15 posts in this topic
I've been titrating Seroquel down from a dose of 600mg XR and I'm now down to 0mg. I've been titrating slowly, without going cold turkey. Because of the way Seroquel XR is formulated, you have to drop from 50 mg to 0. It is worth noting that I'm being treated for Post Traumatic Stress Disorder, not schizophrenia or bipolar disorder. I'm in the process of taking Prazosin (minipress) and titrating it up to a therapeutic level and now that I'm up to 20 mg of Prazosin, I'm feeling okay in general. Prazosin is an alpha 1 adrenergic receptor antagonist in the same way that seroquel is - hence the change in medication.
I reduced the seroquel from 50 mg to 0 mg on Thursday night. I slept fine on the Thursday, but by Friday afternoon, things fell apart. I became irrationally suicidal. I had a large amount of medication due to weaning off seroquel, titrating up the Prazosin and also taking 300 mg of Pristiq per day. Since then, I haven't slept more than 4 hours a night. I can't seem to get to sleep before 5 am, and I wake after a couple of hours at best. The insomnia is intolerable, I just can't drift off to sleep. I'm thinking that I'm going to have to go to the GP and get some sleeping tablets.because I just need something to get me to sleep. My psychiatrist has been really unhelpful, he tells me to just take enough seroquel to make me sleep, but I don't want to do that. I feel like if I do that, that I'll never get off the seroquel.
I need to be able to sleep because I'm a law student, and my trimester is starting in a week's time. How long will the insomnia from the seroquel last?
I'm new on Crazyboards but have benefited as a visitor from many a post. I have a rather unusual request/question. I have sleep anxiety like nobody's business. What I mean by this is that I worry/obsess that I won't get enough sleep AND if I wake up in the middle of the night and can't go back to sleep I get out-of-control anxiety and then, of course, can't fall back to sleep. I sweat, get heart palpitations, GI issues, you name it. And the horrible thing is, these symptoms go into the next day and then usually continue into the next night. The thing is, before all this happened I was always a naturally great sleeper. I could sleep anytime and I loved my sleep. This all started years ago when my first child was born. I went on Paxil and it worked great except for bad side effects. I have since gone off Paxil and had quite a few "sleep anxiety-free years" (always had GAD though). But this has started to rear its ugly head again, off and on for the past couple years. I have started Trintellix and have worked up to 10mg. I have also taken .5mg Klonopin for years. When I started the Trintellix my pdoc bumped me up to 1mg Klonopin but it's not working (!) and this COMPLETELY freaks me out. I have basically been going to sleep at 11:00, waking up at 3:00, and MIGHT get an additional fitful hour in there by about 5 or 6.
I have started CBT (Cognitive Behavioral Therapy). I'm doing it on my own for now, using a workbook called The Anxiety and Phobia Workbook by Edmund Bourne. I understand basically that I need to change my thinking about this problem if I am to make any progress. But this is extremely hard for me to imagine doing. What I am asking for is for feedback from people who have gotten only 4 or so hours of sleep a night for a period of time AND IT HASN'T RUINED THEIR LIFE. I need to be able to tell myself that this isn't the end of the world to only get 4 hours of sleep for a while (and this will be indefinitely until, hopefully, the CBT starts helping). I'm not working on an insomnia plan because I don't have sleep problems per se; I have major, unbearable ANXIETY problems that make it impossible to sleep.
You might be wondering why I started the Trintellix: it is for the sleep anxiety but also for pretty intense GAD. However, I am really, really hopeful that I can manage this with CBT after some time. I may need to stay on the Trintellix, but the sleep anxiety is so horrible (it continues all the next day) that I feel I need to at least try something besides meds.
I thank you immensely for your reassurances
Please can someone help. I am very stressed and worried. I am 19 weeks 3 days pregnant and have been taking 400 mg of quetiapine the whole pregnancy so far for physocosis, insomnia, and anxiety. Can someone please tell me if they have ever or is taking Quatiapine during pregnancy ??? If so how did it effect the baby, mentally.. physically.. please Help. I don't think me stressing about the answers to this is good for me and the child.
I have idiopathic hypersomnia, which isn't as ravenous as it used to be and seems to be well-controlled with Adderall XR 40 mg (which is also for ADHD and to potentiate the antidepressant effects of my MAOI antidepressant, Emsam).
But I also, ironically enough, have intractable insomnia when it comes time to sleep at night. This seems to have been exacerbated when I started the Emsam recently, which comes as no surprise as it did this the first time I was on it the first part of this year. I understand the pharmacology behind selegiline and why it may be so stimulating for me, especially when taken with Adderall XR. But in any case, I've read insomnia and fragmented sleep is actually not uncommon with idiopathic hypersomnia.
