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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Dona on February 21, 2002, at 17:59:35
To all those who remember my post a few weeks ago about my ambien addiction, I confessed to my therapist and psych. and am starting an intensive outpatient program next week. I guess that is good news because I will get this demon out of my life, but right now I am an anxious mess. I have to be without ambien for at least two days so that is why I cannot start program until next week. I tried to not take any last night and wound up forcing my husband to give me one. Poor man--he does not know what to do.
Anyway, I saw psych today and am going to try 200mg of seroquel at night to relax and sleep. Any body have any input about the seroquel? I am still taking 60mg day of prozac. I have a constant headache and sick feeling, but I guess it will get better--I pray it will get better.
Posted by ivoovi on February 22, 2002, at 4:43:49
In reply to My ambien saga--where I am now--info on Seroquel, posted by Dona on February 21, 2002, at 17:59:35
Hi...I too abused Ambien, developed quite a tolerance on it, so I couldn't get to sleep, and I would hallucinate.
My doctor switched me to Seroquel (I didn't tell him about my abuse of it, though). Seroquel works great for sleep, I do wake up a bit groggy in the morning, but that wears off.
However, I have abused Seroquel on occasion. I like to sleep, and sometimes I will take more Seroquel as soon as I wake up so I can sleep all day....and it works. I have been better about that recently, but sometimes the temptation is still there. Hope this helps.200mg, I think, is a big starting dose. 100mg or even 50mg might do the trick.
-Chris
Posted by Elizabeth on February 22, 2002, at 12:13:59
In reply to My ambien saga--where I am now--info on Seroquel, posted by Dona on February 21, 2002, at 17:59:35
Hi Dona. I'm glad to hear that you're getting treatment and that you're off of Ambien. I hope that the program turns out to be a good one. I will be interested to hear about what it's like, what they focus on, etc. I've known a few people who were in addiction treatment and would like to find out how your program is similar and different to the ones I've heard about.
Seroquel is an odd choice for insomnia, but I have had refractory insomnia related to depression, and at one point I did try Seroquel. My experience was that I had to raise the dose every couple days because I became tolerant to the sedative effect. (This is a common problem for me with sedative-hypnotic drugs; the thing I love about Ambien is the lack of tolerance, for me at least.)
> I have to be without ambien for at least two days so that is why I cannot start program until next week. I tried to not take any last night and wound up forcing my husband to give me one. Poor man--he does not know what to do.
Why the "at least two days" rule? Anyway, you should tell your husband not to give you any Ambien, no matter what you say later. Get him to hide it, or throw it away.
> Anyway, I saw psych today and am going to try 200mg of seroquel at night to relax and sleep. Any body have any input about the seroquel?
I agree with Chris that 200 mg is a pretty high starting dose. Expect it to hit you like a rock, but it takes a while to kick in. (Chris: still giggling about your report of Seroquel abuse!) Also, some people feel lousy on dopamine antagonists, although many just find them sedating.
> I am still taking 60mg day of prozac. I have a constant headache and sick feeling, but I guess it will get better--I pray it will get better.
What sort of sick feeling? Is it caused by the Prozac? What dose were you taking before the 60?
-elizabeth
Posted by mdertinger on February 22, 2002, at 15:34:04
In reply to My ambien saga--where I am now--info on Seroquel, posted by Dona on February 21, 2002, at 17:59:35
How long have you been on the Prozac. Those are classic Prozac side effects which will go away for most people in 2-3 weeks.
So Ambien is addictive? I was thinking of asking my pdoc for some.
Posted by Emme on February 22, 2002, at 17:05:02
In reply to My ambien saga--where I am now--info on Seroquel, posted by Dona on February 21, 2002, at 17:59:35
Hi Donna,
I've used seroquel to help me sleep through the night. I personally only needed a flea-sized dose of 12.5 mg. At first I felt the sedative effect strongly. That lessened, but it still helped me sleep through the night. If I take too much, I'm groggy until early afternoon of the next day, but otherwise, I've liked it. I've also experimented a couple of times with using a crumb to two of serquel (and I do mean crumb) for extreme anxiety during the day when I didn't want to knock myself out by taking more klonopin than I'm used to, and that definitely seems to help.
