What is a good sleep med? I am going to call pdoc on Thursday
 

Hello,

I'm going to call the pdoc and ask for something that puts me to sleep.
Over a 6 month period I have averaged 4.5 hrs of sleep a night (not counting about 2 short naps a week).


I need sleep.
Should I make a recommendation to pdoc?

Is anyone here taking Seroquel?
Is anyone taking Zyprexa?
What else?

Thank you.
I need some help.
M.

Seroquel knocked me out, but I take trazadone for sleep. Used to take elavil but trazadone works wonders compred to elavil. :) I sure hope you can get some good sleep soon Mari! When is your pdoc appt? Mine is today. :)

I think either med is a good suggestion, seroquel daily or as needed, zyprexa only as needed to really knock you out.
bizi
I am glad that you are thinking about taking a new medication...it is worth your effort to try.
bizi

He's going to call in Lunesta.


I've got a low fever -- feel like I have a cold or something.
Depressed.
M.

Good luck with the Luenesta.

Will be thinking of you.

Donna:grouphug:

good luck with lunesta, it left a tin taste in my mouth if I remember correctly...I am so glad that you are going to try......
((((HUGS)))))
bizi

good luck
 

i hope the Lunesta works well for you Mari. perhaps even just taking it for a short course of treatment will help.

~ waves ~

What about Tafil ?? (Alprazolam)

Ive heard good things about it... :confused:

HI,
My fever was over 100F for a while.
When hubby got home from work I sent him back out to Walgreens to buy something for nausea so I could keep down Tylenol. He made ginger tea too. Fever is lower thanks to the Tylenol.

Pdoc seemed to think that we might have to go through more than one med, but that we would start with Lunesta -- I didn't pick up the script yet because I was too sick today. And I don't want to test out a new med when I feel sick.

(Well I'm not convinced yet that I am going to try the Lunesta anyway. I'll try to talk myself into it tomorrow).

M.

(Chloral Hydrate) I doubt if they will prescribe it. They prescribed it for me in the 80's,and it put me to sleep. They use all of these new drugs like seroquel,and etc.now BF:hug::hug::hug:

Hope you feel better son Mari! It stinks being sick with a fever. Good luck with the lunesta! :D

alprazolam / benzo rant / Zyprexa & Seroquel
 

Mari already knows this but for anyone who doesn't

Tafil = alprazolam = Xanax = THE most potent, short-acting and MOST ADDICTIVE BENZODIAZEPINE on the market.

bad bad bad bad scene... once on it for any length of time, excruciatingly hard to get off.

bad bad bad bad idea as a "sleep med" ...sure it would work to get to sleep but not to keep one asleep. also, if something non-addictive, or less addictive will do the job, so much the better.

alprazolam is supposed to be prescribed for panic/anxiety. also, it should only be used short term (like any benzo), OR as needed (with limits on frequency) to avoid addiction. but often docs keep scripting benzo's longterm, and ppl get stuck on them.

yes, i'm feeling a little irked about that whole deal in general, since i'm tapering a benzo right now and, even though mine is long-acting and so not as bad as Xanax, tapering is a serious pain in the everything... it is taking me better part of a YEAR (and that is actually good compared to some... :rolleyes:) Anyone on Xanax or who has been on it and tried to get off can attest to how hard it is. the usual way to get off that one, is to switch to Valium first, and then taper that - but even a benzo switch is traumatic.

blech blech blech blech benzos! and especially alprazolam.

so, while yes, i can PERSONALLY relate to how benzos can help with anxiety... in the long run..... sigh... they are chemical slavery! :(

:Soapbox:

ok i will get off it now... (end rant on the bad bad bad benzos :o)

Lunesta does have addictive potential but as best i could tell from the warnings on it, not as great as the benzos. (Mari, if you are concerned about this, i would ask the doc, the pharmacist, or both... maybe even call your mdoc for an opinion.)

