What are your hidden gem medications/drugs/substances and what makes them ideal for your usecase

cheese_greater@lemmy.world to Asklemmy@lemmy.ml – 59 points –

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Naltrexone

I will start with naltrexone, which can help people who have difficulty regulating their drinking have a more natural and sustainable relationship with alcohol should they choose to not cut it out of their lives entirely.

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Melatonin

I can't do sleep hygiene. My cell phone is the first and last thing I see every day. I stare at screens all day for work and for leisure. With moderate melatonin use I can somehow maintain regular and restful sleep.

No side effects if you use it responsibly (e.g. 5 days on, 2 days off, stick with low doses). Very safe. Can improve sleep even if you're already sleeping well. I don't know why more people aren't on it.

A fun hack for melatonin is that smaller doses work better than larger doses.

Yes! Scientific trials have shown that for most people, 0.3mg of melatonin gives better quality of sleep than 3mg.

I've seen pills as high as 10mg on the shelf and have to wonder wtf they're for. If you take too much your body becomes less sensitive to it and you become dependent on supplementation. 10mg is definitely too much.

It's crazy isn't it, 10mg.

I was prescribed (it's prescription-only in my country) 2mg but after I read up on it I cut it to 0.5.

What about in those with ADHD?

I think the big difference between people benefiting at small doses (~0.3mg) and large doses (2+mg) is that the 0.3mg group use it for sleep quality through the night, whereas the 3+mg people just need the sudden shock to get to sleep in the first place.

The drawback with big doses is that your brain becomes less sensitive so your naturally-produced melatonin might not be enough to keep you asleep for the whole night after the pill wears off. It has a very short half-life in the body (under 1 hour), so there's no way for a single dose before sleeping to last 8 hours. We naturally produce only 0.06-0.08mg per night, so it's easy to see how supplementing melatonin could desensitize someone and cause them to wake up after just 4-6 hours of sleep.

I have ADHD and am in the large-dose category and use 2-3mg of melatonin to help me fall asleep. Without it, I can't sleep reliably because my brain often won't shut up. Sleep reliably is so much more important to me than sleep quality.

Using it only 5 nights a week, I'm not significantly dependent. I can still sleep without melatonin, just less reliably. I've tried 0.3mg, but it felt the same as taking nothing.

For me, 10mg would be excessive and probably harmful in a desensitizing way. The most I've taken is 6mg, but it only helped in 2 out of 6 times. The other 4 times my brain just wouldn't stop. If doubling my usual dose didn't help, I don't think doubling it again would be any different.

There are however studies with higher doses, e.g. this one about kids with ADHD that says:

two-third of the patients responded to relatively medium doses (2.5–6 mg/d), whereas doses above 6 mg added further benefit only in a small percentage of children.

so I guess it's different for everyone.

Yep, this seems to the magic number; I shudder when I hear people taking like 5-10mg. How can that be safe unless most of it is destroyed via digestion

Since it's a natural hormone the body already has ways to get rid of it. It has a half-life of less than an hour. The lethal dose is so high we haven't been able to intentionally kill animals with it: "Melatonin is not fatal even at a dose of 800 mg/kg in animal studies".

The big risk of ongoing high doses is becoming so dependent on it that you wake up as soon as it wears off (e.g. after only 4 hours of sleep). At this level you basically can't sleep without it and have to slowly wean yourself off to get back to normality.

I found my dreams were extremely vivid and often extra-disturbing when my dose was high to the extent Im implying. Also, because it was so vivid and palpable, I just didnt feel rested cuz I was so engaged/engrossed by it

Do you use NightShift and Dark Mode, those are helpful altho the name of the game is also brightness, no matter whether its a "good" or "bad" color relative to its effect on sleep

I do. I also messed with the iOS accessibility settings to color shift even more. It helps so much.

I even went to monochrome red at one point and it felt like me cellphone was actively putting me too sleep. Unfortunately monochrome also kills a lot of the enjoyment of using a phone. I was getting sleepier, but felt so bored I just wanted to find something too do to fill the dopamine void.

Unfortunately I have to keep my brightness quite high. My eyes can't focus well in the dark.

Do red laser safety glasses work for you? Laser glasses are really good at filtering everything but their color and red ones mean you won't get the melatonin destroying blue light in.

Yes. They're very effective at making me sleepy, but have 2 big drawbacks: they're uncomfortable to wear in bed with your head on a pillow, and complete monochromaticity seems to ruin any enjoyment you get from using your phone. If I get bored it's much harder to get to sleep because my brain starts fixating on stuff and making me anxious. Yay ADHD.

Why does dark come into this? Like are you referring to lack of ambient light? Having trouble parsing this...

You should use lamps (no overhead lights) and in warm bulb color like as close to incandescent/warm as you can find on the market

Phillips Hue is fantastic for this

That was directly in response to:

those are helpful altho the name of the game is also brightness

Every night I lie in bed, lights off, using my phone for about 20 minutes while waiting for the melatonin to kick in and my brain to calm down. In a dark room I have to keep my phone on quite high brightness (about 1/3rd of maximum).

Lamps aren't an option at that stage as usually my husband is in the room also trying to sleep. I also find that "warm" light still has too much blue

I think it usually recommends 1-1.5 hours prior to bedtime for it to kick in, eh? Also your phone likely has much more blue than a dimmed (10%) Philips Hue Colored bulb programmed to red or amber. Can you look into Philips Hue bulbs, I have them and you can literally ask Siri to set it to Red (very conducive and non-distuptive to sleep) and set it to as low as like 10% of the brightness capacity.

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