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Has anyone been on more than 30mg/day of Restoril (Temazepam)?


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#1 kdbee

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Posted 02 October 2009 - 01:18 PM

because the 30mg simply isn't cutting it for me.
I'm so f*cking grumpy today because I haven't slept in a few days, and while Temazepam works to keep me asleep (for the most part) it still takes a few hours of tossing and turning to get to sleep. I also take 300mg Lithium at bedtime.

Any advice?
Alright. Here you go--

DX/Issues: BP2 (mixed+rapid cycling), OCD, ADD, EDNOS, anorexia nervosa (recovered), BDD, some sort of avoidant shit, really bad & constant paranoia about everything, domestic abuse survivor

Drugs: Lexapro 10, Wellbutrin 450, Abilify 15, Klonopin 2 (max 6mg/day), Adderall 20-30

Past R/X's: Lithium (tried twice), Lamictal (complete hell), Depakote, Abilify (tried twice. second time worked amazingly. AMAZINGLY! Unfortunately, I simply cannot afford it...), Luvox (tried twice), Prozac, Paxil, Effexor, Geodon, Dexedrine (did nothing), Ativan (really good for social phobia), Restoril, Wellbutrin (working amazingly this time around)

Other EEG Biofeedback (worked miracles for my OCD. My compulsions are infrequent and when they happen are manageable the vast majority of the time. Obsessions still happen, not as bad and are manageable), acupuncture- I did this for about a year and a half. While it helped greatly with some problems (my screwed up digestive system, poor immune system, constant lethargy) it did nothing to improve any aspect of my mental health. That said, I definitely think it's worth giving a try :)


#2 kdbee

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Posted 02 October 2009 - 01:26 PM

Also on the PI sheet, it says not to take Temazepam w/other benzos... I've taken 2-4mg of Klonopin a day for a couple of years (though I take it when I wake up). IS this ok? It must be...the same pdoc writes all of my scripts...
Alright. Here you go--

DX/Issues: BP2 (mixed+rapid cycling), OCD, ADD, EDNOS, anorexia nervosa (recovered), BDD, some sort of avoidant shit, really bad & constant paranoia about everything, domestic abuse survivor

Drugs: Lexapro 10, Wellbutrin 450, Abilify 15, Klonopin 2 (max 6mg/day), Adderall 20-30

Past R/X's: Lithium (tried twice), Lamictal (complete hell), Depakote, Abilify (tried twice. second time worked amazingly. AMAZINGLY! Unfortunately, I simply cannot afford it...), Luvox (tried twice), Prozac, Paxil, Effexor, Geodon, Dexedrine (did nothing), Ativan (really good for social phobia), Restoril, Wellbutrin (working amazingly this time around)

Other EEG Biofeedback (worked miracles for my OCD. My compulsions are infrequent and when they happen are manageable the vast majority of the time. Obsessions still happen, not as bad and are manageable), acupuncture- I did this for about a year and a half. While it helped greatly with some problems (my screwed up digestive system, poor immune system, constant lethargy) it did nothing to improve any aspect of my mental health. That said, I definitely think it's worth giving a try :)

#3 Persephone

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Posted 02 October 2009 - 03:35 PM

My best friend's husband (who is actually a pdoc himself!) takes 60 mg of Temazepam. He's a huge guy though - probably 300+ lbs.
Dx: MDD, history of anorexia and bulimia
Rx: Effexor 300mg, Trazodone 100 mg, Lorazepam 0.5 mg prn
Past Rx:
SSRIs: Prozac, Zoloft, Paxil, Lexapro
SNRIs: Effexor, Cymbalta
other ADs: Serzone, Wellbutrin, Remeron
MAOIs: Parnate, Nardil
Mood Stabilizers: Abilify, Lithium, Lamictal
Other: Cytomel, several sleep meds

#4 MarkP

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Posted 02 October 2009 - 04:29 PM

Yeah, temazepam, being a benzo, theoretically, there's no limit on the number that can be taken/prescribed. However, with that amount of citalopram and Adderral (ie: amphetamines) in your regimen -- it comes as no surprise that you're having sleep problems.

We don't know your history, but I suspect there's probably a better approach to your treatment than high-dose anti-depressants and high-dose hypnotics, with strong stimulants ontop of it all. Maybe get a second opinion?? Anti-depressant-induced mania typically takes enormous doses of benzos to treat, with the only safe solution being to initiate a taper of the anti-depressant to a more reasonable dose.

Seroquel might be worth looking into as well, for both its properties concerning bipolar disorder, and your sleeping problem, although, again, the high dose citalopram + stimulants is problematic regardless.

