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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 32. This is the beginning of the thread.
Posted by ronaldo on October 5, 2006, at 5:33:57
Hi, I've been taking Seroquel for the past two weeks for insomnia without any success. I go to sleep straight away but wake after four or five hours. I have been taking 50 mg at night. I did try 100 mg for four nights but also without any success. Has anyone had a similar experience?
I also take 900 mg of Lithium at night for bipolar.
I may give it another seven nights. If it still doesn't work I will taper off.
I think treatment of insomnia is an off label use of Seroquel so I guess it doesn't work every time. Can anyone please share some information on this?
Posted by Phillipa on October 5, 2006, at 10:46:06
In reply to Seroquel for sleep - doesn't work, posted by ronaldo on October 5, 2006, at 5:33:57
My Daughter takes 50mg and wakes in fours hours too. Does anyone know the longivity of a dose? Love Phillipa
Posted by ronaldo on October 7, 2006, at 3:03:09
In reply to Re: Seroquel for sleep - doesn't work » ronaldo, posted by Phillipa on October 5, 2006, at 10:46:06
> My Daughter takes 50mg and wakes in fours hours too. Does anyone know the longivity of a dose? Love Phillipa
According to this chart http://sl.schofield3.home.att.net/medicine/psychiatric_drugs_chart.html
Seroquel only has a half life of SIX HOURS. That might explain why after taking it at 9.30 pm and going to sleep at 11.00 pm I am awake again at 4.00 am or 5.00 am. Should I take some more at that point?Thanks to prodgirl for the link to the chart.
Posted by yxibow on October 7, 2006, at 4:52:37
In reply to Re: Seroquel for sleep - doesn't work, posted by ronaldo on October 7, 2006, at 3:03:09
> > My Daughter takes 50mg and wakes in fours hours too. Does anyone know the longivity of a dose? Love Phillipa
>
> According to this chart http://sl.schofield3.home.att.net/medicine/psychiatric_drugs_chart.html
> Seroquel only has a half life of SIX HOURS. That might explain why after taking it at 9.30 pm and going to sleep at 11.00 pm I am awake again at 4.00 am or 5.00 am. Should I take some more at that point?
>
> Thanks to prodgirl for the link to the chart.
No, actually most people who take Seroquel as a neuroleptic take it once at night because it has HUGE effects at H1, and for those who have schizophreniform or bipolar (which I dont) disorders, the profile is almost usually, but not always sufficient for once daily. Trust me, 800mg at night and I'm out.The Lithium may be creating a hyper-insomnia situation, I wouldn't be surprised. You might need a larger dose if you're considering Seroquel as a sleep agent, although at that point it is exhibiting a serotonergic profile.
Have you tried Ambien at 20mg or Lunesta at 3-4mg ?
Posted by ronaldo on October 7, 2006, at 7:28:38
In reply to Re: Seroquel for sleep - doesn't work » ronaldo, posted by yxibow on October 7, 2006, at 4:52:37
I am taking Seroquel for sleep. I haven't tried either Ambien or Lunesta. Maybe me pdoc will prescribe one of them. I think I will begin to taper off the Seroquel. I've given it a fair trial and it doesn't work. 16 days altogether, mostly at 50 mg but did try 100 mg for four days which still didn't make me sleep. I will cut down to 25 mg for five days and then stop it. Is this advisable? I don't tolerate Seroquel very well. It makes me feel like sh*t during the day and then when the sun goes down I start to feel better. This is also the result of only four or five hours sleep the night before.
Posted by yxibow on October 7, 2006, at 16:34:15
In reply to Re: Seroquel for sleep - doesn't work » yxibow, posted by ronaldo on October 7, 2006, at 7:28:38
> I am taking Seroquel for sleep. I haven't tried either Ambien or Lunesta. Maybe me pdoc will prescribe one of them. I think I will begin to taper off the Seroquel. I've given it a fair trial and it doesn't work. 16 days altogether, mostly at 50 mg but did try 100 mg for four days which still didn't make me sleep. I will cut down to 25 mg for five days and then stop it. Is this advisable? I don't tolerate Seroquel very well. It makes me feel like sh*t during the day and then when the sun goes down I start to feel better. This is also the result of only four or five hours sleep the night before.
