Goosie: insomnia crisis

[Goosie]

Hello. 

This is my intro.   The last 8 months have been hell as my insomnia got worse with each drug given to “help”.   

 

Things fell apart after taking a month of medical marajuana in May 2018.   I then was then put on ambien seroquel and lexepro July 2018. Nothing helped. I was cycling badly ( every other day was good/bad)

 

my shrink ink took me off lexepro (5mg). In sept 2018 and onto lithium.   I could take the lithium due to terrible headaches.  The insomnia worsened and I could no longer live at home as i was a danger to myself.   

 

I went to an inpatient clinic/ rehab. And was tapered off seroquel (25mg). And ambuen(2.5 mg).  I also went back on the lexepro (10mg). For 6 weeks and then was tapered off it for another 6 weeks.    At the end of the lexepro taper things went to hell again. I am again cycling pretty badly.  I sleep a few hours every other night.  I’ve been off the lex. Almost 1 month.    Still on 25 mg hydroxizine and 4 mg melatonin.   Would like to get off these meds but am so unstable I am afraid to start tapering.   

I am calm at night but just don’t sleep.  Sometimes I start to dream but I am still awake. 

 

 

I do do all the sleep stuff people recommend.  Dark room, epson baths, mediation etc.     desperate for relief.  

 

Goosie

 

[ChessieCat]

Hi Goosie and welcome to SA,

 

To get you started please create your drug signature using the following format.   Keep it simple.  NO diagnoses or symptoms please - thank you.

• details for last 2 years - dates, ALL drugs, doses
• summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature

 

Once we have more details about your drug history we will be better able to offer suggestions.

 

This is your own introductions topic where your can ask questions about your own situation and journal your progress.

[Altostrata]

Welcome, Goosie.

 

When did your sleep problem start?

 

You're sleeping a bit every other night, this is a good sign. Your sleep should gradually get better if nothing gets in its way. For now, please continue your regimen. Get into bed or at least lie in the dark at regular bed times. Do not use the computer after 8 p.m.

 

Do the hydoxyzine and melatonin help? Have you tried them separately? 4mg is a rather high dose of melatonin, did you try lower amounts first?

 

Please answer our questions, we may be able to help.

[ChessieCat]

Melatonin

Sleep problems - that awful withdrawal insomnia

[Goosie]

Please help.  I am desperate.   No sleep at all for 3 out of the last 5 days.   The hydroxizine used to help more.  Now I don’t know.   I was put on 4 mg melatonin at alternative to meds in Sedona. I tried to taper to 3 but sleep is worsening.     

I have pounding heart and tight chest all night.   It feeks like a heart attack 

[ChessieCat]

Q:  When were you at Alternative to Meds?

 

39 minutes ago, Goosie said:

I was put on 4 mg melatonin

 

That might be too high a dose.  Please see this topic:  Melatonin

 

Alto commented on this previously:

 

On 1/21/2019 at 6:44 AM, Altostrata said:

4mg is a rather high dose of melatonin, did you try lower amounts first?

 

[Goosie]

I was at alteRnatives to meds from October through Jan.   Have been home 3 weeks.    I was having horrible horrible insomnia do they have me a nightly 3 mg tablet plus another pill that had 1 mg. 

I am trying to traper but the insomnia is worsening.   I am so desperate.  It’s been 8 months of hell with no sign of letting up.   I am obsessed with suicide but am to week to carry anything out.  

[Goosie]

Also i have read the melatonin thread plus many others on this site.  Thank you

 

will this get better?   I am terrified

[Goosie]

Alto my sleep issues started a year ago.   1 month marajuana to sleep in May.  June I was on ambien and trazadone intermittently.  July full crises was put on seroquel and lexepro.  

 

Alternative to meds swapped the seroquel for hydroxizine and melatonin.  

 

For 8 months have been sleeping only a few hours a night.   Since the last of the lexepro taper in dec have been getting little to no sleep every other night.   

[Altostrata]

What effect does 4mg melatonin have? What time do you take it?

 

Did you do this?

 

On 1/20/2019 at 11:44 AM, Altostrata said:

Get into bed or at least lie in the dark at regular bed times. Do not use the computer after 8 p.m.

 

It's also important to keep your bedroom cool and dark, see

 

Tips to help sleep -- so many of us have that awful withdrawal insomnia 

 

Waking with panic or anxiety -- managing cortisol spikes

 

Melatonin for sleep: Many people find it helpful

 

TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime

 

If the hydroxyzine stopped working, stop taking it.

[Goosie]

Yes I lie in bed every night from around 11 pm to 9 am the next morning trying to get rest if not sleep.   No computers after 8.    

 

I have tapered the hydroxizine to about 20 mg.   Should I really just stop ct?   That seems dangerous..... I have been in an antihistamine for 8 months.  

