Posted by Ron Hill on August 7, 2003, at 13:12:50
In reply to To Ron Hill: Sleep problems--anxiety-HELP!, posted by fluffy on August 6, 2003, at 11:10:20
Hi Fluffs,
> And Ron and Katia--I'm so sorry that you guys are feeling bad now.
I'm doing better now. Thanks for your concern.
> I'm having severe difficulty getting sleep. I'm only sleeping because of those wonderful spendy pills of Ambien. I can't afford them though, and I'm becoming a junky. Even though I'm taking the Ambien, I'm waking up too early and feeling panic attacks just held at bay.
> If I can't sleep, then I know an episode is most definitely on its way. I'm still taking 200mg of Lamictal. And so far, it's kept the depression from coming around. But the anxiety/hypomania doesn't budge. I asked my pdoc yesterday what the contingency plan is if I continue to have sleep problems. He suggested Melatonin (doesn't help lately) and if not that, Klonopin. But he said only if I could use it a couple of times a week (so I don't get addicted to it). But frankly, I think I need something every night this month to stave off my yearly mixed state. Has anyone been "addicted" to Klonopin. Can you taper off successfully?
> The next step would be to try Li in conjunction with Lamictal. Why do I still feel afraid to try the damned stuff? Would Neurontin help my sleep? Would Trazodone??? I think I'll try the magnesium thing tonight.> I don't really know what my point is to this post. I'm just feeling desperate and I need some advice and support.
Yeah, I hear ya Katy; good quality sleep in the correct quantity is VERY important for us bipolar patients. My insomnia problems have been resolved (by and large) for a couple of years now. I attribute the improvement primary to magnesium and, to a lesser extent, lithium (my mood stabilizer). I take 800 mg of magnesium at bedtime. I use magnesium malate and magnesium citrate.
It sounds like you have some good ideas regarding things to try for your insomnia. May I comment briefly on a few of them?
Melatonin -- I used to use this. Sublingual was far and away more effective for me than "down-the-hatch" pills. Also minimize the dosage (i.e.; about 0.5 mg/night) and do not take it every night (or else it loses its effectiveness).
Klonopin – I’ve never used a benzo, although I’ve been tempted to try Klonopin to treat my periodic dysphoric mood states. A lot of people around here find Klonopin a very effective sleep aid and a lot of people use it daily for extended periods of time without any problems.
Lithium – If your insomnia is caused by hypomania, then it makes sense that adding another moodstabilizer might help. Lithobid reduces my insomia by treating my hypomania. Of all the moodstabilizers I’ve tried, Depakote had the most dramatic effect in reducing my insomnia. Depakote was notorious for giving me vivid dreams and when I woke up I felt like I had slept very deeply (it also caused me to gain 30 pounds and made me more depressed).
Trazodone – I’ve not tried it but, as you know, it’s known for its sleep aid characteristics.
Seroquel – AP’s are heavy duty stuff with side effects. If it were me I’d try other options first. But that’s just me.
Best Wishes Katy.
-- Ron
poster:Ron Hill
thread:9730
URL: http://www.dr-bob.org/babble/20030807/msgs/248990.html