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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by jerryTRD on December 6, 2010, at 1:17:47
I have to get off the 400mg of Seroquel I take for insomnia. It's causing havoc with my blood sugar levels and metabolism my endocrinologist tells me.
So I was thinking of asking my pdoc for a sedating tricyclic.
Can anyone list the most sedating ones?
Posted by ace on December 6, 2010, at 4:17:47
In reply to Most sedating tricyclics?, posted by jerryTRD on December 6, 2010, at 1:17:47
> I have to get off the 400mg of Seroquel I take for insomnia. It's causing havoc with my blood sugar levels and metabolism my endocrinologist tells me.
>
> So I was thinking of asking my pdoc for a sedating tricyclic.
>
> Can anyone list the most sedating ones?Good idea. I don't why doctors prescribe an anti-psychotic for insomnia, unless it is extremely sever and resistant to all other meds.
Clomipramine is the most sedative TCA in most people.
Posted by SLS on December 6, 2010, at 5:49:10
In reply to Re: Most sedating tricyclics? » jerryTRD, posted by ace on December 6, 2010, at 4:17:47
> > I have to get off the 400mg of Seroquel I take for insomnia. It's causing havoc with my blood sugar levels and metabolism my endocrinologist tells me.
> >
> > So I was thinking of asking my pdoc for a sedating tricyclic.1. Amitriptyline
2. Doxepin
- Scott
Posted by ace on December 6, 2010, at 6:11:48
In reply to Re: Most sedating tricyclics?, posted by SLS on December 6, 2010, at 5:49:10
> > > I have to get off the 400mg of Seroquel I take for insomnia. It's causing havoc with my blood sugar levels and metabolism my endocrinologist tells me.
> > >
> > > So I was thinking of asking my pdoc for a sedating tricyclic.
>
> 1. Amitriptyline
> 2. Doxepin
>
>
> - Scottwould you agree that 400mg Seroquel, to use soley for the purpose of insomnia, is a tad too extreme?
Posted by SLS on December 6, 2010, at 7:47:06
In reply to Re: Most sedating tricyclics? » SLS, posted by ace on December 6, 2010, at 6:11:48
> would you agree that 400mg Seroquel, to use soley for the purpose of insomnia, is a tad too extreme?
25-50mg works better for sleep than higher dosages.
- Scott
Posted by Phillipa on December 6, 2010, at 10:32:25
In reply to Re: Most sedating tricyclics?, posted by SLS on December 6, 2010, at 7:47:06
I once took 10mg of pamelor with other sleep meds and couldn't move on the bed. So for me pamelor was very sedative. Phillipa
Posted by ed_uk2010 on December 6, 2010, at 13:30:39
In reply to Re: Most sedating tricyclics? » jerryTRD, posted by ace on December 6, 2010, at 4:17:47
>Clomipramine is the most sedative TCA in most people.
Not usually. Amitriptyline and doxepin are usually a lot more sedating.
Posted by ed_uk2010 on December 6, 2010, at 13:32:39
In reply to Most sedating tricyclics?, posted by jerryTRD on December 6, 2010, at 1:17:47
>It's causing havoc with my blood sugar levels and metabolism my endocrinologist tells me.
To be honest Jerry, amitriptyline and doxepin generally aren't great for blood sugar either.
Posted by jerryTRD on December 6, 2010, at 20:40:03
In reply to Re: Most sedating tricyclics?, posted by SLS on December 6, 2010, at 7:47:06
> > would you agree that 400mg Seroquel, to use soley for the purpose of insomnia, is a tad too extreme?
>
> 25-50mg works better for sleep than higher dosages.
>
>
> - Scott
>
>Really? Because when I took it at that dosage I felt no sedation. Weird.
Posted by emmanuel98 on December 6, 2010, at 20:49:10
In reply to Most sedating tricyclics?, posted by jerryTRD on December 6, 2010, at 1:17:47
Is seroquel even sedating at 400mg? I found that low doses were sedating, but that effect wore off and higher doses were not sedating at all. Sorry about your problems with seroquel. All these AAPs can screw with your endocrine system. Have you tried trazadone. I find that works pretty well for sleep.
