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Fruitful.Entropy

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  1. I had a very atypical experience, I'm not sure any of it is generally applicable. My atypical experience: After months on 1.5mg, went 3 -> 4.5 -> 6 within a two week period, then went right back down in the next two week period. I was experiencing severe restlessness as a side effect, thus the aborted flight. I had reported significant (for me) depression which is what triggered the boost up. I'm not sure I agree with my PDoc's choice to ramp up so fast on a drug that has an explicit warning to wait a couple weeks before judging side effects. My depression receded, but unknown if that's the result of the trip to 6 or if it naturally receded. I don't know whether the 1.5mg that I'm still on has an anti-depressant effect or not. I stay on it anyway because it very effectively neuters any urges to drink. To put it in context, my current cocktail is 1200mg Lithium, 200mg Lamictal, 1.5mg Vraylar, and 20mg BuSpar. It may be worth noting that the PI sheet lists 3mg as the max dose for bipolar depression and 6mg as the max for bipolar mania, so the mfgr doesn't think you'll see help with the depression up there. I've read that Lamictal has anti-depressant effects in the 100-150 range, and that the 200-400 range may stabilize but not be anti-depressant. So as your experience seems to agree, "more" isn't "better" with Lamictal.
  2. Oh, I didn't think to mention that. I started taking it PM because my PDoc said "It could cause somnolence, or insomnia, no way to tell." I took it for two nights and I could barely get to sleep. I called my PDoc and said "Bad idea, I'm moving it to the morning dose!" And that's when the whole "sleep for 2 hours and then wake up" started, but it was better than taking it at night. TL;DR: Yes, morning dose much better than evening dose in my experience.
  3. That was my experience too - I could get to sleep, but would wake up early AM and be stuck awake. I detailed it in this post as I went, maybe it'll be useful to you. If you have a fitbit that does sleep tracking, you can see the improvement as you go. By 3 months sleep was back to normal, and it was mostly a steady march of improvement that got me there.
  4. TL;DR: Can Vraylar cause a "frog in the throat" symptom, so that I sound like I'm whispering and hoarse? I'm bipolar, medicated for 15 years now. Up until 3-4 weeks ago, I was on 1200mg Lithium, 200mg Lamictal, and 1.5mg Vraylar. The first two are years old, the 1.5mg Vraylar was added several months ago. It messed with my sleep but that faded after 1-2 months. 3-4 weeks ago, my PDoc raised my Vraylar to 3mg, then several days later to 4.5mg, then several days later to 6mg. The goal was to address bipolar depression that hit me suddenly. However, the side effect of restlessness was too much - I couldn't stay in my chair long enough to get any work done. So we reversed the Vraylar, dropping 6mg -> 4.5mg -> 3mg -> 1.5mg over a couple weeks. (And then added 100mg Wellbutrin). One side effect that came in along with the restlessness was vocal problems. It felt like I had a frog in my throat, and I would revert to a whispery voice. My voice sounds hoarse, the way it does when you overuse it and have to speak softly for a while. And every time I think it's getting better I talk with someone and find it's not. I think there's been improvement but not uniformly. It's not listed as a side effect in the Vraylar PI sheet. Has anyone experienced or heard of this sort of symptom, with Vraylar or any other med?
  5. The PI sheet says side effects may appear with a delay: Late-Occurring Adverse Reactions: Because of VRAYLAR’s long halflife, monitor for adverse reactions and patient response for several weeks after starting VRAYLAR and with each dosage change (5.6) I had sleep problems on 1.5 and they faded away after a month or two (of staying at 1.5). When I went 1.5->3->4.5->6 within a couple weeks, I had significant restlessness as a side effect, and we dropped back down to 1.5 before we could tell if it would fade - it was just too disruptive; I couldn't sit at my desk and work. The up and down was really too rapid for me to tell if it was getting worse with each dose, or if it was a previous level dose kicking in after the long half life.
  6. Another update for posterity... At +3 months on 1.5mg Vraylar, my sleep has returned to normal; Fitbit shows me getting an average of 7.3 hours sleep over the last month. It seems my body has adjusted.
  7. Sorry, just seeing these now. My previous experience with Trazadone was during hospitalization 10 years ago. What I recall about it is that it would linger after waking, leaving me feeling groggy and very slow of thought for 2-3 hours. I'm concerned that, for example, my morning meetings at work will suffer if my brain is full of sludge due to Trazadone. That said, I'm considering asking my PDoc for a PRN so I can try that on weekends. My average sleep is now ranging from 5.5 - 6.5 hours (measured by Fitbit, so, add an hour of "awake" but in bed to get traditional "hours of sleep"), but I still feel tired and need naps regularly. And I still have 3.5 - 4.5 hour outlier sleep days. And if Fitbit is to be believed, deep and REM sleep are lower than average. So I'm wondering if a good, deep Trazadone-induced sleep on weekends when it's okay to be slow in the morning might help my mind and body. It's still worth hanging in there at this point. The Vraylar strongly inhibits the sharp depressive dips and alcohol cravings; it's a measurable improvement to my well-being. But I'd like to keep nipping away at the sleep problem.
  8. Quick update - Spoke to PDoc about how to improve my sleep - She half-heartedly asked about Trazadone and I said I'd prefer not to She recommended 3-6 mg of Melatonin 3-6 mg Melatonin at bedtime or at middle-of-night-wake-up-time didn't do anything Tried 9 mg at bedtime and got a better night's sleep Per discussion with PDoc, experimenting with 9 and 12 mg doses Sleep has improved to ~5 hours sleep (compared to 2-3 early on), which is better, but still short of what it should be. Fitbit measures of deep and REM sleep seem lower than average (for whatever that's worth). Still napping if I feel exhausted midday. Continuing to stick with it because otherwise the Vraylar seems to be just what I need in terms of improving mood without inducing mania.
  9. Oh, absolutely. I'm calling my PDoc with updates as warranted; I've called her 3 times in these 2 weeks with either routine updates or requests for change (e.g., after two days of insomnia, I called and said "I want to switch to morning dose to try and address the insomnia.") Her advice on this more recent sleep issue was to nap less, but it's really really hard to not nap when you only had 2-3 the night before. She would. We left it that we'd give it some time to see if I got acclimated to the med and the sleep fixed itself, so that's probably the next step. I just figured I'd do some open source research first
  10. TL;DR: New to Vraylar. Going to sleep, but once I wake up, I can't get back to sleep, so only getting 2-3 hours of sleep a night. I started taking 1.5mg Vraylar 2 weeks ago. The first two nights I took it PM, and it gave me stark insomnia, so I switched to AM dose. Now I'm getting an average of 2-3 hours of sleep a night. I'm getting naps in during the day so I'm functioning, but if anyone has had similar experience I'd appreciate advice on how to address it. Other meds are Lithium and Lamictal (9 years). I'm trying an atypical antipsychotic to try and address chronic mild depression without going manic the way antidepressants would put me. I'm extremely sensitive to stimulants and antidepressants; they push me toward manic. There are no other indications of mania (which is a danger; before Vraylar I tried Latuda and 2 days at 40mg put me over the moon). I can get to sleep normally in the usual bedtime range of 10-12 PM, but I'll wake up between 1 and 3 and not be able to get back to sleep. I routinely wake up during the night and go back to sleep, but for the last week "go back to sleep" isn't happening any more. I am tracking sleep with Fitbit HR so I have confirmation that sleep is short and that deep/REM stages are being deeply reduced. I do routinely listen to soft music to go to sleep, and have tried doing that after my middle-night wakeup, to no avail. Anybody else experience this kind of pattern? Any suggestions?
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