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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by RobertDavid on May 11, 2006, at 22:22:32
For years I've dealt with insomina. Falling asleep never was the problem, just staying asleep. Nothing worked well, not Ambien, Trazadone or Lunesta (was fair). Though I take klonopin at night for anxiety and have for years, that doesn't seem to help. My sleep has improved a little since starting EMSAM, but I'm looking for a better nights sleep on the nights I can't stay asleep.
My doctor suggested occational use of a small dose of Seroquel (12.5 or 25mgs). Otherwise suggested Sonata if and when I wake up at night. Any thoughts?
Rob
Posted by rjlockhart on May 11, 2006, at 22:56:11
In reply to Seroquel for insomnia?, posted by RobertDavid on May 11, 2006, at 22:22:32
Seroquel is used alot for racing thoughts, makes you just all of a sudden ZZZZZZZZZZZZZ. Thats at 300mg.
Good for insomina. Prescribed alot. I think you should maybe try it, but its expensive.
I take Xanax and sometimes Temazepam (Restoril) 30mg for sleep.
thats when i just cannot stop thinking im on fire in my head.
Anyways. take care
Matt
Posted by Phillipa on May 11, 2006, at 23:33:58
In reply to Re: Seroquel for insomnia?, posted by rjlockhart on May 11, 2006, at 22:56:11
Is EMSAM maybe not working so good? Love Phillipa
Posted by RobertDavid on May 12, 2006, at 0:19:06
In reply to Re: Seroquel for insomnia?, posted by Phillipa on May 11, 2006, at 23:33:58
> Is EMSAM maybe not working so good? Love Phillipa
Your too funny! Your such an EMSAM skeptic! The only way you're going to know if it will work for you is if you just try it. I think you're thoughts of trying EMSAM or Nardil are good ones for your anxiety. At some point you're going to have to just dive in and try one (or not) to find out how you'll do.
That said, went to my doctor today. We discussed how well I have done on EMSAM. I spent an hour discussing all the failed trials in the past and how for the first time I really felt a true anti depressant effect, was getting things done, clearer thinking, no negative side effects.
We further discussed my taper of klonopin and that ultimately EMSAM may completely replace it. He brought up that my tapering down on klonopin (which I have been doing) would effect my sleep which I've experienced before.I mentioned my only issue now is this occational insomnia and I've have had it for years. I told him if that would go away I'd be right where I want to be. EMSAM has actually helped that as even when I don't sleep as well as I'd like I still wake up with more energy.
Anyway, he suggested low dose seroquel as I never had much luck with other sleeping pills. So, I'm putting it out there for those that know about it as I know very little about seroquel for insomnia. All I know is that it's an anti psychotic.
Any advise/info is appreciated. Rob
Posted by UgottaHaveHOPE on May 12, 2006, at 0:47:17
In reply to Re: Seroquel for insomnia? » Phillipa, posted by RobertDavid on May 12, 2006, at 0:19:06
RD:
First of all, please read my post above "What would you do?" because I value your opinion.
Seroquel is like being shot with an elephant dart. If it is the only thing it will do, it will cause you to sleep. I have been taking since last summer. This isnt one of those meds that take 6 weeks to work. You will know within the first day. I'd start at 25mg.
Posted by SLS on May 12, 2006, at 8:47:34
In reply to Seroquel for insomnia?, posted by RobertDavid on May 11, 2006, at 22:22:32
The use of neuroleptic antipsychotics to treat insomnia is bound to be a source of debate. Seroquel does a great job of putting people to sleep and keeping them asleep. I don't feel that the risk of EPS is that high with Seroquel. However, I would still be inclined to first try a benzodiazepine drug like Restoril (temazepam) or Ativan (lorazepam) in situations such as yours. I think Restoril would be the better choice if you are having no problems falling asleep. It produces less of a hangover than does Ativan, although I don't find Ativan to be that bad in this regard.
