Wagen : Insomnia, chronic pain, tinnitus - mirtazapine?

[Wagen]

Hello friends,

 

Im at a desperate situation and seek advice from people who suffer from similar problems. After the birth of my son, I started suffering horrible insomnia and after a collapse was prescribed mirtazapine with clonazepam. After about 2 months, I stopped sleeping again, and after another hospitalization I was prescribed amitriptyline and olanzapine. I used these about 2 months and then tapered to 0 by December (following doctors advice). During this process I developed a bilateral tinnitus. In January and February this year, I struggled to sleep without any medication up to mid Feb 2021, when my doctor insisted I use either Lorazepam or Mirtazapine 15 in order to be able to sleep. In desperation and out of total exhaustion (I slept on average 2 to 3 hours a night) I decided to restart Mirtazapine 15. I've been taking it for about 10 days and sleep now broken 4 to 5 or 6 hours a night. I have never taken any drugs or smoked before and was very healthy. Unfortunately, after the birth, my health deteriorated and I seem to be getting worse and worse. I dont believe in antidepressants and truly want to be off them but the truth is that I seem to have lost ability to sleep. After a week of sleeping only 2 or 3 hours I seem to lose my mind. Is anyone here in similar situation? Could mirtazapine help me restore a sleeping rhythm or the longer I take the worse it will be? Thank you very much for your advice. 

Edited February 24, 2021 by Erell
Title

[Erell]

Hello,

 

And welcome on SA. 

 

This site is run entirely by volunteer Administrators and Moderators, all have been through or going through withdrawal.

There are no commercial interests or influences  involved.

 

And oh I'm really sorry for what you've been through. Hang on dear, it really can get better.

 

--》 How are you feeling now that you've reinstated Mirtazapine ?

 

--》 Are you still taking Clonazepam ?

 

--》 Do you have someone who can help you with the baby ?

 

On 2/21/2021 at 11:01 AM, Wagen said:

 After a week of sleeping only 2 or 3 hours I seem to lose my mind. Is anyone here in similar situation?

Yes, a lot if folks here have issues with sleep. You might find some ideas in this thread :

 

tips-to-help-sleep

 

 

Again, welcome.

 

[Wagen]

Thank you so much for your support! 

 

I've been taking now mirtazapine for two weeks and the sleep is very shallow and short - I sleep maximum 4 to 5 hours. I don't know if I should keep taking it bc of the obvious risks with being dependant on the drugs. I don't know if this is better then trying to sleep on my own. 

 

After stopping the amitriptyline I gradually slept less and less and I think that the electrical head buzzing and tinnitus are part of the WD symptoms. 

 

I took the clonazepam only once last week when I had a panic attack from the tinnitus. 

 

I have a very supportive partner who helps with everything related to our son. I'm grateful for that. 

 

I feel very anxious and have phobia from the insomnia. 

 

What increases my chances to heal. To try to stay on mirtazapine and taper slowly (eventhough I don't sleep so much) or going off it and try all possible non-drug strategies? 

 

I'm very desperate and scared bc since the beginning of my history with drugs I'm only getting worse and worse. 

 

Thank you so much for your advice. My doctor keeps telling to take more and more of clonazepam which I'm scared to do. 

[Altostrata]

Hello, @Wagen

 

It sounds like you might have withdrawal syndrome from going off mirtazapine and clonazepam last August. A grueling insomnia is common in withdrawal.

 

Getting 4-6 hours of sleep is not too bad for withdrawal syndrome. What time of day do you take mirtazapine? What is your sleep pattern? How do you feel when you wake up? How do you feel during the day?

 

 

[Wagen]

@Altostrata,

 

I had horrible insomnia after the birth of my son, so it started before taking any drugs. 

 

In September, mirtazapine stopped working, and all my symptoms started when they gave me really high doses of amitriptyline and olanzapine in the hospital. 

 

The head buzzing and really bad tinnitus started this January - I think as a WD from Amitriptyline. Or maybe still from mirtazapine, I don't know. 

 

Now, I don't know if I should keep taking the mirtazapine, it's been two weeks. 

 

I sleep 4 or 5 hours. Last night, I went to bed at 11, fell asleep after 12, woke up at 3:56 and couldn't sleep more. 