All the medicines I've tried for sleep either don't work (benzodiazepines and nonbenzodiazepines, I think I'm extremely benzo-resistant) or they may work but make me feel miserable and dysphoric and make me gain a ton of weight (certain sedating antipsychotics).
Sorry for the long post in advance, but here are some lists that give some background info about my situation.
Here is a list of the meds I've tried for sleep.
alprazolam (Xanax/Niravam) 2 mg: only works at ridiculously high doses, like 6 mg at a time, which I know isn't good for me, so I refrain from doing this unless it's an absolute must chlordiazepoxide (Librium) 25 mg: doesn't seem to work for sleep but does okay for anxiety clonazepam (Klonopin) 1 mg: again, only works at ridiculously high doses... clorazepate (Tranxene) 15 mg: doesn't work at all for anxiety or sleep or anything diazepam (Valium) 10 mg: this one is like playing Russian roulette, either it works (10-20 mg), or it doesn't work, or it actually stimulates me and keeps me from sleeping estazolam (ProSom) 2 mg: this is another one that I have to take supratherapeutic doses of (4-6 mg) to work, 2 mg just doesn't cut it at all lorazepam (Ativan) 1 mg: this benzo literally does nothing to me except make me feel like I have Alzheimer's disease due to its apparently extremely strong amnestic effects oxazepam (Serax) 30 mg: does well for anxiety at 30 mg, but nothing for sleep whatsoever temazepam (Restoril) 30 mg: works at high doses like 30 mg and above, but makes me feel miserably depressed the next day, and all I can do is lay in bed or drag around if I manage to get out of bed) Nonbenzodiazepines:
zolpidem (Ambien) 10 mg: doesn't work well at all, even in supratherapeutic doses zolpidem CR (Ambien CR) 12.5 mg: works even less than regular Ambien, for some reason eszopiclone (Lunesta) 3 mg: this one was like taking a placebo... it literally did nothing at all for me... (3 mg) Even tried 6-9 mg and it still didn't do anything Antihistamines:
diphenhydramine (Benadryl, Unisom) 25-100 mg: hardly does anything to touch my sleep doxylamine succinate (Unisom) 25-50 mg: does a little more than diphenhydramine, but also leaves me feeling hung over the next morning, and also feeling quite depressed hydroxyzine hydrochloride (Atarax) 25 mg: doesn't touch me hydroxyzine pamoate (Vistaril) 50 mg: used to be somewhat calming, but not sedating, doesn't touch my sleep even if I take 100-200 mg of it Antidepressants:
nortriptyline (Pamelor) 50-150 mg: this wasn't prescribed to me for sleep, actually, but I listed it because I know it's used sometimes for sleep, and I wanted to say that it didn't sedate me even one bit... trazodone (Desyrel) 50-200 mg: at first this worked like a charm (and gave me auditory and visual hallucinations), but 50 mg soon became insufficient, so I went up to 100 mg, then 150 mg, then 200 mg, and it just quit working. I took 300 mg one night just to see if it would help, and it helped me sleep for 3 hours, but I woke up with my heart beating rapidly and pounding in my chest—scary experience, would not repeat... Antipsychotics:
chlorpromazine (Thorazine) 100 mg: this makes me sleep for 15+ hours and when I wake up I feel like hell. The first time I took it, I had an acute dystonic reaction, which scared the piss out of me. I'm surprised I was brave enough to take it again (I guess I was just desperate). It also makes me gain weight, but not as bad as Zyprexa. olanzapine (Zyprexa) 5-10 mg: also made me sleep for about 12-15+ hours, and when I wake up I would feel like hell, plus it made me gain weight like crazy without altering my diet, and it made my fasting blood sugar skyrocket into the 200's. quetiapine (Seroquel) 100-300 mg: at 100 mg, no help with sleep; 200 mg, I get help with sleep but I feel like hell the next day and gain weight; 300 mg is even worse than 200 mg and has no antidepressant effect for me despite what is purported by all the psychopharmacology textbooks out there. Saphris (asenapine) 5-10 mg: works perfectly for sleep—helps me get just the right amount of sleep, and it's weight neutral; however, despite an initial antidepressant effect when first taking it after not taking it for a while, I always end up feeling very dysphoric and depressed the morning after I take it after taking it for a few weeks, and end up having to stop taking it. It also has started to exacerbate the akathisia that is being caused by another one of my medicines, Vraylar. α2-adrenergic agonists:
clonidine (Catapres) 0.1 mg: made me sleep alright, but made me sleep forever, and when I woke up, I felt super teary, dysphoric, depressed, and miserable, and couldn't get out of bed all day Orexin receptor antagonists:
Belsomra (suvorexant) 20 mg: this was hit or miss. It would work like a charm sometimes, and sometimes I would just toss and turn all night, unable to get to sleep. But it doesn't matter because my insurance gave me the middle finger last year with a nice little letter saying that they would no longer pay for it anymore. Melatonin receptor agonists:
Rozerem (ramelteon) 8 mg: did absolutely nothing for me Natural remedies:
Melatonin 1-10 mg: I've heard using a sustained release plus an immediate release sublingual tablet is the way to do it, and use the lowest dose possible for each one, so I wound up using 3 mg SR + 1 mg IR SL, and it seemed to work pretty well for about a week, but its benefits started to wear off, and I started feeling depressed more during the day. When I stopped the melatonin, the depression eased up. Valerian root: this actually stimulates me. Lemon balm: anything with lemon balm actually does help me sleep somewhat okay, but I have to watch out for what else is in it Lavender tea: this actually helps quite a bit, but it's hard to find where I live L-Theanine 200-400 mg: supposed to help relax you and help your quality of sleep, but I didn't get any benefits from it. I don't even feel the relaxation effects from it. Ashwagandha 500 mg: didn't help me sleep, but did help ease the nightmares I was having while going through Effexor withdrawal Scullcap 1275 mg: didn't help me sleep, but like Ashwagandha, it helped ease the nightmares I was having while going through Effexor withdrawal Chamomile: just helps me feel relaxed, doesn't help me sleep (probably more I can't think of off the top of my head...) *****************************************************************************************
Here is a list of meds that I haven't tried.
flurazepam (Dalmane): my pdoc refuses to prescribe this one to me and given how long its half-life is, I don't think I'd want to take it anyway midazolam (Versed): I somehow feel like this would work, but it's so short-acting, and I doubt my pdoc would prescribe it to me Onfi (clobazam): not sure if this would benefit me for sleep, I think it's indicated for Lennox-Gastaut syndrome triazolam (Halcion): Very short-acting, not sure if it would benefit me through the whole night Nonbenzodiazepines:
Edular (zolpidem sublingual): I was interested in trying this, but it's not covered by my insurance... bummer. zaleplon (Sonata): another short-acting sleep med, which I doubt would be helpful at sleep maintenance ZolpiMist (zolpidem oral mist): I was also interested in this one, but my insurance doesn't cover it either... T__T Barbiturates:
Butisol (butabarbital): seriously doubt my pdoc would prescribe this, but I wonder if I'm really to the point where I need a barbiturate... Seconal (secobarbital): see above... Antidepressants:
amitriptyline (Elavil): I've heard of this one being prescribed for sleep, but I'm afraid of the weight gain. doxepin (Sineqan/Silenor): I've been curious about this one, but afraid of it because of weight gain. My pdoc at one point acted like she was going to prescribe it for me, but it was just not on my prescription sheet, like maybe she forgot? Or decided it was best for me not to be on it? imipramine (Tofranil): I've heard of this one being prescribed for sleep too, but I think it's contraindicated with MAOIs. (certain TCAs can actually be taken with MAOIs) Antipsychotics:
risperdal (Risperidone): I've heard of this one being prescribed for sleep, but not too commonly... I'd be afraid of the hyperprolactinemia associated with it. Plus I would really rather take just one antipsychotic if I can help it... I don't want to be on one for mood and one for sleep... Other
Xyrem (sodium oxybate): I feel like this would really help me what with my fragmented sleep and poor sleep quality, but my pdoc won't prescribe it (maybe she isn't licensed to?) I may need to find a sleep doctor for that if I want to pursue that. The only problem is I don't have narcolepsy, and I've heard it's next to impossible to get your insurance to pay for Xyrem if you don't have a diagnosis of narcolepsy, but I have heard of it being used off-label for idiopathic hypersomnia-associated insomnia as well as insomnia itself. *****************************************************************************************
Can anyone give me any insight into what I could possibly do for sleep? I feel like I've kind of hit a wall here.
I've also tried relaxation exercises, guided meditation, binaural beats, and that kind of stuff, none of which worked for me.
I know I gave a lot of info to sift through, sorry for the super long post... But any feedback would be appreciated. Thanks!
Posted same topic twice
Moderaters, could you please delete this so no confusion.