#5 kdbee

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Posted 02 October 2009 - 04:51 PM

My best friend's husband (who is actually a pdoc himself!) takes 60 mg of Temazepam. He's a huge guy though - probably 300+ lbs.


Yikes! Being that he's about 3x my size, I probably won't be giving that a try ;)
Alright. Here you go--

DX/Issues: BP2 (mixed+rapid cycling), OCD, ADD, EDNOS, anorexia nervosa (recovered), BDD, some sort of avoidant shit, really bad & constant paranoia about everything, domestic abuse survivor

Drugs: Lexapro 10, Wellbutrin 450, Abilify 15, Klonopin 2 (max 6mg/day), Adderall 20-30

Past R/X's: Lithium (tried twice), Lamictal (complete hell), Depakote, Abilify (tried twice. second time worked amazingly. AMAZINGLY! Unfortunately, I simply cannot afford it...), Luvox (tried twice), Prozac, Paxil, Effexor, Geodon, Dexedrine (did nothing), Ativan (really good for social phobia), Restoril, Wellbutrin (working amazingly this time around)

Other EEG Biofeedback (worked miracles for my OCD. My compulsions are infrequent and when they happen are manageable the vast majority of the time. Obsessions still happen, not as bad and are manageable), acupuncture- I did this for about a year and a half. While it helped greatly with some problems (my screwed up digestive system, poor immune system, constant lethargy) it did nothing to improve any aspect of my mental health. That said, I definitely think it's worth giving a try :)

#6 kdbee

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Posted 02 October 2009 - 05:00 PM

Yeah, temazepam, being a benzo, theoretically, there's no limit on the number that can be taken/prescribed. However, with that amount of citalopram and Adderral (ie: amphetamines) in your regimen -- it comes as no surprise that you're having sleep problems.

We don't know your history, but I suspect there's probably a better approach to your treatment than high-dose anti-depressants and high-dose hypnotics, with strong stimulants ontop of it all. Maybe get a second opinion?? Anti-depressant-induced mania typically takes enormous doses of benzos to treat, with the only safe solution being to initiate a taper of the anti-depressant to a more reasonable dose.

Seroquel might be worth looking into as well, for both its properties concerning bipolar disorder, and your sleeping problem, although, again, the high dose citalopram + stimulants is problematic regardless.



I definitely understand where you're coming from but this has actually been the most consistantly effective cocktail i've been on in 10 years. The only thing that's really not fully taken care of is my depression.
The sleep problem is pretty recent...say the last 3 months off and on. Prior to that I slept without much of a problem (though oftentimes oversleeping)...
We've tried lowering the celexa a few times... once for a couple of months. I suffered really badly from depression and ocd during that period. And when trying to cut the Adderall dose, I simply didn't get out of bed....

Thank you for your feedback, though... definitely things to think about before I see my pdoc next (in two wks).
Alright. Here you go--

DX/Issues: BP2 (mixed+rapid cycling), OCD, ADD, EDNOS, anorexia nervosa (recovered), BDD, some sort of avoidant shit, really bad & constant paranoia about everything, domestic abuse survivor

Drugs: Lexapro 10, Wellbutrin 450, Abilify 15, Klonopin 2 (max 6mg/day), Adderall 20-30

Past R/X's: Lithium (tried twice), Lamictal (complete hell), Depakote, Abilify (tried twice. second time worked amazingly. AMAZINGLY! Unfortunately, I simply cannot afford it...), Luvox (tried twice), Prozac, Paxil, Effexor, Geodon, Dexedrine (did nothing), Ativan (really good for social phobia), Restoril, Wellbutrin (working amazingly this time around)

Other EEG Biofeedback (worked miracles for my OCD. My compulsions are infrequent and when they happen are manageable the vast majority of the time. Obsessions still happen, not as bad and are manageable), acupuncture- I did this for about a year and a half. While it helped greatly with some problems (my screwed up digestive system, poor immune system, constant lethargy) it did nothing to improve any aspect of my mental health. That said, I definitely think it's worth giving a try :)

#7 recoverymouse

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Posted 02 October 2009 - 05:07 PM

Even if it's okay to take both drugs, at some point habituation to benzos becomes a concern. Over time they can loose their effectiveness, which could explain the recent sleep problem.

Also, you might consider taking the lithium in the morning, unless you've already tried that and found it was making you sleepy. (I think lithium can cut both ways-- sleep-inducing or activating.)


#8 kdbee

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Posted 02 October 2009 - 05:54 PM

Even if it's okay to take both drugs, at some point habituation to benzos becomes a concern. Over time they can loose their effectiveness, which could explain the recent sleep problem.

Also, you might consider taking the lithium in the morning, unless you've already tried that and found it was making you sleepy. (I think lithium can cut both ways-- sleep-inducing or activating.)


