![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Sailboat77 on May 20, 2011, at 11:44:25
I had posted last time that I've been having great difficulty both falling asleep and staying asleep recently. I've always had sleep problems since starting Parnate months ago (60mg). The situation seems a bit worse now that I'm taking 20mg of Vyvanse and 15mg of Adderall in the morning along with my MAOI. This combination of Stimulants and MAOI's has been an outstanding success for my mood, but not my sleep...... which was already in poor condition before the stimulants.
So I've tried Ambien, Lunesta, some type of tricyclic, and Xanax, but none of them work or only work temporarily (although Xanax does calm me down a little but does not make me sleepy). The only thing that has ever truly worked is Seroquel 100mg- one dose to fall asleep and another when I wake up in the middle of the night
{Here's the update}
I went to my doctor (general practitioner) and told her that it's been hard for me to fall asleep and the quality has been awful. I also told her that I don't like taking Seroquel, an atypical antipsychotic, for sleep issues. I wanted a medication specifically meant for sleep. I gave her 4 recommendations you guys gave and she was open to trying something new:
-She didn't like Sonata because a) it's similar in chemical structure to the Ambien which didn't work for me and b) it's very expensive.
-Zanaflex (Tizandine) is not compatible with the MAOI I am taking because it lowers my already unstable blood pressure.
-Halcion (Triazolam) has problems with rebound insomnia, dependance, and tolerance.+What we decided on is Ativan. It's a muscle relaxant, amnesic, sedative, and hypnotic. This is now my new med. Keeping in mind that I have a long history of an overactive metabolism/liver that synthesizes medicines/chemicals quickly so I usually need larger doses than normal. I took a 1mg tablet of Ativan at 11:00 and then another 1mg at 11:35. I started to become sleepy, but since I had to get up early the next morning I took half a dose of my usual Seroquel. I fell asleep within 10 minutes and never woke up.
So far, I think this is a minor success considering it was only one night. What I want to do next is to see if I need the Seroquel at all. Also, I will be mindful of whether I am growing tolerant to any of its effects. Honestly, that scares me most, that I'll grow tolerant of the one sleep drug that helps. But it's too early to tell and for now I'm fully rested.
Just so I don't forget, I really have to thank all you guys for your support and suggestions. They were so helpful and very nice
----I'll provide another update in a few days----
*I hope this experience of mine can help others.
Feel free to ask questions or make suggestions
of your own ( I only got this far by taking some of your advice)
Posted by Phillipa on May 20, 2011, at 13:08:29
In reply to Sleep Problems with MAOI (updated), posted by Sailboat77 on May 20, 2011, at 11:44:25
I just didn't know you could build tolerance to seroquel and if so how is it any different then benzos? Ativan sounds like a good choice. Good luck. Phillipa
Posted by floatingbridge on May 20, 2011, at 15:27:09
In reply to Sleep Problems with MAOI (updated), posted by Sailboat77 on May 20, 2011, at 11:44:25
Fingers are crossed :)
Do you need to taper seroquel?
Ativan is longer acting than xanax? I could look that one up.
Good luck!
Posted by emmanuel98 on May 20, 2011, at 19:19:05
In reply to Re: Sleep Problems with MAOI (updated) » Sailboat77, posted by floatingbridge on May 20, 2011, at 15:27:09
Parnate gives me terrible insomnia. I take 100mg trazadone plus 2mg ativan and sleep like a baby. Seroquel also works for me, in very low doses (as low as 25mg), but AAPs make me gain weight, so I stopped the seroquel.
Posted by Sailboat77 on May 22, 2011, at 2:57:46
In reply to Re: Sleep Problems with MAOI (updated), posted by emmanuel98 on May 20, 2011, at 19:19:05
The Ativan seems to calm me down at 2mg, but I really don't get very sleepy. I still need the Seroquel at 100mg to fall asleep. I think my quality of sleep is improving though, so that's positive.
I talk to my Psychiatrist next week and I'm sure we'll talk about this and maybe he'll suggestion something else or tell me to stay the course. I'd just rather not have to take an antipsychotic (Seroquel) to get good sleep.
Posted by floatingbridge on May 22, 2011, at 11:54:13
In reply to Re: Sleep Problems with MAOI (updated), posted by Sailboat77 on May 22, 2011, at 2:57:46
Sailboat,
I slept and slept last night on 10mg of Valium. (This was my second night. The first night I was up at 3:45.) I feel a little sluggish, but o.k. and nothing like when I tried flexeril or doxepin.
I'll keep you posted. You, too, okay?
Posted by floatingbridge on May 28, 2011, at 6:10:44
In reply to Sleep Problems with MAOI (updated), posted by Sailboat77 on May 20, 2011, at 11:44:25
Sailboat, how has your sleep been? Is ativan getting you to and keeping you asleep?
Hoping,
fb
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.