Zyprexa and Seroquel are not addictive at all. Zyprexa i found to be far far more effective overall, but both carry a risk of diabetes. For sleep, i'd think Seroquel might be more appropriate for nightly use, insofar as very small doses (25mg) often suffice (compared to 400-600mg as an antipsychotic).

Zyprexa is much more potent - antipsychotic dose ranges 10-20mg. The smallest dose available is 2.5mg... proportionally a heftier dose than 25mg of Seroquel. when i have taken only 5mg a day for 7 days, i have gained weight and appetite on Zyprexa. that said i found it a very very very calming drug... use as needed can help not only with sleep, directly, but also with dysphoria, anxiety, and mixed symptoms in any combination - even just 5mg for just 2-3 days, taken every so often.

Heck !

Benzos ! :mad:

Xanax and such
 

Hi,

Waves has been a great help with benzos.


Recently I reduced my Klonopin dose.
So now I am taking 2.0 Klonopin because I tapered from 2.5 to 2 this past fall. At some point I will try to make one other small reduction on the Klonopin.


I'm not in the mood to research the Lunesta at this moment (still weak that fever yesterday) but I know it has benzo qualities. I will check with the pharmacist when I go pick up the med. I also was not paying attention to pdoc on the phone yesterday. I was focused on getting him on the phone. Pdoc said that Lunesta was short acting (8 hours) and that it could be stopped at any time because it does not cause dependency (! :confused:) .

On the web, this dependency seems to be partly dose specific. I won't know what dose he ordered until I pick it up. In particular, I will ask the pharmacist if whatever pill I get can be broken in half.


A couple of years ago I took Ambien for three nights.
I stopped it mostly because I had too much anxiety in general about sleep meds. I'm still anxious about the Lunesta but I am more desperate for sleep than I was then.
M.


---
Whoops. Those bolds are annoying to look at. I will go back later and edit them out.

Pharmacy did not get the call from the pdoc
 

HI,

The pharmacy said that they have no record of the pdoc phone call. They do not have my Lunesta.

I can't call the pdoc's office until Tuesday.

I'm not going to start a new med during the week.


So I am done with this Lunesta business. :(

M.

Dear Mari
 

even if you call pdoc during the week and get the med... you could start trying it out next weekend... nobody is going to push you. once you have it, you could start it whenever you feel comfortable.

i hope i didn't frighten you with the bit about possible addiction. it is dose related but also, it is not as bad as the benzos from what i could tell reading the RxList entry (under Warnings - dependence). also, taking it for a short period should not be problematic at ALL. maybe this a snippet will help reassure you - from
RxList - Lunesta (under Clinical Pharmacology):
anyway it is up to you of course. i just hope i didn't scare you away. :(:o

-----
i am just having a hard time right now, dealing with the way that so many of us are given benzos, and for long-term, when there ARE other meds for anxiety. and nobody seems to work on the psycho-social aspects of anxiety/tension etc.

you know, i tried to get into a DBT group... turned out to be private only, and therefore too costly. there was a state one (free) but that REQUIRED a diagnosis of Borderline Personality disorder DUH. heck why can't they run workshops to help other people ... one of the objectives is to learn stress-tolerance for which, instead, we are scripted benzos and dismissed. :( this just makes me sad and angry. after many years of use, the problems caused by benzo's are not limited to addiction. :(

~ waves ~

Oh me.:(:(:( I was basically off of Xanax after a real long time of gradual withdrawal. Then anxiety hit me full force,and I thought that I was going to have a heart attack,because of the pain in my chest. It was anxiety. My doctor put me back on Xanax. ??? The pain went away. %&% if I do,and %&% if I don't. Dang.:(:mad::confused: BF:hug::hug::grouphug::hug::hug:

My family doctor started me on Valium years ago,because I was having a terrible time with anxiety,and panic attacks that started before I went to a Military Academy,and then got worse.

When I moved back home I went to a Psy. Doc. I continued to be medicated with Valium.

Then they changed it to Librium.

Then They changed it to Ativan.