Yeah.. 5 days, maybe a little longer, you haven't been on the medication very long. You may have insomnia withdrawals even though it didn't work for you but I don't think anything adverse, personally. Offlabel medications like Seroquel and Trazodone tend to make you feel like "sh*t" during the day because of the hangover effect from an antihistamine or similar sedative action.
I would be prepared that your psychiatrist might not be open to either Lunesta or Ambien but try to make a case for them. They have both been in use for long term in a number of patients. And I believe that medication intended for sleep is the best medication. The only other one that is off label that I would recommend is a very small dose of Remeron, but that tends to make people gain weight very rapidly. A few dont.
Posted by Phillipa on October 7, 2006, at 20:06:12
In reply to Re: Seroquel for sleep - doesn't work » yxibow, posted by ronaldo on October 7, 2006, at 7:28:38
Ronaldo you didn't include your diagnosis. Are you on a mood stabalizer? As Bipolar you said you are in a manic stage didn't you? So maybe call the pdoc before cutting down. you may need more not less. Love Phillipa. Shoot me an e-mail.
Posted by ronaldo on October 8, 2006, at 7:58:55
In reply to Re: Seroquel for sleep - doesn't work » ronaldo, posted by yxibow on October 7, 2006, at 16:34:15
Paradoxically it seems that Seroquel, while it puts me to sleep quickly, it does so for only four or five hours and then it seems to STOP me from going back to sleep again, ie it keeps me awake. Is this something to do with its six hour half life? Is it possible that when I come off Seroquel completely that while I may have more difficulty in going to sleep that once asleep I will sleep right through until say 7.00 am?
My original sleep problem was due to coming off Zyprexa - withdrawal. I have now been completely off Zyprexa for two weeks. I had early awakening problems with Zyprexa before I started to come off it. While I was coming off it this got worse and I started waking up at 2.00 am and 3.00 am. After starting Seroquel this improved to 4.00 am and 5.00 am. I took the Seroquel to help me with the insomnia caused by the Zyprexa withdrawal. I want to see what I am like when I am completely free of anti-psychotics. My dx is Bipolar in remission so I hope I don't go high...
Paradoxically I started on Zyprexa to help me sleep. It worked beautifully for about 18 months and then the early awakening started. I would only recommend Zyprexa for sleep in the short term, say six months or best used only occasionally eg. weekends. 5 mg of Zyprexa used to send me to sleep for 12-14 hours when I was first taking it. 2.5 mg gave a very beneficial 8 hours.
Posted by craiggetty on October 8, 2006, at 18:35:03
In reply to Seroquel for sleep - doesn't work, posted by ronaldo on October 5, 2006, at 5:33:57
25 mg of Seroquel 2 hours before bed is enough to put me out. And I also often wake up 5 hours later. But when I take 50-75mg I do sleep through the night. Sometimes I'll take the 25mg with a couple of beers though I don't necessarily recommend it.
Other sleep meds I've tried:
Sonata: Only worked for 4 hours at maximum dose.
Trazadone: I often woke up in the middle of the night. Even when I slept throught the night I felt like I had a hangover in the morning.
Remeron: Didn't always sleep through the night, or when I took enough to do so I'd have that morning hangover feeling.
Posted by cache-monkey on October 9, 2006, at 14:40:44
In reply to Re: Seroquel for sleep - doesn't work, posted by craiggetty on October 8, 2006, at 18:35:03
I think that Seroquel's sleep benefits might be better at *lower* doses at which it's mainly an anti-histamine. Higher doses leads to noradrenergic effects which could "burn" through the antihistamine drowsiness. I'm on it at 12.5 mg and am finding I sleep better and longer than when I was on 50 mg.
Good luck,
cache-monkey
Posted by yxibow on October 9, 2006, at 18:37:03
In reply to Re: Seroquel for sleep - doesn't work, posted by cache-monkey on October 9, 2006, at 14:40:44
> I think that Seroquel's sleep benefits might be better at *lower* doses at which it's mainly an anti-histamine. Higher doses leads to noradrenergic effects which could "burn" through the antihistamine drowsiness. I'm on it at 12.5 mg and am finding I sleep better and longer than when I was on 50 mg.
>
> Good luck,
> cache-monkeyIts an antihistamine at any dose, trust me...
