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DammitJanet

Best typical AP for sleep-least side effects?

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I see pdoc tomorrow. My sleep is getting worse and worse. That’s even with 2 mg klonopin added last night it is the number one issue affecting my mental health...so I need help. I have tried literally everything else...except typical AP’s. 

Please I need suggestions on which will work, have no wt gain, and preferably not make me a zombie the next day. 

Please help!

@mikl_pls ?

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Posted (edited)
1 hour ago, DammitJanet said:

I see pdoc tomorrow. My sleep is getting worse and worse. That’s even with 2 mg klonopin added last night it is the number one issue affecting my mental health...so I need help. I have tried literally everything else...except typical AP’s. 

Please I need suggestions on which will work, have no wt gain, and preferably not make me a zombie the next day. 

Please help!

@mikl_pls ?

Low-dose Thorazine might be an option ( maybe 25mg to start)....I have actually tried it in the past, and it did knock me out.....I didn't have any weight gain on it, but did feel somewhat groggy in the morning.

However, when I changed pdocs, the new doc was not comfortable with Thorazine, so I had to try something else.

Be aware that some docs might not be comfortable with prescribing it.

Edited by CrazyRedhead
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2 minutes ago, CrazyRedhead said:

Low-dose Thorazine might be an option ( maybe 25mg to start)....I have actually tried it in the past, and it did knock me out.....I didn't have any weight gain on it, but did feel somewhat groggy in the morning.

However, when I changed pdocs, the new doc was not comfortable with Thorazine, so I had to try something else.

Be aware that some docs might not be comfortable with prescribing it.

Are there any others if that falls through?

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9 minutes ago, DammitJanet said:

Are there any others if that falls through?

Well, the only other one I'm familiar with with is loxapine....I've seen a few folks on it here......I've never had any personal experience with it, though......

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Ok. I think I’ve heard Michael talk about stealazine (sp) so I’m hoping he noticed I tagged him. 

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2 minutes ago, DammitJanet said:

Ok. I think I’ve heard Michael talk about stealazine (sp) so I’m hoping he noticed I tagged him. 

Hope so, too.....He probably knows much more about typical APs than I do.

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1 minute ago, DammitJanet said:

Oh man nm that one! Weight gain is a common side effect. 

Which one--loxapine?

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Just now, CrazyRedhead said:

Which one--loxapine?

No, stelazine. 

Actually, I just searched loxapine and a side effect was trouble sleeping. 😐

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Posted (edited)
14 minutes ago, DammitJanet said:

Actually, I just searched loxapine and a side effect was trouble sleeping. 😐

Hmm......I didn't see trouble sleeping as a side effect of loxapine here:     https://en.wikipedia.org/wiki/Loxapine#Side_effects

It mentions "intense sleeping", as a side effect, and also "somnolence" (drowsiness)

Edited by CrazyRedhead
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https://psychopharmacologyinstitute.com/antipsychotics/first-generation-antipsychotics/

If you skip down to adverse effects section, there's a table that lays out some of the side effects, including sedation

https://psychopharmacologyinstitute.com/antipsychotics/first-generation-antipsychotics/

Stelazine is trifluoperazine, and is marked as low. Perhaps Michael finds it more calming vs knock your ass out sedating.

Looks like CRH picked a winner with thorazine.

 

Here's another. Quotes in italics.

Ignore the title in the link below

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC487011/

So if you were going on a typical, you want one that is low potency

In general, the high-milligram, low-potency antipsychotics, such as chlorpromazine and mesoridazine, produce more sedation than the low-milligram, high-potency antipsychotics such as haloperidol and fluphenazine (Table 1).

However, the sedation tends to be related to affinity for H1 receptors...so like antihistamines which I know you don't do quite well on.

Studies have indicated that sedation may also be related to the affinity of the medication for the histamine H1 receptors.

Although both dosage and affinity for histamine H1 receptors play a part in the sedative effect of a medication, what ultimately determines sedative effect is the amount of the drug reaching the histamine H1 receptors in the central nervous system.

 

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3 minutes ago, DammitJanet said:

Oh dear...looks like I’m SOL 

Not necessarily.......You took Seroquel, which at low doses has an affinity for H1 receptors..

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Just now, CrazyRedhead said:

Not necessarily.......You took Seroquel, which at low doses has an affinity for H1 receptors..

It also made me eat like a horse. 😐

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2 minutes ago, DammitJanet said:

Oh dear...looks like I’m SOL 

Perhaps i'm a bit too fascinated/obsessed with anticonvulsants due to my adventures in lamotrigine, but both carbamazepine and oxcarbazepine are sedating and weight neutral.

Failing that, amoxapine is a metabolite of loxapine, it's an AD that even has  sedation as a common side effect. Does hit the H1 receptors quite hard, so that also might not be an option.

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Posted (edited)
2 minutes ago, DammitJanet said:

It also made me eat like a horse. 😐

I didn't gain any weight on Thorazine.....If your pdoc will let you have it, I would say it's at least worth a try.

Edited by CrazyRedhead
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Just now, argh said:

Perhaps i'm a bit too fascinated/obsessed with anticonvulsants due to my adventures in lamotrigine, but both carbamazepine and oxcarbazepine are sedating and weight neutral.

Failing that, amoxapine is a metabolite of loxapine, it's an AD that even has  sedation as a common side effect. Does hit the H1 receptors quite hard, so that also might not be an option.

Isn’t there a lot of daytime grogginess with Tegretol? I was on it once and I think that was a problem, but maybe now with vyvanse it wouldn’t be so bad. 

Just now, CrazyRedhead said:

I didn't gain any weight on Thorazine.....If your pdoc will  let you have it, I would say it's worth a try.

Ok will ask

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9 hours ago, DammitJanet said:

Isn’t there a lot of daytime grogginess with Tegretol? I was on it once and I think that was a problem, but maybe now with vyvanse it wouldn’t be so bad. 

Ok will ask

Second this, no weight issues if taking it only for sleep, especially since it’ll be low dose and most listed side effects refer to higher dose antipsychotic effect 

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3 hours ago, Iceberg said:

Second this, no weight issues if taking it only for sleep, especially since it’ll be low dose and most listed side effects refer to higher dose antipsychotic effect 

Thanks, do you know if it will interfere with donating plasma?

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