Wagen : Insomnia, chronic pain, tinnitus - mirtazapine?

[arbor]

Hi @WagenI'm so sorry you're experiencing this feeling of high alertness.  I have also struggled with this as well as sleeplessness and tinnitus.  It's crazy-making, isn't it?    If it's helpful to you, I want to share that the tinnitus is growing a tiny bit quieter.  I take that as a good sign, and I think the same will happen for you.  Please hang in there.  This W/d requires such an incredible amount of patience.

Thinking of you,

Arbor

[Altostrata]

You decided you didn't want to get dependent on clonazepam after taking it for 4 months or more. But you were already physiologically dependent, evidenced by your development of clonazepam withdrawal syndrome, at least. Your symptom pattern is grueling, but it is normal for withdrawal syndrome.

 

7 hours ago, Wagen said:

Are my insomnia symptoms manageable by non drug techniques or there is no chance? My body feels very very alert and I don't know what to do to break the cycle. 

 

Some people do manage insomnia with non-drug techniques. Which techniques have you tried from 

and how have they worked for you?

 

[Wagen]

2 hours ago, arbor said:

Hi @WagenI'm so sorry you're experiencing this feeling of high alertness.  I have also struggled with this as well as sleeplessness and tinnitus.  It's crazy-making, isn't it?    If it's helpful to you, I want to share that the tinnitus is growing a tiny bit quieter.  I take that as a good sign, and I think the same will happen for you.  Please hang in there.  This W/d requires such an incredible amount of patience.

Thinking of you,

Arbor

Arbor, im glad the tinnitus improved for you! For me with the sleep deprivation, it's only getting worse and worse. 

 

What worked for you with the sleep?? 

 

Thank you very much for your thoughts! 

[Wagen]

21 minutes ago, Altostrata said:

You decided you didn't want to get dependent on clonazepam after taking it for 4 months or more. But you were already physiologically dependent, evidenced by your development of clonazepam withdrawal syndrome, at least. Your symptom pattern is grueling, but it is normal for withdrawal syndrome

 

I know now it's too late to regret but I stopped as per doctors instructions. I know I was supposed to know better and check but I trusted them. I never took drugs like that before. But I know it was my responsibility not to follow them without checking. 

 

I tried meditation, dark place to sleep, no screens, breathing exercises, binaural beats music, magnesium, fish oil, hypnosis recordings, white noise, gentle stretching, exposure to light during the day. I just can't sleep after 3am.

 

The only thing that helps to fall asleep at 10pm is the meditation recording. I listen to it again at night but it doesnt bring me back to sleep. 

 

Is there anything else I could do???? 

[Altostrata]

Do you sleep from 10 p.m. to 3 a.m.?

 

How has your sleep pattern changed in the last month?

[Wagen]

I go to bed around 10pm and usually fall asleep within 30 to 45 mins. On bad days I wake up around 1, on good days I stay asleep until 3am and that's it. 

 

The sleep pattern has worsened. Last month I was able to get maybe 30 mins of dreamy sleep around 5am but now I'm just totally awake from 3am.

 

The pain also gets worse around this time which probably adds to the inability to fall asleep again. 

 

I've tried to address the pain by all possible means too but I was told it's chronic and for life due to central sensitization. 

 

I don't know what to do, Altostrata, my brain is slowly killing me. 

 

 

[Altostrata]

If you get 5 hours of sleep, that's not too bad for withdrawal syndrome.

 

I don't know what to suggest. You've rejected reinstatement of any drug and decided to cope with the withdrawal symptoms. This means using non-drug techniques to get by while your body heals from suddenly going off multiple drugs.

[Wagen]

On 5/8/2021 at 2:00 AM, arbor said:

Hi @WagenI'm so sorry you're experiencing this feeling of high alertness.  I have also struggled with this as well as sleeplessness and tinnitus.  It's crazy-making, isn't it?    If it's helpful to you, I want to share that the tinnitus is growing a tiny bit quieter.  I take that as a good sign, and I think the same will happen for you.  Please hang in there.  This W/d requires such an incredible amount of patience.

Thinking of you,

Arbor

Arbor, I'm so happy it seems more quiet! How many hours a night do you sleep? I know the tinnitus would probably decrease so much if I was able to sleep. But it's a vicious circle and I can't break it

[Wagen]

On 5/8/2021 at 8:20 AM, Altostrata said:

If you get 5 hours of sleep, that's not too bad for withdrawal syndrome.

 

I don't know what to suggest. You've rejected reinstatement of any drug and decided to cope with the withdrawal symptoms. This means using non-drug techniques to get by while your body heals from suddenly going off multiple drugs.