 

I feel the whole day very hyper and tense and at this point fear that will have to start taking antipsychotics in case I went to see doctors. 

 

I feel like it doesn't work for me that well for sleeping, I continue to have the head buzzing and tinnitus. 

 

Would you recommend staying with mirtazapine or should I stop now when it's still relatively early. 

 

If to stop now, how fast should I taper after two weeks only. 

 

Thank you so so so much for your support. I'm in this all alone. 

[Wagen]

@Erell@Altostrata

 

I just want to say big thank you for your support. I cant say how much it means to have someone who believes in my complaints. NONE of the doctors I met ever accepted any symptoms I described. Thank you so much. 

[Nomansland]

Hello @Wagen,

 

iam sorry what youre going through.

 

Maybe, this could help to convince your doctors about severe withdrawal? It describes many withdrawal symptoms and slow tapering.

Currently its not available in dutch, only english and german, but we are working on it.

 

Greetings

 

Nomansland

[Wagen]

@Nomansland

 

Thank you for this!

 

Im at the moment at a very bad mental state but I SWORE to myself that if I ever get out of this I will dedicate my life to change the world of psychiatry. My hospital stay was brutal and traumatising.

 

I see that you also use mirtazapine - would you advise to me to keep using it to consolidate sleep or should i stop? Ive been using it only for two weeks now and my sleep is very poor - on average 4 hours a night.

 

Unfortunately, with mirtazapine i do sleep more. Without it, I reached many nights of zero sleep a week. Would you recommend to try to stop it while its not that long and power through the insomnia, somehow?

 

I experience tinnitus and electrical buzzing in ears.

 

Thank you for your advice.

[Nomansland]

Hello @Wagen,

 

you clearly are in withdrawal from coming off/changing these drugs too fast. Its not your fault, doctors are unaware of this, sadly.

Its important not to panic and not to make sudden decisions, especially when we feel so bad. I cant tell you what will happen if you go off mirtazapin now, but its important to

maintain sleep. Too less can affect other withdrawal symptoms.

 

Please wait for suggestions from the experienced moderators and try to work on non-drug technics to calm your system down.

We all will get through this!

 

Greetings

 

Nomansland

 

[Wagen]

@Nomansland Thank you very much, I will then await help of the experienced moderators.

[Wagen]

@Altostrata, @Erell,

 

Let me please know what you advise. 

 

The ear buzzing and tinnitus are really bad and I don't feel well, I think my brain is really destroyed from all these changes, but I don't know if mirtazapine will make me feel any better to stabilize. 

 

It's been today 14 days since I took it. 

 

I fear that if I continue, then I will face prospect of more then 15 months of tapering. 

 

Thank you so much and I apologize for many messages. I don't have anyone else to help me. 

 

 

[Mimi79]

Hi @Wagen

I understand well your feeling right now. It is so panicking of not knowing what to do to feel better. 
I will let the moderator give you the best advice about what to do with Mirtazapine. 

But I can tell you that I was at the same place as you, as the first time I took an antidepressant, it was for chronic insomnia. And it was Mirtazapine.

I thought that I had lost my ability to sleep by myself. Of course, I was wrong. We never lose it.
This fear or phobia of insomnia is the reason that kept me on ADs during all those years.  If I could talk to the younger me, I would give her this advice: « Don’t take meds and go see a psychotherapist. »

Now I am still stuck on mirtazapine, trying to taper it, but my sleep is good. 
I have overcome my sleep anxiety by myself, using CBT tools. I am no longer afraid of not sleeping. 
 

Take care!

 

 

[Altostrata]

17 hours ago, Wagen said:

I feel the whole day very hyper and tense and at this point fear that will have to start taking antipsychotics in case I went to see doctors. 

 

This is typical of withdrawal syndrome. I believe you may have withdrawal syndrome from going off the 0.5mg clonazepam you started in August. How did you go off it?

 

Tinnitus and buzzing may also be withdrawal symptoms, or they can be adverse effects from drugs. Are your symptoms better or worse after you take mirtazapine? Are they worse at any particular times of day?

 

Many people find fish oil and magnesium supplements helpful, see

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.

[Wagen]

@Altostrata,

 

Thank you very much. 

