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Anyone here have BPII and have trouble sleeping?


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I'm female, 29, with BPII and have trouble sleeping except when I take Seroquel. I love that Seroquel has allowed me to sleep regularly for the first time in my life. But I think I hate Seroquel more because I've gained so much weight from it. I've been trying to find something else in place of Seroquel that will help me sleep. So far nothing has worked (Trazadone, Ativan, Abilify, Chlorol Hydrate, Rozerem, Lunesta, etc., etc.). I wanted to know if any of you were like me (I feel so alone sometimes) and what you are taking so I can let my pdoc know what to try next.

I'm taking: Trileptal 1200mg, Cymbalta 30 mg, Seroquel 100 - 200 mg/daily

Thanks.

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second attempt at reply...

Yes! Sleep problems are almost synonymous with Bipolar disorder. Numerous scientific studies have found this, and one or more genes has been associated, so it's not just your imagination. Dr. Phelps has quite a bit of information on sleep and Bipolar II: http://www.psycheducation.org

Cymbalta has done wonders for my sleep in the last three months, but I see you are already on it.

a.m.

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JW54--

When you say "trouble sleeping", do you mean initiating sleep or maintaining it? "Initial insomnia" is when you fall asleep well after hitting the sack (>30 minutes trying to fall asleep). Among other things, it's a symptom of delayed sleep phase disorder, which is when your body's circadian rhythm dictates that you go to sleep much later than when the rest of society does. For example, left up to its own devices (i.e. sans Mirapex*** for me), my body wouldn't want to sleep until 4 AM. So, going to bed at 11 PM without any assistance from meds and relaxation techniques will get me nowhere for a few hours. DSPS is very common in individuals with MDD and bipolar disorder.

The other kind of insomnia is "maintenance insomnia", which is normally characterized by early awakening, often more than 2 hours earlier than intended. It is definitely possible, also, to have both types of insomnia at once.

If you only have pure sleep initiation problems, you should speak with your pdoc about one of the more powerful short-acting benzos/hypnotics (Ambien and Sonata come to mind first). Sleep maintenance is typically treated by the longer-acting sedatives... the benzo flurazepam (Dalmane) is actually approved for the treatment of insomnia, though I found that it gives me more vivid dreams than usual. AmbienCR is widely considered better for maintenance insomnia than immediate-release Ambien. Some people also like to use clonazepam (Klonopin) for sleep maintenance, although I found that at dosages required for sleep, it slowed my breathing down enough to make me wake up hypoxic and stumbling drunk each morning.

Also, the sleep maintenance meds in general do a good job of initiating sleep, as well. AmbienCR is a good example, as it releases half the dose immediately to help you fall asleep, and the other half throughout the night to help you stay asleep.

All else failing, in your shoes, I'd talk to the pdoc or GP about setting up a sleep study. They can look at other issues there that could ruin your quality of sleep, such as sleep apnea.

***n.B.: Mirapex is a somewhat sedating D3 dopamine activator used for the treatment of the parkinsonian syndromes. I don't recommend that it otherwise be taken for sleep issues... plus, the manufacturer says that (for obvious reasons), it's generally just plain silly and pointless to take Mirapex with an AP/AAP.

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Hi. I'm a 27 yo female and have the same problem. When I was on Zyprexa I seemed to sleep much better, however I gained a lot of weight on it and I see that's already a problem for you so don't know if it's worth a try or not. They're in the process of switching me over to depakote and my sleep problems have returned.

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Guest Jenerickly Disabled

I can relate, I have been diagnosed with Borderline Personality, Schizophrenia, and I am sure that I have BP2 when diagnosed I had all the signs of Bi-Polar. Anyway, I have tried everything for sleep from Ativan, Restoril, Ambien CR, Seroquel, Sonata, ohhh, there are so many. But now I take 1200mg trimictal and an older anti-depressant called Doxepin HCL 100mg. I take the 2 of these together PM & I am out fast and stay asleep thru the night. There are of course the couple nights a week when I still wake up once or twice & have to get up for a little while, but everything is so much better than it used to be. I would take what I can get, it is better then no sleep at all. I don't know if this has ever been used for anyone else, I don't think it is common but I don't know, all I know is that it helps for me.

Current meds: Cymbalta 60mg, Ultram 100mg. ,Skelaxin 800mg 3x daily, Darvocet 3x daily (Ultram,Skelaxin, & Darvocet are for fibromyalgia, totally unrelated), Klonopin 1mg - 3x daily, Trimictal 1200mg, Doxepin 100mg PM.