- Scott
Posted by JaclinHyde on May 12, 2006, at 9:38:07
In reply to Seroquel for insomnia?, posted by RobertDavid on May 11, 2006, at 22:22:32
Well imho seroquel works to put you to sleep and to keep you to sleep but makes you feel like crap the next day. I just can't function on even the smallest dose the day after. I drag around the house and can barely get my act together to get dressed. It does muck with your sugar levels which is why I might feel that way on it. Ambien CR is a better choice for me. Lunesta is good but since the Ambien is a controlled release it works through the night. Hell even trazodone is better than seroquel imho.
This is my experience, ymmv.
JH
Posted by llrrrpp on May 12, 2006, at 9:49:45
In reply to Re: Seroquel for insomnia?, posted by JaclinHyde on May 12, 2006, at 9:38:07
my pdoc gave me seroquel (25 mg tablets) to take at bedtime. I have been suffering with bad insomnia for months. I only just started my first anti-depressant about 10 days ago. so far so good, but the insomnia seemed aggravated by cymbalta. Hence the seroquel, prescribed 4 days ago. I take 25 mg, and I feel woozy within about 30-45 minutes, and sleep through the night. (yay!!) As far as lethargy and somnolence during the day, I was experiencing this when I started the cymbalta, and it's gradually getting better. One other thing I noticed is that in these last 4 days my appetite has gone WAY up. I feel like eating breakfast the minute I get out of bed. For me, this is a good thing, because I had complete loss of appetite (and weightloss) due to major depression. Nevertheless, I will probably quit taking seroquel if I notice too much weight gain. Also, my pdoc said that the seroquel will augment the cymbalta, rather than working against it. I'm new to the whole medication thing, so I'll just have to trust him on this. Good luck :)
Posted by RobertDavid on May 12, 2006, at 15:25:56
In reply to Re: Seroquel for insomnia?, posted by llrrrpp on May 12, 2006, at 9:49:45
Thanks for all the info and advise. I took 12.5mgs last night and it knocked me out. Damn, I'm so med sensitive. Problem is that it's now 1:00 in the afternoon and I'm still a zombie.
I'm functioning, but am definately not as alert, sharp, like it negated the energy I get from EMSAM. That said I certainly got 8 hours sleep!
I don't know if the side effects would go away over time, but I only need it for occational use so I think I'll have to try something else on the nights I have trouble sleeping.
Since falling asleep isn't my issue, staying asleep is, my doctor also suggested that I might try taking Lunesta (which I have had some limited success with) during the middle of the night when I wake up instead of taking it at bedtime. I mentioned to him my concern that I thought you need to take it at bedtime and make sure you have 7 to 8 hours of sleep ahead of you, but he said that's a general warning and that I most likely wouldn't be groggy if I still had at least 4 hours to stay in bed.
I think I'll try that next time. Otherwise I'll take a look at Restoril, perhpas Ambien CR per some of your suggetions. Thanks again for the info. Rob
Posted by UgottaHaveHOPE on May 12, 2006, at 15:54:46
In reply to Re: Seroquel for insomnia?, posted by RobertDavid on May 12, 2006, at 15:25:56
Seroquel really helped me with sleep. It also made me groggy the next day. I guess there are tradeoffs with everything. I just drank a caffeine drink when I needed a boost.
Posted by RobertDavid on May 12, 2006, at 16:04:43
In reply to Re: Maybe cut your 12.5 pill in half?, posted by UgottaHaveHOPE on May 12, 2006, at 15:54:46
Thanks, I am considering cutting it in half and trying that. I definately sleep with it. Good idea....Rob
Posted by Jost on May 12, 2006, at 22:22:31
In reply to Re: Maybe cut your 12.5 pill in half? » UgottaHaveHOPE, posted by RobertDavid on May 12, 2006, at 16:04:43
> Thanks, I am considering cutting it in half and trying that. I definately sleep with it. Good idea....Rob
Cutting the 25 mg pill into quarters, although the pieces aren't exactly equal, works well for me, so far. I've tried it off and on but felt dazed and out of it. The last ten days to two weeks or so, I've done it almost every day, and the grogginess has receded somewhat.
