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I can't even DRUG myself to sleep anymore!


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Apparently my body has just decided that it is never, ever going to sleep normally again. Assuming I'm sleeping normally (which I haven't been in WAY too long) I will sleep from maybe 10 pm to 7 am. I'm also a pretty heavy sleeper.

Recently, it's just been ridiculous. Before I started taking anything, I would lie awake for three hours fantasizing about people breaking in and killing me, then I'd finally fall asleep, have nightmares about my stepfather, and then wake up at like 6:30 or 7 in the morning. The anxiety got so bad I seriously considered sleeping under the bed for when the burglers came to kill me. Pdoc gave me 1 mg Ativan to cut the insomnia. First night, it worked like a charm - my head went blank, no more anxious thoughts, slept like a baby. Kept this up for four-ish days, then it stopped working. My brain was busy and noisy, and I wasn't sleeping. Pdoc gave me a couple 50 mg Seroquel (XR) to tide me over until my exams finished, so I wouldn't be a Remeron-zombie during midterms. These put me out - more gently than the Ativan, but still tolerably. Then, I stopped taking the Seroquel and pdoc gave me Remeron, 15 mg for a week and then up to 30. The 15 knocked me out, though I was quite zombified. Moved up to 30, and was a little less zonked, still having bad dreams, but not so many outright nightmares, and it was quite tolerable. Even started to get some of the anti-depressant effects after a while. Then, I decided to move my dose up a couple of hours to see if I'd have an easier time getting up in the morning. Stopped sleeping, had horrible nightmares, woke up all the time. Moved the dose back - still having quite bad insomnia. I'm not really blaming it on the dosing time anymore - I think it's something else coming up.

I'm frightened to get into bed, because I'm so afraid of the thoughts/noise in my brain as soon as I slow down and try to go to sleep. I have no attention span during the day, because if I do anything that doesn't occupy me COMPLETELY, my brain starts to go batshit. It takes me over an hour to fall asleep (not terrible, but uncomfortable when you're having busy brain like I've got) and I sleep super lightly - wake up early in the morning for no good reason, wake up multiple times during the night.

Went to see pdoc on Mon. and she gave me some more Seroquel and said to take 25-50 on top of my mirtazapine. I took 25 on Monday - nothing. Didn't notice any difference. My head was still busy as hell, I still couldn't fall asleep, still woke up all the time. I figured 25 was too low - took 50 last night (25 right before I went to bed, and another 25 an hour later when I still wasn't asleep). Still nothing. Slept a LITTLE bit longer, but still very lightly, couldn't get to sleep etc.

My question is - what the fuck? My anxiety is pretty high right now, it's true, because I'm going home in a few days, but this is ridiculous. I should not be taking 50 mg of Seroquel and not even feeling it. I took 50 mg before and it worked like a charm, and it was only for 2 days then, so I can't be tolerant already. I'm not sure what's going on. Am I so anxious about going home that it's not doing anything? Is it the activating-ness of the Remeron (but I've been sleeping with the Remeron and nothing else for at least a month)? Is it some sort of interaction with my asthma meds (but I was taking those the last time I took Seroquel)? Is this some sort of weird Remeron poop-out?

I still have some lorazepam - I might take that tonight on top of the mirtazapine (but no seroquel) and see if that makes any difference. However, these days, I can take an Ativan and really not feel it either. Which is weird, because I've only ever taken it once before (around October) and it was for less than two weeks. Am I just completely impossible to sedate? Compared to the states I've been in before, the anxiety that I'm actually FEELING is only moderate. I'm suspecting there's something going on in my head that I'm not seeing or feeling, though, if that makes any sense.

Forgot to add - I've tried lots of non-drug stuff too - breathing exercises, relaxation exercises, good sleep hygeine. I just cannot sleep. Right now, I'm thinking my anxiety is just kicking the ass of anything that comes near it. Any suggestions? I've never heard of 50 mg of Seroquel NOT being sedating... ;)

Should I take it with food or water or something? Am I missing something really obvious? I think it will probably go away/improve when I'm not on the verge of spending two weeks with my family, but those two weeks are just going to be THAT much more hellish if I can't find a way to get some sleep.

Grr - I had my hopes up, too. I was so SURE I had something in my arsenal that would kick the insomnia. It made me feel so much safer about going home. But it looks like it's just me and the thoughts...

ETA: The weird thing is, I'm having this non-specific "white noise" in my head (all the time, but it bothers me more when I'm trying to sleep). It's like the subjective feeling of standing in a crowded room where everyone's talking. But there aren't voices or anything. It's just this feeling of generalized noise or static in my head. I had this before I started taking any meds, but it went away for a while. Pdoc has no idea WTF it is, or at least, no idea that she's sharing with me.

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My first thought was your asthma meds. But really I don't know. I take 100 mgs. of Seroquel at night and it helps me sleep. But I'm really tolerant to most meds, I figure because of my addiction issues. (but again I have no clue).