I hope the seroquel helps you and I wish you the best of luck with your program.
Emme> To all those who remember my post a few weeks ago about my ambien addiction, I confessed to my therapist and psych. and am starting an intensive outpatient program next week. I guess that is good news because I will get this demon out of my life, but right now I am an anxious mess. I have to be without ambien for at least two days so that is why I cannot start program until next week. I tried to not take any last night and wound up forcing my husband to give me one. Poor man--he does not know what to do.
> Anyway, I saw psych today and am going to try 200mg of seroquel at night to relax and sleep. Any body have any input about the seroquel? I am still taking 60mg day of prozac. I have a constant headache and sick feeling, but I guess it will get better--I pray it will get better.
Posted by susan C on February 22, 2002, at 21:01:35
In reply to Re: My ambien saga--where I am now--info on Seroquel, posted by mdertinger on February 22, 2002, at 15:34:04
Posted by Elizabeth on February 22, 2002, at 22:48:42
In reply to Re: My ambien saga--where I am now--info on Seroquel, posted by mdertinger on February 22, 2002, at 15:34:04
> So Ambien is addictive? I was thinking of asking my pdoc for some.
Some people get addicted, yes. I think it's rare. (Ambien is used as a "party drug" in some circles.) If you're not generally predisposed to addictions, and if you don't abuse the drug, I think you're unlikely to get hooked on Ambien. Ambien causes little "physical addiction" (dependence). Most people don't develop tolerance (even after quite a long time), and withdrawal symptoms (if any) consist mainly of mild rebound insomnia.
-elizabeth
Posted by Ponder on February 23, 2002, at 15:44:06
In reply to Re: Ambien addictive? » mdertinger, posted by Elizabeth on February 22, 2002, at 22:48:42
I can't imagine! Unless it's a sleep-over where people actually want to sleep! :-)
> Some people get addicted, yes. I think it's rare. (Ambien is used as a "party drug" in some circles.) If you're not generally predisposed to addictions, and if you don't abuse the drug, I think you're unlikely to get hooked on Ambien. Ambien causes little "physical addiction" (dependence). Most people don't develop tolerance (even after quite a long time), and withdrawal symptoms (if any) consist mainly of mild rebound insomnia.
>
> -elizabeth
Posted by Gracie2 on February 24, 2002, at 23:26:37
In reply to Re: My ambien saga--where I am now--info on Seroquel, posted by Emme on February 22, 2002, at 17:05:02
It's not clear to me either why an anti-psychotic like Seroquel is prescribed for us non-psychotics.
I am taking 400 mg nightly as prescribed and it makes me groggy. During the first couple of weeks, the fatigue was just grueling. I was going to stop taking it but I noticed (rather it was pointed out to me) that the Seroquel actually has made a big difference.
Old Me: the Insomnia Queen arrives nearly every night. I went to great lengths to help myself sleep: melatonin, 5-HTP, Alluna, Benadryl, Nyquil, valerian, hot baths, a new mattress, counting sheep, waking early, avoiding naps, hypnosis tapes, and a sound machine that makes white noise (it also makes the sound of a heartbeat like something out of an Edgar Allan Poe story, which only creeped me out). My body just laughed at these pathetic attempts to make myself sleep. Eventually I started wearing sweatpants to bed because I knew that I would soon be up again and wandering the house like an exhausted ghost - waiting for sunrise, too exhausted to do anything constructive.New Me: 400 mg. of Seroquel will usually knock me out cold. I'm often in bed by 10:00 and sleep soundly for 8 hours - no trouble sleeping and no waking up in the middle of the night. The stuff MAKES you sleep but, curiously enough, it also
refuses to let you sleep late in the morning. There is still some lethargy when you wake up, but a few shots of Starbucks Espresso will take the edge off.An amusing anecdote: I felt well enough today to go to Barnes & Noble. I had a handful of bargain books when I spotted a new hardcover: Surviving Manic Depression. Since I've been diagnosed with this problem by two psychiatrists (the second doctor said that my symptoms were "classic"), I put away the other books to buy this one, along with a book for my husband that I found in the bargain aisle - the 2002 Gun Buyers' Guide. The cashier stared at my Manic Depressive book, then my Gun Buyers' book, and she looked up at me with such a worried expression that I busted out laughing.
