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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Novelagent on May 23, 2012, at 8:05:28
I've been off Effexor for 3 weeks now, and my sleep ranges from being zero hours to 7 hours... I have a resident, and residents don't like to prescribe meds for sleep-- not unless they're boring and don't work. But I'm trying to work with my doc, so I'm looking for ideas.
I've taken Seroquel for sleep before, and at a low dose (200mg? Not sure-- it was years ago)- it worked wonders. I'd try klonopin, but she won't prescribe that for a couple of months (long story). I'm on Invega Sustenna (similar to Risperdal Consta). Should I go with prn or nightly Seroquel as an add-on until I get better sleep naturally? Or something else?
It should be able to slow my body down-- it's not really that I need to be calmed down; it's more of a physiological thing. I have a self-hypnosis mp3, and it works when my body isn't in a tense spot like it is a lot when I oughtta be sleeping.
What's worse is that I'm now on Vyvanse, which means if I can't sleep until 3 or 4 at night like last night, I still have to wake up at 7 AM and can't take a nap with it. I've tried melatonin, but that will just make me yawn a bit, but won't affect the tense-like state I seem to be in some nights.
Posted by CaffeinePoet on May 23, 2012, at 8:27:17
In reply to Sedating non-SSRI for Effexor withdrawal?, posted by Novelagent on May 23, 2012, at 8:05:28
Are you new to the Vyvanse and still working on that dose? I wonder if it is too high.
Since melatonin didn't work and the doctor won't precribe sleep medications, can you try benadryl?
Posted by Phillipa on May 23, 2012, at 10:50:01
In reply to Re: Sedating non-SSRI for Effexor withdrawal? » Novelagent, posted by CaffeinePoet on May 23, 2012, at 8:27:17
And you require a stimulant? Phillipa
Posted by novelagent on May 23, 2012, at 16:44:25
In reply to Re: Sedating non-SSRI for Effexor withdrawal? » Novelagent, posted by CaffeinePoet on May 23, 2012, at 8:27:17
> Are you new to the Vyvanse and still working on that dose? I wonder if it is too high.
>
> Since melatonin didn't work and the doctor won't precribe sleep medications, can you try benadryl?
>Benadryl doesn't work-- I need something that knocks me out like Seroquel.
, and the insomnia persists even on days I'm not on a stimulant. I was on Dexedrine Spansules, 30mg/day until today, my first day of Vyvanse. I don't have anxiety or any of the other symptoms of amphetamine toxicity.
definitely need Vyvanse for ADD and negative symptoms.
Posted by CaffeinePoet on May 23, 2012, at 17:04:32
In reply to Re: Sedating non-SSRI for Effexor withdrawal?, posted by novelagent on May 23, 2012, at 16:44:25
> Benadryl doesn't work-- I need something that knocks me out like Seroquel.If the resident is willing to prescribe Seroquel, why not go with that?
Posted by bleauberry on May 24, 2012, at 19:13:29
In reply to Sedating non-SSRI for Effexor withdrawal?, posted by Novelagent on May 23, 2012, at 8:05:28
I'm not a fan of APs for sleep issues but hey if it works and you're ok with it then I don't see any problem in taking it. I think it might be important to be thinking of other pro-sleep substances as well, along with the med, with the goal of not needing the med any more at the earliest opportunity.
In terms of supplements I think some of the more helpful ones for me when I needed them were glycine, gaba, and magnesium. Sometimes I took just one and sometimes all. Combos usually work best because there is a good synergy. Niacinamide at high doses can help support good sleep.
In terms of herbs I would favor a combo of any 2 or 3 of these: skullcap, lemon balm, passionflower, valerian root.
None of these have the knockout power of meds but what they do is work in synergy to basically calm everything inside down so that sleep can happen. They relax and calm. Some of them have had clinical studies verifying their effects. But then, 2000 years of usage already knew that. The herbal teas that state on the package they are for sleep or insomnia probably don't have the power for what you need, but I do think it would be a good idea to have a cup maybe mid afternoon and another early evening because it will help to set the stage, biologically, for sleep.
200mg seroquel seems like a lot for what you need. I would think maybe 25mg would be a good first try.
Ok let's pretend you try it and you like. Now the first thing you want to do is get off the risperdal. Just seems to risky and unknown waters to me when some takes 2 antipsychotics at the same time for an extended period of time.
Posted by novelagent on May 26, 2012, at 9:35:00
In reply to Re: Sedating non-SSRI for Effexor withdrawal?, posted by bleauberry on May 24, 2012, at 19:13:29
I'm on Invega Sustenna, which is like Risperdal Consta, only it is dosed just once a month. Abilify just wrapped up their phase III testing of their once-monthly injection, so I guess that means they'll be able to sell (not to be confused with Abilify Injection, which is simply short-acting Abilify in Injection form).
My doc and I agree that I need a depot medication, because I'm on 70 mg of Vyvanse, so we can't risk me forgetting a dose.
