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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by CareBear04 on January 13, 2005, at 14:52:19
i can't think of any way to get some decent sleep! for awhile-- close to two months-- i was really ill and so spent all my time sleeping and lying around when not seeing doctors. even up until the end of last week, i was still so tired and loopy. but since the start of this week, it's like the energy i've stored needs a release, and i'm having manic-like energy. i don't know whether it's hypomania or agitated depression; i've had numerous bouts of both, but in any case, i'm bouncing off the walls and can't settle down to sit still or sleep but am physically agitated all the time. these are the sleeping meds i've used:
-ambien 10mg for most of the past two years; -sonata, which didn't work;
-trazadone at 50mg, which usually worked well but lasted into the morning;
-restoril, which worked weird-- sometimes giving me great sleep but mostly not and always taking between an hour or two to work and forever to wear off;
-ativan 2mg at night, which worked well until i became tolerant;
-klonopin 2mg
-most recently, 10mg of ambien + 2mg of klonopin.during the day, i take 4mg of xanax. this meds have all worked pretty well for between a year or two without pooping out. finally, tolerance seems to have caught up with me all at once. in past episodes of this kind of energy, i've been able to reign in the agitated energy with benzos and knock myself out with sleeping pills, but it hasn't worked now. since i haven't been on trazodone in awhile, i tried that last night at 100mg, twice what i took before, and it put me to sleep ok but i was up within 4 hrs.
does anyone have any suggestions? i've tried things, too, like melatonin and benedryl, but they've never worked. i have no attachment to my meds, and i would be so happy to get off the benzos. i've been told over and over that they've messed up my sleep over time. but in the short-term, lack of sleep makes my manias and depressions work, and lack of sleep and appetite actually gives me more agitated energy.
has anyone been like this or know what i could do about it?
thanks so much!!!!
Posted by Joslynn on January 13, 2005, at 15:34:11
In reply to any sleep meds that would help?, posted by CareBear04 on January 13, 2005, at 14:52:19
Remeron is a special type of AD that makes me sleep like a bear. They tell people to take it at night because it has the side effect of drowsiness. It does increase appetite though, but maybe something worth researching? It''s not a sleep med per se.
Posted by CareBear04 on January 13, 2005, at 16:05:06
In reply to Remeron?, posted by Joslynn on January 13, 2005, at 15:34:11
thanks, josslyn. my dr suggested remeron also because of increased appetite at a low dose, but before, we didn't want the drowsiness of the low dose. i'm sort of afraid of remeron for some reason. maybe i haven't heard very good things about it? the other suggestions were trying depakote again or going back on low-dose zyprexa, which at 2.5mg knocked me out not just for the night but for the next day and made me hungry enough to gain 3 pounds a week. i rejected remeron, depakote, and zyprexa yesterday because i sort of prefer this agitated energy over the deadness of before.
do you or anyone have experience with tricyclics? i've heard they are really effective, much like remeron in side effects but maybe more potent for mood? was remeron a good AD for you or just a good sleep and anxiety med?
thanks!
Posted by King Vultan on January 13, 2005, at 17:09:22
In reply to Re: Remeron? » Joslynn, posted by CareBear04 on January 13, 2005, at 16:05:06
> thanks, josslyn. my dr suggested remeron also because of increased appetite at a low dose, but before, we didn't want the drowsiness of the low dose. i'm sort of afraid of remeron for some reason. maybe i haven't heard very good things about it? the other suggestions were trying depakote again or going back on low-dose zyprexa, which at 2.5mg knocked me out not just for the night but for the next day and made me hungry enough to gain 3 pounds a week. i rejected remeron, depakote, and zyprexa yesterday because i sort of prefer this agitated energy over the deadness of before.
>
> do you or anyone have experience with tricyclics? i've heard they are really effective, much like remeron in side effects but maybe more potent for mood? was remeron a good AD for you or just a good sleep and anxiety med?
>
> thanks!