[Goosie]

Also my bedroom in cool and pitch black as I covered the windows with electrical tape 

[Goosie]

I take the melatonin around 10.  I find it makes me sleepy- the only time I feel sleepy but it passes within an hour so I try to take it close to bed time

[Goosie]

Also- shouldn’t I taper hydroxizine at 10%?    I don’t see how hydroxizine 25 mg is much different than seroquel 25 mg

[Altostrata]

Hydroxyzine is an antihistamine with a half-life of about 20 hours, which means it may be supplying some sedation during the day. I'd reduce it by 25% every few days.

 

It could be the hydroxyzine has turned paradoxical on you, as these sedating antihistamines often do, and your sleep will improve as you lower the dose.

[Goosie]

Thanks alto.   I agree after 8 months the hydroxizine is probably no longer helping.  I will continue to taper and let you know what happens.  

[Goosie]

Alto I went down a bit on the hydroxizine last night.   Was still awake at 6 am and then only fell into a half dream state where I am still aware for an hour or so.    Had severe akathasia trying to sleep.     

 

I dont think a fast taper will help me sleep.   I am too used to the antihistamine.    

 

Also all drugs with antihistamine action seem to be a nightmare to taper off of -  seroquel Remeron etc.     

 

i am not not sure I understand why hydroxizine is considered easier to taper from.   

 

I feel like my only option is to go slow and try not to get so desperate that I take more drugs.   

 

Does this nightmare ever end?   Do people recover from this horrific insomnia?????

 

i really need hope 

 

 

 

thanks 

 

 

 

 

 

[Goosie]

Also I am on bio identical hormones but my period is still almost non existent.  2 days bleeding max.   Should I stay on them? I went on them when the crisis started 8 months ago.     Not sure if they are hurting or helping.  

[ChessieCat]

You've made a lot of changes in the last few months.  It would probably be better to only make necessary changes at this time.

[Goosie]

So I used to sleep ok every  Other day.   Last night I had two nights with almost no sleep in a row.  ( 0 hours and 2 hours).   It really feels like I am getting worse.   Does anyone know of others who have gone through this and made it out?  Desperate for hope.....

[Altostrata]

I don't understand your reasoning about hydroxyzine. If it's not helping you sleep, why would reducing it be a problem?

 

Seroquel is not an antihistamine, it's an antipsychotic.

 

Poor sleep two nights in a row doesn't make a pattern. Please stay calm, you'll probably experience waves and windows for months.

 

[Goosie]

Thanks alto.   I have a real problem with fear and panic when the symptoms become inbearable.   Your suppprt means the world to me.   

 

So so here is my thinking regarding seroquel and hydroxizine.   I like to look at the pharmacy dynamics on Wikipedia rather than rely on labels since labels are often used for marketing purposes.     

 

Both hydroxizine and seroquel are strong antagonists of h1 making them both antiiistamines.   The k1 ( measure on wiki) at h1 is 2-19 for hydroxizine and 2.2-11 for seroquel.  

 

Both are dopamine antagonists though hydroxizine only works on 1 dopamine receptors while seroquel works on many.   For  seroquel the d2 number is 245 and for hydroxizine it is 378.    

 

So so they are comparable.   At low doses like 25 mg i don’t think either drug affects dopamine too much.    

 

Seroquel does have strong action on  the alpha receptors which hydroxizine doesn’t have so that probably makes seroquel harder to taper 

but I would guess that the histamine antagonism is a big part of trying to tAper low dose seroquel.    Hence I would imagine that tapering hydroxizine low dose is similarly hard.   

 

Seroquel is considered an anti psychotic at high doses because of the dopamine antagonism but at low doses it shouldn’t have so much affect on dopamine.  

 

I might be be totally wrong but this is what makes sense to me.   

 

I have been been on a h1 blocking drug for 8 months and have been in crisis the whole time.   

 

I don’t think I am strong enough to survive a sudden change in anything.     

 

 

Do let let me know your thoughts as you are more of an expert than me.  

 

Thank you

 

[Rachellynn]

Thank you for stopping by my page and showing some love. Sending hugs❤️❤️

[Goosie]

you are welcome rachellynn.  my page is a ghost town. lol

[Rachellynn]

When i was well...i lived in OB. I miss SD. Mine was too at first lol. Stick around long enough, you make friends. Hopefully you won’t have to! Lol😘

[Goosie]

Sending love rachellynn.    💕💕💕

[Goosie]

@Altostrata I was wondering if you could comment on my reasons for doing a slow taper off hydroxizine.    It diesnt seem like many people on this site take it for sleep.   At least I couldn’t find much doing a search.   

 

What is your experience as a mod with hydroxizine tapers?  Thanks!

[Altostrata]

I believe you're overthinking the supposed similarity between quetiapine and hydoxyzine. Quetiapine is a much more powerful drug. Despite some effect on histamine receptors, quetiapine is not an antihistamine, no matter what the armchair scientists at bluelight might say.

 

If you want to to a slow taper off hydroxyzine to control your health anxiety, do a slow taper.

 

If hydroxyzine has gone paradoxical on you, which is common for the sedating antihistamines, it will keep you awake that much longer during your slow taper.

[Goosie]

@Altostrata forgive me I am trying really hard to understand.  I have been in crisis for the last 8 months and am not functional at all.   