Posted by jerryTRD on December 6, 2010, at 20:54:14
In reply to Re: Most sedating tricyclics?, posted by emmanuel98 on December 6, 2010, at 20:49:10
> Is seroquel even sedating at 400mg? I found that low doses were sedating, but that effect wore off and higher doses were not sedating at all. Sorry about your problems with seroquel. All these AAPs can screw with your endocrine system. Have you tried trazadone. I find that works pretty well for sleep.
Seroquel used to be very sedating for me but now I seem to be somewhat tolerant to those effects.
Yes I've tried Trazodone and I really hated it.
Posted by ace on December 7, 2010, at 2:02:03
In reply to Re: Most sedating tricyclics?, posted by SLS on December 6, 2010, at 7:47:06
> > would you agree that 400mg Seroquel, to use soley for the purpose of insomnia, is a tad too extreme?
I'm going to answer my own question!
400mg Seroquel for insomnia is a stupid idea IMO.
I cannot see how it could be justifies, based on the information you gave me.
Posted by SLS on December 7, 2010, at 5:42:27
In reply to Re: Most sedating tricyclics? » SLS, posted by jerryTRD on December 6, 2010, at 20:40:03
> > > would you agree that 400mg Seroquel, to use soley for the purpose of insomnia, is a tad too extreme?
> >
> > 25-50mg works better for sleep than higher dosages.
> >
> >
> > - Scott
> >
> >
>
> Really? Because when I took it at that dosage I felt no sedation. Weird.You are definitely weird.
:-)
My ex-girlfriend found Seroquel to be stimulating at any dose.
- Scott
Posted by jerryTRD on December 7, 2010, at 16:56:57
In reply to Re: Most sedating tricyclics?, posted by ace on December 7, 2010, at 2:02:03
> > > would you agree that 400mg Seroquel, to use soley for the purpose of insomnia, is a tad too extreme?
>
> I'm going to answer my own question!
>
> 400mg Seroquel for insomnia is a stupid idea IMO.
> I cannot see how it could be justifies, based on the information you gave me.
>
>
Saw my pdoc today and told him I wanted to try a sedating TCA but he said they don't hold a candle to Seroquel. He wants me to remain on it for it's mood stabilizing properties AND for sleep. I told him that once it gets me to sleep that's ALL i want to do! Sleep for like 3-4 days! But he wasn't having any of it - even tho I told him I have never felt Seroquel to have any mood stabilizing effects.Anyway, we stopped the Lexapro and upped my EEffexor XR to 300mg. Then he asked about my sleep apnea and gave me Nuvigil to try for 7 days. I know it's basically the long-acting form of Provigil but I thought I'd give it a try. Ugh - make me hot and shaky at 150mg.
Then he said if 400mg Seroquel doesn't get me to sleep that he'd increase it!!!!!! NOOOO!!!!!! I want to be OFF the seroquel!!!! He did suggest Depakote as a replacement for Seroquel - which I am considering because I HATE Seroquel with a passion. It's keeping me asleep and away from life!
Posted by ace on December 11, 2010, at 0:01:05
In reply to Re: saw pdoc today..... » ace, posted by jerryTRD on December 7, 2010, at 16:56:57
> Saw my pdoc today and told him I wanted to try a sedating TCA but he said they don't hold a candle to SeroquelThat's hard to justify too. It depends on the dosages involved and the patients very unique response.
He wants me to remain on it for it's mood stabilizing properties AND for sleep.I told him that once it gets me to sleep that's ALL i want to do! Sleep for like 3-4 days! But he wasn't having any of it - even tho I told him I have never felt Seroquel to have any mood stabilizing effects.
ReallY? This doctor does not seem to be very big on compromise and patient input from what I can tell here.
> Anyway, we stopped the Lexapro and upped my EEffexor XR to 300mg.Gald about the Lexapro stopped.
Then he asked about my sleep apnea and gave me Nuvigil to try for 7 days. I know it's basically the long-acting form of Provigil but I thought I'd give it a try. Ugh - make me hot and shaky at 150mg.
>
> Then he said if 400mg Seroquel doesn't get me to sleep that he'd increase it!!!!!! NOOOO!!!!!! I want to be OFF the seroquel!!!!That's ridiculous. Especially in light of the prior comments you have made.
He did suggest Depakote as a replacement for Seroquel - which I am considering because I HATE Seroquel with a passion.GET OFF THIS DRUG. See another doctor if necessary. SLOWLY taper of this.
It's keeping me asleep and away from life!
That is not what a call a good therauputic response. maybe the doctor thinks so, but I don't think so, and you don't think so.