Seroquel might be a better choice among the atypical APs because (I think) it has a much shorter half life than does Zyprexa. The drowsiness and hunger would not tend to linger into the next day nearly as much. You could also try the tricyclics Surmontil/trimipramine or doxepin, both of which have extremely powerful histamine blockades, but again, you might have some hangover/appetite effects from these. Halcion/triazolam is cheaper and more powerful than Ambien and has a much faster onset of action than does Restoril. Like Ambien, waking up too soon can sometimes be a problem, though. I alternate between 0.25 mg triazolam one night and 5 mg Ambien + 25 mg Benadryl the next. From your description, though, it sounds like you might benefit more from an atypical AP.Todd
Posted by CareBear04 on January 13, 2005, at 18:23:48
In reply to Re: Remeron? » CareBear04, posted by King Vultan on January 13, 2005, at 17:09:22
thanks todd! i did try seroquel once at 25 or 50mg, and it made me really tired, though not as bad as zyprexa. i only was on it for a week or two, and maybe right now, it would give me some sleep without being too sedating. risperdal made me really tired at first at 0.5mg, but eventually i made it up to 2 without sleeping all the time. might have messed with my cognitive functioning, though, but i was on other things that could have been responsible. abilify made me sleep a lot at first at 10mg and then it turned agitating. trilafon made me sleep all day and night, but didn't have appetite effects. it's supposed to be a moderate potency AP (and they explained that the higher the potency, the less sedating), so something like thorazine, i guess, knocks you out. haldol has been the most effective AP that i've been on-- not sedating but calming just the same. i think that's all the APs i've been on. i haven't tried geodon, but my sense is that it's more like abilify and more activating.
i can't remember your other suggestions. tricyclics? i'd like to try them, but my heart has been unpredictable lately.
i tried halcion, too, for a few days. i guess it's more addictive than the others, so it was a short stint. my dr now won't give it to me b/c she's worried it will make me even more dopey and cause more memory loss. i liked halcion, so too bad.
maybe i should try trilafon again for just a day to see if it will help me sleep at night without knocking me out for whole days.
thanks for the suggestions!
Posted by PoohBear on January 13, 2005, at 18:49:46
In reply to any sleep meds that would help?, posted by CareBear04 on January 13, 2005, at 14:52:19
> i can't think of any way to get some decent sleep! for awhile-- close to two months-- i was really ill and so spent all my time sleeping and lying around when not seeing doctors. even up until the end of last week, i was still so tired and loopy. but since the start of this week, it's like the energy i've stored needs a release, and i'm having manic-like energy. i don't know whether it's hypomania or agitated depression; i've had numerous bouts of both, but in any case, i'm bouncing off the walls and can't settle down to sit still or sleep but am physically agitated all the time. these are the sleeping meds i've used:
>
> -ambien 10mg for most of the past two years; -sonata, which didn't work;
> -trazadone at 50mg, which usually worked well but lasted into the morning;
> -restoril, which worked weird-- sometimes giving me great sleep but mostly not and always taking between an hour or two to work and forever to wear off;
> -ativan 2mg at night, which worked well until i became tolerant;
> -klonopin 2mg
> -most recently, 10mg of ambien + 2mg of klonopin.
>
> during the day, i take 4mg of xanax. this meds have all worked pretty well for between a year or two without pooping out. finally, tolerance seems to have caught up with me all at once. in past episodes of this kind of energy, i've been able to reign in the agitated energy with benzos and knock myself out with sleeping pills, but it hasn't worked now. since i haven't been on trazodone in awhile, i tried that last night at 100mg, twice what i took before, and it put me to sleep ok but i was up within 4 hrs.
>
> does anyone have any suggestions? i've tried things, too, like melatonin and benedryl, but they've never worked. i have no attachment to my meds, and i would be so happy to get off the benzos. i've been told over and over that they've messed up my sleep over time. but in the short-term, lack of sleep makes my manias and depressions work, and lack of sleep and appetite actually gives me more agitated energy.
>
> has anyone been like this or know what i could do about it?
>
> thanks so much!!!!Remeron worked great for me, but caused, me to gain too much weight.
The best is Lorazapam, but it's habit-forming, so most docs won't prescribe for long periods.
I've been using 50-100mg of Seroquel per night for nearly a year with GREAT results. I generally sleep through the night or perhaps wake only once, instead of 4-6 times per night.
Seroquel is an atypical anti-psychotic that is used for treatment of schitzophrenia. It just so happens that in small doses, ie 100mg and below, it's sedating, so it makes a good sleep-aide and helps level my moods at the same time.
As your doctor about it.
Tony
Posted by Colleen D. on January 13, 2005, at 20:48:07
In reply to Re: any sleep meds that would help? » CareBear04, posted by PoohBear on January 13, 2005, at 18:49:46
lower dosages? My pdoc told me that the more I took the less likely it would help me sleep. I took trazodone and didn't care for the next day's hangover; I think that was 50mg. I now take 25mg of doxepin with great sleep, some vivid dreaming, but I do wake up rested and refreshed.
Good luck!
Colleen
PPD, GAD and OCD
Posted by CareBear04 on January 13, 2005, at 21:19:44
In reply to Aren't trazodone and doxepin more sedating at...., posted by Colleen D. on January 13, 2005, at 20:48:07
thanks everyone. i think trying seroquel again would be my first choice before zyprexa, remeron, and depakote. i feel really tired, but i just can't slow things down.
