Medication
 

Hi everyone,:(

I have been suffering from severe insomnia for the last maybe 16 weeks now. It could be going on longer now, I don't really know. I know it's been since at least March. I get about 2 hours of sleep a night, and that is on a good night. I had a sleep test and was told I have moderate sleep apneea. I use the machine, but i have found it doesn't make a differece. I know it takes a while to get used to, and it's only been 3 weeks.

I do see a sleep specialist now, and my pdoc will not help me whatsoever with medication to help me sleep because he says you have a specialist now that's not my job. I know he doesn't know what to do with the issue of my sleep anymore, but to be like that really ****** me off.
Anyways, I am on many medications.

i have medical problems as well as a very bad back. I am on some psych medications and no sleeping meds because my pdoc says i have to wait to see the insomnia specialist i see and I don't see him until the 24th of this month.

I am on for psych meds, Nardil, which was changed somewhat on Friday to see if that could be the problem, Neurontin, Requip for Restless leg syndrom,, Depakote and valium when needed.
See I told you I take a lot of medications. I don't know if you know this but Nardil is a MAOI and so I am very litmited to what I can and can't take while on that. I have been on pretty much every SSRI out there so they decided to try this.

I just am so tired, and I am doing what am supposed to be doing according to my sleep specialist, and she is now wanting me to see an insomnia specialist, which i know what he is going to say, but am going to go anyways. I live in a small appartment with my dad and step-mom so when i am up all night i am in my room all night. There isn't anywhere for me to go, my dad sleeps in the living room and my step-mom in the other room, yeah weird family and has been for years.

Thanks for listening,
Jen

Jen sorry to hear about the sleeplessness. This is a frustrating problem. Do you think you can time it to a med change, dose, or new combination.
When I started the Lexapro I started at 10 mg and had terrible insomnia. Then I read others that had the issue, and a side effect noted about it.

I reduced the dose to half and every other day the first few days to get the long half life reduced in my system. Sometimes just treating a new symtom with new meds is not the answer but compounds the symptoms.

Have you been on the neurontin very long, did they add a new med along the way?

Just a thought, but I know that often many meds are used, especially with the back injury, etc, but I have a distrust for doctors that readily perscribe a med, often from a pitch from the pharma comp rep, especially for off the gen use....

Why the neurontin? nerve pain?
I am sorry for all this insomnia, chronic pain, and sleep issues. I hope that soon there is someone that can get to the bottom of things,
Sometimes we all need a Dr. House in our life.
:grouphug:
Di

I was put on neurontin in January when having severe migranes. Also that's when I started the nardil. On friday I saw my pdoc and we degreased the Nardil to 2 in morning and 2 at night...i was taking 2 in morning, 2 in afternoon and 1 at night. I don't know, I really have no faith in anything working at this point.

The only new meds that I have been added are pain meds and that was way after the insomnia began. I was doing so well with all the not sleeping for the first 2 months, like i could handle the maybe 1 hours a night to 2 hours a night sleeping, but now when i go to a doc. for help and they are telling me i can't/wont help you it is frusterating and makes me think what's the point, if a doc. won't help then who is going to help?

Anyways, am just not in a good position right now, I am so tired, and I can't sleep, I know i will be up in 2 hours anyways, so what's the point, that's basically how it has become here for me, so would rather get no sleep than any at all.

Thanks, Jen

Dear Jen,
 

I'm thinking about the Nardil because its side effects are listed as insomnia. I know that the Nardil did not cause the insomnia, but it might be contributing to the problem. The Emsam patch (also an MAOi) has fewer side effects than the the oral medication, but it costs quite a bit on some insurance plans.

I'm also thinking that you might benefit from a bipolar or an a-typical anti-pschiotic med in addition to the Depakote all ready on board. If so, an atypical anti-psychotic like Seroquel or whatever you and your pdoc talk, about could help.

I hesitant to ask this because I don't like to make changes to my plans, but are there any of your meds that you could lower or go off in the future?

When your physical state gets better, it will be easier to see what is what. I think often conditions kind of blend in together for treatment and the docs have difficulties.
For people who have only one condition, the docs seem to be able to prescribe fine most of the time. For more than one condition, they have a harder time.

I wear a sleep mask for apnea too and I don't feel any better when I wear it. I do wear it because the docs said I needed it -- so I cooperate.