Altostrata, from your experience, do you think that my insomnia is the original one caused by the pain or at this point its caused by the withdrawal?

 

Doctors keep saying that chronic pain patients are simply on sleeping meds for life. 

 

I keep hoping that the insomnia is caused my the drugs and I can still heal from it with time. 

 

Do you think that I'm being stubborn by not wanting to reinstate? Id do it but Im so so scared from the side effects after I got the tinnitus, so many more things could go wrong! 

 

Thank you very much for your thoughts. 

[arbor]

Hi @Wagen--The insomnia is one of the most challenging symptoms for me.  I was in fact starting to sleep for longer than 2-5 hours a night, but after the second vaccine I'm very lucky to get 2 hours.  It's hard not to despair.  I hang on to the belief that it will improve.  I hold that belief for you as well.  There are testimonies in the Success Stories--even of people who went of their medications quickly.  I admit, I read them over and over.  Let me know if I can share with you more.  Arbor

[Altostrata]

There is no way for me to know if your insomnia arises from your underlying pain or from withdrawal. If it got worse after withdrawal, it's from withdrawal.

 

If you don't care to reinstate, you will have to learn ways to cope with the symptoms, which may include poor sleep and pain. We don't have any instant cures for these, or we'd be telling everyone about them, making a fortune, and close this site.

 

3 hours ago, Wagen said:

Doctors keep saying that chronic pain patients are simply on sleeping meds for life. 

 

There are other opinions about this. Doctors want to give you a quick solution with a pill. You should join a support group for people with chronic pain.

 

As you must be aware, many have gotten trapped in a cycle of dependency on opioids. Sleep drugs also incur dependency.

[Wagen]

9 hours ago, arbor said:

Hi @Wagen--The insomnia is one of the most challenging symptoms for me.  I was in fact starting to sleep for longer than 2-5 hours a night, but after the second vaccine I'm very lucky to get 2 hours.  It's hard not to despair.  I hang on to the belief that it will improve.  I hold that belief for you as well.  There are testimonies in the Success Stories--even of people who went of their medications quickly.  I admit, I read them over and over.  Let me know if I can share with you more.  Arbor

Arbor, I hope the sleep will come back. If your body got to the point it could sleep more then 5 hours, it will go there again. 

 

In 10 months of my journey, I haven't been able to make this breakthrough. If you have any tips, please do let me know. I read everything about sleep in this forum, tried so many strategies, but no chance to sleep more then 3 4 hours, mostly less. 

 

I'd be grateful to learn from your experience.

[arbor]

Dear @Wagen The insomnia is so very difficult.  I'm scratching my head as to what might help me occasionally.   I think that when I get up and change rooms, then go back to bed and read something soothing to my nervous system, my body is more likely to relax and my mind to switch channels.  I choose Buddhist books because I find its philosophy helps me to let go of my fear, sadness and despair.  Other people have different things they read which I think works for them in a similar way.  Also, know in the night that you're not alone, that we're all routing for one another.

I send you hugs,

Arbor

[Altostrata]

You might try playing very soft music while you're sleeping. See:

 

What is the sleep cycle?

 

Waking with panic or anxiety -- managing the morning cortisol spike

 

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

 

Path to Better Sleep FREE online for everyone from the US Veterans Administration

 

Music for self-care: Calms hyperalertness, anxiety, aids relaxation and sleep

 

White noise devices for sleep

 

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

 

[Marija]

On 3/4/2021 at 9:29 AM, Wagen said:

@Marija

 

Marija, just wanted to support you in your struggles. I also have been fighting insomnia for many months now, together with many withdrawal symptoms.

 

I have tried to reinstate mirtazapine for two weeks now but then decided to do rapid taper - I dont expect it to ever help me. 

 

I will try to face to insomnia and hope that my body will take the sleep when it needs to.

 

Have you tried this approach? The longest I went without sleep has been three days for me. Then I was always given something to sleep. 

 

What happened to you after you didnt sleep for 5 days in December? Did your body eventually sleep?

 

I feel so so exhausted from all these drugs and just want to heal. I just dont know if its possible at all without sleeping.

 

Im thinking on you and understand how you feel.

Hello @Wagen I'm sorry for not replying sooner.