Does ANYONE who has read this think so???!!!Can you find another doctor without too much hassle (not necessarily a shrink)
Posted by jerryTRD on December 11, 2010, at 19:46:26
In reply to Re: saw pdoc today..... » jerryTRD, posted by ace on December 11, 2010, at 0:01:05
>
> > Saw my pdoc today and told him I wanted to try a sedating TCA but he said they don't hold a candle to Seroquel
>
> That's hard to justify too. It depends on the dosages involved and the patients very unique response.
>
>
> He wants me to remain on it for it's mood stabilizing properties AND for sleep.
>
>
>
> I told him that once it gets me to sleep that's ALL i want to do! Sleep for like 3-4 days! But he wasn't having any of it - even tho I told him I have never felt Seroquel to have any mood stabilizing effects.
>
>
> ReallY? This doctor does not seem to be very big on compromise and patient input from what I can tell here.
>
>
> > Anyway, we stopped the Lexapro and upped my EEffexor XR to 300mg.
>
> Gald about the Lexapro stopped.
>
> Then he asked about my sleep apnea and gave me Nuvigil to try for 7 days. I know it's basically the long-acting form of Provigil but I thought I'd give it a try. Ugh - make me hot and shaky at 150mg.
> >
> > Then he said if 400mg Seroquel doesn't get me to sleep that he'd increase it!!!!!! NOOOO!!!!!! I want to be OFF the seroquel!!!!
>
> That's ridiculous. Especially in light of the prior comments you have made.
>
>
> He did suggest Depakote as a replacement for Seroquel - which I am considering because I HATE Seroquel with a passion.
>
> GET OFF THIS DRUG. See another doctor if necessary. SLOWLY taper of this.
>
> It's keeping me asleep and away from life!
>
> That is not what a call a good therauputic response. maybe the doctor thinks so, but I don't think so, and you don't think so.
> Does ANYONE who has read this think so???!!!
>
> Can you find another doctor without too much hassle (not necessarily a shrink)
>
>I live in a small town and he's the only pdoc here. He isn't that bad of a pdoc, but sometimes he doesn't compromise - as you stated.
Maybe I should consider switching to Depakote? I don' t know much about it tho.
Posted by ed_uk2010 on December 12, 2010, at 11:52:21
In reply to Re: saw pdoc today..... » ace, posted by jerryTRD on December 11, 2010, at 19:46:26
Hi Jerry,
Why does your doctor want to give you Depakote? Depakote is useful for mania, but not depression or insomnia.
Posted by jerryTRD on December 13, 2010, at 23:21:02
In reply to Re: saw pdoc today..... » jerryTRD, posted by ed_uk2010 on December 12, 2010, at 11:52:21
> Hi Jerry,
>
> Why does your doctor want to give you Depakote? Depakote is useful for mania, but not depression or insomnia.
>
>Good question Ed. He made a big deal about Seroquel being a "mood stabalizer" even tho I told him it had never worked that way for me.
He's not that bad of a pdoc - but sometimes- like telling him Seroquel was making me want to sleep for days, etc - it goes in one ear and out the other.
I would think he'd want me on Lamictal for mood stabilization. I don't even know if I NEEd mood stabilization - my diagnosis is Major depressive Disorder - recurrent/chronic w/ Generalized Anxiety Disorder.
I dunno - I just hate that a person has control over my well-being and I have little input. But I'm in a small town and to find a pdoc in a neighboring city who has experience treating someone in my chronic state and who takes my insurance (Medicaid/Medicare) is slim.
No wonder I feel hopeless.
Posted by medamorphosis on December 16, 2010, at 17:23:24
In reply to Most sedating tricyclics?, posted by jerryTRD on December 6, 2010, at 1:17:47
> I have to get off the 400mg of Seroquel I take for insomnia. It's causing havoc with my blood sugar levels and metabolism my endocrinologist tells me.
>
> So I was thinking of asking my pdoc for a sedating tricyclic.
>
> Can anyone list the most sedating ones?Sorry, late on this, Ive tried all TCA and this is what I've found. unless you want the strong SRI effects of clomipramine, then amitriptyline def 2nd. Has an equal SRI/NRI ratio. trimipramine works totally diffent but is rather sadative effect. Corrects sleep for many, tho can cause nightmares in some (like me).To be taken all at night.
happy searching,
med
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