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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by nmk on September 24, 2002, at 11:47:12
Hi,
I am currently weaning off Effexor (down to 37.5 mg) , and will be off for good by next week. It was relatively painless with the exception of some nausea and vomitting. Two weeks ago, I started Lexapro, 10 mg, and have experienced severe insomnia these past four nights. My nighttime cocktail consists of 30 mg remeron and 25 mg seroquel which has worked quite well these past five months but now I don't know what to do. Could the insomnia be caused by the discontinuation of the Effexor or is it due to the Lexapro? If it is the Effexor, will it subside once I am off a few weeks? I am taking both in the am so I think the timing is right. I have a call into my doc and am hoping he calls before tonight....I need to be knocked out cold. Any advice would be helpful.
Thanks,
Nicole
Posted by Mystia on September 24, 2002, at 22:48:41
In reply to Severe insomnia...please help, posted by nmk on September 24, 2002, at 11:47:12
I can tell you that when I started Lexapro 10 mg/day, I had severe insomnia for 3-4 nights. Then it started getting better every night. Now, I have been on Lexapro for 1 week and 4 days, and the insomnia is completely gone. So, maybe it IS the Lexapro. I don't know anything about Effexor, so I can't say it's NOT that.
Myst
Posted by Bill L on September 25, 2002, at 8:25:16
In reply to Severe insomnia...please help, posted by nmk on September 24, 2002, at 11:47:12
I can think of a few alternatives:
1) Ask your doc if he thinks that lowering the dose of Remeron would help you sleep. I believe that Remeron has the paradoxical effect of making one more tired at a low dose than at a high dose.
2) Ask your doc for Ambien to take for a week or 2 as your body adjusts to the Lexapro.
3) Try Valerian at night for a couple weeks until you adjust to Lexapro. It helps a lot of people to fall asleep. It has a calming effect.
Posted by etoc on September 25, 2002, at 13:36:48
In reply to Re: Severe insomnia...please help, posted by Bill L on September 25, 2002, at 8:25:16
If you have already tried Ambien and/or trazodone. Nothing will knock you out at night quicker than 25mgs of Seroquel or 2.5 of Zyprexa. With some day-time fog being the major side-effect. This usually subsides after 1 week.
For me the Seroquel is a Godsend. It may also help, given the appropriate dosage, to potentiate certain antidepressants.
Posted by McPac on September 25, 2002, at 19:20:43
In reply to Severe insomnia...please help, posted by nmk on September 24, 2002, at 11:47:12
Low doses of Remeron (7.5-15 mg.) will give you a good night's sleep.
Posted by utopizen on September 25, 2002, at 20:58:10
In reply to Re: Severe insomnia...please help, posted by etoc on September 25, 2002, at 13:36:48
> For me the Seroquel is a Godsend.Unless it's also needed for other conditions, I would avoid using Seroquel for simply going to sleep when they are hundreds of other medications with sedating qualities.
I ussually take 1mg of Klonopin when I need to go to sleep, but this isn't very common (thank God- I only get 15mg of Klonopin every other month or so, and that's after begging for "emergency dosing."
When I don't think it's worth the scarce Klonopin supply I have, I try to rough it out with cheap antihystamines. If you want to know a little secret, the active ingredient in Benadryl is so sedating it's re-marketed as a sleeping aid OTC. Mine's Tylenol Sleep or something, but any benadryl or benadryl generic or sleep aid will typically be the same antihystamine.
Although that's generally what I use when I'm not tired now but know I will be soon and want to speed up the process... not exactly something that's going to win a fight with knocking down a stimulant (although I do remember taking 4 benadryls and it knocked me out of my Adderall dose so I could take a nap).
Posted by Gracie2 on September 26, 2002, at 23:47:14
In reply to Re: Severe insomnia...please help, posted by utopizen on September 25, 2002, at 20:58:10
I've had negative responses in the past to this suggestion, but Seroquel ended my insomnia after many terrible years of chronic sleeplessness. Since you are already taking a low dose of Seroquel, prehaps you could discuss a higher dosage with your psychiatrist if OTC sleep aids don't help you.
Seroquel is an anti-pyschotic and, I believed, used only for treatment of schizophrenia. I'm not pyschotic or schizophrenic, and Seroquel was not prescribed for my insomnia. It was prescribed for bipolar disorder, and it works very well. I take 400 mg at night, and it took me awhile to adjust to this dosage. I believed this was VERY high, but my pyschiatrist told me that some patients take 800 mg daily! For me, the best part is that I don't have to continually increase the dosage for it to remain effective.
Good luck to you, I know how miserable insomnia is.
-Gracie
Posted by nmk on September 27, 2002, at 10:52:56
In reply to Re: Severe insomnia...please help, posted by Gracie2 on September 26, 2002, at 23:47:14
Thank you for all of your advice, you are such a support to me. I talked to my doc and he increased the seroquel to 50 mg and reduced the remeron to 15 mg. Last night was the first night of sleep in awhile. At this point, I just need to do what works in getting through the effexor withdrawals, even if the seroquel is a questionable aid for sleep.
Posted by McPac on September 29, 2002, at 21:20:15
In reply to Re: Severe insomnia...please help, posted by nmk on September 27, 2002, at 10:52:56
nmk, I am using 7.5 mg. Remeron as a very effective, long-term sleep aid.
Good luck to you.
This is the end of the thread.
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