Posted by jerrympls on January 13, 2005, at 23:24:35
In reply to any sleep meds that would help?, posted by CareBear04 on January 13, 2005, at 14:52:19
Lunesta is supposed to come out this month. www.lunesta.com
Posted by Tabitha on January 14, 2005, at 2:15:11
In reply to Aren't trazodone and doxepin more sedating at...., posted by Colleen D. on January 13, 2005, at 20:48:07
> lower dosages? My pdoc told me that the more I took the less likely it would help me sleep. I took trazodone and didn't care for the next day's hangover; I think that was 50mg. I now take 25mg of doxepin with great sleep, some vivid dreaming, but I do wake up rested and refreshed.
>That's good to know. I had a pdoc tell me to take 150 mg doxepin. Being in general a low-dose kind of person, I cautiously tried 50mg and it was still way way too much. Absolutely awful experience. I think if I'd taken the 150 I would have fallen straight to the ground and woken up 3 days later in a puddle of drool...
Posted by lars1 on January 14, 2005, at 12:23:22
In reply to any sleep meds that would help?, posted by CareBear04 on January 13, 2005, at 14:52:19
Hi CB,
This isn't really what you were asking for, but since it sounds like you have a lot of restless energy, I am wondering if some exercise might help. It wouldn't need to be anything strenuous if you don't feel up to it. Even just walking can do a lot of good. (Actually, that seems to be the only exercise that I have much luck at keeping up.)
Another thing you might look at is your sleeping habits. If you do a web search on "sleep hygiene," you will find a lot of good information and might see some simple things you may have overlooked that will make it easier to get a good night's sleep.
Best regards,
Lars
Posted by CareBear04 on January 14, 2005, at 16:22:57
In reply to Re: any sleep meds that would help? » CareBear04, posted by lars1 on January 14, 2005, at 12:23:22
thanks, lars! i've depended on sleeping drugs for so long-- two years instead of the recommended two weeks or less. i wish i'd never started them at all, though in hypomanic or agitated depression states, it's usually more dangerous not to get sleep. still, once hooked it's hell to try to get off. i've seen the sleep hygiene tips before but have usually ignored them, figuring that the drugs are enough to supercede them. exercise does help some, but since i usually do it in the afternoon, the effects don't seem to last into the night. the other thing i've tried in the past month is acupuncture. i had an appt yesterday for the first time in weeks, and it did help to relax me and get my heart rate down. my dr also suggested that i take as much propranolol as i need to slow my heart out of concern that i won't be able to rest when my heart is going so rapidly.
Posted by CareBear04 on January 14, 2005, at 16:25:16
In reply to Aren't trazodone and doxepin more sedating at...., posted by Colleen D. on January 13, 2005, at 20:48:07
hi colleen,
i forget if this was discussed, but is the inverse relationship between dose and sedation true of seroquel and other antipsychotics, too? i was on the lowest doses of seroquel and zyprexa, and i was knocked out seriously. and i've heard it's true of remeron? does sedation wear off with these drugs or is it permanent? if you or anyone else knows, i'd appreciate your knowledge. thanks!
Posted by Maxime on January 15, 2005, at 22:37:23
In reply to any sleep meds that would help?, posted by CareBear04 on January 13, 2005, at 14:52:19
Nozinan. It's in the same family as Thorazine. It's an old anti-psychotic. But it's so potent that you only need a small dosage to fall asleep. It's the only thing that works for me.
Maxime
Posted by CareBear04 on January 17, 2005, at 13:01:25
In reply to Re: any sleep meds that would help?, posted by Maxime on January 15, 2005, at 22:37:23
hey everyone,
thanks so much for your responses. i was sick over the weekend, so i managed to get sleep without taking meds.
yesterday, i went back on seroquel. my doctor prescribed 100mg, and i took 50. i fell asleep quickly, but i couldn't sleep past 5:30 or so. would a higher dose help me sleep longer? i've never been on a dose higher than 50.
thanks!
Posted by PoohBear on January 17, 2005, at 13:07:48
In reply to Re: any sleep meds that would help?, posted by CareBear04 on January 17, 2005, at 13:01:25
>would a higher dose help me sleep longer? i've never been on a dose higher than 50.
> thanks!My experience using Seroquel for sleep is that it is sedating at lower doseages, not higher. You could try doses greater than 100mg, but personally, I don't think it will work and will cost twice as much. Since Seroquel is still under patent, it's expensive...
Tony
This is the end of the thread.
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