 

I stopped taking clonazepam suddenly upon doctors direction. He said I could just stop taking both clonazepam and olanzapine. 

 

The tinnitus started after that. 

 

Then, I gradually stopped amitriptyline, also on their advice, slower, but of course still very fast

 

The symptoms of electrical buzzing started in January. 

 

The symptoms are slightly better in the morning. 

After I take the mirtazapine, I try to sleep. I don't feel much worse after taking it but it doesn't work for sleeping at all. I went to bed last night at 11 and fell asleep only around 4am and woke up at 5am.

 

Cooukd you please advice if I should continue taking it? It's been now 15 days since I started and I don't know if there is any benefit. 

 

Thank you so much for your advise. 

 

[Wagen]

@Mimi79,

 

Mimi, I swear I would never touch drugs if I got at least two or three hours of sleep. 

 

I noticed that the longer I go without sleep the less I sleep, it is as if my body went into another dimension. 

 

Last night, I slept only one hour. Did it happen to you too, while on mirtazapine? 

 

My question is, can my sleep improve while I'm on mirtazapine or it can never give me more hours?? 

 

Im afraid that it may actually prevent me from sleeping bc I feel so agitated on it. 

 

I'm so so scared from tonight. 

 

I really don't know what to do. 

[Wagen]

@Erell, @Altostrata, @Shep, @brassmonkey, @Gridley, @manymoretodays, @Gridley

 

Experienced moderators, I very mych apologize to tag you all here and overwhelm, Im desperately looking for help. I dont know what to do.

 

I spoke with my doctor but he doesnt believe I have the symptoms I describe.

 

I suffer from intense head buzzing and tinnitus. 

 

I started taking mirtazapine 15 two weeks ago after I went to nights with zero sleep.

 

I slept a little better for the first nights but now Im again back to 0 to 1 hour last few days.

 

I feel very tense and anxious that I cannot survive this.

 

Before I get really addicted to mirtazapine15, would you advise I stop taking it?? It doesnt seem to help with my sleep at all.

 

The doctors took me so fast from very high doses last autumn that my body is in a very shocked state now, I think.

 

Please advise, each night Im afraid Im increasing my dependancy to a drug that doesnt seem to help with sleep at all.

 

Thank you so much and I apologize for beeing so insistent. I dont know who else can help me.

 

 

 

 

[Shep]

Quote

 

August 2020 - Mirtazapine 30, Clonazepam 0.5

September 2020 - Changed to Amitriptyline 100, Olanzapine 10, Clonazepam 0.5

Tapered to 0 by December 2020

February 2021 - Mirtazapine 15

 

 

You could rapid taper off the mirtazapine, meaning taper by 25% every few days until you're off. I would get off within the next week if this is what you choose to do, since it takes about a month to develop dependency on an antidepressant. If the first 25% reduction causes a problem, I would updose back to the full dose and try to stabilize. You can then do a gradual taper later. 

 

You were previously on mirtazapine long enough to become dependent from August to September, so it's hard to predict if you'll have withdrawal or not. It's also complicated by withdrawal from olanzapine and clonazepam. Please note that clonazepam can cause dependency in as little as 2 - 4 weeks and in some people, just a few days. So you're really dealing with a destabilized nervous system due to polypharmacy. 

 

 

7 hours ago, Wagen said:

I stopped taking clonazepam suddenly upon doctors direction. He said I could just stop taking both clonazepam and olanzapine. 

 

The tinnitus started after that. 

 

Benzos like clonazepam are notorious for causing tinnitus as a withdrawal symptom (and possibly from the olanzapine), so you likely were dependent on at least one of those drugs. 

 

You've been off clonazepam for almost 2 months and benzo reinstatements don't work well after one month, so I wouldn't reinstate that drug. 

 

I'm not sure the olanzapine should be reinstated, either, though please post if you feel it helped at all with the insomnia. It's a dangerous drug with a lot of side effects, so it may not be something you wish to re-start. Since you started olanzapine at the same time you switched antidepressants and added in a benzo, it's going to be very hard to know how if that drug really affected your sleep. 

 

On 2/25/2021 at 1:28 AM, Wagen said:

I had horrible insomnia after the birth of my son, so it started before taking any drugs. 

