vetdoc going off valium and Wellbutrin

[Altostrata]

When do you take Valium? This could also be a paradoxical reaction to it.

 

Please list the dosages you take of all your drugs and when you take them.

[vetdoc]

Alto

 

Wellbutrin 150mg SR 10:00 AM , 50mg IR 1:30 PM  

 

Lamictal  100mg   10:00 AM,  100 mg   1:30 PM

 

Valium   2mg         1:00-2:00 AM

 

Doxepin 7mg         2:00 AM

 

Alto I also wondered about the Lamictal, because when I used to take  it at night it felt activating and seemed to intefere with my sleep. It still gives me horrible vivid dreams.  I know its supposed to calm the glutaminergic system, but could it now be out of balance with the reduction of the Wellbutrin and also acting paradoxical?

 

I certainly have a history with Wellbutrin being on it for 8 years and then C/T by a P Doc, then reinstated  6 months later. Then I had the acute activating crisis 6 months ago when I switched brands from Canadian to US brand.  This is what precipitated the sudden Wellbutrin taper Im doing now.  I suppose my brain has a marked sensitivity to it. 

 

I appreciate you  trying to help me out with this.  I never thought the antidepressants would be so much more difficult to taper then the benzo.  I hope I might be done with these drugs by the time I"m 70 (67 now).

 

Thanks Alto

[Altostrata]

Yes, a change in the Wellbutrin might have caused another of the drugs to be metabolized faster.

 

Please check the CYP table for all your drugs (info http://survivingantidepressants.org/index.php?/topic/1466-flockhart-cytochrome-p450-drug-interaction-table/);table here http://medicine.iupui.edu/clinpharm/ddis/clinical-table/ and post the results in this topic. Substrates and inhibitors are most germane.

 

Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and post the results in this topic.
 

[vetdoc]

Alto

 

Buproprion  strong inhibitor p450

Diazapam-substrate

 

Buopropion increases doxipen levels

 

Bupropion decreases valium metabolism

doxepin-Lamictal increase side effects dizziness, cordination

 

Since the wellbutrin inhibits p450 for valium thus slowing the metabolism of valium, could the decrease in wellbutrin be causing the valium to be metabolized quicker and giving me some symptoms.

 

Alto I did updose my Wellbutrin yesterday from 200mg back to 225mg. I struggled with the decision , but decided to do it, since I was doing well on the 225.  I slept for about 6 hrs straight for first time in a week.  I don't know if the up dose could work that quickly in improving my insomnia symptom.  If so it appears the updose helped at least for the first day of up dossing.  What do you think?

 

Thanks

[Altostrata]

If it works, it works.

 

I need to know which P450 cyp is involved for each, for example, buproprion substrate 2B6. This is in the gray bar in the P50 Drug Interaction table.

 

Also, please copy and paste the report from the Drug Interactions Checker http://www.drugs.com/drug_interactions.html

[vetdoc]

Bupropion    substrate           2B6

Diazapam     substrate           2c9,  3a4,5,7

                           

Bupropion            inhibitor                 2D6

Doxepin               inhibitor                  2D6

lansprezole         inhibitor                 2C19    I take lansprezole

 

Significant - Monitor Closely:

Significant interaction possible (monitoring by your doctor required)

doxepin + Wellbutrin SR oral

doxepin increases toxicity of Wellbutrin SR oral by unspecified interaction mechanism

Additional Information: Keep bupropion dose as low as possible as seizures may occur.

Significant - Monitor Closely:

Potential for interaction

doxepin + Valium oral

Valium oral and doxepin both increase sedation and drowsiness

Significant - Monitor Closely:

Potential for interaction

doxepin + Wellbutrin SR oral

Wellbutrin SR oral will increase the level or effect of doxepin by altering drug metabolism

 

doxepin ↔ lamotrigine

Applies to: doxepin, Lamictal (lamotrigine)

Using doxepin together with lamoTRIgine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

bupropion ↔ doxepin

Applies to: Wellbutrin (bupropion), doxepin

Talk to your doctor before using buPROPion together with doxepin. Combining these medications may increase the risk of seizures, which may occur rarely with either medication. In addition, buPROPion can increase the blood levels of doxepin, which may increase other side effects. You may be more likely to experience seizures with these medications if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should avoid or limit the use of alcohol during treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

• bupropion + doxepin

  bupropion will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Potential for interaction, monitor.