They put me on very stong sleeping pills. (Seconal,Tuinal,then Quaalude) Then I told the Psy.Doc that I wanted to get off the Quaaludes.(2 pills a night) He took me off them cold turkey. I asked him if I could slowly withdraw from them,and he said no. IT WAS MY IDEA to get off of them! I lived through a 2 year nightmare. I started drinking alot of beer before bed. I think the Pdoc lost his licence in this state to practice psychiatry. I don't believe it had anything to do with me. He must have done this to alot of patients. Their Mental Hospital even closed after a while.

##&&##%% I went through hell on earth through this whole thing,and after that also.

I was put on a mild sleeping pill called Chloral Hydrate that helped for awhile. Then I decided to stop taking it. It wasn't a problem.

Then I was put on Xanax.

Now I'm on Xanax,seroquel,and Luvox.

I have this anxiety that won't stop. It's been a long,and tormenting situation.
There have been so many misunderstandings.

There where so many misunderstandings that I went through,and people have made so many mistakes.:mad::mad::mad:

Family,church,doctors made mistakes,and I was so traumatized. I have been hurting for years. Depression,anxiety,OCD,Panic Attacks:(:hug::confused: A bad combo,when everyone around you does not understand. They said this,that,and the other where the problems. They where wrong,wrong,WRONG!!!:mad: BF:hug::hug::hug:

Waves,
 

Dear Waves,

Your info did not scare me.
More info is always good.

I have refused to consider sleep meds with my pdoc since I started with him years ago. He brought it up in our last appt. again two weeks ago and I told him no way. I told him I have a psychological sleep problem (not medical) and even if he gave me something I would not take it.

I saw tdoc on Wed and came home really worried about refusing sleep and help with sleep. Then Thursday I felt really really awful physically (not sleeping is wearing me out) and thought that I should be smart and ask for help.

So I tried asking for help.
That mood lasted for two days.
I'm done.

Docs do need to give patients more information.

That is a shame that you can't get into a DBT group. I know that you have thought about DBT for a while.

M.

Dear Steve,
Wow. That two year period of going off Xanax sounds like a nightmare.


Sorry about your history of not being successfully treated for anxiety.
I wish the pdocs could better help you with your anxiety.
Have you tried DBT like Waves mentions?
Can you get something like that?

M.

When I was in the Wellness center,I went to one meeting after another. I have mixed feelings about it.

That 2 year period that was talking about was the period of time in which I was withdrawing from Quaalude. It was my idea,but the doctor made me do it cold turkey. I remember those nights,and going out to get beer to help calm me down. That's probably why Quaaludes are not used in this country anymore. They are just to powerful,and addictive.

With the Xanax,it was more like a half a year of withdrawal I tried. My doctor didn't know I was doing this,because my trust in doctors are gone,after what I've been through with the Quaalude sleep medication.

I don't know what else to do but take the Xanax. When they take me off of it,I end up in emergency condition. I was in a hospital years ago,and they though it would be good to take me off Ativan cold turkey,and I had a seizure.
Now I don't trust hospitals.

I just have a shattered memory of all of my life being anxious,and having panic attacks,and depression. Then I slowly developed OCD. For these reasons, I'm alone,have never been married,and don't really have friends. I was misunderstood,am misunderstood,and may die alone,which I don't want. I have no choice, but to live this misunderstood illness. I don't drink anymore,so I don't have friends anymore.

Now they are talking about budget cuts,in schools,and mental health services in my state. I thought that a mental health parity bill was signed. What's happened to the insurence for people from the bottom up Obama was talking about. BF:hug::hug::hug:

I'm upset,and depressed again. I keep getting letters from the IRS. How could our people take Mental Health services away,or cut funding to it? We are people in great need,and they don't care. BF:hug::hug::hug:

sleep deprivation v.s. sleeping at night
 

Dear Mari,

thanks for your kind words. i am glad i didn't scare you. :) I was actually surprised you were looking for sleep meds... since i was aware in the past that you had tried and they didn't work as you would basically choose not to sleep. But yes, sleep deprivation is really awful.

