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Dr. Bob is Robert Hsiung, MD,
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Posted by ramji on May 25, 2008, at 8:17:40
I've tried to find this info on the internet with no luck so far ...
I'm currently on Wellbutrin 450mg, Abilify 10mg and Zoloft 50 mg. I'm having sleep issues ... I tend to sleep only 2 - 3 hours most days. My doc tried Seroquel, but I could not function the next day even on the smallest dose. Same with Trazadone.
I'm 52 years old and diagnosed with Bipolar disorder .... my doc said type 2 with mixed and rapid episodes. The hospital says type one.Here's the question. When I was younger (20's and 30's) I was on Elavil for depression. It worked well until I was stupid enough to wean myself. I understand it has been used in small doses for sleep disorders and headaches (?) .... is this an option for me?
I'm expecting to switch docs and wanted to ask here first.
Thanks,
Ramji
Posted by SLS on May 25, 2008, at 9:10:51
In reply to Sleep meds, posted by ramji on May 25, 2008, at 8:17:40
If you want to stick with sedating tricyclics, you could go with doxepin (Sinequan) or trimipramine (Surmontil).
Are you trying to avoid benzodiazepines (Ativan, Restoril, Klonopin) and pseudobenzodiazepines (Lunesta, Ambien, Sonata)?
What other drugs are you taking?
- Scott
Posted by emme on May 25, 2008, at 9:22:03
In reply to Sleep meds, posted by ramji on May 25, 2008, at 8:17:40
> I'm currently on Wellbutrin 450mg, Abilify 10mg and Zoloft 50 mg. I'm having sleep issues ... I tend to sleep only 2 - 3 hours most days. My doc tried Seroquel, but I could not function the next day even on the smallest dose.
What is the smallest dose of Seroquel you have tried? I generally chop the 25 mg tabs into quarters.
emme
Posted by NewHampshireGuy on May 25, 2008, at 11:27:42
In reply to Sleep meds, posted by ramji on May 25, 2008, at 8:17:40
approximately how long do you guys think I should take seroquel before going to sleep? I am using it for sleep but would rather just take ambien or lunesta and klonopin. but I am diagnosed bipolar.
seems like the only thing seroquel has done to help that is make me a little more moody and flat/zombified but am going to give it a few more weeks to see if it shuts down the thoughts in my head/high energy to where i can sleep normally without anything...
does seroquel work that way? can it so called "rebalance" a chemical imbalance and help me sleep again
same thing happened with me years ago wear I all of a sudden got high energy and songs in head/racing thoughts and severe insomnia, and Effexor fixed it. but tried effexor again years later and had exact opposite affect of making everything worse
so I am just worried Seroquel really won't "balance" what I need it to in the way that Effexor did
can anyone take a minute to educate me or take a guess as to what might help? it would be VERY much appreciated!
Posted by Phillipa on May 25, 2008, at 11:45:52
In reply to Sleep meds, posted by ramji on May 25, 2008, at 8:17:40
Welcome to babble ramju see you are new. You've already gotten some info but what are the other meds you're currently on? Thanks Phillipa and welcome again.
Posted by X-ray on May 25, 2008, at 12:29:20
In reply to Sleep meds, posted by ramji on May 25, 2008, at 8:17:40
Hello Ramji,
I have been on Elavil for 36 years.
This drug is a very good sleep aid.
I take 50 mg in the evening.Elavil will certainly give you a good night's sleep.
The question is how this drug mixes with Wellbutrin and Abilify.I doubt that Elavil and Zoloft go well together.
You see, I have been on Elavil and Prozac for a couple of months.
That was the worst time in my life.Best of Luck,
X-ray
Posted by boltsdraggin on May 25, 2008, at 20:14:54
In reply to Re: Sleep meds, posted by X-ray on May 25, 2008, at 12:29:20
I've seen Elavil used with Abilify/Zoloft combo's. Elavil is an old tricyclic that has been used for years for depression, mood swings, chronic pain issues, and sleep aid. Seroquel..wow, to use it in addition to what you're already on seems a bit much. Too bad the Trazadone didn't work.
Posted by Molybdenum on May 25, 2008, at 20:20:22
In reply to Re: Sleep meds, posted by X-ray on May 25, 2008, at 12:29:20
Hi Ramji,
I've been taking one sleeping pill or another for 20 years. The best I've found so far are:
12.5mg Zolpidem CR - I've been taking this for years and have never built up a tolerance. I skip it occasionally when I feel I'm tired enough to fall asleep without it, and have felt no ill effects for "missing a dose". It is short acting, so no hangover effect the next day. Plus of all the benzos, I recall reading that it has the least negative impact on sleep. So highly recommended. Price-wise there's a generic now, so that's good too.