I might be more used to 800mg at bedtime than others but it is still fatigue making as at this point in my life I can't drink cups of lattes.-- Jay
Posted by ronaldo on October 10, 2006, at 9:20:36
In reply to Re: Seroquel for sleep - doesn't work, posted by cache-monkey on October 9, 2006, at 14:40:44
> I think that Seroquel's sleep benefits might be better at *lower* doses at which it's mainly an anti-histamine. Higher doses leads to noradrenergic effects which could "burn" through the antihistamine drowsiness. I'm on it at 12.5 mg and am finding I sleep better and longer than when I was on 50 mg.
>
> Good luck,
> cache-monkeyThanks cache-monkey,
That is very interesting. I will try it at 12.5 mg. Some patients on www.askapatient.com report using such small doses. That will entail cutting a 25 mg tablet in half. Is that what you do? How many hours sleep do you get out of 12.5 mg?
...Alan
Posted by ronaldo on October 10, 2006, at 9:53:54
In reply to Re: Seroquel for sleep - doesn't work, posted by cache-monkey on October 9, 2006, at 14:40:44
> > I think that Seroquel's sleep benefits might be better at *lower* doses at which it's mainly an anti-histamine. Higher doses leads to noradrenergic effects which could "burn" through the antihistamine drowsiness. I'm on it at 12.5 mg and am finding I sleep better and longer than when I was on 50 mg.
> >
> > Good luck,
> > cache-monkey
>
> Thanks cache-monkey,
>
> That is very interesting. I will try it at 12.5 mg. Some patients on www.askapatient.com report using such small doses. That will entail cutting a 25 mg tablet in half. Is that what you do? How many hours sleep do you get out of 12.5 mg?
>
> ...AlanBTW what time do you take your 12.5 mg? and do you just take it with some water?
Posted by ed_uk on October 10, 2006, at 14:49:57
In reply to Re: Seroquel for sleep - doesn't work, posted by ronaldo on October 10, 2006, at 9:20:36
>That will entail cutting a 25 mg tablet in half
I use nail scissors to cut unscored tablets. Alternatively you can buy a tablet cutter for about 99p from a pharmacy.
Ed
Posted by ronaldo on October 11, 2006, at 6:09:00
In reply to Re: Seroquel for sleep - doesn't work » ronaldo, posted by ed_uk on October 10, 2006, at 14:49:57
Brave soul that I am last night I tried just 12.5 mg (down from 25 mg) of Seroquel with just my usual 900 mg of Lithium. I went to bed at 10 pm anticipating a blissful 8 hours sleep but it was not to be. I was awake at 2.30 am, went to sleep at 10.30 pm (say), which makes four hours sleep.
I did not go back to sleep. I awoke with a stuffy nose with an unpleasant chemical smell which gave me something akin to sleep apnea except I did not fall asleep; I was hovering on the brink of falling asleep when I would miss a breath and have to make a conscious effort to inhale. I get anxious when I think I cannot breath. I think it was all in my mind. Unpleasant nevertheless.
12.5 mg of Seroquel was not a wasted experiment. I cut the 25 mg in half with a Stanley blade. I have now reduced my Seroquel from 100 mg (4 days)to 75 mg (1 day) to 50 mg (7 days) to 25 mg (for 3 days)to 12.5 mg for 1 day. I am hoping I am now weaned off the Seroquel and can do without it. Any comments?
Tonight I may just take the 900 mg Lithium or I may take 7.5 mg of Zopiclone with it. It might be worth it to see how I sleep just on the Lithium now that I am free (at last) of the horrible anti-psychotics. Sorry that is just me and my experience and how I feel; I know that anti-psychotics really help some people.
Henceforth I will try to lead a life free of anti-psychotics - off label and on label. My chemist told me that the Seroquel taken with the Zopiclone would enhance the action of the Zopiclone but when I tried it on Monday night I only slept till 4.20 am and as always I did not go back to sleep. It was quite difficult getting to sleep as well - strange sensations in my head. So hopefully that is the end of the Seroquel for me. As far as the Zopiclone goes I think I may try one night on Lithium alone to give the Seroquel one extra day to clear my system (Seroquel and Zopiclone do not go well together in my experience) and then I might try Zopiclone and Lithium on Thursday night. I don't expect to sleep tonight with just the Lithium but I want to see what happens. So far I have been hooked on the Olanzapine then onto the Seroquel and now onto the Zopiclone. My GP says it is easy to get hooked on Zopiclone. Thats why he would only give me 14 of them. (14 x 7.5 mg)
I feel like I am entering the final battle of my two year campaign against insomnia. If only.
