonia (Loss of quality of life)
Arthritis
Back Pain (Dorsalgia)
Body Injury (not otherwise specified)
Cachexia
Cancer / Tumor / Malignancy
Chronic Fatigue Syndrome
Complex Regional Pain Syndrome
Crohn’s Disease
Dementia
Depression
Dizziness
Eczema / Dry skin
Eating Disorder
Fibromyalgia
General Anxiety / Severe Stress
Glaucoma
Headache
Hepatitis C
HIV / AIDS
Infections (topical, bacterial, fungal)
Insomnia (difficulty GETTING to, or STAYING asleep)
Irritable Bowel Syndrome (IBS)
Low Energy
Lupus (Systemic Lupus Erythematosus)
Menopausal symptoms (Hot flashes, depression, low energy) Migraines
Movement Disorder
Multiple Sclerosis
Muscle Pain / Soreness
Nausea / Vomiting
Neuropathy / Nerve Pain
Parkinson’s Disease Post-trauma pain Psoriasis
PTSD
Restless Leg Syndrome Rosacea
Scoliosis
Seizures
Sexual dysfunction / concern Shingles
Skin burns
Sleep Apnea
Social Anxiety
Substance Dependence, Withdrawal or Craving (alcohol, benzodiazepines, nicotine, opiates, excessive medications)
Tourette’s Syndrome
Ulcerative Colitis

ADAPTOL Instruction for using
Pharmacological action
Adaptol (mebicar) refers to a group anxioliticeski funds. Has a mild tranquilizing effect, reduces or eliminates the feeling of worry, fear, anxiety, razdrazhitelej emotional stress. The action is not accompanied by changes in motor function (coordination of movements) and muscle relaxation, therefore adaptol is considered day tranquilizer. Has no hypnotic action, but potentiates the effects of drugs for the treatment of sleep disorders. Is membranostabilizatora, a cerebral protector and adaptogen due to their antioxidant effect (especially under stress of various origins, which is accompanied by oxidative phenomena). Has properties of antagonist-agonist adrenergic system. As a neurotransmitter - acting dopamine-positive, due to what is observed in asthenic effect of adaptol. Relieves withdrawal symptoms after cessation of Smoking.
The oral bioavailability of 80%. The blood is associated with eritrotsitami (40% of the administered dose) – most of the drug not bound to proteins and circulates freely, getting through different membranes. Cmax in the serum observed after 0.2 hours after oral administration, the plateau of action of 3-4 hours, after which the concentration of the drug is gradually reduced. Is eliminated from the body by the kidneys, accumulation does not occur, and not biotransformation.
Indications for use
• Symptoms of neurosis, neuroses (emotional instability, fear, irritability, anxiety);
• in complex therapy with the goal of relief of somatic and vegetative, neurological adverse side-effects of neuroleptics, also improves the overall tolerability of this group of drugs;
• pain in the heart, not associated with angina;
• improvement of the menopause, premenstrual syndrome (reduces the severity of vegetative manifestations);
• oxidative stress of various etiologies as an adaptogen and a cerebral protector;
• comprehensive treatment of nicotine dependence (reduces the craving for Smoking).
Method of application
Tablets administered orally, regardless of the time of reception of food. Appointed 300-500 mg of adaptol 2-3 s. the Maximum single dose – 3 g. the Maximum daily dose – 10 g. Duration of treatment from 2-3 days to 3 months, determined on an individual basis. In Pediatrics can be used with 10 years. The children used a dosage of 300-500 mg 3 S. In the treatment of nicotine addiction adaptol use 0.6-0.9 g 3 s every day for 5-6 weeks.
Side effects
Adaptol patients is well tolerated. Rarely-allergic reactions, in the case of high doses – dyspepsia (the drug in this case, stop). Very rare – hypotension and hypothermia (usually pass on their own).
Contraindications
Individual hypersensitivity to the components adaptol.
Pregnancy
Has good penetration into all tissues of the body. Clinical studies on the use of adaptol in pregnant and lactating women were not conducted. Not recommended for pregnant and lactating mothers.
Drug interactions
Combined with tranquilizers group of benzodiazepines, antidepressants, hypnotics, psychostimulants and neuroleptics.
Overdose
Has no toxic properties in overdose. In case of overdose very high doses of washed stomach and appoint detoxifying tools.
http://drdoping.com/shop/adaptol-500mg

Grandaxin (Tofisopam) is a benzodiazepine anxiolytic drug that is used in Russia and some European countries. Despite being a benzodiazepine derivative, pharmacological action of Grandaxin is differs from that of typical benzos because of the structural differences.
Grandaxin is a 2,3- benzodiazepine derivative and belongs to the novel class of drugs called homophthalazines. Tofisopam does not cause sedation or cognitive functions impairments; moreover, it may produce a moderate stimulative action, possibly by increasing the sensitivity of dopaminergic receptors.
The drug does not bind to benzodiazepine receptors, it is suggested that its anxiolytic effect is mediated through its effect on opioid signal transduction.
One of the most important advantages of Grandaxin over commonly used benzodiazepines is that Tofisopam does not form an addiction.
Indications for use are: * Conditions followed by emotional tension, anxiety, apathy, and obsessive worrying * Reactive depression * Post-traumatic stress disorder * Menopause (as a standalone therapy or as adjuvant therapy with hormonal preparations) * Premenstrual syndrome * Alcohol abstinence syndrome