Ugh. I've been thinking about MarkP's post and am now obsessing over whether I'm on the wrong drugs altogether. The Adderall and the Klonopin are both lifesavers (though like you said, I have built up quite a tolerance to the Klonopin, but this isn't new...I have been on it for several years now). I take Klonopin when I wake up (I need it to get through the day) and the Lithium I take at night because it does make me sleepy.

I really don't know what to do anymore. OCD- under control, ADD- under control, Anxiety- under control, Depression- so far from being under control. Also because I've not been sleeping at night, I really can't function during the day as I'm exhausted.
I wish I could remember why I stopped taking previously tried drugs... I'm trying to remember why I stopped Wellbutrin. Lost cause...I took it like...7 years ago. Same pdoc but she doesn't keep notes on that shit.

;)

Edited by ksh, 02 October 2009 - 05:55 PM.

Alright. Here you go--

DX/Issues: BP2 (mixed+rapid cycling), OCD, ADD, EDNOS, anorexia nervosa (recovered), BDD, some sort of avoidant shit, really bad & constant paranoia about everything, domestic abuse survivor

Drugs: Lexapro 10, Wellbutrin 450, Abilify 15, Klonopin 2 (max 6mg/day), Adderall 20-30

Past R/X's: Lithium (tried twice), Lamictal (complete hell), Depakote, Abilify (tried twice. second time worked amazingly. AMAZINGLY! Unfortunately, I simply cannot afford it...), Luvox (tried twice), Prozac, Paxil, Effexor, Geodon, Dexedrine (did nothing), Ativan (really good for social phobia), Restoril, Wellbutrin (working amazingly this time around)

Other EEG Biofeedback (worked miracles for my OCD. My compulsions are infrequent and when they happen are manageable the vast majority of the time. Obsessions still happen, not as bad and are manageable), acupuncture- I did this for about a year and a half. While it helped greatly with some problems (my screwed up digestive system, poor immune system, constant lethargy) it did nothing to improve any aspect of my mental health. That said, I definitely think it's worth giving a try :)

#9 recoverymouse

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Posted 02 October 2009 - 06:09 PM

Hey don't freak out. Sleep problems can be from a million different sources. Any events in your life that may be disturbing your sleep? Have you had your thyroid levels checked recently?


#10 kdbee

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Posted 02 October 2009 - 06:19 PM

Hey don't freak out. Sleep problems can be from a million different sources. Any events in your life that may be disturbing your sleep? Have you had your thyroid levels checked recently?


Nah, nothing's changed in my life. The depression has been getting worse and worse for the last several months and I can't seem to figure it out... life has been going along it's normal route insofar as external triggers.
Thyroid levels, no, I haven't. Hmm... Thanks, I'll bring that up to the pdoc, too and get a script.

And freaking out... why not? I'm so good at it! ;)
Alright. Here you go--

DX/Issues: BP2 (mixed+rapid cycling), OCD, ADD, EDNOS, anorexia nervosa (recovered), BDD, some sort of avoidant shit, really bad & constant paranoia about everything, domestic abuse survivor

Drugs: Lexapro 10, Wellbutrin 450, Abilify 15, Klonopin 2 (max 6mg/day), Adderall 20-30

Past R/X's: Lithium (tried twice), Lamictal (complete hell), Depakote, Abilify (tried twice. second time worked amazingly. AMAZINGLY! Unfortunately, I simply cannot afford it...), Luvox (tried twice), Prozac, Paxil, Effexor, Geodon, Dexedrine (did nothing), Ativan (really good for social phobia), Restoril, Wellbutrin (working amazingly this time around)

Other EEG Biofeedback (worked miracles for my OCD. My compulsions are infrequent and when they happen are manageable the vast majority of the time. Obsessions still happen, not as bad and are manageable), acupuncture- I did this for about a year and a half. While it helped greatly with some problems (my screwed up digestive system, poor immune system, constant lethargy) it did nothing to improve any aspect of my mental health. That said, I definitely think it's worth giving a try :)

#11 MarkP

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Posted 02 October 2009 - 08:35 PM

I definitely understand where you're coming from but this has actually been the most consistantly effective cocktail i've been on in 10 years. The only thing that's really not fully taken care of is my depression.


Yeah, thats a difficult situation, and don't really know what to say about that -- hard to mess with success, definitely.. I know, with myself, I tried 2 SSRI's a year ago, and quite frankly, I'm lucky to be alive after that debacle. No GP's gonna ever try me on another anti-depressant again unless they tie me down and force it down my throat!

We've tried lowering the celexa a few times... once for a couple of months. I suffered really badly from depression and ocd during that period. And when trying to cut the Adderall dose, I simply didn't get out of bed....


