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Posted (edited)

I’m dead to the world tired.  Falling asleep on the train despite getting enough sleep.  I’m curious which drug to you seems to be the culprit.  Options below:

morning:

-fanapt (not likely because have me horrible insomnia)

- lithium 150

-lamictal 250

 

even’ing:

lithium 600

zyoreza 15

prazosin 2

klonopin - 0.75

 

i also take B-12, folate, and D supplements but I started them after this was already a problem.  Same thing with xanax.

Edited by dancesintherain

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I suspect the Lamictal is making me tired, though I'm only on 50mg. But since I got out of the hospital I sleep 11 or 12 hours a night and still take naps. Though that may be one of those side effects that is supposed to go away in time.

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@dancesintherain

I’m confused sorry. Are you taking Xanax and klonopin too? I don’t see when you take the Xanax on your list? Maybe I misread though. Just wondering if that could be an issue? As in, if taking two benzos plus zyprexa at bedtime is sedating you throughout the day?

And I take my lamictal at bedtime. I remember it reduced some sleepiness for me. I was really tired and now practically all of my meds are taken at bedtime. I don’t know if that’s helpful or not. Something to chew on and discuss with your pdoc. 

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Thanks—I take 0.75mg of klonopin at night.

the Xanax is during the day (0.25mg twice daily) and not likely the cause as it was only just added.  It’s possible but I’m fairly sure they predate the symptoms.

thanks harp—that’s two votes for lamictal at night.  I’ll see where it goes.

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@dancesintherain

I know I always mention this. But it doesn’t hurt to look for physical causes too. 

I know you have hashimotos like me. Have your thyroid levels been checked like the full panel recently? (I think they were?)

Have you ever had a sleep study night or daytime one done? I’ve had both. I wasn’t even snoring but my GP saw I had a small some kind of throat opening (I really don’t recall the technical word she used lol) and suggested I get a sleep study plus husband said I sometimes breathed weird on my back?). So I did one and I had barely enough “episodes” of it and now I use a CPAP machine and take nuvigil for speculated narcolepsy too and sleep apnea tiredness. If you have any questions about either of those just let me know. 

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Thanks Cheese.  Thyroid levels are fine as of about three weeks ago.  did sleep study about three years ago and it came back fine.  Vitamin D, B-12, folate are all in the process of getting fixed.

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The only problem here is that Lamictal is not sedating. 50 mg is nothing, folks with seizures start at 600 mg and don't experience sedation. You list a number of sedating meds you say you take, look there.

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I take 250, not 50.

 

i tend to have the opposite reaction (fanapt is traditionally sedating and it gives me insomnia).  I’m curious where to start.

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Posted (edited)

@dancesintherain

Personally, I’ve always taken lamictal at bedtime. My pdoc has said it should make me a little drowsy. That was my first pdoc though. I honestly do believe that it does have this effect on me IME. Ymmv of course. We all react differently to meds. I take 300 mg at bedtime along with others and they all help me sleep. 

Edited by Wonderful.Cheese

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Thanks Cheese.  I left my pdoc a message and explained that it’s largely when I’m sitting idle (the 45 min train ride is the worst, but I also had some when sitting in her office for an appointment).  I do okay when I have to do things, though still tired.

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Lamictal is confusing. Side effects say it can cause sleepiness OR insomnia. I’m gonna try it one in the am and one in the early evening to see how that goes. I’d hate to try it all at night and be wide awake all night! Thanks for this thread!

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6 hours ago, dancesintherain said:

I’m dead to the world tired.  Falling asleep on the train despite getting enough sleep.  I’m curious which drug to you seems to be the culprit.  Options below:

morning:

-fanapt (not likely because have me horrible insomnia)

- lithium 150

-lamictal 250

 

even’ing:

lithium 600

zyoreza 15

prazosin 2

klonopin - 0.75

 

i also take B-12, folate, and D supplements but I started them after this was already a problem.  Same thing with xanax.

Zyprexa? 

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As a hangover?  Could be.  I take it pretty early (7ish).

 

o realized from talking with pdocs receptionist that it also comes on when I have to sit and do nothing for a while (like waiting two hours for an appointment with her—which was at 12).  So maybe it’s not an immediately after taking them issue.