M.

nice of you to check on meds, i am not bi-polar. so i don't take the typical meds that someone with bi-polar would take.

right now i don't even care. am sorry for those who put time into reading my posts.

jen

I
 

Dear Jen,
I'm very sorry.
I know that you are not bipolar.

The docs borrow medications from this and that disorder to try to help their patients -- therefore many folks are familiar with other folks' meds.

I hope that your new specialist can help you sleep.

M.

no i am sorry, i am not doing well right now.
I can barley walk and I can't sleep and it's so frusterating. I went to the store and bought some sleep medication. i know i am probably not even supposed to take it, but it doesn't say can't take with MAOI so am going to take some tonight.
I am just overwhelmed and and can only take so much more of not sleeping.
I am sorry.
Jen

Hello Jen

i am so sorry you are going through this sleepless ordeal!

what is the OTC sleep aid that you are going to try tonight?

i am a bit surprised actually - because many OTC sleep aids are 1st generation antihistamines which do interact with MAOIs... sounds like you found something different ... i'm curious - i hope you don't mind my asking.

anyway i hope it helps.

i hope the insomnia specialist can figure out how to help you in a more permanent sense, and does so, quickly.

take care :hug:

~ waves ~

The medication is called Rest Simply with the active ingredient Diphenhydramine HCL which I guess is benedryl. I did read the box before I bought it because usually it says not to take if using a MAOI, but this didn't. The last time I took benedryl I almost passed out. i don't know what to do. At this point I don't care, and then maybe it will just make me sick. i plan on taking 2 along with my many meds I take at night so hopefully can sleep longer than 2 hours. don't know what to do.

Thanks,
Jen

Dear Jen,

it sounds like you have already figured this out, since you know the active ingredient... just in case...

diphenhydramine DOES indeed interact with MAOIs ... the problem is not just that the MAOI will cause increased sedation but overall central nervous system depression will be magnified... this includes risk of respiratory failure. :( we don't want that!!!!

i am really surprised it is not on the box or on a leaflet somewhere... this is usually a "do not take if you have taken a MAOI w/in x time period" type drug... :(

please, if you don't want to talk to the doc i understand, but at very least talk to the pharmacist about it first. :o

i am very concerned here. :hug:

~ waves ~

Thanks for the info, guess i won't be taking that because am not just on a MAOI, am also on tylenol with codeine and benzos right now so from what webmd says it can cause reactions.
I can't take the not sleeping anymore though, i don't know what to do. I am so at a loss right now.

zykes, yes, benzos and codeine too... bad idea becomes worse idea... :(

i'm sorry Jen... i wish i had some ideas for you instead of just sitting here being the bearer of bad news. :(

i honestly don't feel comfortable suggesting even herbal remedies - it is harder to find out about interactions, and also if they are strong enough to cause sedation, they can be strong enough to be a problem with your other meds too, you know?

do the best you can to stay sane. get as much rest as you can even without sleeping. do you ever meditate, or do breathing exercises? not to help you sleep i mean, but these things might help you feel better in spite of not sleeping is my thinking here... :o

:hug:

~ waves ~ so relieved that you are not going to take the diphenhydramine...

hi jen,
I hope that you are able to rest tonight.
not sleeping is a common problem, you are not alone.
bizi

HI
 

Sending you lots of good sleep vibes.

M.

now am tempted to take those pills. I know rationally shouldn't, but am too emotional. It's 3:22 and got maybe 45 min. of sleep.
Worth it or not??

Dear Jen,
You can call your doc and let him know that you need sleep more than the Nardil. . . . just a thought.

M.

Thanks everyone for your support.
I have already went there with my pdoc. he said he won't help me because I have a sleep specialist. My sleep specialist is sending me to an insomnia specialist but don't see him till 24th so have to just be like this.
Oh well, I will quit complaining.
Sorry
jen

Hi Jen

please don't worry about complaining. we can still listen, even if we can't fix it. your pdoc doesn't want to script anything and i can appreciate that, but he is still involved because the meds the meds he has you on affect anything else that might be prescribed by any other doc, including the sleep specialists he is banking on.