 

This also will be a complicating factor. Have you been able to address why the insomnia started? Does your son keep you awake at night? Is your diet healthy? Are you getting help with caring for your newborn? 

 

Please let us know your thoughts on withdrawing from mirtazapine with a rapid taper. Also, as Altostrata mentioned in her post here, you may want to try some fish oil or magnesium, one at a time to see how you do. They can be calming to the nervous system. 

[Wagen]

@Shep thank you so so much for responding!! Thank you!! 

 

I want to stop taking the mirtazapine, it doesnt seem to bring me anything good. 

I will then do 25% every 2 days. 

 

I just don't know what to do with sleep - I reached a point when I go for two days of no sleep and I'm not even tired. I don't understand. It started bc after our son was born I developed a back pain that I continue to have until today. I became very anxious about it and stopped sleeping. I was also extremely vigilant bc he was a colicky baby and the first three months never slept for more then two hours in a row. Until now he is a very bad sleeper. 

 

My partner is very supportive and we are able to care after our son well. He has all what he needs. It's me who is in a horrible state and I try to get through the days for his sake. He unfortunately still wakes up a lot at night and although my partner looks after him at nights, I hear him crying. 

 

At this point the ringing in ears is the most distressing part, making it so hard to sleep. 

 

What would you recommend to do if I go three nights of no sleep? 

 

I had the best reaction in terms of sleep to clonazepam. I don't know if this is better or worse then olanzapine to sleep. When I took olanzapine it was such a high dose - I was severely sedated in the hospital. 

 

I'm doing all non-drug strategies but since I know I can easily go to no sleeping at all, I need a plan B I think. 

 

Thank you so much for helping me!!!!! 

 

[Mimi79]

17 minutes ago, Wagen said:

I just don't know what to do with sleep - I reached a point when I go for two days of no sleep and I'm not even tired. I don't understand.

When I read this, it reminds me something. Few months after the birth of my first girl, I had a period of very intense insomnia. Like you, I wasn’t able to sleep more than 1-2 hours a night, and strangely, I wasn’t tired at all (not physically). I had the feeling it wasn’t normal, so I did a blood test and we find out that I was having a « post partum hyperthyroiditis ».  It last a few weeks, then it settled by itself. At this time, my gp gave me Ativan to help, but knowing the cause removed all my anxiety, so I didn’t use the pills. This kind of thyroïditis after giving birth is very frequent, but undiagnosed because the symptoms are sometimes unnoticeable or misinterpreted. Surely a lot of women have been misdiagnosed with GAD or postpartum depression because of that. If I hadn’t insisted to do the blood test, my Gp was going to medicate me for depression. 

[Shep]

37 minutes ago, Wagen said:

He unfortunately still wakes up a lot at night and although my partner looks after him at nights, I hear him crying. 

 

Is your partner able to take your baby and stay with a relative or can you make use of a hotel to get some sleep? If your baby is waking you up at night, there's no drug that's going to help you unless it sedates you beyond reason. 

 

37 minutes ago, Wagen said:

I had the best reaction in terms of sleep to clonazepam. I don't know if this is better or worse then olanzapine to sleep. When I took olanzapine it was such a high dose - I was severely sedated in the hospital.  

 

I had the best reaction in terms of sleep to clonazepam. 

 

Please find a way to get to a quiet space to sleep at night if at all possible. You've had repeated hospitalizations and that only leads to more drugs. 

 

If you reach a crisis state, you may want to reinstate a small amount of clonazepam, however, since you've been off it for about 2 months, it may or may not work as well, but I would definitely try it before going back into the hospital. 

 

Edited February 26, 2021 by Shep
add more info

[Wagen]

17 minutes ago, Shep said:

Please find a way to get to a quiet space to sleep at night if at all possible. You've had repeated hospitalizations and that only leads to more drugs. 

 

If you reach a crisis state, you may want to reinstate a small amount of clonazepam, however, since you've been off it for about 2 months, it may or may not work as well, but I would definitely try it before going back into the hospital. 

 

@Shep OK, so would you say if I take clonazepam twice a week to sleep, it's OK? Im at such a state that I don't know what crisis means, I feel like I'm continuously pushing my limits.

 

Or, should I just not take any drug no matter what happens? 

 

When I spoke to my doctor, she also suggested promethazine, but I don't know about that. 