Mirtazapine has also been very good for me. I take it as an anti-depressant, but it has always been good at "knocking me out" without any hangover effects. Good news is that there's a generic for it too, plus the sleep inducing effects are obtained on the lowest doses. I recall reading that this drug has little negative impact on sleep too. So highly recommended. When I take it at 8pm, I am often asleep by 9pm. Sometimes I fall asleep watching TV - which is "not like me", hence it's "knock out" effect is not to be underestimated..!
Melatonin is good too and "natural", depending on your definition. I take 6-9mg of the "slow release" version at 6pm. Some people are very sensitive to it & need much less. If you have trouble falling asleep, you take the immediate release. If you have trouble staying asleep, take the slow release. It's very inexpensive. So again, highly recommended. If you're in the US I believe it's available without prescription. You can read more about it at http://www.melatonin.com.
Lastly, there's one I only discovered today "cyproheptadine". http://en.wikipedia.org/wiki/Cyproheptadine. Wiki says "cyproheptadine enhances sleep quality and quantity whereas benzodiazepines tend to decrease sleep quality". It may not be an option for you if it interferes with your other meds (I can't consider it on these grounds), but otherwise it sounds worthwhile trying.
Take Care & welcome to Babbleville :)
Molybdenum.
Posted by elanor roosevelt on May 25, 2008, at 22:31:15
In reply to Re: Sleep meds, posted by Molybdenum on May 25, 2008, at 20:20:22
ambien
it's not a bad sleep quality
half life is 5 hours or so
only rob is that you have to stay in bed and not stumble about and munch
many people abuse ambien to get high
but it's a stupid black-out kind of high and it wastes the med as there is a window of time for falling asleep and if you resist it you miss itso you get in bed, take the ambien and read a few pages of a novel and go to sleep
Posted by Jedi on May 26, 2008, at 2:35:03
In reply to Re: Sleep meds, posted by NewHampshireGuy on May 25, 2008, at 11:27:42
Hi,
I just use Seroquel for the histamine affect. 25mg knocks me out in about an hour. I've been taking it for over a year for this with no tolerance built up. There are some studies which suggest that adjunctive Seroquel at higher dosages can help with treatment resistant GAD.J Anxiety Disord. 2008 Mar 13.
Quetiapine as an adjunctive pharmacotherapy for the treatment of non-remitting generalized anxiety disorder: A flexible-dose, open-label pilot trial.
Link: http://www.ncbi.nlm.nih.gov/pubmed/18455360?
ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSumSeroquel is also being studied as an augmentation for ADs in treatment resistant depression:
Hum Psychopharmacol. 2007 Jan;22(1):1-9.
Effects of adjunctive antidepressant therapy with quetiapine on clinical outcome, quality of sleep and daytime motor activity in patients with treatment-resistant depression.
Link: http://www.ncbi.nlm.nih.gov/pubmed/17191266?ordinalpos=17&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSumIf I wake up in the middle of the night while taking just 25mg of Seroquel, I know for sure I am drugged. After eight hours sleep, I have a small residual hangover which is easily knocked out with about three cups of coffee.
Take care,
Jedi> approximately how long do you guys think I should take seroquel before going to sleep? I am using it for sleep but would rather just take ambien or lunesta and klonopin. but I am diagnosed bipolar.
>
> seems like the only thing seroquel has done to help that is make me a little more moody and flat/zombified but am going to give it a few more weeks to see if it shuts down the thoughts in my head/high energy to where i can sleep normally without anything...
>
> does seroquel work that way? can it so called "rebalance" a chemical imbalance and help me sleep again
>
> same thing happened with me years ago wear I all of a sudden got high energy and songs in head/racing thoughts and severe insomnia, and Effexor fixed it. but tried effexor again years later and had exact opposite affect of making everything worse
>
> so I am just worried Seroquel really won't "balance" what I need it to in the way that Effexor did
>
> can anyone take a minute to educate me or take a guess as to what might help? it would be VERY much appreciated!
Posted by garylee on May 26, 2008, at 17:59:56
In reply to Sleep meds, posted by ramji on May 25, 2008, at 8:17:40
> I've tried to find this info on the internet with no luck so far ...