If i may say so, i actually think that something like Zyprexa could benefit you a great deal. not for continuous use, just for occasional use. like maybe on weekends. it is too strong to fight, but of course, you still have the choice not to take it at night. however, for times when you are chronically sleep deprived, you might even consider just using it in the daytime ... i mean, in this case, i see 2 distinctproblems 1. phobia about sleeping at night, and 2. sleep deprivation. just because you don't have a solution for 1 yet, does not mean that you cannot or should not take some steps to fix 2. (because clearly, keeping up the deprivation is not helping you fix 1. anyway, right? Zyprexa is an excellent stabilizer with anxiolytic qualities and will really really take the edge off for a few days... which in turn should mean that any sleep you get (including naps), whenever you choose to get it, will be better quality sleep, and that in turn will feed right back into your overall state of mind.

another possibility comes to mind, but this one won't work except on a very occasional basis. Neurontin (gabapentin). The nice thing about this med is it doesn't interact with anything as it is mostly eliminated unchanged via the kidneys. i used to use it prn for sleep. first night 300 would work. second or third night i'd have to up it to 600 and after that the hypnotic effect would mostly go away. others may have a different experience with it... i don't know. for some 100mg is enough to cause sleepiness. also, while the very first time in my life that i had it, it nearly knocked me on my butt w/in a half hour, subsequently, it did not make me sleepy for about 4-5 hours. that's just weird, with a half life of 5-7 hours. :confused: maybe my body eliminates it more slowly... :rolleyes:. anyhoo. the following day i also would feel refreshingly relaxed. however, this med is fightable if one has the inclination to do that... just tossing it out there.

i just hope you can get some sleep, somehow. :o :hug:

~ waves ~

Dear Steve
 

Dear Steve,

for anxiety, ever heard of buspirone (brand name BuSpar)? i have a friend who took it (or maybe is still taking it i don't know. anyway he found it worked wonders for his anxiety. it is non-addictive. withdrawal from the benzo's still has to be done because this med is not similar to the benzo's and will not cover withdrawal reactions.

should you ever decide to try to come off Xanax again, for any reason though, it would be best to switch you to Valium from Xanax. even if it is a slightly higher dose than what would be the Xanax equivalent - because coming of Xanax, as you found out on your own skin, is just very very tough. some people can run the gauntlet, but others run into a brick wall with it, like you did. and it is not your fault either. that is because 1, it is short acting, and there is no working around that. 2, it is very potent, and the dosages to taper smoothly would need to be broken down in smaller fractions that 0.25mg... which, especially in the latter part of the taper, becomes a significant amount. valium is longer acting so it doesn't produce the peaks and troughs in action that Xanax does. Also, and 20mg = 1 mg of Xanax. that means that 1mg Valium = 1/20th (i.e. 0.05) mg Xanax - you see how that is a much, much smaller dose than you could ever break the smallest Xanax pill into!

it makes me mad that, in spite of taking the Xanax, you still have to face the panic and anxiety! urghhh!!!! that is like the worst of both worlds! but i do understand how you got there, and it is not your fault.

for the long term, like Mari says, it would be good if you could get into a DBT program... but i'm not sure how available those would be. you would have to inquire with your local health services/pdoc/hospital.

wishing you well.

~ waves ~

Dear Steve,

:hug: :hug: :hug:


You know if a meeting is working for you or not.
Maybe in the future you can try again at a different place.

Do you need to go off Xanax?
Are you worried about it?


I looked up mental health parity because you mentioned it. It took effect on January 1, 2010 but it left enforcement of the details up to each state. Essentially, the law is very weak.
I'm not clear about Medicare and Medicaid because they are under a different set of laws and are also left to each state.
I couldn't find what I am looking for. I also got angry again about our government.

Our society needs to place a greater value on its people.

I want to live in a world where people are healthy and cared for.

M.

BuSpar
 

Dear Steve and Waves,
I think Pamster is on Buspirone. In a post somewhere months ago she said she was doing well on it.


M.