When I went to see my psychiatrist for the first time in 6 months, he asked me sternly why I hadn't come in to see him earlier. I said, "I thought I was getting better and that I could handle my emotional problems on my own." I told him I was uncomfortable with the stigma associated with mental disease. He looked irritated and said, "Would you try to treat cancer or diabetes on your own? Do you think there's really a difference between seeking help for a physical or mental ailment?"
Well, damn Skippy there is. Particularly here in the Southern Midwest, where a majority of us have not evolved to the latest thinking. We still smoke, eat Big Macs, shun bottled water, love
deep-fried food, don't wear seatbelts, have gun collections, drive cars without vanity plates, and don't give a fiddler's fart about sushi, DNKY
or Tommy Hilfinger. In the same vein, anyone who seeks help from a psychiatrist is crazy.But I digress. The point is, if Seroquel can knock out this problem for a die-hard insomniac like me, it must be useful for others. I don't know about 400 mg daily - this seems excessive to my untrained mind. But even the lethargy is acceptable (to me, anyway) when the pay-off is deep, regular, wonderful sleep.
-Gracie
Posted by Kai on February 25, 2002, at 0:30:53
In reply to Re: My ambien saga--where I am now--info on Seroquel, posted by Gracie2 on February 24, 2002, at 23:26:37
Hhmm... Have a good night's sleep. Lucky I live Hawaii! (maybe you should check out Fast Food Nation at Barnes and Noble).
Posted by Elizabeth on February 25, 2002, at 0:45:36
In reply to Ambien a party drug?, posted by Ponder on February 23, 2002, at 15:44:06
> I can't imagine! Unless it's a sleep-over where people actually want to sleep! :-)
<g> No, seriously; some people get a kick out of sub-hypnotic doses of Ambien. My experience with this drug is that it makes it easy to get to sleep if I lie down, but it won't "knock me out" if I don't. A few times I've taken Ambien and then gotten distracted and stayed up. I got kind of goofy, but not tired. (And that's on my usual dose of 20 mg.)
-elizabeth
Posted by Elizabeth on February 25, 2002, at 2:00:32
In reply to Re: My ambien saga--where I am now--info on Seroquel, posted by Gracie2 on February 24, 2002, at 23:26:37
> It's not clear to me either why an anti-psychotic like Seroquel is prescribed for us non-psychotics.