>
> I'm currently on Wellbutrin 450mg, Abilify 10mg and Zoloft 50 mg. I'm having sleep issues ... I tend to sleep only 2 - 3 hours most days. My doc tried Seroquel, but I could not function the next day even on the smallest dose. Same with Trazadone.
> I'm 52 years old and diagnosed with Bipolar disorder .... my doc said type 2 with mixed and rapid episodes. The hospital says type one.
>
> Here's the question. When I was younger (20's and 30's) I was on Elavil for depression. It worked well until I was stupid enough to wean myself. I understand it has been used in small doses for sleep disorders and headaches (?) .... is this an option for me?
>
> I'm expecting to switch docs and wanted to ask here first.
>
> Thanks,
>
> Ramji
Hi Ramji, and welcome to Babble! :O)What does of Seroquel were you taking? I was taking 25mg along with 0.5mg Clonazepam, crushed, for over 4 yrs. The Seroquel was only used for it's drowsiness side effects, not it's antipsycotic properties.
The Seroquel knocked me out within about 30 - 40 minutes (especially when crushed) and the Clonazepam kept me under for a good 6 -7 hours.
My only quarm with it has been since I have doubled the dose on both is the weight gain. I awake alot during the night to eat carbs... BUT, at least I can get some sleep. With out these two meds I would not be able to sleep for days, literally.
Hope this helps?
Gary
Posted by blueboy on May 28, 2008, at 9:36:10
In reply to Sleep meds, posted by ramji on May 25, 2008, at 8:17:40
> I've tried to find this info on the internet with no luck so far ...
>
> I'm currently on Wellbutrin 450mg, Abilify 10mg and Zoloft 50 mg. I'm having sleep issues ... I tend to sleep only 2 - 3 hours most days. My doc tried Seroquel, but I could not function the next day even on the smallest dose. Same with Trazadone.
> I'm 52 years old and diagnosed with Bipolar disorder .... my doc said type 2 with mixed and rapid episodes. The hospital says type one.
>
> Here's the question. When I was younger (20's and 30's) I was on Elavil for depression. It worked well until I was stupid enough to wean myself. I understand it has been used in small doses for sleep disorders and headaches (?) .... is this an option for me?
>
> I'm expecting to switch docs and wanted to ask here first.
>I don't know much. It seems like kind of strange drugs to be taking for bipolar, to me, but again . . .
I'm BP II and antidepressants keep me awake, too. I was on them for years and decades with no success. What I think they did to me was to induce more or less ongoing hypomania, which is NOT good even though it feels good. But prolonged lack of sleep has got to be bad for your health.
For me, Klonopin (2.5 to 3 mg, body weight 230 lbs) seems to have a great effect on manic-type episodes. Great sleep and it tends to stop the episode.
Ambien puts me to sleep just fine for 4 or 5 hours and works really fast. The problem is, if you are actually bipolar -- well, in my case, I will sleep but if the episode is bad enough, it's sometimes a very weird and unsatisfactory sleep. At other times, for simpler insomnia, I get good sleep from Ambien. Like if my mind is not spinning completely out of control.
Posted by garylee on May 29, 2008, at 14:25:43
In reply to Re: Sleep meds, posted by blueboy on May 28, 2008, at 9:36:10
Hi Blueboy
First off, it's a very well known fact that Bipolar's (especially type II/NOS like me) should NEVER take antidepressants, especially SSRI's. You will experience periods of none or small amounts of sleep as the SSRI will make you hypomanic, almost without a doubt.
I was first diagnosed Bipolar back in 2000 after a 6 week trial on Prozac. I had no response whilst on it, but almost as soon as I came off I was hypomanic for the first time for a good few weeks. The med had triggered rapid cycling in me and after the hypomanic spell I hit the worst depression of my life, I was suicidal for a good while too. I was in a dark place. It was especially bad as I was spending the summer in Ibiza, constant sun, sand, sea, girls, clubbing. I wanted to stay in bed all day... That isn't normal.
Anyhow, I have got a little better since then, by no way near remission but it is manageable now. I'd recommend taking a mood stabilizer such as Lamictal (a standard Bipolar MS). I also recommend Sulpiride, just a low dose, has very handy antidepressant qualities at around 100mgh - 200mg and also helps with general anxiety and social phobia.
For sleep I take Seroquel (50mg) and Clonazepam (1mg), without this combo I could go for days without any sleep, just the way my brain works. I'm looking for a med to replace Seroquel because of the weight gain, but it'll do for now.