Previous meds: Lamictal, Depakote, Lyrica, Neurontin, Paxil, Zoloft, Lexapro, Prozac, way, way, way, way, too many to list, it would go on & on & on...

Oh ya, I am also a recoving heroin addict. That really helps things out... I am sure I have caused all these problems & I have to be so careful w/ meds so I don't have any issues with dependency, so far so good... I think I just used the heroin to try and ease some of the racing thoughts, depression, etc..... I was self - medicating.

But it has been 8 months & I am struggling along.

If anyone has any advice, comments, whatever -- fire away!!!

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Without Seroquel, I just don't sleep. I could be up for DAYS. Weight gain kicked my ass though, and I had a gastric bypass earlier this month. Since then, I have been able to reduce my seroquel by 1/2. My goal is to be at the lowest dose possible to get me to sleep. Once I'm there, i can usually maintain sleep fairly well. Due to the weight gain, I also had some issues with obstructive sleep apnea, which reallllllly messed with my sleep. Have you had a sleep study? You might want to think about it.

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I have trouble sleeping, which drives me crazy as I'm tired, sleepy, and drowsy all day! My psychiatrist gave me ambien. 10 mg has helped me for months. It helps get me to sleep, and to stay asleep through the night.

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Have you tried Remeron (Mirtazapine)?

It's supposed to help with sleep & has a sedating effect on some. Didn't knock me out, but it did for my roommate..

I feel silly for forgetting to recommend that.

Remeron (and trazodone) also boosted the activity of my Cymbalta. Probably had to do with their activity in blocking some of the "bad" (serotonin 2A and 2C) receptors.

Back to the knockout pill theme though, yeah, Remeron worked for me. Just watch for the carb cravings... Remeron itself won't make you gain weight, it'll just give you hardcore cravings for foods that will. Remeron isn't a sleep med for me anymore, I take it as an adjunct to Cymbalta as well as for relief of GI reflux disease (in some people, it acts as a stomach prokinetic).

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Not sleeping is both a cause and a symptom for me. I was taking amitriptyline (a tricyclic antidepressant) for a while, then Zyprexa (horrible weight gain, but fantastic sleep), and now I'm back on tricyclics - this time trimipramine, and it works fine for me with no side effects.

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karuna and guest - I will jot down your suggestions and mention it to my pdoc next week.

THA25 and Cetket - As far as Rozerem, it did nothing for me as I couldn't sleep but I did break out in a rash.

I actually have been trying Sonata 20 mg which has been working okay. I like it in that I no longer get the horrible hunger pangs like I did on Seroquel but I wake up a couple times at night from it. I guess it's just trial and error with me to find the perfect med.

Thanks again for all the suggestions.

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  • 2 weeks later...

Nothing but seroquel could make me sleep but it caused weight gain and constipation so I stopped taking it. I began taking 5HTP and Melatonin in conjunction and was able to sleep like a baby. Just a thought. I don't think it could hurt to try it out maybe.

I"m taking seroquel again though, because of other factors.

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  • 2 weeks later...

I was taking benadryl which puts me to sleep but I wake up 3-4 hours later so it feels like I just took a long nap. Tried valerian and the same thing, only wasnt as groggy in the AM. My therapist recommended melatonin but I may ask my NP to prescribe some trazadone for me next time I see her. I really dont want to take an AP for insomnia bc of side effects. What is rozerem?

Cat

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I previously wrote that I was using 10 mg ambien. My (new) pdoc told me she doesn't like me being on ambien at all--I'm not sure she said it was because I am bipolar, but I sort of have that impression. She doesn't like the blackouts that can happen, I remember her saying that. She told me she'd much rather I use risperdal or clonazepam (both prescribed for other things, originally), and avoid ambien.

I haven't taken an ambien in at about two weeks, though I have leaned on clonazepam a few times, and I'm sleeping as well. Not an easy thing for me, though. Getting some good exercise again (jogging) surely is helping me, too.

For what it's worth....

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  • 2 weeks later...

I had the type of sleep prroblem where I was waking up at around 3 and not being able to get back to sleep for hrs. I would worry and fret incessently about all the bad things I've ever done.

Ativan did help break that cycle but was not strong enough so I'm now on 2 mg Clonazepam which totally works for me. I take it in the morn. too for anxiety. and don't get sedated.

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