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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by linkadge on January 16, 2007, at 18:04:47
I have all morning classes. I know there is no such sleep med that doesn't give some hangover.
But if I use seroquel on a regular basis I'm screwed.
I'm basically sleeping every other night.
Linkadge
Posted by Llurpsie_Noodle on January 16, 2007, at 18:12:09
In reply to Help, I can't sleep, No seroquel, posted by linkadge on January 16, 2007, at 18:04:47
Linkadge, how are you screwed on seroquel long term?
I actually habituated to seroquel 25 mg very quickly. Still helped me fall asleep, but I could wake up without the morning groggy after a few days of practice. when I went up to 300mg, it took about 2 weeks of agonizing "snooze" button mornings before I was ready to emerge from the bedroom before 9 am
How about anti-histamine? just for short-term use. Use a little to help you fall asleep. Coffee in the am. (do you take any stimulating meds, you can set your alarm for 30 minutes before you must get out of bed, and keep those meds by the bed with a glass of water. Then you can take them, fall asleep and wake up quasi-refreshed. That's how I got through the first 3 weeks of seroquel doses above 100mg.).
sending you some peace ~~~~~
-Ll
Posted by linkadge on January 16, 2007, at 18:36:15
In reply to Re: Help, I can't sleep, No seroquel » linkadge, posted by Llurpsie_Noodle on January 16, 2007, at 18:12:09
Its just like a light switch turns on right about the time I am ready to go to bed.
This little part of my brain won't shut off.
I am doing ok in school, not falling behind, but the insomnia is killing me.
Linkadge
Posted by saturn on January 16, 2007, at 19:10:49
In reply to Re: Help, I can't sleep, No seroquel, posted by linkadge on January 16, 2007, at 18:36:15
Link what sleep meds have you tried aside from the Seroquel?
And by screwed do you mean EPS?
Posted by linkadge on January 16, 2007, at 19:18:49
In reply to Re: Help, I can't sleep, No seroquel » linkadge, posted by saturn on January 16, 2007, at 19:10:49
No, I mean I get nothing out of class if I take seroquel the day before.
Linkadge
Posted by SLS on January 16, 2007, at 20:14:28
In reply to Re: Help, I can't sleep, No seroquel, posted by linkadge on January 16, 2007, at 19:18:49
I think you may be a TCA responder. I know how you feel about the CV side effects, but perhaps you can give the drug a 4-6 week trial to see what happens. The initial sensations of elevated HR and palpitations usually dissipate. For sleep, doxepin is sometimes chosen. However, if you respond properly to any TCA, the insomnia should resolve. You would probably like nortriptyline better than desipramine. It tends to be a little "smoother" in my experience and should be less likely to disturb sleep early in treatment.
- Scott
Posted by linkadge on January 16, 2007, at 20:29:34
In reply to Re: Help, I can't sleep, No seroquel » linkadge, posted by SLS on January 16, 2007, at 20:14:28
I might mention it at a the next doctors apt.
Have you ever taken trimipramine? Perhaps not as strong an AD.
Linkadge
Posted by Phillipa on January 16, 2007, at 20:59:23
In reply to Re: Help, I can't sleep, No seroquel » SLS, posted by linkadge on January 16, 2007, at 20:29:34
Link you've been under a lot of stress lately. Can you get a benzo , lunesta, ambien for tonight? Love Jan
Posted by Quintal on January 16, 2007, at 21:46:08
In reply to Help, I can't sleep, No seroquel, posted by linkadge on January 16, 2007, at 18:04:47
I have very much the same problem linkadge. I got two hours of light sleep last night and about three the night before. I'm starting melatonin with calcium again along with a herbal sleeping remedy containing valerian and hops. It seems to be making me drowsy already. I also take it with a bit of OTC painkiller containing codeine and that helps me drift off more easily. Have you tried Benadryl?
Q
Posted by blueberry1 on January 17, 2007, at 5:25:40
In reply to Help, I can't sleep, No seroquel, posted by linkadge on January 16, 2007, at 18:04:47
That's a tough question Linkadge, how to get decent sleep without effecting the ability to be sharp during the day. I can't think of many possibilities. And since miles vary a lot, it makes it even harder.
That being said, what about Trazodone? Take it early in the evening so it is pretty much worn off by the time you wake up? Or Benadryl? I found 25mg Benadryl grogginess in the morning to wear off in about an hour or two. Sleeping meds like Ambien or Lunesta actually had grogginess carryover through about half the next day with me, followed by uninvited anxiety or worsened depression that had not been there prior. Lots of things can help sleep. But finding one that doesn't screw the next day is hard. All I could think of in the drug department are 25mg benadryl, 25mg traz, or .25mg xanax. Those should not carry over into the school day. Seroquel would probably carry over too much. Remeron also. Tricyclics also, not to mention their overall cognitive dulling effects. You don't need that for school. Just sleep. And all I can think of at this moment is Traz, Benadryl, Xanax, or maybe Lunesta or Ambien if you respond to them better than I did.
If you need results like right now and can't wait for a doctor appointment, than that pretty much narrows it down to benadryl.
You know herbals pretty well, yeah? Skullcap? Passionflower? Any of those or others? I did not find them to have the knockout punch of drugs, and skullcap did seem to carryover through the next day, so I don't know.