It's the only thing that's let me sleep through the night and get about enough hours. I don't know it it will keep on working, but it seems promising.
Jost
Posted by Caedmon on May 13, 2006, at 17:26:06
In reply to Seroquel for insomnia?, posted by RobertDavid on May 11, 2006, at 22:22:32
Seroquel works very well for some people.
How much trazodone did you ever try? Some people require a lot.
Have you ever tried OTC melatonin? I'm always surprised at how well it works for me even vs. Rx meds. Although I try not to take it more than a few times a week, lest it affect my natural endocrine balance.
- Chris
Posted by RobertDavid on May 14, 2006, at 21:42:49
In reply to Re: Seroquel for insomnia?, posted by Caedmon on May 13, 2006, at 17:26:06
> Seroquel works very well for some people.
> How much trazodone did you ever try? Some people require a lot.
>
> Have you ever tried OTC melatonin? I'm always surprised at how well it works for me even vs. Rx meds. Although I try not to take it more than a few times a week, lest it affect my natural endocrine balance.
Seroquel kicked my butt, I slept hard even at such a low dose of 12.5mgs. Someone suggested even taking half that dose which I may try.As for trazodone, it was years ago that I tried it. I really couldn't tell if it helped me sleep, but like most other anti depressants I've tried I felt out of it the next day. I can't remember the dose, I want to say 5 mgs, but not sure. And now that I'm on EMSAM I suppose there might be a drug interaction anyway.
I've tried melatonin and think it may have helped some, just not that noticable. My brother swears by it.
My latest try is taking the patch off at night. I'm going to do it for a week. When I saw my doctor last we discussed meds to treat this life long insomnia issue. EMSAM hasn't made it worse, I just never have slept well.
My doctors theary is that since EMSAM has made me feel so much better, improved mood, more energy (which is making me more active, I go to the gym more often) I should sleep better because I'm using more energy during the day. That by taking off the patch at night I'd reduce the selegiline temporarily (which is activating for me) and sleep better. He felt I'd most likely still get the same theraputic response I've been getting.
I tried it for 2 nights and indeed I slept great. I'm going to give it a week and see what happens. If I start feeling worse I'll just go back to 24/7 with the patch.
Posted by Tony P on May 16, 2006, at 11:45:22
In reply to Re: Seroquel for insomnia?, posted by Caedmon on May 13, 2006, at 17:26:06
> Seroquel works very well for some people.
>
> How much trazodone did you ever try? Some people require a lot.
>
> Have you ever tried OTC melatonin? I'm always surprised at how well it works for me even vs. Rx meds. Although I try not to take it more than a few times a week, lest it affect my natural endocrine balance.
> - ChrisMelatonin seems to work for me (melatonin + Seroquel + Neurontin is an elephant gun ;-)
Seroquel (usually 50 mg) is turning against me. Not only do I feel like crap the next day, and need 2 alarms and 2 cups of strong coffee to function, but it also causes akathisia (like restless leg only all over). Last night was terrible, I was about ready to gnaw my leg off. I discovered from Wikipedia that large doses of vitamin B6 sometimes help - I took 400 mg and fell asleep about an hour later, thank God.
Trazodone used to work, but didn't give me anything like normal sleep. More recently it gave me akathisia too.
Discovered from Wikipedia (turning into a very useful ready-reference for medical info) that trimipramine, a TCA, is "the only effective drug against insomnia known so far that does not alter the normal sleep architecture". I am going to ask my pdoc about it today.
Has anyone taken trimipramine, either for insomnia or depression, or both? I'd like to hear experiences.
This is the end of the thread.
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