...Alan
Posted by ronaldo on October 11, 2006, at 9:27:48
In reply to Re: Seroquel for sleep - doesn't work, posted by ronaldo on October 11, 2006, at 6:09:00
Just spoke to my GP on the phone, nice man, very nice man. He told me not to take any more Seroquel but to take 2 X 7.5 mg Zopiclone tonight.
zzzzzzzzzzzzzzzzZOPICLONEzzzzzzzzzzzzzzzz... (i hope)
Posted by yxibow on October 11, 2006, at 10:40:46
In reply to Re: Seroquel for sleep - doesn't work, posted by ronaldo on October 11, 2006, at 6:09:00
My GP says it is easy to get hooked on Zopiclone. Thats why he would only give me 14 of them. (14 x 7.5 mg)
>
> I feel like I am entering the final battle of my two year campaign against insomnia. If only.
Good luck with the zopiclone. If your GP is part of NHS, BNF 52 always notes that these drugs can only be taken up to 4 weeks (I believe, when I last read it.)However, Lunesta in the US is approved for long term use, and contains what is essentially a patented generic drug. Zopiclone (Imovane) is a racemic mixture of two stereoisomers, only one of which is active (Lunesta).
This is all scientific folderal I know, for someone who just wants some sleep. I know the depths of insomnia myself. If I'm lucky I get 7 hours of sleep, even with Seroquel and 20mg of Ambien. I have no trouble falling asleep, its staying asleep. Sleep was better and almost psychedelic under Remeron, however the sheer weight gain was a showstopper.To many zzs...
-- Jay
Posted by Phillipa on October 11, 2006, at 19:59:14
In reply to Re: Seroquel for sleep - doesn't work, posted by yxibow on October 11, 2006, at 10:40:46
Jay save some of your sleep med and when you wake-up before you're ready take it then. That's what I do. Love Phillipa
Posted by yxibow on October 12, 2006, at 2:07:35
In reply to Re: Seroquel for sleep - doesn't work » yxibow, posted by Phillipa on October 11, 2006, at 19:59:14
> Jay save some of your sleep med and when you wake-up before you're ready take it then. That's what I do. Love Phillipa
You can -- but you run the risk of sleepwalking while awake in a sense. All pseudobenzodiazepines warn that you should have 7-8 hours of sleep. If you wake up with 6h45m of sleep and take another Ambien, you'll be tripping the lights fantastic when your alarm goes off. A smidgen of Seroquel might be different but you'll still be groggy, trust me. At least for me anyhow.
-- Jay
Posted by ronaldo on October 12, 2006, at 4:40:14
In reply to Re: Seroquel for sleep - doesn't work, posted by ronaldo on October 11, 2006, at 9:27:48
Well last night about 8.00 pm I could not stand the anxiety any more and so I took 12.5 mg of Seroquel. That seemed to do the trick. I had horrible visions of me getting a stuffy nose with my Zopiclone and having panic attacks because I thought I couldn't breathe. My anxiety centres around my breathing - I have no problem with my breathing, I am perfectly healthy in that respect - I just have a phobia of suffocating.
I took the two Zopiclone about 9.30 pm and I was asleep by 10.30. I woke up at 3.30 am and lay awake until 7.00. Zopiclone seems to be quite a clean drug. I experienced none of the anxiety I had with the Seroquel. No bitter metallic taste in the mouth. Lying awake from 3.30 to 7.00 I felt wrapped in a warm and pleasant drowsiness. Now that I am up I feel quite refreshed, just a slight sedating hangover.
Tonight if the Seroquel anxiety leaves me alone I will try two Zopiclone on their own (with my normal 900 mg of Lithium). Does anyone think it is possible that the Seroquel, even at 12.5 mg, is overwriting its signature on the Zopiclone and making me wake up at 3.00? Or is it more likely that I am so used to waking at 3.00 my body does not know any different? Does anyone think there will be an improvement, ie sleep beyond 4.00 am, if I don't take the Seroquel? I am hoping to come off the Seroquel and to stay off it.