Adderal is a mixture of various amphetamines, some being longer acting than others. Do you take the Adderal all in one shot, when you try to wake up in the morning? Immediate release? Extended release? Maybe you could do a trial of a shorter acting, and less potent agent, ie: methylphenidate (Ritalin) in place of the Adderal.

#12 kdbee

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Posted 02 October 2009 - 08:56 PM

Adderal is a mixture of various amphetamines, some being longer acting than others. Do you take the Adderal all in one shot, when you try to wake up in the morning? Immediate release? Extended release? Maybe you could do a trial of a shorter acting, and less potent agent, ie: methylphenidate (Ritalin) in place of the Adderal.


Yeah, I know... And, I've tried all of 'em. The only other one that worked well for me was Ativan... but it's too expensive. And I take 20mg in the morning (not ER). Less does absolutely nothing.

Edited by ksh, 02 October 2009 - 08:57 PM.

Alright. Here you go--

DX/Issues: BP2 (mixed+rapid cycling), OCD, ADD, EDNOS, anorexia nervosa (recovered), BDD, some sort of avoidant shit, really bad & constant paranoia about everything, domestic abuse survivor

Drugs: Lexapro 10, Wellbutrin 450, Abilify 15, Klonopin 2 (max 6mg/day), Adderall 20-30

Past R/X's: Lithium (tried twice), Lamictal (complete hell), Depakote, Abilify (tried twice. second time worked amazingly. AMAZINGLY! Unfortunately, I simply cannot afford it...), Luvox (tried twice), Prozac, Paxil, Effexor, Geodon, Dexedrine (did nothing), Ativan (really good for social phobia), Restoril, Wellbutrin (working amazingly this time around)

Other EEG Biofeedback (worked miracles for my OCD. My compulsions are infrequent and when they happen are manageable the vast majority of the time. Obsessions still happen, not as bad and are manageable), acupuncture- I did this for about a year and a half. While it helped greatly with some problems (my screwed up digestive system, poor immune system, constant lethargy) it did nothing to improve any aspect of my mental health. That said, I definitely think it's worth giving a try :)

#13 Maceo

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Posted 12 November 2009 - 12:53 PM

I think the maximum recommended dose for Restoril is 60mg (six tablets). I have certainly taken that much on some nights. While it won't kill you tolerence and dependence will probably be an issue if you take temaz every night. If I take it every night it stops doing anything at all.

I don't find it to be a very powerful sedative. 15mg of Remeron does a much better job of knocking me out.

#14 Guest_Mike_*

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Posted 26 January 2010 - 01:25 AM

I think the maximum recommended dose for Restoril is 60mg (six tablets). I have certainly taken that much on some nights. While it won't kill you tolerence and dependence will probably be an issue if you take temaz every night. If I take it every night it stops doing anything at all.

I don't find it to be a very powerful sedative. 15mg of Remeron does a much better job of knocking me out.



Hi I have done a great deal of research. Im currently diagnosed type 1 bi polar. I have trialled and error through alot of them. I take 60mg a day of adderall, I definetly have to take it in the morning because of its lasting effects. I had been taking a sleeping pill with it called Immovane 7.5mg (non benzo) to sleep at night. this is a very strong hypnotic and I couldn't walk 20 minutes later yet being high on adderall 60mg it still knocked me out wiht a great sleep. However it did in time loose effectiveness. Went to the Psychiatrist he put me on temaszepam 30mg. at first this benzo did work but I had to eventually self medicate it to maintain strength. I jumped from 1 a night to 3. it worked great well rested and shut down for the night. I weigh 140lbs and have taken up too 180mg of temazepam at night before several times with no negative effects aside from sleep to run down the adderall. it takes alot of benzos to harm you especially since you are on the adderall (amphetamine) it keeps your central nervous system stimulated for long periods of time, temazepam will be effective if based on weight and dose should be ok to increase the temaz dose gradually; dont jump past 3 first time. Temazapam does the exact opposite of adderall and slows the central nervous system down. If its ok with you try taking one alcoholice beverage 1 hour before the benzodiazapine, it will enhance its effectiveness about 25%-50% If you have access to seroquil aswell I would not suggest the three together as it may trigger a delusional episode along with the benzo you wont remember the manic episode as the benzo has amnesia in it so you will frequently forget events taken place during its peak period. One trick: drink a beer or whatever 1 hour before bed, pop the benzo's and head right to bed. dont wait for it to hit just close your eyes and once it hits you will be out before you know it. Temazepam overdose is rated at about 20-30 30mg pills for OD your safe with a few extra, the adderall will keep you stimulated enough central nervous system wise to physically be ok. I have done this for years with no negative effects.

Let me know your thoughts, its been a while since you posted.

Mike





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