 

Unfortunately, my insomnia didn't go away after those 5 nights of no sleep. I ended up reinstating mirtazapine and taking lorazepam. Since then, I updosed twice - once from 0.5mg to 0.75mg and then from 0.75mg to 2.5mg (my most recent updose about three weeks ago). After reinstatement and after my two updoses I slept reasonably well for about 2-3 weeks and then crashed. The same thing is happening right now after my updose to 2.5mg about three weeks ago. It's currently day five of only about 2 hours of very light broken sleep a night and I'm not doing well at all. The possibility of this carrying on for a long period of time makes me want to jump off a bridge. However, the last time I updosed, I promised myself I wouldn't mess with my dose anymore and just stick it out no matter. No lorazepam either. I have no idea whether I'm going to be successful at sticking to my promise but I want to do my best. It's very very hard. Makes me totally non-functional and I feel like I'm quite literally dying from sleep deprivation. Sometimes I even wonder if it's worth it. I feel like I've kindled with my system so much though that waiting it out is my only option unfortunately. I really really hope the relentless insomnia is going to pass soon. Please feel free to get in touch with me for any support. I often feel better after speaking about it with someone. Stay strong and take care.

 

Marija

[Wagen]

On 5/20/2021 at 2:40 AM, Altostrata said:

You might try playing very soft music while you're sleeping. See:

 

What is the sleep cycle?

 

Waking with panic or anxiety -- managing the morning cortisol spike

 

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

 

Path to Better Sleep FREE online for everyone from the US Veterans Administration

 

Music for self-care: Calms hyperalertness, anxiety, aids relaxation and sleep

 

White noise devices for sleep

 

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

 

 

Altostrata, I think that insomnia is really making me insane. I was trying not to give up for 6 months now but I cannot take it anymore. The sleep is worse and worse. I have never slept past 4am in these months.

 

Is there a chance that reinstatement could help me to get some sleep and then take it from there? I thought Id never say that I would consider taking drugs again but the sleep deprivation combined with pain and worsening tinnitus is unbearable.

 

My doctor presribed to me so many things to sleep that I dont know what would be most sensible.

 

Im considering amitriptyline or mirtazapine. I dont want to start taking again clonazepam or even the olanzapine.

 

Im scared to death from the drugs but my current existence is on the edge of barely functioning. I have a son and want to be able to be a mum for him. I know that drugs are not an answer but maybe they could give me some sleep so that I can be with him a bit longer. 

 

I tried all possible non-drug coping techniques but I never get past 4 hours of sleep. 

 

Amitriptyline - I took it for about 3 months and the tinnitus significantly worsened after I stopped taking it. I slept about 6 hours on the dose of 40, then it started to get worse and worse.

 

Mirtazapine - I took it for 1 month last August and it totally stopped working for insomnia and thats when the doctors told me to start all those other drugs. I then tried it for 3 weeks this past February and I slept very randomly with some nights of zero and some with about 5 hours. I stopped because I got scared from increased agitation and anxiety and felt it was not helping me.

 

Its been more then 3 months since I I took both drugs and I hate to think I should start again but I really cant cope with the constant sleep deprivation. My ringing brain never gets rest.

 

What do you think about reinstatement at this moment? Would you advise to go back on amitriptyline or mirtazapine?

 

Thank you very much for your thoughts.

 

 

 

 

[Altostrata]

On 5/7/2021 at 11:20 PM, Altostrata said:

If you get 5 hours of sleep, that's not too bad for withdrawal syndrome.

 

I don't know what to suggest. You've rejected reinstatement of any drug and decided to cope with the withdrawal symptoms. This means using non-drug techniques to get by while your body heals from suddenly going off multiple drugs.

 

If you want to consider reinstatement, please read our discussions about reinstatement from the beginning of this topic.

 

I cannot tell you how you will react to reinstatement or taking any other drug.

[BfromNJ]

hello.  I read through your thread and wanted to share my experience and thoughts with you.   I too developed tinnitus pretty bad a few years back.  Probably med related.  It was so grueling and I thought I would go insane.  I was not sleeping well before it and it certainly didnt help.  Please have hope.  There is a wonderful forum called tinnitus talks and they are very supportive and helpful.   You will adapt to it after some time.  I find mine is worse at night when i try and sleep. or at least that is when i notice it the most.    I use a white noise machine. I find it helps my mind focus on that instead and helps to cancel out the tinnitus.  Anxiety, Stress and lack of sleep can also make tinnitus worse.   Since your insomnia started after the birth of your son, have you asked the doctor to check your hormone levels?  your body goes through such an ordeal with the birth of a child.   If you are getting 4-5 hours a night, at least that is something.  Maybe how you are feeling the next day is not entirely from lack of sleep but also hormonal or some post partum issue?  I wish you well and for some kind of peace and healing.  Stay strong!  

[Wagen]

On 3/8/2021 at 12:54 PM, Shep said:

I think if you truly believed that, you wouldn't have joined this site. You figured it out already, and that's a good thing. We should all do our own research. The very drugs that they say will heal are drugs that destroy sleep architecture. Doesn't sound like a very solid plan to me. 