...Alan
Posted by Phillipa on October 12, 2006, at 18:41:01
In reply to Re: Seroquel for sleep - doesn't work, posted by ronaldo on October 12, 2006, at 4:40:14
For me its usually four hours and awake. And no hangover or drozziness from taking a messily 5mg of valium? I used to years ago take 5mg of valium with 450mg of mephrobamate every morning when I got up taking care of three kids. Repeat the 5mg of valium around lpm. Drive my Son to Nursery School and felt great. Went shopping or whereever I wanted to go. And then at bed time another 5mg of valium. At that time usually three beers too. It's just me. My body wakes up after 4-5hours. In the hospital that's how I got in trouble. They gave me 20cc of chloral hydrate, xanax, klonopin, and 50mg of seroquel. When I woke up the orders were to give me 50mg more of seroquel. Mind you this is the first I'd ever taken this med. And in the morning I almost fainted. Tried to talk could think the words . Nothing came out of my mouth. The staff put me back to bed. I'm not a coffee drinker cause of anxiety. But the charge nurse went to the cafeteria and bought me a large cup . I drank it and the doc dc'd the med that day. That was my experience. But my current regime causes no problem at all. Love Phillipa
Posted by ronaldo on October 18, 2006, at 16:51:52
In reply to Re: Seroquel for sleep - doesn't work » ronaldo, posted by Phillipa on October 12, 2006, at 18:41:01
> For me its usually four hours and awake. And no hangover or drozziness from taking a messily 5mg of valium? I used to years ago take 5mg of valium with 450mg of mephrobamate every morning when I got up taking care of three kids. Repeat the 5mg of valium around lpm. Drive my Son to Nursery School and felt great. Went shopping or whereever I wanted to go. And then at bed time another 5mg of valium. At that time usually three beers too. It's just me. My body wakes up after 4-5hours. In the hospital that's how I got in trouble. They gave me 20cc of chloral hydrate, xanax, klonopin, and 50mg of seroquel. When I woke up the orders were to give me 50mg more of seroquel. Mind you this is the first I'd ever taken this med. And in the morning I almost fainted. Tried to talk could think the words . Nothing came out of my mouth. The staff put me back to bed. I'm not a coffee drinker cause of anxiety. But the charge nurse went to the cafeteria and bought me a large cup . I drank it and the doc dc'd the med that day. That was my experience. But my current regime causes no problem at all. Love Phillipa
Hi Phillipa,
Well I've given up on Seroquel now. I tried 12.5 mg and it almost put me to sleep. I lay on my bed and I could feel the whole room move but I didn't go to sleep. One s/e of Seroquel is a stuffy nose. Sounds trivial and quite harmless doesn't it? But coupled with a background mood of anxiety it turns quite nasty. I felt as if I couldn't breathe. If I breathed through my mouth I felt like I was hyperventilating. Unpleasant. The only relief I could get was by going outside for a walk around the block or down to the promenade and up along the beach.
I think I may have gone about it the wrong way. Instead of starting with 25 mg I should have begun with 12.5 mg or 6.25 mg. (Almost impossible to cut the 25 mg tablet accurately into these small amounts.) I think I may have had more luck with it by starting small.
In the end what happened is I went high, hyper-manic. I have a tentative diagnosis of Bi-polar. Whether this hyper-mania was due to coming off the 5 mg Olanzapine or a result of sleep deprivation I don't know. I came off the Olanzapine about a month ago, tapered off. On Sunday I was feeling so anxious I phoned the off-duty CPN (community psychiatric nurse) who advised me to take 5 mg of Olanzapine and discontinue the Seroquel. I took the 5 mg and it didn't work so I took 5 more, and then another 5 which made 15 mg altogether. I got my 8 hours sleep but it was quite broken but at least I got back to sleep again.
Monday my old pdoc prescribed me 10 mg of Olanzapine taken at night. I am getting 7 hours sleep on this medication. But I still feel tired and have dark rings around my eyes.