 

Thank you so much for your advice. 

 

I will try to find a way to find a quiet place. 

 

Thank you so much. 

[Wagen]

2 hours ago, Mimi79 said:

When I read this, it reminds me something. Few months after the birth of my first girl, I had a period of very intense insomnia. Like you, I wasn’t able to sleep more than 1-2 hours a night, and strangely, I wasn’t tired at all (not physically). I had the feeling it wasn’t normal, so I did a blood test and we find out that I was having a « post partum hyperthyroiditis ».  It last a few weeks, then it settled by itself. At this time, my gp gave me Ativan to help, but knowing the cause removed all my anxiety, so I didn’t use the pills. This kind of thyroïditis after giving birth is very frequent, but undiagnosed because the symptoms are sometimes unnoticeable or misinterpreted. Surely a lot of women have been misdiagnosed with GAD or postpartum depression because of that. If I hadn’t insisted to do the blood test, my Gp was going to medicate me for depression. 

 

@Mimi79 thank you for sharing your experience! Unfortunately, it was checked early on and the levels seemed fine. This was more then 7 months ago though. Do you think I should have it checked again? 

 

[Mimi79]

@Wagen

I think the risk of post partum thiroiditis is higher in the first 12 months after birth. It happens typically around 6 months post partum. I had mine exactly at the 6th month.

It was a good reflex to check it. My GP didn’t have the idea. I auto diagnosed myself. 
But the year after, I started having bad insomnia and this time, it wasn’t link to my thyroid. This is when my Gp put me on mirtazapine. 
Where do you come from? I have a book about insomnia that saved my life. It helped me to overcome my sleep anxiety. I must have found this book earlier in my life, when I first started to have bad insomnia.

 

Take care!

Anne-Marie

[Wagen]

3 minutes ago, Mimi79 said:

@Wagen

I think the risk of post partum thiroiditis is higher in the first 12 months after birth. It happens typically around 6 months post partum. I had mine exactly at the 6th month.

It was a good reflex to check it. My GP didn’t have the idea. I auto diagnosed myself. 
But the year after, I started having bad insomnia and this time, it wasn’t link to my thyroid. This is when my Gp put me on mirtazapine. 
Where do you come from? I have a book about insomnia that saved my life. It helped me to overcome my sleep anxiety. I must have found this book earlier in my life, when I first started to have bad insomnia.

 

Take care!

Anne-Marie

@Mimi79

 

Anne-Marie, 

 

That's why everyone is kind of giving up on me. They say, it's been 9 months since your son was born, you should sleep fine now.

 

I swear I don't know what to do. I love my son more then anything but when I don't sleep for three days I become suicidal. It's awful. I carry on only for him. 

 

What is the name of the book, I will try to read it. I feel I tried everything. But I can't give up! I love my son. 

 

As part of my withdrawal symptoms from all the drugs I was given in the hospital, I developed quite horrible tinnitus, so now the sleeping is even more difficult. 

 

I'm glad you were able to find stability for your family and you sleep well now.

 

Martina

[Mimi79]

48 minutes ago, Wagen said:

What is the name of the book, I will try to read it. I feel I tried everything. But I can't give up! I love my son. 

Be sure that you will overcome it. When it happens (I remember so well!), our world is falling apart. During my awful sleepless night, I was down spiraling. Because we have a baby, we want to be in good shape, to be able to work and give him the best life we can. All this pressure exacerbated my anxiety. Insomniac like us are often perfectionist person. 
 But I forgot that first, insomnia is not permanent. And it is not a disease but a symptom. When we bring back balance in our live, it settle by itself, sometime with a little help. And there is proved ways to overcome it. Cognitive behavioral therapy for insomnia has proved to be more efficient on the long run than pills.
The book have been wrote by one of the world leader expert in insomnia. His name is Dr Charles Morin. He works at my brother’s university here in Quebec (Canada). I’ve even took part in one of his numerous scientific research about insomnia.

His book contains all you have to know about sleep, insomnia and how to overcome it using CBT techniques, the rules you have to follow to regain confidence in your ability to sleep. It is not a quick fix, you have to apply ALL the rules and be persistent, as it can take few months to fully work. It is a step by step guide to relearn how to sleep.
I have the french version of the book. It’s 

«Vaincre les ennemies du sommeil by Dr Charles M. Morin», but there is an English version too. You can do some research on Amazon with his name. I think he wrote numerous books, both in French and English.