Calling it an antipsychotic is misleading. It's a dopamine and serotonin receptor antagonist. Psychosis is just one of the conditions that can be treated with quetiapine. The "atypical antipsychotics" (including Seroquel) are used to treat nonpsychotic disorders such as depression (usually in conjunction with antidepressants), mania, obsessive-compulsive disorder, and behavioral disturbance in dementia and personality disorders (for example, symptoms of mood lability, suicidality, aggression, and dissociation in borderline personality disorder). And, as you've discovered, they can cure even the most refractory case of insomnia! (I had various ones -- olanzapine, risperidone, quetiapine, even older drugs like molindone and thioridazine --
thrown at me for a while when it was assumed that if 10 mg Ambien wouldn't work, then no dose would. They knocked me out all right -- the next day wasn't so great, though. With olanzapine and thioridazine, the sedation carried over well into the next day. Molindone caused this weird sleepiness accompanied by inability to sleep! Risperidal caused "REM rebound"-type sleep (sleep deprivation may have contributed to the REM rebound), despite the fact that I was taking Nardil which should have suppressed REM sleep completely. I don't remember any dreams from Seroquel, but I felt lousy the next day. I tried to stick it out with Seroquel, but I continued to feel lousy and kept having to increase the dose to get the same sedative effect. I didn't get up to 400 mg, though -- that's a pretty hefty dose, and I can see how it'd cause daytime grogginess if you started out on that much.BTW, I got a good laugh from your Barnes & Noble story! Thanks :-)
-elizabeth
Posted by Dona on February 25, 2002, at 11:34:12
In reply to Re: My ambien saga--where I am now--info on Seroquel, posted by Elizabeth on February 25, 2002, at 2:00:32
I appreciate the info. I am taking 200mg of Seroquel and I noticed that the first night I fell asleep right away, but not so since and I hate to keep raising the dose. I just don't think the docs realize how awful insomnia is. I would never have gotten so addicted to ambien if it were not for the insomnia and chronic arthritis pain. Anyway, I have been on prozac for years so I don't think it is a problem. I am trying an intensive program to stop the ambien but boy, I still miss it a lot!!
Posted by fachad on February 25, 2002, at 14:00:46
In reply to Re: My ambien saga--where I am now--info on Seroquel, posted by Dona on February 25, 2002, at 11:34:12
I saw and replied to your first post about the Ambien issue.
I'm glad to hear you are getting treatment for your problem.
I still think it would be worthwhile for you to ask your pdoc about doxepin for your insomnia. It is available in 10mg capsules, and you can take up to 300mg/day in extreme cases.
I knew someone who was treated for Xanax withdrawl with it, and she was told she could take a 10mg capsule every hour, all day, every day, if she felt she needed it (and that was still only 240mg/day, less than the max dose.
It works better than Ambien for keeping you alseep, although it takes longer than Ambien to make you fall asleep.
It's also very cheap, which is a plus compared to Ambien. It's not a controlled substance, and is not abusable.
Anyway, it would be worthwhile for you to ask you pdoc about it to see if you could try it since the Seroqual seems to not be totally effective for your insomnia.
Posted by Elizabeth on February 28, 2002, at 1:24:25
In reply to Re: My ambien saga - did you consider Doxepin? » Dona, posted by fachad on February 25, 2002, at 14:00:46
I'm sort of iffy about the doxepin idea. It is generally agreed to be the most sedating tricyclic, and lots of people use it to good effect for insomnia. But I don't see it being more effective or less likely to cause tolerance than Seroquel. I also think that doxepin is more likely to cause side effects (based on its binding profile), particularly if she has to keep increasing the dose.
I think Zyprexa might be worth a try. It seems to be more sedating than the other atypical antipsychotics (except Clozaril). The tolerance problem may still be an issue, of course. Another option would be to use one of the older antipsychotic drugs. I tried taking Mellaril -- an itty bitty dose of it, 10 mg I think -- one night, and I slept extremely well. The disadvantage is the risk of extrapyramidal symptoms, although this is dose-dependent (and Mellaril is among the least likely of the phenothiazines to cause EPS).
There are a lot of other things you could try. I could list a bunch of them if you want (I think I did recently in response to someone else's post, in fact).
BTW, a note to fachad:
> I knew someone who was treated for Xanax withdrawl with it, and she was told she could take a 10mg capsule every hour, all day, every day, if she felt she needed it (and that was still only 240mg/day, less than the max dose.
Tricyclic antidepressants are not very good for people who are in benzodiazepine withdrawal, IMO. A sedating anticonvulsant would have been my choice (possibly in conjunction with clonidine or guanfacine). TCAs lower the seizure threshold, which is bad for somebody who's in benzo withdrawal.
-elizabeth
Posted by fachad on February 28, 2002, at 14:43:00
In reply to Re: doxepin for insomnia?, posted by Elizabeth on February 28, 2002, at 1:24:25
My previous pdoc was very much against antipsycotics, and he always drilled into me the horror of tardive diskinesia and EPS.