I guess I became hyper-manic and that caused me not to sleep. In the end I was screaming to myself inside my head. I wanted to come off Olanzapine and all that has happened is I have ended up on double the dose I was on before. I hope it makes me twice as well as I was on the original 5 mg. If I had got the Seroquel to work, ie got it to make me sleep, I would not be in this position. My new pdoc, who is away on holiday, prescribed 50 mg of Seroquel. If he had not gone on holiday I would have been able to discuss the Seroquel dosage with him. If he had told me he was going on holiday I could have phoned him before he left and gone through the pro's and con's of dosage with him. If, if, if...
I will stick with the 10 mg of Olanzapine now for the next 3 weeks to regain my sleep pattern. Then I see my social worker and we can discuss whether to stay on 10 mg or to bring it down.
...Alan
Posted by ed_uk on October 19, 2006, at 15:33:10
In reply to Re: Seroquel for sleep - doesn't work, posted by ronaldo on October 18, 2006, at 16:51:52
Hi Alan,
>I wanted to come off Olanzapine and all that has happened is I have ended up on double the dose I was on before
Do you think 7.5mg zopiclone might allow you to reduce your olanzapine back down to 5mg?
Ed
Posted by ronaldo on October 20, 2006, at 12:50:40
In reply to Re: Seroquel for sleep - doesn't work » ronaldo, posted by ed_uk on October 19, 2006, at 15:33:10
> Hi Alan,
>
> >I wanted to come off Olanzapine and all that has happened is I have ended up on double the dose I was on before
>
> Do you think 7.5mg zopiclone might allow you to reduce your olanzapine back down to 5mg?
>
> Ed
Hello Ed,The Zopiclone is only a temporary measure. My GP prescribed 14 x 7.5 mg but I don't think he will give me any more, possibly a further 14 but no more after that. I think there is some NHS ruling that says no more than 28 to be prescribed at one time. So I prefer to stay off the Zopiclone if I can.
I have been thinking of trying a small amount of Seroquel, say 12.5 mg, with my Olanzapine (10 mg) and see if that improves my sleep, ie 900 mg Lithium, 10 mg Olanzapine, and 12.5 mg of Seroquel taken at about 9.30 pm. Perhaps the Seroquel will work better now that I am not so high. I think I will try it this Saturday night. Do you know if there are any drug interactions between Seroquel and Olanzapine?
I will keep the remainder of the Zopiclone in reserve for when I really need them. I have about 7 left. While I was high, ie before I went back on the Olanzapine, even 2 x 7.5 mg Zopiclone did not put me to sleep properly. I only got 5 hours of sleep out of it. Awake at 3.30 am but felt very drowsy in a pleasant way until getting up at 7.00 am.
On 10 mg of Olanzapine with my usual 900 mg of Lithium I get about six or seven hours sleep which is normally sufficient but I really need more than that at the moment to catch up on all the sleep I have lost over the past 7 weeks.
It would be really nice if a small amount of Seroquel added to the Olanzapine and Lithium would knock me out. With just the Olanzapine I don't fall asleep straight away and I wake up fairly early, about 5.45 am. I fall asleep about 11.00/11.30 pm.
It seems my sleeping problem has been caused by my going too high, rather than lack of sleep making me hyper-manic. It is very difficult for me to detect an elevation of my mood. I just think oh well I must be getting better. :-) I really miss my hypo-manic moods which is why I wanted to come off the Olanzapine in the first place.
...Alan
Posted by ed_uk on October 20, 2006, at 15:02:41
In reply to Re: Seroquel for sleep - doesn't work » ed_uk, posted by ronaldo on October 20, 2006, at 12:50:40
Hi Alan
>I think there is some NHS ruling that says no more than 28 to be prescribed at one time.
Although GPs can prescribe more than 28 if they wish, it is fairly uncommon for patients to be prescribed quantities greater than 28 zopiclone. Most GPs would probably refuse, zopiclone is only licensed for short term treatment in the UK, although some people do take it on a long term basis.
>The zopiclone is only a temporary measure
I thought so..... but the high dose of olanzapine might be equally temporary? You might be able to reduce your dose fairly soon if things are going OK.
>Do you know if there are any drug interactions between Seroquel and Olanzapine?
Such a low dose of Seroquel would almost certainly be safe with Zyprexa. High doses of both drugs would not generally be prescribed together.
By the way, have you ever taken valproate (Epilim, Depakote, Orlept)?
Ed
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