Meds for sleep problems...why is my doc hesistant?

[GreenGal]

Hey Guys,

Ok, I have severe sleep problems.  I should point out I've always been more of a night person...I even usually worked 4PM-Midnight when I was working.  That being said, bedtime for me was usually 2:00am or so and if I had to I could be up around 8:00am.  Now, I'm lucky to get to bed by 8:00am.  It's so ridiculous and so frustrating...I just can't take it anymore.  The sun is coming up earlier and earlier and it's just damn depressing to still be awake.

Yet for some reason both my family doc and my pdoc are hesistant to prescribe anything specificially for sleep (i.e. Lunesta).  It was like pulling teeth to get my benzo script out of them, and even that appears to be inadequate (Klonopin 0.5mg mid day and 1.25mg at bedtime) because it doesn't control my anxiety and my cortisol levels are still through the roof when I've been told it should help lower them.

My diagnosis are: (should really list these in a signature): GAD, Panic Disorder/social phobias, Pain Disorder, OCD and Borderline Personality Disorder.  So, obviously you can see where a benzo wouldn't be unreasonable...especially since my anxiety is really bad (not working because I basically just sit around and cry and stress).  Yet my doctors have refused to change or increase the benzo over the last few months citing that I'm "young" and too likely to get addicted (I'm 24).  And sleep medicines...last time my GP finally said he'd "think it over" but that most likely he'll defer back to the pdoc who wants to give me Seroquel.  I dont want to take Seroquel as I know there are other, less heavy duty meds out there.  Plus, why take an AP for SLEEP? I know it can be very effective...but I'm the kind of person who would rather not go to an off-label use of something without first trying the drugs out there that are actually meant to help you sleep.

One other thing I should point out is that I've never abused benzos, never tried to get a refill early, I don't smoke, drink or abuse other drugs and never have.  I literally lead the most boring, by the book life imaginable so I don't know why they are soooo concerned about abuse with me (they've even mentinoed that I might be likely to sell them!?!?).

Anyways, any suggestions for a good med would be great...and any tips for how to convince my doctor might be even better.

Thanks

[Penny Century]

doctors do not like to give borderlines benzos.  they will sometimes, but in low doses and strictly monitored.  benzos decrease inhibition and in a diagnosis associated with impulse control, this is seen as a bad thing.

this is probably why he doesn't want to give you ambien or lunesta.  ambien in particular, and lunesta to a degree, makes you kinda wonky and out of it.  lunesta doesn't work on me, but i've done some nasty shit to myself on ambien.

which is probably why they're thinking seroquel.

you are unlikely to do something impulsive and potentially harmful on seroquel.

yeah, seroquel blows.  and it can have a vicious hangover, but it will knock you out.

i agree that as you've been careful with your benzos and a compliant patient they should give you a chance.  i'm just explaining the standard doctor rationale.

sorry you can't sleep.

penny

[Guest FrannyNZooey]

I know it sucks. I been in your place with sleep disorders since a child, especially so noted since teen.

I also would look for jobs after college in my counseling field in programs that had second shift, so not the nicest places, all due to my sleep pattern.

But in all honesty, I am now 40, and way back in twenties I was given valium even for my anxiety stress condition so to say back then. later after brothers died in my late 30's was given Xanax it so bit for me, I could feel it leave like a clock from my body. So then given ativan, not much better.

I ask about Klonopin, from knowledge of such meds, since dispense meds in my lovely places I worked. Also I join a panic/anxiety group, that was very best for me, but that was while living in Indianapolis area.

I have not found such a group to meet that one in all the ways it did. I was also dx with PTSD, after couple other things surface in therapy, and others happen.

I was given Ambien first for sleep, it was same as Xanax for me. I would wake up right at 2 hour mark wide awake, some nights right after brothers deaths I was tempted to take another 10 mg. So I told doctor, and stopped it.

later when Lunesta came out, it did about same thing with waking up, but not so harsh of an awakening as Ambien, but also no sleep after couple hours, and sometimes not even falling asleep after taking it for couple hours as Ambien.

So, no refill, and have half bottle in nightstand.

I was told Seroquel then also, but opted out. Read so much negative here, and saw, heard so much negative first hand. The big weight gain, food munchie cravings, the morning hangovers, headaches.

Is there really a sleep med? I believe I need a horse tranquilizer, so does Hubby, and has told so to all Docs.

Sleep, restful, good, without stress trying, without finally getting when the birds are chirping, is so my dream too.

I want a daytime job, same as Hubby, and to be in bed sleeping with Hubby.

Is that too much for us to ask for?

Aly

[GreenGal]

Thanks Penny,

I figured that was likely it...but I think it may have something to do with me in particular as well as they have been hesistant for awhile (I've had sleep problems for years...they are just worsening as of late) and I only received the BPD diagnosis in September/October or thereabouts. 

I understand what you're saying about impulse control...so far I haven't had any problems with the benzos and that...in fact I'm pretty rational and dont' do a lot of the impulsive things characteristic of borderline.  If I'm having a really terrible panic attack that's when I'll start to do really inappropriate things.

Plus, I live with my fiance who I know would be more than happy to monitor me if I tried Ambien or Lunesta or something and stay awake until I fell asleep to try and make sure I didn't do anything impulsive.

*sigh*  Well, I see my regular doctor tomorrow and I'll see what he can do.  It sucks but it's not too terrible right now because I don't have to work, so if I need to sleep all day I can.  But my Dad is getting remarried in a week and a half and I'm the unofficial best man and it's going to be a long day starting reasonably early and I won't get through it without some sleep

[Penny Century]

i have no idea if it would work for you, but maybe your doctors would be ok giving you and rx for rozerem...

the ad has has a GIGANTIC 0 for 0 dependence or abuse in clinical trials.  ZERO they say!!!

i've never tried it.  it works for some, and doesn't for others.  it all depends upon why you can't sleep.  maybe it will help you  maybe it won't.

i forgot what you said about your cortisol, but i think you said it was elevated at night, which can really fuck sleep.  i think fixing that issue will be what finally allows you to sleep.

[HaloGirl66]

i have no idea if it would work for you, but maybe your doctors would be ok giving you and rx for rozerem...

the ad has has a GIGANTIC 0 for 0 dependence or abuse in clinical trials.  ZERO they say!!!

<{POST_SNAPBACK}>

That's what I was going to suggest.

I don't know anything about Borderline PD, so this may not apply to you, but if you can take anti-depressants, what about something like trazadone or remeron?

[ncc1701]

Heya GreenGal,

OK I responded best I could on your other med thread.

Sleep is indeed (to repeat myself) wayyy underrated.

Imovane (zopiclone) is in Canada and is basically the same as Lunesta (eszopiclone).

Ambien we don't have, for whatever complex patent reason.

Starnoc (zaleplon) we have also.

I would think of those before trazodone.

See my other reply.

--ncc--