 

@Shep

 

Shep, 

 

I keep mentally repeating what you told to me almost every night when I cannot sleep. 

 

It's been now since that 3 months and my sleep continues to be disastrous. I'm averaging 3 hours. 

 

I read the entire site hundreds of times, trying to implement all your advice, but it seems that my brain is stuck at this mode of extreme sleep deprivation that gives me sleep only not to die basically. The moment I get a bit of rest, the brain makes sure to make me stay awake until the next point of total exhaustion. I can't break the cycle and sleep unless I'm dead exhausted. 

 

I know I asked this before but is there anything else or more I can do? It feels like waiting for a miracle that is not coming. I'm barely functional. 

 

I'd do anything just to break this horrible cycle. Thank you for you  thoughts. 

[Wagen]

On 6/6/2021 at 1:18 AM, Altostrata said:

 

If you want to consider reinstatement, please read our discussions about reinstatement from the beginning of this topic.

 

I cannot tell you how you will react to reinstatement or taking any other drug.

 

Thank you, Altostrata, I know none uf us can predict. It's been a long while so there is also a low chance that the reinstatement would predictably work. I'm sorry I keep asking. Thank you for your support. I will try to keep going. 

[Wagen]

On 6/9/2021 at 8:10 PM, BfromNJ said:

hello.  I read through your thread and wanted to share my experience and thoughts with you.   I too developed tinnitus pretty bad a few years back.  Probably med related.  It was so grueling and I thought I would go insane.  I was not sleeping well before it and it certainly didnt help.  Please have hope.  There is a wonderful forum called tinnitus talks and they are very supportive and helpful.   You will adapt to it after some time.  I find mine is worse at night when i try and sleep. or at least that is when i notice it the most.    I use a white noise machine. I find it helps my mind focus on that instead and helps to cancel out the tinnitus.  Anxiety, Stress and lack of sleep can also make tinnitus worse.   Since your insomnia started after the birth of your son, have you asked the doctor to check your hormone levels?  your body goes through such an ordeal with the birth of a child.   If you are getting 4-5 hours a night, at least that is something.  Maybe how you are feeling the next day is not entirely from lack of sleep but also hormonal or some post partum issue?  I wish you well and for some kind of peace and healing.  Stay strong!  

 

Thank you for your supportive words! 

 

I had tinnitus now for more then 6 months and because I don't sleep it feels like I cannot possibly ever get used to it. It's a torture 24/7. 

 

The white noise unfortunately deosnt help me bc it makes it louder :(( I cannot really mask it unless the sound is super loud which makes it impossible to sleep. 

 

The 4 hours are extremely rare, its more 3 hours on average, for months and months now. 

 

I had the hormones checked and it was ok. The births definitely triggered something in my body and the drugs made it worse. It's now all together with the withdrawal symptoms and I definitely suffer from anxiety now. I never had it before but the months of suffering with no hope of improvement took toll. 

 

I try to keep going but it feels I do that not bc Im healing but bc my body takes every last bit of my past healthy self to stay alive.. Until its depleted, I guess. 

 

My best wishes and healing to you!!! 

[Wagen]

On 5/27/2021 at 1:31 PM, Marija said:

Hello @Wagen I'm sorry for not replying sooner.

 

Unfortunately, my insomnia didn't go away after those 5 nights of no sleep. I ended up reinstating mirtazapine and taking lorazepam. Since then, I updosed twice - once from 0.5mg to 0.75mg and then from 0.75mg to 2.5mg (my most recent updose about three weeks ago). After reinstatement and after my two updoses I slept reasonably well for about 2-3 weeks and then crashed. The same thing is happening right now after my updose to 2.5mg about three weeks ago. It's currently day five of only about 2 hours of very light broken sleep a night and I'm not doing well at all. The possibility of this carrying on for a long period of time makes me want to jump off a bridge. However, the last time I updosed, I promised myself I wouldn't mess with my dose anymore and just stick it out no matter. No lorazepam either. I have no idea whether I'm going to be successful at sticking to my promise but I want to do my best. It's very very hard. Makes me totally non-functional and I feel like I'm quite literally dying from sleep deprivation. Sometimes I even wonder if it's worth it. I feel like I've kindled with my system so much though that waiting it out is my only option unfortunately. I really really hope the relentless insomnia is going to pass soon. Please feel free to get in touch with me for any support. I often feel better after speaking about it with someone. Stay strong and take care.

 

Marija

 

Hi Marija, 

 

Thank you for your response, I hope you sleep better these days!!!