Steve
 

i'm sorry if my posts are causing you upsetness about being on Xanax. there is no hurry to do anything. and you don't have to do anything about it. i just wanted you to know there are options.

the way that docs have treated you in the past - with the cold turkey off quaaludes and then in the hx off Ativan... is just preposterous. :(:mad: i'm so sorry you had to go through that.

should you ever want to try to get off Xanax in the future, my suggestion is to find a doc that will agree to work with you, starting with a switch to Valium and then subsequently tapering that. the switch needs to be at a dosage not less than 20 times the Valium as you are taking Xanax, in mg. that is the benzodiazepine equivalence, and undershooting that will cause problems. overshooting just a little might be prudent.

but you don't need to do anything at all, and i'm sorry if my posts sounded pushy. they were meant for your information only. :(

:hug:

~ waves ~

similarly, Mari
 

i was also not meaning to be pushy about the sleep meds. or sleep aids. or mood aids which help with sleep or whatever. just giving an opinion of what i think could help, if you chose to try a med. and also just my perspective about separating the issues of when-to-sleep and overall-not-sleeping.

i really hope it wasn't upsetting. if so, i am sorry. :o :hug:

~ waves ~

Waves,
Your posts are helpful, well informed, and to the issue at hand.

I am generally upset about my situation and my own response to it.

It is helpful sometimes (until it gets boring :o ) to write about it.
I hope that is ok -- that I persistently complain about my sleep situation.
I have a pretty good team right now ( strong internist, pdoc, sleep doc, tdoc).
Even so, at this time they have almost nothing for me.

So the people here on the boards help.
M.

Dear Waves,
How is the benzo taper going?
M.

Hi Waves I don't plan on getting off Xanax. With all of the anxiety that I have,it wouldn't make sence. I'd be asking for a major breakdown,if I tried to get off the Xanax. It hasn't even intered my mind to try to get off of the Xanax in a long time. People at church where making me feal guilty for taking it. I know better now. I'm also on seroquel,and Luvox. I haven't drank any alcoholic beverages in years.

I just don't have peace because of the IRS'es letters. Other problems are happening at the same time. I'm trying to find peace,but I can't feel peace. BF:hug::hug::hug:

Mari

I hope that if you decide a sleep med is a good idea again you will
call and ask for one.

I'm personally sorry the doc didn't call in the Lunesta.

Donna

Dear Mari
 

heck. i just wrote a long message and the system logged me out... i normally do a 'copy' before attempting to post but i didn't... duh, and it's all gone. and i don't feel like typing it all again. well you might appreciate more brevity anyway. :D

overall, it's going ok. after i messed up, i think pdoc freaked and wanted me to go slower than planned, but i think the plan was and is just fine. the problem came due to gross ad hoc divergences from it. after i flipped, i stayed at the same dose for a good while. i don't think pdoc is aware of exactly how much & how fast i went down (i only really noticed it much later myself, looking back at my schedule/log :eek:). anyway, i think i will stick to my plan. i don't want to drag things out more than necessary. i want this stuff out of me. i am being careful about not skipping any doses, also.

so... i am doing ok at the moment. thanks for asking.

how is your sleeping going? are you getting some?

~ waves ~

hi waves, you sound good, glad that you have a handle on the taper now.
good for you!
((((HUGS))))
bizi

update: Lunesta
 

Hi,
I called the pdoc's office to get my med called in again.
They said that the pharmacy mostly messed up . . . . but it was partly both of them.
It's a good thing I had not asked for anything difficult.
:confused:

Sleep difficulty has increased . . . . breathing difficulties with the cold. (3 hours of sleep last night and I got to work late in the am.)


I'll pick up the Lunesta and take it some time later.


Hubby made a chicken soup Sunday night with my ingredients (potatoes, carrots, green beans, 1 slice of ginger, two cloves of garlic, and one cooked chicken breast that was in the freezer.

He heated up rice on the side and cut up some avocados.
Very nice.


M.

Dear Waves,
I know that this varies depending on variables, but is it possible to do a benzo taper that is relatively smooth -- no problems?

Is it possible to do this slowly enough that most of it goes well? Is that the case?