Mari has a point in that the Nardil is probably the worst interaction as far as taking an OTC sleep aid concurrently, and you are running out of gas here. it may be worth it to call your pdoc and tell him that you are breaking down and the MAOI severely limits other medication you can take so you want to suspend it for a while.

you would not be asking him to script anything, only to advise if you can safely suspend the Nardil (he may want you to taper it), and if so how much time should you wait before it is reasonably safe to take diphenhydramine - for instance. (standard wait period is 14 days.)

and even if you don't do any of this, please feel free to complain to us! :o

~ waves ~

Dear Jen, :hug:



Yes, you could just sort of tell him that you want to taper off the Nardil so that you can allow the insomnia specialist to have medication options.

In the meantime, while you wait for the specialist's appointment on the 24th:
It seems to me that getting a few minutes more of sleep at night is more important than the Nardil. This depends on what you feel are your greatest needs.

M.

i did just call and leave a message. I don't know if he will call back or not. He usually does but when I have called lately he doesn't call me back. He told me when i have seen him he only has one other patient on Nardil.
I don't even know what to do right now. I can't think straight. I am and have been hallucinating for weeks and he knows that, but does he even think to try anything or see what can be done...NO.
I suppose I can try and find a new pdoc, but would have to travel out of town. I am not even supposed to drive because i can't see straight cause of lack of sleep. But I can try and see if I can use my mom's car when and if I can get an appointment with someone else. I really don't know what to do anymore.
Maybe should just ask him for a referral, but I have been on every medication at least SSRI wise and they all didn't work. I have done the best of the Nardil except for the sleep, and am talking about my mood, but now it has gone downhill so fast that I am I don't even know. I am not planning on anything, just lots of thoughts.
Maybe the break of no one being home for almost 4 days and no dog no nothing will do me some good. I am supposed to see my T on wednesday but don't know if i will or not. i know in my head i should, it's just gettint to hard to deal with. too close to things that hurt and i don't like it.
anyways, so i called and we'll see if he even returns my call, am not banking on it.

please see your tdoc and explain that you are needing emotional support right now...don't dealing with the past or what ever else it is that is making you upset about therapy..the "hard stuff"...maybe you could even call and tell her/him that or email if you can do that.
you need all of the support that you can get.
((((HUGS))))
bizi

Well done, Jen!

i hope your pdoc calls you back and is cooperative this time! lack of sleep messes with moods badly and an antidepressant can't fix that until the sleep is back on track. so i don't even know how valuable the nardil is right now. once you are sleeping again, you could try the nardil again and, provided it wasn't the cause of the sleep problems, it will probably help you again.

i think it is good that you are considering another pdoc too, if this one doesn't cooperate, but i hope he will. if you have to go anywhere, perhaps someone can drive you.

how long, in therapy have you been 'too close' to things that hurt too much? ... could that be interfering with the sleep? :eek: if so, maybe you can talk to your therapist about it...

:hug:

~ waves ~

Dear Jen, :)
That's great that you made the call!

Now call the tdoc and ask for a break on the hard stuff. Right now you need help with what is happening day to day.

M.

my t and i have been working on hard things on and off for a year, but probably a month now. so i haven't been sleeping since march, and yeah we worked on stuff but i wasn't really "there". I dissociate a lot and don't know a lot about what happens there either. So lately we have been really working hard on stuff, and then other things came up with a good friend who told me i am too much to deal with and she can't deal with me cause she can't talk to me all the time. i don't understand where she got that i needed her to call me all the time and that hurt me bad. i hadn' cried in over i don't know how many years and last weekend i couldn't take it anymore and basically cried all weekend and now i feel like i am going cry all time.

i went so far as to ask to be sedated to get some sleep from 3 different docs. all said no and one said that's how micheal jackson died. they tell me can't help me. well if doc. can't help then who can?

really how long can a person go on 2 hours or less a night of sleep. i supposed people get less and then they can get kinda caught up but i can't even do that. i hate bed time now.

my t is the best t i have ever had and i know she is good. she lets me call, she is the only t that has ever let me call her/him and she actually gave me her cell# and am sure others have it to. I just don't use it a lot, don't think it's warrented a lot either. i already know what she going to say, my choice to come or not and she will say i really want you to come. she knows i am going through a hard time but not much she can do for me or anyone right?

