Insomnia

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...ba href=/insomnia/a/b, anxiety, bipolar disorder, panic attacks and withdrawal from cocaine and alcohol — all known as off-label uses.

Its most frequent off-label use is as an adjunct to drugs used to treat pain, especially pain thought to have nerve involvement.Thus, gabapentin was part of the medication prescribed for my unrelenting pain after a double knee-replacement operation last year.

It was prescribed again last fall when I developed debilitating back and leg pain caused by a pinched nerve in my back.Between the two prescriptions, I made a discovery that changed my life for the better.

While taking Neurontin three times a day for the knee pain, I had none of the hot flashes that had plagued me day and night after breast cancer in 1999 made me stop postmenopausal hormones.

But when I weaned myself from gabapentin last May, the hot flashes returned, resulting in three sleepless nights in a row.

I wondered whether it could be a factor and decided, with my doctor's approval, to try just one 300-milligram capsule before bedtime.

Voilà!

No hot flashes.

No waking up damp and clammy and unable to go back to sleep.I've stayed on the drug, and this winter I've been able to wear turtlenecks.

I'm sleeping much better.

On the dose that helps me — 300 milligrams after breakfast and 300 or 600 milligrams at bedtime — I've noticed no unusual effects beyond an ability to sleep comfortably for seven hours a night.

Last September, I found a report in The Lancet, the medical journal, by researchers ...

...ba href=/insomnia/a/b, eating disorders and other behavioral problems.A more recent light therapy approach is "dawn simulation," which attempts to simulate an earlier dawn through exposure to artificial light.

This follows the theory that SAD is triggered by the reduced period of bright daylight during winter.The method attempts to recreate the increased intensity of sunlight that occurs in nature in the summer when the sun rises earlier in the day.

"The logic here is that it might put people with seasonal affective disorder into remission," Golden said.Still, the exact mechanisms by which light therapy works remain unclear, the researchers said.The studies selected by the authors for inclusion in their meta-analysis were grouped into four categories: bright light for SAD, bright light for non-seasonal depression, dawn simulation for SAD and bright light as an adjunct therapy combined with conventional antidepressants for non-seasonal affective disorder.These study groups were limited to adults ages 18 to 65 years who met a criterion-based mood disorder diagnosis.The meta-analysis demonstrated statistically significant treatment effects for SAD, dawn simulation for SAD and bright light treatment of non-seasonal depression, the report said."The effect size of the light therapy intervention in our meta-analysis was comparable to what has been described in the clinical literature for conventional medications to treat depression," Golden said.

"The findings are as strong or as striking."More ...