But first, you have to figure out that you are probably experiencing  some withdraw symptoms from your past use of mirtazapine (and other meds). It is normal that it messes with your sleep. The first thing you have to do is stabilize your CNS, with the help of the moderator here on SA. And once it is done you can start using the CBT tools to overcome your insomnia. 
 

For your tinnitus, are you able to use « White noises »? It can help. I have a low tinnitus myself, and I always use a fan in my bedroom.

 

I know it is not easy, you are living hard times, but don’t forget there is hope! I remember crying and screaming at my husband that I was so afraid of not sleeping for the rest of my life! It was my anxiety mind that was playing a trick on me. 
 

Sleeping is natural, it will come back. In times, one step at a time. 
 

I’m here to help. 

Take care @Wagen

 

Anne-Marie

[Nomad]

2 hours ago, Wagen said:

@Mimi79

 

Anne-Marie, 

 

That's why everyone is kind of giving up on me. They say, it's been 9 months since your son was born, you should sleep fine now.

 

I swear I don't know what to do. I love my son more then anything but when I don't sleep for three days I become suicidal. It's awful. I carry on only for him. 

 

What is the name of the book, I will try to read it. I feel I tried everything. But I can't give up! I love my son. 

 

As part of my withdrawal symptoms from all the drugs I was given in the hospital, I developed quite horrible tinnitus, so now the sleeping is even more difficult. 

 

I'm glad you were able to find stability for your family and you sleep well now.

 

Martina

When my tinnitus was at it’s worst I used a white sound machine to block out the ringing in my ears while I was sleeping. I also started taking 30mg of zinc twice a day. There is some evidence that zinc helps alleviate tinnitus.
   The only way that I am getting any sleep is because I’m taking two different benzodiazepines. I do not recommend this because it is documented that benzodiazepines can cause dementia and other complications after prolonged use. It’s also extremely difficult to get off of them once you have started. One of the withdrawal effects can be insomnia. It just creates a vicious cycle. 
   I recently talked to a sleep medicine specialist who mentioned a new sleep medication called Belsomara but she said that I needed to consult with a psychiatrist to see if it would be an option in my situation. You may want to investigate Belsomara or prescription strength melatonin and ask your doctor about it. 

[Gridley]

32 minutes ago, Nomad said:

You may want to investigate Belsomara or prescription strength melatonin and ask your doctor about it. 

We are a site for going off drugs.  We do not recommend the use of sedative/hypnotics such as Belsomra or benzodiazepines for sleep issues for dealing with withdrawal from previous psychiatric drugs. Sleep problems are one of the most common withdrawal symptoms and our approach is to deal with them without drugs.

 

I found the following post from one of our moderators, a veteran of the sleep wars, to be helpful.

 

There is, unfortunately, no "silver bullet" to withdrawal or any of its symptoms, including insomnia.  If there were, SA would be a much smaller site than it is at this point.  Sadly, it continues to grow as more and more people get caught in the psychiatric medication "web."

 

insomnia and disordered sleeping is a hallmark of psychiatric medication withdrawal.  It starts earlier than that with many studies making it clear that SSRIs (and other psych meds) frequently suppress REM sleep for those who take the meds.  https://www.sleepio.com/articles/sleep-aids/antidepressants-and-sleep/  Given this as a backdrop, it should be no surprise that coming off the meds can wreak havoc on sleep.  The good news, however, is that the brain works hard to achieve homeostasis and, all other things being equal, the brain will return to a place where sleep becomes, as it should be, a matter of routine.  How long that takes for any one person is impossible to predict.  