 

Im a mess here. 

 

I read your thread and you seem to have some sense of normal sleep patterns still with you. Even though sometimes it doesn't seem to you, you do have that!!! 

 

Im afraid it's not my case I think my brain only sleeps when it's about to collapse. The moment I feel liiiiittle bit recharged, Im awake again. It often happens only after minutes of sleep. I slept last night 3 hours after I didn't sleep at all the night before and now it's almost 10pm here and I feel extremely awake with not even a sign of sleepiness. That means another zero night. Pure torture.

 

Can you sleep when you are not totally exhausted? 

 

My best wishes and healing to you! I'm thinking on you. 

[Wagen]

On 5/19/2021 at 10:21 PM, arbor said:

Dear @Wagen The insomnia is so very difficult.  I'm scratching my head as to what might help me occasionally.   I think that when I get up and change rooms, then go back to bed and read something soothing to my nervous system, my body is more likely to relax and my mind to switch channels.  I choose Buddhist books because I find its philosophy helps me to let go of my fear, sadness and despair.  Other people have different things they read which I think works for them in a similar way.  Also, know in the night that you're not alone, that we're all routing for one another.

I send you hugs,

Arbor

 

How are you doing, Arbor? Thinking on you! 

[arbor]

Dear @Wagen--I've just been catching up on your thread.  I'm so sorry that you're having problems sleeping still.  Insomnia and tinnitus are two of my big symptoms.  All I can say is that it's hell not to sleep, and when the tinnitus is screaming I feel very desperate.  Meanwhile let me share with you what I do and what sustains me.  Recently my sleep has improved to about 5 hours.  Before going to bed I take melatonin and magnesium.  When I wake in the night, as you know, I get up and come back and read a while.  Then I remember that awhile ago I also read somewhere that many people have insomnia and that it won't kill me.   With my head on the pillow I just meditate, following my breath in and out.  This helps me to focus on the breath rather than my worries.  It helps me to feel that at least I'm using the awake-time to improve my meditation skills.  Even just lying there we are getting some rest--we don't have to do anything else.  Basically, I endure, strengthening myself against my despair by reading quotes I've copied from the Success Stories.  I'm truly trying to take one moment at a time.....it's excruciating, but it's what I have in front of me.

Here's an (overly-cropped) picture of my kitty.

Thinking of you💗

Arbor

 

[Ripley]

Dear Wagen

 

I'm sorry you're suffering from insomnia and I know how gruelling it can be. Please don't lose hope in sleeping again as things can and will improve and you will get through this.

 

I havent read all of your thread so apologies for that but, as Arbor said, have you tried using melatonin? I take 0.33mg an hour before bed and believe it helps me feel sleepy. I wish I'd tried it sooner but I was afraid of taking anything that might make things worse. If you don't have any adverse effects from it, then stay with it for several days as I think the effects became stronger with time. It's worth a shot. 

 

And stay off the phone or computer for at least a couple of hours before bed. Try to do something relaxing, I just watch tv with my husband. (I'm sure you know this already.) And in the night, try to just accept whatever will be. Your body and mind will sleep as soon as they are able to. Try not to get upset if it doesn't look like it will happen that night - just try to rest your body and mind as much as you can without sleep. It's more likely to happen that way.

 

I notice that you tried mirtazapine at 30mg and 15mg. At the higher doses it can be activating and is more likely prescribed for insomnia at the lower doses where it's more sedating such as 7.5mg or 3.75mg. This might be why you didn't find it helpful. When our cns is sensitised, then even these doses can be too high so a much smaller dose would be better. I'm not suggesting a reinstatement - I'm not a moderator - but if you were thinking about it, you would only take a tiny amount. A tiny amount of any drug for that matter. 

 

I also haven't been able to tolerate magnesium and only take a low dose of fish oil. I don't know how much you take of these but perhaps try less or even skipping them for a day or two to see if it helps? I also eat a lot of walnuts, pumpkin seeds, eggs and salmon in my diet and try to drink a lot of water and definitely no caffeine or alcohol. I also find ginger gives me insomnia but magnesium chloride baths are soothing. I'm just giving you everything I've learned in case it may be relevant or helpful to you. My sleep is generally pretty good right now, although I never take it for granted.

 

I hope things improve for you soon,

Ripley x

 

 

[Altostrata]

On 6/22/2021 at 12:37 PM, Wagen said:

It's been a long while so there is also a low chance that the reinstatement would predictably work.

 

That is correct, but a sample still might be something worth trying.

 

Have you tried melatonin to initiate sleep?

 

Did we talk about fish oil and magnesium supplements?

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you.