Bipolar II's seem to react well to Dopaminergics, especially DA's such as Pramipexole and Ropinerole. I was almost in remission after a experiment with Pramipexole, long story, but I changed meds and second time round it didn't work.
I could ramble on more, but I should let you get a comment in! What are your current meds?
Gary
Posted by Molybdenum on May 29, 2008, at 19:02:06
In reply to Re: Sleep meds, posted by blueboy on May 28, 2008, at 9:36:10
Hi blueboy,
if the Ambien works to get you to sleep but just doesn't last long enough, have you tried adding some Melatonin (slow release)..? It's really cheap too.
I had this particular sleep prob & adding melatonin worked for me. You can fine tune the dose and it doesn't cause me any hangover the next day. Because it's "natural", I wouldn't expect it to interfere with your other meds.
Take Care :)
Mr. Be Damned.
Posted by blueboy on May 31, 2008, at 10:04:36
In reply to Re: Sleep meds » blueboy, posted by Molybdenum on May 29, 2008, at 19:02:06
> Hi blueboy,
>
> if the Ambien works to get you to sleep but just doesn't last long enough, have you tried adding some Melatonin (slow release)..? It's really cheap too.
>
> I had this particular sleep prob & adding melatonin worked for me. You can fine tune the dose and it doesn't cause me any hangover the next day. Because it's "natural", I wouldn't expect it to interfere with your other meds.
>I'm not having sleep problems right now. But I do have melatonin and L-tryptophan in my medicine cabinet and I'll be sure to give them both a try next time I get into an insomnia mode.
Posted by blueboy on May 31, 2008, at 10:13:32
In reply to Re: Sleep meds @ Blue boy, posted by garylee on May 29, 2008, at 14:25:43
> Hi Blueboy
>
> First off, it's a very well known fact that Bipolar's (especially type II/NOS like me) should NEVER take antidepressants, especially SSRI's. You will experience periods of none or small amounts of sleep as the SSRI will make you hypomanic, almost without a doubt.
>
> I was first diagnosed Bipolar back in 2000 after a 6 week trial on Prozac. I had no response whilst on it, but almost as soon as I came off I was hypomanic for the first time for a good few weeks. The med had triggered rapid cycling in me and after the hypomanic spell I hit the worst depression of my life, I was suicidal for a good while too. I was in a dark place. It was especially bad as I was spending the summer in Ibiza, constant sun, sand, sea, girls, clubbing. I wanted to stay in bed all day... That isn't normal.
>
> Anyhow, I have got a little better since then, by no way near remission but it is manageable now. I'd recommend taking a mood stabilizer such as Lamictal (a standard Bipolar MS). I also recommend Sulpiride, just a low dose, has very handy antidepressant qualities at around 100mgh - 200mg and also helps with general anxiety and social phobia.
>
> For sleep I take Seroquel (50mg) and Clonazepam (1mg), without this combo I could go for days without any sleep, just the way my brain works. I'm looking for a med to replace Seroquel because of the weight gain, but it'll do for now.
>
> Bipolar II's seem to react well to Dopaminergics, especially DA's such as Pramipexole and Ropinerole. I was almost in remission after a experiment with Pramipexole, long story, but I changed meds and second time round it didn't work.
>
> I could ramble on more, but I should let you get a comment in! What are your current meds?
>
> Gary
>I was just diagnosed BP II a week or two ago. I dropped a chunk of change to see a diagnostic specialist at a research facility. I could bean my pdoc, although he's a good guy and I'm sure he's feeling embarrassed at bit (and he is, after all, the one who suggested the assessment/second opinion).
Yeah the SSRI's were rough on me. After very bad episodes with Wellbutrin and Effexor, I developed a solid case of restless leg syndrome. I don't know if they "caused" it or not, but I suspect some connection because -- well, because it feels exactly like the seizures I got from the Wellbutrin.
I started Lamactil 7 days ago, 25mg for two weeks then will go to 50mg and visit my pdoc after four weeks at 50.
BTW I had a crappy day yesterday, as I broke out in a weird rash and was really bummed out, since I have high hopes for the lamotrigine (after decades of antidepressant treatment and dozens of drugs). PLUS my dermatologist was out of town. But her partner skipped lunch to see me and said she was 100% sure it wasn't Stevens-Johnson and fairly sure it wasn't a reaction to the drug at all. She did a biopsy to make sure it was some sort of contact dermatitis rather than a side effect.
This is the end of the thread.
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