M.

yes
 

yes, it is absolutely possible - many people do. a big variable though, is individual response. more sensitive individuals may need to come off much more slowly to avoid problems.

also, as i see it, if the drug is already subtherapeutic for them, a non-benzo anxiety agent could probably be helpful, and provided there are no interactions, i don't see why it should not be introduced early on in the taper to target baseline anxiety/panic... otherwise i think that a person remaining untreated for such a long time (slow taper), on top of withdrawal symptoms might be likely to give up, seeing no way to get off the benzo. this is only an opinion... and not a professional medical one... just my own deductive reasoning.

psychological addiction also plays a big part, and cannot be discounted - it is just as real and can produce physical symptoms as well as possibly anticipated feelings of anxiety. face it, even just the idea of going off a drug you believe is helping you, is anxiety-provoking! i suspect i am helped by the idea that i don't think it is helping me much, and ultimately may be hurting me. :D

as far as sensitivity, too... although one can guess, one doesn't know how one will respond to a withdrawal until one is in it. for instance, in my case, barring my obvious screwup, i have been pretty ok so far, which is a good indicator. however that doesn't absolutely guarantee that i will be problem free the whole way. should things creep up on me, i will have to slow the taper down and/or take a pause... i am prepared to do so, if necessary.

basically, tapering when one is messed up in any way, even if it is not withdrawal related, is a bad idea. i scheduled and observed a pause in the taper the month of december - due to the holidays (stress). and i think it is necessary to adjust the schedule on the fly if any sort of stressors/problems creep up, physical, emotional, or situational.

i was lucky that symptoms did remit rather quickly after i messed up. for a few people, they can persist once they get them. protracted withdrawal syndrome can last months. in that case, the person might not feel better until they get the stuff out of their system, so it can be a balancing act of going slow enough to be able to handle it, yet still put up with some crud and "run the gauntlet" so to speak. at least then, things WILL settle down eventually and other treatment options can be sought without benzo's complicating the picture. these are the worst withdrawal cases though. most people do not get protracted withdrawal. and not everyone even gets withdrawal if the taper is slow enough.

wiki - protracted benzo withdrawal

one thing the Ashton manual does NOT say, but which i planned for going on intuition, i later read about as advice in wikipedia, funnily enough: the latter portion of the taper should go in smaller increments. i chose to do this because i felt that at a certain point, the proportion of decrease relative to the original dose was going to be too large relative to the current doses... so after the halfway mark, my schedule considers each reduction as a % relative to half the dose, not to exceed 10% of that. this does not match Wiki's suggestions precisely, but it is a similar principle.

clearly one can do this in more than two phases but i don't know how useful that is. i actually did progressively smaller reductions overall: plan had my first reduction by 5 droplets (literally, droplets of liquid drug), then several by 4, two by 3 (which got lost in the screwup where i zapped a total of 8 droplets in only 2 weeks :eek:), the remaining reductions at 2 droplets but for the final one, of only 1 droplet.

here's what Wiki suggests:

i removed references to chordiazepoxide (Librium) for smoother reading.

for further info see:
wiki - benzo withdrawal management - the section includes general information, benzo drug interactions, and a suggested process (partly cited above).

the entire wiki article is quite interesting. the links i have given are to subsections within it - just scroll up to start at the top.

hope i didn't "bore" holes in your eyes! :cool::rolleyes:

~ waves ~

oops! missed this...
 

hi Mari, earlier, when i posted my benzo reply, i missed your update on lunesta! :o

lol, really! ;) well at least they are fixing things.

ugh... 3 hours sleep ughhh, i'm sorry. :( i hope the stuff works well for you. you especially need the rest considering you're sick. in fact, not sleeping might have contributed to being sick. sigh. vicious cycles.

yummmmm! i love chicken soup with ginger in it! rice and avocados good too! :) good to know hubby is taking care of you.

hope you feel much better all around soon.

~ waves ~

Good luck Mari

Donna

good for hubby, brownie points!:)
soup sounds wonderful!
bizi