He would generally let me try anything I asked for, but he would not let me try amoxapine (an old TCA similar to an AP) and he gave me the worst lecture ever about permanent disfigurement, etc. when I asked for it.
He even called my wife's GP to caution him about giving her too much Compazine for nausea and vomiting because of the potential for TD and EPS.
I am still amazed at how many people here who are not psychotic who take APs for sleep or to augment ADs.
Maybe my pdoc was just an AP-phobic, the way some docs are benzo-phobic.
> I'm sort of iffy about the doxepin idea. It is generally agreed to be the most sedating tricyclic, and lots of people use it to good effect for insomnia. But I don't see it being more effective or less likely to cause tolerance than Seroquel. I also think that doxepin is more likely to cause side effects (based on its binding profile), particularly if she has to keep increasing the dose.
>
> I think Zyprexa might be worth a try. It seems to be more sedating than the other atypical antipsychotics (except Clozaril). The tolerance problem may still be an issue, of course. Another option would be to use one of the older antipsychotic drugs. I tried taking Mellaril -- an itty bitty dose of it, 10 mg I think -- one night, and I slept extremely well. The disadvantage is the risk of extrapyramidal symptoms, although this is dose-dependent (and Mellaril is among the least likely of the phenothiazines to cause EPS).
>
> There are a lot of other things you could try. I could list a bunch of them if you want (I think I did recently in response to someone else's post, in fact).
>
> BTW, a note to fachad:
>
> > I knew someone who was treated for Xanax withdrawl with it, and she was told she could take a 10mg capsule every hour, all day, every day, if she felt she needed it (and that was still only 240mg/day, less than the max dose.
>
> Tricyclic antidepressants are not very good for people who are in benzodiazepine withdrawal, IMO. A sedating anticonvulsant would have been my choice (possibly in conjunction with clonidine or guanfacine). TCAs lower the seizure threshold, which is bad for somebody who's in benzo withdrawal.
>
> -elizabeth
Posted by tle333 on March 21, 2009, at 18:48:41
In reply to Re: doxepin for insomnia?, posted by Elizabeth on February 28, 2002, at 1:24:25
> I'm sort of iffy about the doxepin idea. It is generally agreed to be the most sedating tricyclic, and lots of people use it to good effect for insomnia. But I don't see it being more effective or less likely to cause tolerance than Seroquel. I also think that doxepin is more likely to cause side effects (based on its binding profile), particularly if she has to keep increasing the dose.
>
> I think Zyprexa might be worth a try. It seems to be more sedating than the other atypical antipsychotics (except Clozaril). The tolerance problem may still be an issue, of course. Another option would be to use one of the older antipsychotic drugs. I tried taking Mellaril -- an itty bitty dose of it, 10 mg I think -- one night, and I slept extremely well. The disadvantage is the risk of extrapyramidal symptoms, although this is dose-dependent (and Mellaril is among the least likely of the phenothiazines to cause EPS).
>
> There are a lot of other things you could try. I could list a bunch of them if you want (I think I did recently in response to someone else's post, in fact).
>
> BTW, a note to fachad:
>
> > I knew someone who was treated for Xanax withdrawl with it, and she was told she could take a 10mg capsule every hour, all day, every day, if she felt she needed it (and that was still only 240mg/day, less than the max dose.
>
> Tricyclic antidepressants are not very good for people who are in benzodiazepine withdrawal, IMO. A sedating anticonvulsant would have been my choice (possibly in conjunction with clonidine or guanfacine). TCAs lower the seizure threshold, which is bad for somebody who's in benzo withdrawal.
>
> -elizabethI got off doxepin about 4 months ago and haven't slept ONE NIGHT since. DO NOT take this if you don't need it, cuz getting off is far worse than ANY symptom you are experiencing now!! Also, I gained 25 pounds!!
This is the end of the thread.
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