Posted by pianolady on July 24, 2003, at 3:09:11
In reply to Re: Chronic Insomnia » Guy, posted by Simcha on July 24, 2003, at 1:24:41
I've tried several of the things suggested. I used ambien for several years and it became ineffective. I've also tried sonata, desyrel, benadryl, and a host of other things. I have been taking seroquel for several years. Also, I am currently using halcion in addition to the seroquel. The halcion has worked fairly well for me, but I keep to a regiment of only using the prescribed dosage regardless of whether it works one night and doesn't another. I figure that way I won't have to be too concerned with overusing benzos or with any potential addictive properties (many people question whether benzos are or are not addictive, but that's a whole other subject).
On the issue of seroquel, I only stopped taking it a week ago and I had been on it for several years. It had a very sedating effect on me and so I used it at night. But, as someone else pointed out, antipsychotics should only be used to enhance sleep if there is another reason for using them (psychosis or other uses as prescribed by pdoc). I typically did not use but 25 mg, but many people take much more than this--particularly those who are actively psychotic. Overall, I would say that seroquel has been fairly effective. I'm not completely sure that I agree with my pdoc discontinuing it, but after dealing with yet another episode of mild/moderate psychosis (one of many), it seemed reasonable to consider another antipsychotic.
The suggestion of using melatonin is one that my pdoc has discussed with me on many occasions. I did not really ever have a successful trial with it, but I understand that it is fairly safe. The information I received indicated that about 300 micrograms were adequate to help in readjusting the sleep cycle rather than the 1 to 3 milligrams that are in many OTC preparations. You may want to consider this.
Another issue that I would discuss with your doctor is whether there is another drug that could be used for your psych illness that would have a sedative effect as a "side effect". (Like the seroquel for me). If a change of this nature is reasonable, this may allow you to take one less medication and in my book that's advantageous (decreased cost and fewer drug-drug interactions when you can go to fewer different meds).
One thing is certain, there are no absolute answers to sleep problems. If there were, I wouldn't be up at this hour! (The new antipsychotic is very activating and I drank a couple of soft drinks with caffeine earlier this evening--usually I find it's better to avoid caffeine when it's reasonably possible).
Also, I typically have this strategy for sleep problems. I go to bed at a similar time each evening (not for the last week because of the new meds) and I will stay in bed for an hour. If I haven't fallen asleep in an hour, I will get up and do something as quiet and non-stimulating as possible. Then I wait until I am truly sleepy to go try sleep the second time. If I don't get much sleep that night, I absolutely avoid napping because it further upsets the sleep cycle. I try the same thing the next night and so on. At some point the body usually takes over and I eventually get a good night or two. But, one caution--I've found that my psych illness is much worse when my sleep cycle is off, so I carefully monitor this and discuss it at most meetings with my therapist and pdoc.
poster:pianolady
thread:244545
URL: http://www.dr-bob.org/babble/20030723/msgs/244767.html