 

When a drug goes paradoxical doesn’t that mean that the body now has a compensating reaction to it?  If you stop taking the drug won’t you go into terrible withdrawl then?   Everything on this site says taper slowly.   

Do you recommend a fast taper for hydroxizine simply because you think this drug is less harmful?  Sorry I am stupid.  Just trying not to die.   

[Altostrata]

1 hour ago, Goosie said:

When a drug goes paradoxical doesn’t that mean that the body now has a compensating reaction to it?  If you stop taking the drug won’t you go into terrible withdrawl then?   Everything on this site says taper slowly.    

Do you recommend a fast taper for hydroxizine simply because you think this drug is less harmful?

 

When a drug goes paradoxical, the body's way of coping might not be something with which you're comfortable, e.g., keeping you awake.

 

If you're in this situation, you don't have any choice but either continue to experience the paradoxical reaction or reduce the drug.

 

Withdrawal symptoms result from physiological dependency. I doubt you are physiologically dependent on this antihistamine, but I addressed that here

 

On 2/20/2019 at 12:15 PM, Altostrata said:

Hydroxyzine is an antihistamine with a half-life of about 20 hours, which means it may be supplying some sedation during the day. I'd reduce it by 25% every few days. 

 

It could be the hydroxyzine has turned paradoxical on you, as these sedating antihistamines often do, and your sleep will improve as you lower the dose.

 

Although it is sedating, hydroxyzine is not a psychiatric drug, it's an old antihistamine. See https://en.wikipedia.org/wiki/H1_antagonist

 

Compared to psychiatric drugs, it is weak. It's like Benadryl, which also can go paradoxical. We see this all the time.

 

Your choice how you want to go off. Please let us know how you're doing.

[Goosie]

Thanks @Altostrata  I’ll try to taper faster.  I am at about 18-20 mg at the moment.   

 

I am am so emotionally broken.   I need helping holding on.   

 

Have othrrs gotten past past their sleep issues after being on an antihistamine?

[Altostrata]

We would not put effort into running this site if no one ever recovered.

 

It is possible that you'll see improvement when you go off hydroxyzine. You also need to nurture your sleep with these methods:

 

On 2/19/2019 at 3:10 PM, Altostrata said:

....

It's also important to keep your bedroom cool and dark, see

 

Tips to help sleep -- so many of us have that awful withdrawal insomnia 

 

Waking with panic or anxiety -- managing cortisol spikes

 

Melatonin for sleep: Many people find it helpful

 

TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime

 

If the hydroxyzine stopped working, stop taking it.

 

[Goosie]

@Altostrata I have read those links many many times and implement all the sleep hygiene I can.   

I am desperately trying to get off hydroxizine.    I tried to taper in dec, but got such horrific insomnia that I went back up.    I tried again this feb and am barely holding on.     I do feel like it still has a calming effect on me, it’s just that my sleep has deteriorated further.     

 

Thank you for your help.   It’s hard to tell whether the worsening insomnia is from  lexepro withdrawl, seroquel withdrawl, Ambien withdrawl, or marajuana effects.  (Mj tipped me over the edge to start).    I am doing my best to hang on.    Thank you again.    

[Altostrata]

A grueling insomnia is a common symptom of withdrawal from psychiatric drugs. We have many people who have experienced this and recovered from it.

 

I see you were taking phenibut at one time. This is a benzo-like drug that taken regularly will incur dependence. If you quit it cold turkey, that might have added to your withdrawal symptoms.

 

If you don't feel you can reduce the hydroxyzine, then don't. I don't have any easy solutions for you.

[Carmie]

Hi Goosie, 

 

Thanks for your message. Yes, I always stabilised after each taper. 

 

You will eventually stabilise, even though you’ve been struggling for eight months. It might take quite a while though because you went off so many medications so quickly. There is no answer as to when you will stabilise, it takes time, sometimes a long time.

 

I’m tapering off Seroquel myself, and one night when I didn’t take it I didn’t sleep a wink. When I get down to the lower doses and finally jump off I’m expecting I’ll probably end up with rebound insomnia too. I’m not focusing on that now, I just live in the moment. 

 

You need to focus on something else other than your symptoms, otherwise you are really going to stress yourself out. I have Chronic Fatigue Syndrome and whether I sleep well or not I live in utter exhaustion. I can’t even explain it. I remember reading an article once that said comparing ordinary tiredness with someone who has CFS is like comparing a match to lightening. 

 

I still try and focus on what is positive in my life and I have lots of hobbies and distractions to keep me going. If I’m too exhausted to do anything I just lie there and listen to music or something. Please find yourself some distractions to help you cope. 

 

Sending hugs🤗

 

 

[Goosie]

Thanks so much for the response.  I try to think of other things but I am debilitated by the chronic pain that I find it hard.    

 

My my main issue is finding hope to keep going.   The insomnia is so severe even on sleeping pills- it’s like they have no effect.  

 

Thank you you for being my friend.  I am sure you will have no problem getting off seroquel - you have the right mindset.  

 

Sending lots of love

gwen