i am too much for people now, so i have to keep quiet about things. i write things down. she wants me write free association and bring in. it's really long just like last week i wrote things and it was 16 pages, but she was fine with it. i think it's too much and don't know if i bring this in or not. says same thing over and over, no purpose and doesn't really say anything just mumbo jumbo. nothing that she doesn't already know.
i just want to be alone, like no one here at home and that starts tomorrow morning and goes till friday, i can't wait. not even the dog, no responsibilites nothing. but just the T appointment, and my mom says she get me there, i know i should go and i probably get worse or something if i don't go, so i need to, just scary when i go sometimes. i fight the tears for last 3 weeks and don't know how much longer that can go on.
anyways, am so sorry this so long.

thanks for all your support i do appreciate it, you are all wonderful people.
hugs
jen

Dear Jen

it sounds as though you have a really good T. it sounds like a good idea to keep your appointment. but i bet she will be receptive if you ask her for support with your day to day help right now rather than working on the big bad issues. who knows, she might have some good ideas to help you through until you can sleep again.

for the rest, just keep doing the best you can and stay safe. you are doing great - everything considered - imho.

crying can go in waves. maybe when your friend hurt your feelings that kind of pulled the stopper off on suppressed feelings ... you may need to cry for a while. crying can relieve a lot of tension too.

:hug:

~ waves ~

Jen

I'm Donna and I'm sorry its taken me so long to come and support you.
I have been working to get my house ready for my son's graduation
parties.

I also don't have bipolar. But have anxiety issues and chronic pain issues.
I happen to take Neurotins Generic for chronic pain. And I've been told
that I need to make sure I take the full 900mg a day to receive full help
for my pain. And I found they were right. And the zanaflex for the muscle
relaxer I think is what I was told it is. And its something I notice when
I don't take its bad too. I take verapamil for my migraines, and it was
just upped because they were getting worse. I was started on it because
I also had high blood pressure and it works for both. I had asked to
be started on topamax, because it works for migraines. So I'm on it too.

I also have imitrex, for when they hit. And it works good too. But it
also puts me to sleep. I also take medication mediform for diabetes.
And then I have asthma and take two inhalers for that when needed.
One of those all the time. And I take hmmm, something for allergies
I've forgotten its name. I have taken myself off three drugs because
I didn't need them any more.

I also take something else for high blood pressure, I can't spell it.
And then I have tylenol with coidene I can take for severe pain.
But my pain doctor told me to quit waiting till it got so bad I was crying.

I was waiting till I couldn't walk or even hardly do my job. Which I
love.

I am here just let me know how to help. By the way the tylenol with
codeine puts me to sleep if I take two. Donna:grouphug:

i forgot to mention, Jen, that i have migraines too. and several years ago they increased in frequency to about 15 days out of every month. i took gabapentin (Neurontin generic) as a preventive for them and it worked great. i had to keep up at 1200mg qd. after about a year i tried tapering off and i was back to my "usual" frequency (2-3 days a month), so i don't need a preventive currently... but gabapentin helped me when i did.

~ waves ~

thanks all for support,
i so tired right now...i keep falling asleep while writting. it's only 7:15 and i know i won't be sleep long but going to go to bed anyways. if up all night again nothing i can do bout it no more. doc never even call me. figures. he nevermind, not apprpriate for me to say.
thanks again everyone, i am going to end up taking a valium tonight and extra pain pills cause hurt so bad, so may.
oh guess who just called, him. going to take 14 days to get taper down to 3 pills a day, so he said well, his nurse said call in 2-3 weeks, yeah whatever. will do this myself.
anyways, tc everyone hugs.
nite
jen

nite nite Jen. :)

i'm glad your doc called you at least, even if the news wasn't great.

i hope the Valium and pain pills lend you more sleep than usual, even just a little more.

rest well and sleep well. :hug:

:Zzzz::Zzzz::Zzzz:

~ waves ~

Hi,

I hope you sleep. :Zzzz:

I'm glad you called the pdoc's office and got support for the taper.

Mari

So am up now, have tried to go back to sleep. No go. i wear a cpap mask and i can't do it anymore. feels like someone has their hands over my mouth and can't breath, actually started a few days ago. i try, but i can't keep it on.
slept for 1 hour 45 min which is about right. It's like 11:30 pm and i know i will be up for hours. i have been writing and writing and writig and then realizing maybe i shouldn't write so much cause i don't know if I can tell T some of that stuff, and then again i have gone in there and said things and she said jen you have already told me that so please don't worry and I am not here to judge you in any way shape or form. So obviously she knows a lot more than i thought i told her.
Well, going to take something for this horrible headache and try again to just lay and relax, and maybe listen to something relaxing.
hugs to all, and hope you all have sweet dreams.
jen

Dear Jen,

It sounds like you have a good tdoc.