 

So, what do you do?  In no particular order, some of the things to try:

 

• Don't place too much significance on sleep.  Rest should be the key and when your body absolutely needs to sleep it will.  The anxiety that comes with lying awake and saying "I must sleep" is far worse than the not sleeping.  It's hard but it can be done.
• Try a journaling practice before bed -- get out the things that are on your mind and add 3 things you are grateful for from the day
• Get a sleep ritual in place so that you do the same thing day after day and start to repair your circadian rhythms
• Take a warm bath with epsom salts few hours before bedtime and add in a cup of chamomile tea
• Use lavender essential oils in a diffuser at bedtime
• Exercise early in the day so that you aren't activated near bedtime
• Get outside and get some sunlight early in the day so that your rhythms are reestablished
• Make sure you have a consistent bedtime 
• Try not to be too activated in the couple of hours before bed and, of course, no caffeine
• Add a meditation practice
• Try yoga
• Go for walks in nature

Most insomnia is the result of the body being "hyperstimulated."  It is very hard to calm down an overstimulated body, especially when it is the result of chemical cascades that come as a result of medication use and withdrawal.  But, it can be done to a certain degree and the skills learned will provide valuable as your body improves over time.  

 

From my own perspective, my sleep is still not great, but it it better than it was.  I went through many stretches of 2 or 3 days with zero or an hour or two a night of sleep.  At this point, I have the occasional sleepless night, but most nights I'm good for at least 5 and usually closer to 6 hours.  By "normal" people standards that's not great, but it feels pretty good when compared to 0 or 2-3 hours a night.  As the saying goes, "in the land of the blind the one-eyed man is king!"

 

Try not to let it become the dominant factor in your life.  Over time, it will get better and you will heal.  Just do your best to continue to live your life what your brain is repairing itself.

----

 

 

Regarding melatonin, we recommend starting with a very low dose, around 0.3mg.  Too much melatonin can have a paradoxical effect, meaning that it will keep you awake.  

 

 

 

 

 

 

 

 

Edited February 26, 2021 by Gridley

[Shep]

21 hours ago, Wagen said:

Shep OK, so would you say if I take clonazepam twice a week to sleep, it's OK? Im at such a state that I don't know what crisis means, I feel like I'm continuously pushing my limits.

 

Or, should I just not take any drug no matter what happens? 

 

When I spoke to my doctor, she also suggested promethazine, but I don't know about that. 

 

If you're breastfeeding, please work closely with your doctor to make sure anything you take is safe. As Gridley noted, we're a site for coming off psychiatric drugs. If you feel you need continued treatment with other psychiatric drugs besides those you are tapering, you'll need to work with your doctor. 

 

Clonazepam twice a week may be okay, but only if you're a fast metabolizer. This is a a drug half-life calculator. 

 

Drug Half-Life Calculator

 

Clonazepam has a half life of 18 - 50 hours. So if you're a slow metabolizer, you would still have 13% of the drug in your system at 150 hours (6.25 days). So you could become dependent with taking it twice a week. Also, benzos can cause rebound symptoms, so it really depends. 

 

I would use it for crisis states to stay out of the hospital and try the tips that Gridley listed in his post, as well as those found here:

 

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

 

Let us know how you're doing. 

[Wagen]

16 hours ago, Gridley said:

We are a site for going off drugs.  We do not recommend the use of sedative/hypnotics such as Belsomra or benzodiazepines for sleep issues for dealing with withdrawal from previous psychiatric drugs. Sleep problems are one of the most common withdrawal symptoms and our approach is to deal with them without drugs.

@Gridley,

 

Thank you so much for your reply. 

 

I desperately want to be off this horrible staff, I just wanted to plan in advance little bit, because it happened already few times that I reached two days without sleep and then I became very suicidal. 

 

Before my son was born I have never taken any drugs and never smoked or drank alcohol. 

 

I'm just so so scared that my body forgot how to sleep on its own, and especially now that I suffer from all these withdrawal symptoms it feels even more difficult. 

 

I will try to power through it and hope that if I don't sleep two days in a row the third one I will. 

 

It's been 9 months now and I seem to be getting worse as more and more withdrawal symptoms emerge.

 

Thank you very much for your help. 

[Wagen]

3 hours ago, Shep said:

If you're breastfeeding, please work closely with your doctor to make sure anything you take is safe. As Gridley noted, we're a site for coming off psychiatric drugs. If you feel you need continued treatment with other psychiatric drugs besides those you are tapering, you'll need to work with your doctor

@Shep

 

Thank you very much for your help and all the information about the half life of clonazepam. Based on what you say, it seems that maximum once a week would be safe. 

 

I'm not breastfeeding anymore.