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1 hour ago, dancesintherain said:

As a hangover?  Could be.  I take it pretty early (7ish).

 

o realized from talking with pdocs receptionist that it also comes on when I have to sit and do nothing for a while (like waiting two hours for an appointment with her—which was at 12).  So maybe it’s not an immediately after taking them issue.

Yeah the sitting around gets me too

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Posted (edited)

I’m not sure what to do with that.  Because I’m always going to be sitting for the train. And I can’t run the risk of dozing off and missing my station/having my stuff stolen.

 

i also don’t have the same problem in the 430pm train.  It’s weird.

 

for now I’m going to hope it’s an easy drug fix.  We will see what my pdoc does/says.

Edited by dancesintherain

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Posted (edited)

I heard from her receptionist and was told that “it’s okay to dial it back a bit and keep 1/2 a pill as needed.”  I asked to clarify what “it” was and she said Xanax...isn’t that what you were asking about.  (I talked to a different person earlier today and this person apparently didn’t read the note.)

i told her I thought it was least likely to be xanax because of when I take it, namely after the sleepiness, and he short half life. She asked what I wanted then and I said I didn’t know.  I hoped that my pdoc would have an idea.  I didn’t know whether to split a dose, change when something’s taken, etc. but I could tell her that I don’t think Xanax needed to be changed.  And that if it did, definitely not from 0.5 to .125 with no substitution.

we will see what happens with round two.

 

Now I am doubting myself on when this started and wondering if I'm having a paradoxical reaction to one of the supplements.  All say to take in the morning because of risk of insomnia (they're liquid form).  But maybe they're the culprit rather than my meds?  I wish I paid better sense of this stuff before it hit the point of needing a change.  I sent her the timing info related to supplements in case she wanted to go down that path.

Edited by dancesintherain

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So round 2 version makes more sense from my perspective.  I'm cutting the klonopin evening dose back from 0.75 to 0.5.  If that doesn't work by my next appointment (two weeks out), we'll think about decreasing zyprexa from 15mg to 12.5mg.  I mentioned the supplement situation but said we can talk about it later.

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Posted (edited)
11 hours ago, dancesintherain said:

So round 2 version makes more sense from my perspective.  I'm cutting the klonopin evening dose back from 0.75 to 0.5.  If that doesn't work by my next appointment (two weeks out), we'll think about decreasing zyprexa from 15mg to 12.5mg.  I mentioned the supplement situation but said we can talk about it later.

Sounds reasonable, dances! Good luck! I hope it helps you. Sitting idle usually makes me sleepy or fall asleep too, and that’s with nuvigil on board for me (but I have sleep disorders, mind you).

That’s hard. I can see how it would be very problematic on a train ride! Yikes! I’d be worried too!

ETA: would anything like having a coffee or soda help on the train ride? Or don’t you drink caffeine?

Edited by Wonderful.Cheese

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@dancesintherain, prazosin may also be contributing to it. In addition to what has been said about Zyprexa, I'd also say that lithium may also be contributing.

I've been meaning to ask you about Fanapt, btw. I guess it's confounded by taking Zyprexa with it, but did you notice any antidepressant effect of Fanapt? Also, has it caused any weight gain? My pdoc said it isn't associated with weight gain, but everyone's different I suppose.

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thanks Cheese.  I've been trying to pull back on caffeine, but maybe this particular train ride isn't the time to  make that lifestyle change ;-) I hope her change helps.  If it doesn't, I do think it's time to play around with the supplements.  the sitting idle portion isn't helping though.

thanks mikl_pls - it sounds like the summary is that anything I take could be causing it.  I'm not going on the train in the am today (a friend is driving me to a doctor), so I won't get to test out the new theory.

Re: Fanapt - I'm not sure I noticed AD one way or the other.  I needed a new AAP that was weight-neutral and it was one of few that I hadn't tried.  We were also primarily looking for something that was anti-psychotic, so it won the day on that one.  we joked about not knowing what it was doing when I switched back to zyprexa for sleep assistance...and then I went hypomanic.  So it was definitely doing something, but probably in the mania squashing land.

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