I hope your headaches abates.

M.

in consideration to the mania that you sound like you are experiencing....have you ever tried zyprxa? it is a good anti psychotic medication that can really help and help you sleep. maybe you could take it short term to get you some sleep.
ask your pdoc about it to see if it might help you
bizi

I wonder if you just give your Tdoc what you write and let her read
it in her own time. Say and then just then talk about the things in
what she reads that she sees a real need to discuss right then.

So that way what has already been discussed can be put to the side
for a while. She can always take time to say we will discuss this
if you need to. But its something we have idscussed beofre.

Donna

yes i have been on zyprexa, and i have no clue what it was like. Do you think I am in a manic state? because I sure don't feel like that, don't even know what one of those feels like actually.
Finally everyone here is gone and am home alone till friday evening, and already the tears have started. thanks again,
jen
I am not sure if i am going to give her what i have written, it is like 16 pages hand written, a little too much i think, and some is very repetative. I am sure she would want to read it, but I don't know right now.
I only got about 1.5 hours or maybe a little more of sleep again last night and my head is pounding, and I can't think straight right now. I see her tomorrow so now use of calling her and telling her how i feel.

Dear Jen,
Bring her everything you wrote.
Let her decide what parts she wants to read.

I think right now you do not need the stress of trying to make a decision about what to give her. Give her the whole stack of pages. She is a professional. She'll manage.

M.

But what if I write more, i mean there could be 20 pages or something like that. I don't expect her to read them, and I just wrote a huge thing last week. I am at a loss right now, i have so much inside but don't know if i should keep writting or just let it sit. I am so conflicted on the inside right now. So tired, yet i can't close my eyes.
I am home alone now for 3 days at least till friday late afternoon and it is so nice, and peaceful and i don't have to worry about keeping up the front for people.
thanks again everyone, you have been so kind to me and it's nice.
jen

Dear Jen

nobody (not even a doc) can diagnose you over the net. did your pdoc evaluate you for bipolar? you mentioned in an earlier post that you are not bipolar, so i thought he had already ruled that out, is that not the case?

as far as simple impressions go...

no you don't sound manic to me. i find your posts to be very coherent, especially considering the sleep deprivation! if you were manic or even hypomanic i would expect you to be more rambling and/or more scattered in thought process... if that is happening it is not coming across to me in your posts.

mania is associated with lack of sleep yes, but lack of sleep alone does not constitute mania. sleep deprivation can trigger mania IF someone is bipolar. furthermore, lack of sleep per se is not considered a manic symptom by the DSM, which lists decreased need for sleep as a manic symptom - i.e. feeling rested after only 3 hours. from everything you say, you feel anything but rested!!! so, it sounds to me like you have insomnia plain and simple and the sleep deprivation that ensues. depression, irritability, difficulty concentrating are 100% normal symptoms for sleep deprivation.

do you know for what reason you were given the Zyprexa? that is curious because Zyprexa is not typically given for depression unless there are unusual features. it is also used in bipolar as a mood stabilizer.

as for your journal, i would say stop writing at some point - maybe a couple hours before you go in? basically, give yourself time to take stock, read through what you wrote ONCE and decide what you want to share with her. if you are still not sure or can't concentrate doing that, just hand her the lot and don't worry - she can skim. i hope you will talk to her about the sleep situation and that you guys can step down from the intense stuff for a while, until your sleep is straightened out.

:hug::hug::hug:

~ waves ~

Just keep remembering that she is the professional and technically a friend
if she is good. So I would say she will know what to do if you hand her
all the pages. Just write out all the frustrations so you can get over them.

I hope you can find a way to get some sleep. I think just laying down
and relaxing can be good too sometimes.

Donna

I have been evaluated and have a few diagnosis none of which are bipolar. So I think that the docs are/were just grasping at straws. I have been on lithium before too, but that didn't last long because i became toxic very soon and became very sick. So i have been on a lot of meds, and I think the docs don't know wha to do next.
I have stopped writting, 19 pages, and I don't know if am going to bring in yet, i might just give to her and say read when you can, but it was her that wanted me to write, i just didn't know iwas going to write that much.
Well, we are under a tornado warning here so i guess i better pay some attention to the wind and rain and the sirens that are now going off.
thanks everyone,
jen