Posted by SLS on January 17, 2007, at 6:45:51
In reply to Re: Help, I can't sleep, No seroquel » SLS, posted by linkadge on January 16, 2007, at 20:29:34
> I might mention it at a the next doctors apt.
>
> Have you ever taken trimipramine? Perhaps not as strong an AD.
Yes. I tried trimipramine. Although I didn't see a hint of a response to it (I'll double-check my notes), I would not discourage you from trying it. It might be the ideal drug for you to test the waters of TCA. Perhaps you can then move on to nortriptyline if trimipramine is without effect. You know, of course, the potential of trimipramine to enhance sleep architecture, so there are multiple reasons for you to try that first. I can't attest to the subjective experience of HR and palpitations with trimipramine. My body has become so accomodated to the effects of tricyclics, I am a poor judge of it.TCA and elevated HR is a package deal. It does mitigate over time, but it is likely to remain elevated relative to your unmedicated baseline. I have not yet been given enough reason to be afraid of this as a long-term condition. Maybe you can research this further to help settle your mind or unsettle mine. :-)
Consider the TCA thing a 4-6 week experiment if you are uncomfortable with a long-term commitment. The outcome might provide you with some important information about your psychobiology. With nortriptyline, I recommend starting at 25mg at night and working up to 75mg as your initial target dosage. If after 3 weeks you don't respond, then I would raise the dosage to 100mg and go another 3 weeks and/or assay your blood level. Although the therapeutic range is supposed to be 50-150 ng/ml, I would opt for adjusting the dosage to reach towards the upper limit. You know, of course, that unlike the other TCAs, nortriptyline has a dosage window of efficacy. If you take too much, you can lose the therapeutic effect. Most people respond to 75-100mg
It is my hope that you respond favorably (perhaps for the first time) to one of the TCAs and become accommodated to the CV side effects. In order for you to become comfortable with living long-term with an elevated HR, you will probably want to do some research into the consequences of doing so. Remember, though, that although TCAs are labelled "cardiotoxic", they may not be cardiotoxic at therapeutic dosages. I believe that it is an infrequent event that conduction abnormalities should appear.
See if the crap works first. You have plenty of time to decide how long you think it is safe to live with. Since you are a "virgin", the sensations of elevated HR and palpitations will be significant early in treatment, but they will most likely disappear with time.
TCA responders:
Melancholic mood and thoughts.
Insomnia
Early morning awakenings
Morning worst time
Lack of appetite - low body weight
Agitation
- Scott
Posted by SLS on January 17, 2007, at 8:20:19
In reply to Re: Help, I can't sleep, No seroquel » linkadge, posted by SLS on January 17, 2007, at 6:45:51
I wonder if using a cardio-selective beta-blocker might not act as a remedy for the TCA CV effects. Remember, though, that the TCAs are NE alpha-1 antagonists, and hypotension might become a problem. In fact, it is this property of the TCAs that minimize the load on the heart by acting as an after-load reducer.
- Scott
Posted by linkadge on January 17, 2007, at 8:24:57
In reply to Re: Help, I can't sleep, No seroquel » linkadge, posted by SLS on January 17, 2007, at 6:45:51
My biggest problem is that I just cannot fall asleep. If I do fall asleep I can ususally stay asleep.
I have actually tried doxapin and clomipramine which both were very helpful, much more helpful than SSRIs. I decided to stop based on the cardiac reactions.
You should not feel or hear a healthy heart. TCA's mae my heart do disturbing thigns.
While I never completely close the door to any drug, I just have so many reserves.
Its like the drug could be doing wonders, but then that part of my brain that says I am taxing my heart just won't shut up till I stop the drug.
Linkadge
Posted by JayBTV on January 17, 2007, at 8:55:24
In reply to Re: Help, I can't sleep, No seroquel, posted by linkadge on January 17, 2007, at 8:24:57
I know this is the med forum but you could try using one of those Biaural beat programs in unison w/ a med.
I append random MP3s with Adobe Audition and make 30-45min "decents" into low-Theta/Delta brainwave freqs. It's very easy to do that using the Binaural Panner.
I think most people use Brainwave Generator (www.bwgen.com) and I've used that w/ success as well. Key is that you _need_ to use headphones but most times sound files dipping into the delta range (lowest freqs) will help knock me out.
Sorry since this is kinda off-topic.....there was a thread on this subject moved to Alternative not too long ago.
Currently Remeron is gettin me my ZZZs w/ minimal morning hangover. Good luck,
-Jay
Posted by linkadge on January 17, 2007, at 10:41:11
In reply to Re: Help, I can't sleep, No seroquel, posted by SLS on January 17, 2007, at 8:20:19
I know desipramine has been linked to cardiac problems, at least in kids, but what sorts of long term data exist on the cardiac safety/hazzard of TCA use. Or data on relative safety?
Linkadge
Posted by Dr. Bob on January 18, 2007, at 21:24:02
In reply to Re: Help, I can't sleep, No seroquel, posted by JayBTV on January 17, 2007, at 8:55:24
> I know this is the med forum but you could try using one of those Biaural beat programs in unison w/ a med.
I'd like to redirect follow-ups regarding beat programs to Psycho-Babble Alternative. Here's a link:
http://www.dr-bob.org/babble/alter/20070114/msgs/723850.html
Thanks,
Bob
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