51 posts in this topic
So I am in quite a nasty situation. Over 3 months ago I was able to kick my addiction to heroin with therapy and Suboxone. Also, I successfully got my bipolar II under control with Lithium ER 900mg and Seroquel XR 300mg.
For the last 6 weeks I am having fragmented sleep. I am able to fall asleep relatively easily only to wakeup after 2hrs. I then go back to sleep and from then on I wake up roughly 5 times a night.
I've eliminated all caffeine from diet, I don't smoke cigarettes within 2hrs of bed and I don't watch TV or use any other screen before retiring.
My addiction specialist has tried me on
trazadone 150mg--did nothing
Doxepin 75-150mg--only makes me sleeoy
Ambien CR (w/ doxepin)--barely any change. I think it slightly improves the quality of sleep in between waking up.
Does anyone have any recommendations for a sleep maintenance medication? I prone to rapid weight gain from AP's and dont want to double up as I am taking quetiapine already.
For what it's worth....my sleep hygiene is very good. I've started exercising in the morning before work. I work as a credit analyst and sit in front of a computer from 9 to 5. HOWEVER...my insomnia is causing me to nod off at my desk which is unacceptable.
Any tips/ideas/recommendatins are welcome. Mikl_pls I'm looking your way as you are the resident amateur psychopharmacologist. ;-)
Hello, all. I'm new to this site. I've been working with a pdoc for the past 3 to 4 years and, more recently, a therapist, due to what I personally classify as treatment resistant MDD. I'm in my mid-forties. Throughout this time, my pdoc has tried multiple "cocktail" combinations of medications. Some combinations work for a while, but it's difficult to become excited when I'm in a good period because I know the bottom can, and likely will, drop out from under my feet again. I'm curious whether anyone has had any success with a similar pharmaceutical lineup like mine. I'm also hoping someone might have tips on outrunning the black dog for longer than a few months at a time. I trust my pdoc, but I'm wondering if I should get a second opinion. Unfortunately, I live in an area where there are not many pdocs from which to choose.
Some things to know:
I have sleep apnea. For most of my adult life, I've fought drowsiness during the day no matter how much sleep I get. I've had multiple CPAP titrations, but they never seem to do much for the daytime sleepiness. About 3 years ago, I was diagnosed with ADD. Current medicinal lineup:
Adderall (15 mg x 2 per day) Lamictal (75 mg x 2 per day) Xanax (0.5 mg x 3 per day) Buspar (15 mg x 4 per day) Trintellix (20 mg x 1 per day) Made me nauseated when I took it during the day, so my pdoc had me start taking it at bedtime, which made all the difference. Starting today, replacing Latuda with Vraylar (1.5 mg x 1 per day) Previously tried the following:
Paxil (40 mg x 1 per day) I started this for social anxiety nearly 20 years ago and was taken off of it around 6 months ago. Going off of this after so long was a terrible experience, but those effects have subsided. Prozac Wellbutrin (150 mg x 1 per day) Latuda (20 mg x 1 per day) Seroquel (25 mg x 1 per day) Slept like a baby on this, but it made the daytime drowsiness worse. Rexulti Experienced akathisia with this one. Abilify Also experienced akathisia on this. Viibryd Had stomach cramps I'm also using the following supplements:
Omega-3 Vitamin D Vitamin B6, Magnesium, Zinc capsule Ashwaganda/Rhodiola
Hi all. I hope you can help me or give me some advice.
I quit klonopin and gabapentin (first tapered one and then the other) and since then nothing but constant panic attacks anxiety and no appetite. The reason I stopped these was because I could not eat anything and I wasn't sure which med was the culprit. I recently read that gabapentin can cause loss of appetite and figure this med is the problem. I tapered from 1500mg/day to 600mg. I took 600mg last night and my doc told me I could go ahead and take 300mg tonight and be done with it. He told me that I should take each lowered dose for 3 days until I was down to 600mg. I have one day left and then within 40 hours it should be out of my system.
I've been on gabapentin a few months starting with 600mg and going up slowly but ever since starting I have had trouble eating. I thought it was my anxiety but now I'm not sure.
My current meds are only Effexor and ativan prn. I've tapered everything that wasn't having any significant effect. I know for sure that Effexor works for my depression. I've been on it for probably 15 years and I doubt it's causing my appetite issues.
Perceiving value in your life is not a thought form of perception (awareness) at all. Rather, it is an emotional awareness. In other words, our emotions do not have some sort of mind control effect on us where they force us to perceive, through our thinking, our lives being good or bad to us. It is purely the emotions themselves that allow us to see values in our lives. Emotions are actually a sense like sight. They allow us to see the values that things and situations hold in our lives. It is only our positive emotions that allow us to see the positive qualities of life (i.e. the good values) while it is only our negative emotions that allow us to see the negative qualities of life (i.e. the bad values). Having neither positive nor negative emotions would be no different than a blind person. No value judgment can allow this blind person to see just as how no value judgment or mindset can allow us to see the values in our lives.