Two antipsychotics are used all of the time, This is just until I get klonopin, which may take a few months, because it may require me switching docs to get it. My doc prescribes klonopin to other patients, but I once had not asked to refill my klonopin, and my clinic wondered how I was managing without the klonopin.
I'm not sure what made them think to call the pharmacy and ask, but they called the pharmacy and found I was being prescribed klonopin and Dexedrine by another doc. It was because the other doc would prescribe me Dexedrine, and they wouldn't at the time. I would sort of fill my klonopin from either doc, but trash the other doc's script alternately each time, so I wasn't doctor shopping-- in fact, had I been filling both, they wouldn't have called my pharmacy to ask what meds were being filled.
But even though I clarified this, my doc was just like "we'll see." She's a resident, and one thing I've noticed sbout residents is that they like to sit on things before making any changes to meds. Part of it is they like to confer with their supervising doc, but another part of it is they're not being paid by me, and have no incentive to keep me happy as a patient.
anyway, so I saw one doc who prescribed for my psychosis, and another doc who didn't know I had psychosis prescribed me Dexedrine, This was before Shire had studied Vyvanse for schizophrenia,
I've been conditioned to have insomnia, and if I take something that helps me sleep for a month, I'll break thst conditioning. I've done this before with Ambien-- a month into Ambien, I asked my doc not to give me anymore, and I was all set.
I paid $30 and $20 shipping for 2day USPS Express to receive 500g of Inositol powder. I get it today.
I'm going to take 12 grams of it each night for insomnia (crossing my fingers-- heard good reviews online) and post-SSRI sexual dysfunction. I've been off Effexor for 3 weeks now, and even though my urologist gave me Cialis, I can't get it up or have any remote interest in sex.
I've read two reviews of Inositol giving night-and-day differences for people with PSSD. One is a Doctor of Pharmacy who started it under the hypothesis it would re-sensitize 5HT-2A receptors. wish me luck, I'll report on the results,
I'd buy Valerian root and things, but I'm unemployed until a month from now. Buying citicoline and Inositol were a big deal. I'll be able to experiment with more stuff in a month, but I hope skullcap and such aren't all like $20 or $30 each, because I can"t afford to buy things that have a good risk of not working at that price. I bought the inositol because the theory is so good, and the citicoline because so much research has been done on citicoline (CDP choline) for cognitive impairment.
> I'm not a fan of APs for sleep issues but hey if it works and you're ok with it then I don't see any problem in taking it. I think it might be important to be thinking of other pro-sleep substances as well, along with the med, with the goal of not needing the med any more at the earliest opportunity.
>
> In terms of supplements I think some of the more helpful ones for me when I needed them were glycine, gaba, and magnesium. Sometimes I took just one and sometimes all. Combos usually work best because there is a good synergy. Niacinamide at high doses can help support good sleep.
>
> In terms of herbs I would favor a combo of any 2 or 3 of these: skullcap, lemon balm, passionflower, valerian root.
>
> None of these have the knockout power of meds but what they do is work in synergy to basically calm everything inside down so that sleep can happen. They relax and calm. Some of them have had clinical studies verifying their effects. But then, 2000 years of usage already knew that. The herbal teas that state on the package they are for sleep or insomnia probably don't have the power for what you need, but I do think it would be a good idea to have a cup maybe mid afternoon and another early evening because it will help to set the stage, biologically, for sleep.
>
> 200mg seroquel seems like a lot for what you need. I would think maybe 25mg would be a good first try.
>
> Ok let's pretend you try it and you like. Now the first thing you want to do is get off the risperdal. Just seems to risky and unknown waters to me when some takes 2 antipsychotics at the same time for an extended period of time.
Posted by former poster on June 1, 2012, at 23:39:43
In reply to Re: Sedating non-SSRI for Effexor withdrawal?, posted by novelagent on May 26, 2012, at 9:35:00
For benzodiazepine withdrawal insomnia I take Doxylamine. More sedating and longer lasting than Benedryl. On days when I have too much caffeine or I have to get to sleep early I add Ashwagandha and Melatonin to the Doxylamine. I don't think I could have ever gotten off of benzo's if it weren't for Doxylamine. Best of luck...
Posted by papillon2 on June 2, 2012, at 9:36:12
In reply to Re: Sedating non-SSRI for Effexor withdrawal? » novelagent, posted by former poster on June 1, 2012, at 23:39:43
Have you ever tried prescription Melatonin which has been compounded specifically for you? If not, this may be worth a shot. My psychiatrist says that the over the counter melatonin varies widely in efficacy so it's possible that you tried a not-so-good version. Doses up to 10mg have been studied.
Otherwise
- Immediate release Seroquel (quick knock out and on a lower dose than the ER version)
- Zyprexa
- Low dose Remeron (that is if you're not using "SSRI" as short-hand for any form of anti-depressant)
This is the end of the thread.
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