Maybe it is just stress about going home. Hopefully after the holidays your sleep will get back to something more resembling normal. Do you see pdoc again before you go?

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-sigh- Nope. No more pdoc until January. :) It's starting to sink in that I'm up a creek without a pdoc for nearly a month, which is probably why every single mental & physical problem I have has suddenly become super-intractable. I can feel myself starting to get all batshit already just thinking about it - I'm slowly flipping the shit just thinking about the combination of lack of any kind of real world support and living with my family. ;) I can actually feel the craziness beginning to well up, and I'm not even HOME yet. I'm trying not to panic, but it's really difficult. Last time I was at home, I lived there for the whole summer and it was hellish. Maybe I should have stuck this up in Blogland - I don't think there's much anyone can do about the fact that nothing sedating is even touching my anxiety or my insomnia. I guess I just wanted to rant and rave a little bit :)

The worst thing is, I bet everything would feel just a little bit more bearable if I could just get some sleep. The exhaustion is not helping my emotional stability. It's a total chicken/egg thing, I swear. I can't sleep because I'm too upset/anxious, so I'm tired, which makes me more upset and anxious, which makes me less able to sleep and so on and so forth. I've gotten caught in these loops before, but I was hoping the drugs pdoc gave me would head it off. Since it seems like not, I just don't know what to do. I'm starting to get that nasty hopeless feeling creeping up on me. Damn.

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I'm slowly flipping the shit just thinking about the combination of lack of any kind of real world support and living with my family. ;) I can actually feel the craziness beginning to well up, and I'm not even HOME yet. I'm trying not to panic, but it's really difficult. Last time I was at home, I lived there for the whole summer and it was hellish.

Situational anxiety and depression - especially when there's a rational reason for it, like too much impending exposure to the familial units - can burn right through a person's maintenance meds. Not getting enough sleep simply cannot help matters.

I'd spend a minute to poke fun at the "I would lie awake for three hours fantasizing about people breaking in and killing me," line in your initial post... but I couldn't get much sleep last night myself. It seemed a nice night to leave a window partly open ... until the gunfire went off, then it was people talking in the back alley, then it was a freaking car alarm on the street ... :) someone else will have to call you paranoid this time out.

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Thanks for the advice, everyone. Called pdoc today, and she said to just keep bumping the Seroquel until I sleep. I suggested cutting back the Remeron, but she wasn't into that. Don't really blame her - I'd like to keep the AD effect on board if I can. Therefore, will bump Seroquel as needed. Hopefully NOW I'll get some rest ;)

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You wanna hear something funny? I don't sleep. Ever. I get 2 hour a night if I'm lucky. I actually start dreaming before I fall asleep and it's frightening. I have bizarre hallucinations, my mind doesn't stop and I'm afraid of everything. I'm in pure terror sometimes.

I've been on Ativan, Seroquel, etc.... but last night I tried a little combo that worked pretty well.

I took 3 Benadryls, 3 Melatonin Plus's (that's got 25mg of L-Theanine) plus one 200mg 5-HTP (time release) and actually slept for about four hours! It's a miracle.

I also take this stuff called Somatomax sometimes, you can buy it on Ebay or online or sometimes I get it from a local gym. It puts you in a coma but you can build up a tolerance quickly. Just google it.

Merry Christmas!

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What are your hours in bed?

My sleep is back to being moderately bad again but my sleep behavior is off again and I don't care - again!

But... when I DID care, I went to sleep clinic, got 'studied'!, and tried several non-drug pattern changes.

The ONLY thing that worked - and actually started me sleeping fairly well after YEARS of 0-4 hrs/night - was this:

Set a wake up time that works with your schedule. Stick with it no matter what! EVERY DAY. Even if you only got 1 hr of sleep. Second, don't GO to bed until you are sleepy. Even if it means staying up all night. Don't read in bed, watch TV in bed etc. Third, IF you go to bed and can't fall asleep, GET UP out of bed, go to another room and sit and read or listen to music - don't watch TV - and don't go back to bed until you are sleepy.

Wash. Rinse. Repeat!

Be mindful of stimulating activities less than a couple hours before bed - like TV programs that might 'wind you up' etc.

You may find yourself up 'til 3AM ! ;) - or later, but stick with it for at least a couple of weeks. It might surprise you and work!

Good luck.

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I'm actually wondering if the Remeron might not be making matters worse. AD's can sometimes exacerbate symptoms like anxiety & sleeplessness.

Pdoc says no - I asked. Also, the timing's not really right for it to be the Remeron.

I've been bumping the Seroquel, and I've had some success with 150 mg. We'll see how that holds up to repeated trials ;)

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I'm actually wondering if the Remeron might not be making matters worse. AD's can sometimes exacerbate symptoms like anxiety & sleeplessness.

It depends on the AD and the patient's problems, but Remeron (a tetracyclic AD) is usually sedating. According to the info at RxList "somnolence" was the most common reason for discontinuation, and just over half the patients in the US drug trials reported it as an "adverse event".

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