I think I have a problem...xanax no longer working for sleep

[bluesme]

So I suspect I've developed a tolerance/dependence on xanax to help me sleep. Years ago I only took it only when I needed it if I couldn't sleep. These last 3 months I've taken 1mg. to sleep - although I promptly wake at 5:30 a.m. Lately 1 mg. doesn't do the trick - have had to get up to take another .5 - still promptly awakening before dawn. I am freaking scared. The nightly xanax was never part of my routine until some major stressors appeared in my life. NOW I feel like I'll never be able to sleep w/o taking something. Ugh!

So, tonight I'm going to try Seroquel.

Can anyone relate to this? HELP!

[Mindful Momma]

I'm right there with you. At first it was the same as you, Xanax at lower doses to help with sleep, then Klonopin....no help and the insomnia just got worse. I was put on Ambien CR, regular Ambien, Lunesta, Restoril, Sonata....nothing. So, Pdoc put me on Remeron and that seemed to help for the long hall...I mean you can take it on a nightly basis. Zyprexa knocks out (at least of me) but they tend to only give you that if you are having a severe manic episode and need to come down quick. He would often mention Trazadone as an option. Amitryptiline also helped too at higher doses.

At any rate, talk to your Pdoc and she was he/she has to say...good luck!

[bluesme]

Thanks for your reply. Seems I got this lovely onset insomnia when I switched from Zoloft to Lamictal. I've since switched back to Zoloft AND the insomnia is still there at night. I just want to throw the Zoloft in the garbage - it worked well the first couple times I was on it but this time...if only I could sleep...then I think I'd feel 100% better.

[Lolie]

Plenty of options still left on the pharmaceutical table. Benzos are only supposed to be used short-term and are well-known for becoming ineffective after a while - the reason people still feel better after taking them even once they've become ineffective is because it staves off withdrawal symptoms.

A lot of doctors won't prescribe Seroquel for insomnia alone. Although it does work as an antihistamine and make people drowsy at low doses, it carries similar risks to other neuroleptic drugs and many prescribers don't consider those risks acceptable in the absence of a condition requiring antipsychotic medication.

Do you have good sleep hygiene routines in place? Have you learned any relaxation techniques, used a white noise generator etc along with medication in the past? Sometimes a combination of meds and non-medical stuff works better than either alone.

BTW, you shouldn't just cease the Xanax even if it's no longer effective. Talk to your doctor about making the transition to something else.

[MarkP]

I had the same problem with Ativan (lorazepam), and was up to 3mg nightly on it. Switched to temazepam (Restoril), and that worked much better, at the 15mg dose, which I have since reduced (by breaking open the capsules and dumping some of the powder out).

Those Ashton benzo equivilancy charts are quite misleading, IMHO, and are only for tapering purposes from chronic use (ie: round-the-clock use of short-half-life benzodiazepines), and not therapeutic equivilance.

Alprazolam (Xanax) is marketed as a "daytime" tranquilizer, ie: its goal is to provide relief from symptoms of panic disorder, with a minimum of sedation. Temazepam (Restoril), on the other hand, is marketed as a sleeping pill or hypnotic.

So that'd be my suggestion; if you need a sleep med, get onto a product that is licensed and studied as a sleep med, and whenever possible, stay off the high-potency benzos as tolerance tends to develop most rapidly for them.

[crtclms]

....Benzos are only supposed to be used short-term and are well-known for becoming ineffective after a while - the reason people still feel better after taking them even once they've become ineffective is because it staves off withdrawal symptoms.

Wrong. Please stop making sweeping generalizations about benzos. I would love to see the study that says that people feel better after taking them, yet then goes on to say it is because they are ineffective. Feeling better does not necessarily equate with being high, just because some people use them recreationally.

Some people do use benzos long term for anxiety. Many on this board, including myself.

Less so for sleep, but some people are told to do so by their p-doc, including mine.

In the OP's case, I think calling a p-doc immediately is a good idea. Trouble sleeping may have to do with dependence (which should not be confused with addiction). It also may mean your mood is changing, and that is what is affecting your sleep, which would also affect the efficacy of the benzos.