 

Please know that I don't want these drugs in my system but the insomnia is so severe for such a long time that I fear that I can never sleep anymore. It's been 9 months. 

 

I'm afraid I can go crazy if I don't sleep for 72 hours. That's how I ended up the first time in the hospital. 

 

If it happens again and I don't sleep for 72 hours, should I just hold on and hope I sleep somehow? 

 

Last night I managed to sleep better but of course that doesn't count because I still took 11,25 mirtazapine. 

 

I wanted to ask you - for such a disturbed nervous system as mine, what is more healing - to go off mirtazapine and face the horrible insomnia with occasional use of clonazepam to be able to sleep or to stay on the drug and wait for some time to stabilize somehow? 

 

Thank you very much again, I truly appreciate your advice and time. None of the doctors I spoke to was as understanding as you here. Thank you. 

 

[Gridley]

17 minutes ago, Wagen said:

now that I suffer from all these withdrawal symptoms it feels even more difficult. 

I'm sorry you're feeling so bad.  Withdrawal can be very difficult, and lack of sleep is so common. You are not alone in this.  Many, perhaps most, of us have sleep problems due to withdrawal.  

 

20 minutes ago, Wagen said:

 

It's been 9 months now and I seem to be getting worse as more and more withdrawal symptoms emerge.

 

Please try to keep in mind that though it may not seem so to you, your system is healing.  It's a slow and frustrating process, but you will heal.

[Nomad]

Trying to ignore insomnia is a bad strategy. If you commit suicide because of it then nothing else matters. Do whatever you need to do to get some sleep. Once you get some sleep then you can be in a place of strength, stability and good judgement to continue the tapering process. 

[christianjw12]

@Wagen, Insomnia is a very painful thing. I experienced it (my record wad 5 days with 0 sleep then the last day, I almost passed out and I managed to sleep a good night but it restarted 2 weeks after) and this is how I started antidepressant and ended in post acute withdrawal.

What I've learned through this experience is that insomnia is a vicious cycle. The fact we don't sleep, we get anxious and because we are anxious we can't sleep.

What you need to learn is that in order to break this cycle, you have to accept it without rejecting it. 

What I found very helpful was a book named The Sleep Book by Dr.Meadows. Have a look about it, it teach us non drug technique to cope with insomnia. If you can fully accept the situation and no worrying more (thus adding more anxiety and making you unable to sleep), accepting that maybe you'll stay awake all night then you can be able to sleep again.

 

[Wagen]

@christianjw12 thank you for your experience!!

 

I know it's anxiety, I'm supposed to to go to bed in about 1h now and of course I'm freaking out. 

 

I'm sleeping on average three hours a night now. 

 

The thing is that when I don't sleep for 2 days in a row I truly don't know how to cope. Once I reached this state, my body just becomes hypervigilant and I don't sleep at all. I sleep more when I sleep more. 

 

I hope there is hope for me. 

 

[christianjw12]

2 minutes ago, Wagen said:

@christianjw12 thank you for your experience!!

 

I know it's anxiety, I'm supposed to to go to bed in about 1h now and of course I'm freaking out. 

 

I'm sleeping on average three hours a night now. 

 

The thing is that when I don't sleep for 2 days in a row I truly don't know how to cope. Once I reached this state, my body just becomes hypervigilant and I don't sleep at all. I sleep more when I sleep more. 

 

I hope there is hope for me. 

 

 

@Wagen, don't force yourself to sleep if you can't. Just act like a normal human again. Try to be regular with your sleep pattern (less time with screen before bed as well) but don't try to control your sleep, you have very little control over it.

Learn about acceptance, and everytime you feel anxious when you have to go to bed, just accept it and face it. You don't control your anxiety but you control your action and your reaction. When you'll fully accept the fact that maybe you won't sleep (it's true that the lack of sleep is not good for your body but we don't actually die from it, a doctor told me) and you accept it, you'll get freedom from this vicious cycle.

 

[Nomansland]

Hi @Wagen,

 

this sleep meditation helps me to calm down my system sometimes https://www.youtube.com/watch?v=-JmAIaa8IF8&feature=youtu.be

Maybe give it a try? And look at the sleep tips thread that Shep posted. I can really help!

 

Greetings

 

Nomansland