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What's Next? - sleep medication issues (ambien & xanax pooping out)

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So I am really really tired of getting only 4 hours sleep at a time, and I *know^ it is not a deep sleep and I toss and turn. I am not sure what to try next. See my siggy for my current cocktail if you want to know what else I am on. Ideas on what to try next? Benzos help with the brain noise from the ADD but I become very tolerant of them quickly, same with all the ambien-ish meds. My experience with seroquel was life threatening and horrible so I am very hesatant about any sedating AP's. And I've already been through several TCAs.


Sleep Aids Tried:


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Well, ok.

You have been through a lot, so I really don't think chamomile will mave much of a dent, but it couldn't hurt.

Have you tried getting a consultation to see if light box therapy is an option ormight help? Do you know what your sleep patterns are and have you been making a note of them? I don't know that it WOULD help, but at this point, you should explore the option if you can.

Sometimes Provigil is prescribed during the day, but you haven't had luck with stimulants.

How is the brain noise going, and are you taking anything for the neurological stuff? [and what is going on with that? is it aura things or migraines or somethings else? or not sure?]

You are hesitant about APs, but I will mention that on the very rare occasions that I take risperdal, I fall asleep slowly and comfortably and wake up the same way. I don't feel hung over or achey. [but I don't know of any who take risperdal for sleep only, I don't know if it would be prescribed by your doctor.] Though you may want to look into APs again if you are really stuck.


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What have you tried cocktail-wise? At times (like now), Ambien alone doesn't do squat for me. I've had good luck in the past with 5-10 mg of Ambien, 10 mg of Sonata (which has never worked for me alone, and 7.5 mg (or less) of Remeron.

More recently, my bedtime cocktail is the same as above except swap out the Remeron for 8 mg of Rozerom. I was also taking 1 mg of Xanax and bedtime, but recently moved that to the morning. I've noticed I'm now having sleep latency issues, which could be from the Xanax wearing off (the XR only lasts about 17 hours, which means I'm coming down from it around 4:00 a.m.), or it could be the Strattera which I recently added to my morning cocktail.

At any rate... I've found that sometimes the meds that don't work at all for me individually somehow work well when mixed together.

Edited to add: how about chloral hydrate? Weren't you going to give that one a try? It didn't work for me, but YMMV.

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I always need 20 mg for Sonata for every 10 mg, Ambien.

By immense trial and error (and the advice of an internist), I found this combination to work - and only this one: t Ambien (for onset) plus Klonopin (for general calming) plus Neurontin (for sleep maintenance),. The latter two an hour before bed, the Ambien ca 1/4 hr before ready to drop off. They also put me in the right cycles for dreaming, etc. A good non-demanding book to read for a little while in bed (I dragged out Kidnapped and Tale of Two Cities most recently)

With all due respect for sleep hygiene (and let me take a moment to congratulate you on your extreme self -discipline with it!) , I have found that when my life allows it, staying up until I'm nearly comatose, helps a lot. Truly, I know it fucks with what's left of my Circadian rhythm (near zilch) but it helped me regain the drowsy response.

I lost it for a good while.

It's a good feeling to actually FALL asleep - to sometimes even have to fight it while I wend my way to bed. I managed to completely wean from all sleep (and other) meds doing this. Even dropped down to only 1/2 mg Klonopin /day (GRADUALLY to avoid seizures). This took a couple of weeks, of course tho all but the Klonopin went pretty quickly. Sleep deprivation therapy in a way, except I allowed myself to sleep at the end of each long cycle.

However, whether thru psychological dependence or whatever, I went back on them 6- 8 months later, in an attempt to regulate my Circadien rhythm (I'm not nearly as displined as you, about sleep hygiene. Notice when I post?? Self discipline would go a long way with me ;) ) You might not need to, depending on work etc.

(I'm sure you have a good light blocking shade when you want to sleep after the sun is up, right? And sound conditioner? And the house is cool at night? Restricted fluids at bedtime? Only take meds on an empty stomach?)

BTW maybe I missed it, but do you use a light lamp in the AM? I've always wanted one of those with the rising sun . The light gradually gets brighter and brighter as the alarm time approaches, Maybe the light IS the alarm, in fact. (Hammacher Schlemmer used to carry them, I think)

Of course, I 'm lucky to be able to manage without a fixed time for an alarm which helps a lot.

Speaking of light, reminds me of Melatonin. Dement (THE sleep researcher) says it's best taken at twilight and not later, for sleep, especially to regulate Circadian rhythm disorders (which I have in spades. Must have been imported from another planet!)

And have you tried Rozerem - the new melatonin reuptake inhibitor? I think it works great WITH other meds, tho that's not how it was designed.


Very sympathetically,


PS A nightlight is important so if you need to go potty you don't need to turn on anything bright. (You probably knew this).

OK here's a little something I find soothing. An hour or so before bed, I screw in a blue light bulb to dim my living room. Blue is somehow calming. I use a weird little flourescent thing I got at Walmart.

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Have you tried Doxepin? That worked well for me, as did Neurontin (which made my ankles swell).

I currently take 75 mg of Trazodone and 500 mg of depakote and that works great. The depakote is for headaches, but seems to make me very sleepy.

I have never understood how people can sleep without medication! I expect insomnia will be a lifelong issue for me---my mother has it too and has similar other mental health issues.

Good luck


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  • 1 month later...

Zyprexa kicks your ass when it comes to sleep... I know you are hesitant about APs but you can get a dose as low as 2.5mgs. I think its worth a try. I'm sorry that you can't sleep, you can have some of my sleep if u'd like ;)

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I'm sorry you can't sleep. I'm sleepless over here too.

It looks like you have the ADD and the sleep issues. Are you sure the ADD is being treated well enough? I know sometimes my brain is so full of noise, both from ADD and I'm sure from the psychosis that sometimes comes with my mood states that I can't sleep. It is like a train wreck in my bedroom.

I've tried Rozerem (sp?). It seemed for me to take awhile to work, but it did, and I fell asleep. I woke up 2 hours later due to my phone ringing, but I did fall asleep. I have some more and I'm going to try it out a bit.

And I have to chime in for Zyperxa- IF you are OUT of options and IF you can handle the side effects. I say this because it is my favorite drug in the whole world, but gives me such harsh side effects (lactation, 30lb weight gain in 3 weeks, hair falling out in clumps...) that my pdoc took it out of my med schedule. It helps me sleep because it knocks out mania. Like Seroquel, a side effect is sleepiness, so IF you are sure you're out of other options, you could try Z. on this stuff i have never felt better feeling crappy.


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