I slept fair last night, on the 225mg Wellbutrin, but I forgot my afternoon 35mg dose and had to take it at 7:30 PM

 

Thanks Alto

[Altostrata]

I really can't say what's going on. Clearly your drugs are in some sort of balance when it comes to sleep.

 

Drugbank has more extensive information about buproprion's metabolization at http://www.drugbank.ca/drugs/DB01156(see the ADMET section):

 

CYP450 3A4 substrate

CYP450 2D6 inhibitor

CYP450 2C19 inhibitor

CYP450 inhibitory promiscuity -- High

 

I wonder if bupropion reduction permits faster metabolization of doxepin. Do you take doxepin to sleep?

 

Why do you take lansprezole?

[vetdoc]

Yes, I take the doxepin for sleep.  I take the lansprezole for a Hiatal hernia and  gastric reflux. 

It does seem the doxepin may be  less effective the past few months.  I thought it was  tolerance due to taking it for a couple of years.  Alto I just want to stay as stable as possible while tapering off these poison drugs.  I don't have a lot of reserve at my age, and these withdrawal symptoms take everything out of me.

I definitely want to start a taper of the Lamictal as soon as I am stable enough on the Wellbutrin.  The side effects are horrible, severe fatigue, vivid dreams,headache  and dizziness. 

 

Thanks Alto

[vetdoc]

Alto

You had mentioned the possibility of the valium going paradoxical.  Since I take it at night would you suggest taking it earlier in the day or splitting the dose?

 

I'm just confused  and frustrated why I can't get consistently stable anymore the past six months, ever since I had the issue with the change in Wellbutrin brand name from Canada,  to US brand name.  This is what precipitated the forced taper of the Wellbutrin in the first place.  Somehow the homeostasis of my brain with these drugs has been affected since then.

 

The one caveat to in this is the Lamictal.  I had been on Wellbutrin alone  for 8 years prior to being taken off and had no issues.  So is it possible that their is some interaction causing an imbalance here.  I won't really know until I taper it lower.

 

I've exhausted all avenues in trying to figure it out myself.  Maybe their is no answer, it;s just how my brain chemistry reacts with these drugs.  There is just to many variables to figure out here.  I'll just need to plug along and grin and bear it. Certainly there are many people who have it worse then me.

 

Slept fair last night  Difficulty falling into sleep  slept 6 hrs restless  Sleep disturbance only symptom now

[Altostrata]

Skyler tells me at your dosage of Valium, a paradoxical reaction would be unusual. You'd have to ask her about splitting the dose.

 

It could be that, when Wellbutrin, which is stimulating, is reduced, all the "brakes" you're taking at night to sleep might be too strong and you're getting a paradoxical reaction. Could be any of the "brakes": lamotrigine, Valium, or doxepin.

 

Yes, there are a lot of variables.

 

At what times of day and dosages do you take each of your drugs?

 

Do you still have the hernia? What were your symptoms of reflux?

[vetdoc]

Alto

 

I take the

Lamotrigine 200g around 10:00AM

Wellbutrin    150SR, 35mg IR 10:30AM, 35mg IR 2;30 AM

benicar         20mg  blood pressure med AM

Lansprezole  20mg 6:PM

1mg melatonin,  1:30 AM

valium 2:00 AM

doxepin 7mg 2:00 AM

 

Yes I still have the Hiatal Hernia. Reflux symptoms are primarily severe heartburn and ocassional esophageal reflux when sleeping.  I have my bed elevated about 10" at the head portion.

[Altostrata]

Please include the ADMET info from drugbank for benicar.

 

Did you include benicar in your drug interactions report?

 

Why do you take 3 drugs and melatonin in the early a.m.?

[Skyler]

Vetdoc, I don't see any reason you need to split the diazepam, though it will not hurt anything.  But I am wondering why you also take that at night.. at 2 mgs, it's not sedating except when added to everything else.  How about moving the diazepam to the daytime?

[vetdoc]

Alto here is the info

 

Benicar

Property Value Probability

Human Intestinal Absorption + 1.0

Blood Brain Barrier - 0.8719

Caco-2 permeable - 0.6865

P-glycoprotein substrate Substrate 0.7247

P-glycoprotein inhibitor I Non-inhibitor 0.5917

P-glycoprotein inhibitor II Inhibitor 0.6029

Renal organic cation transporter Non-inhibitor 0.807

CYP450 2C9 substrate Non-substrate 0.7429

CYP450 2D6 substrate Non-substrate 0.8602

CYP450 3A4 substrate Non-substrate 0.5149

CYP450 1A2 substrate Non-inhibitor 0.782

CYP450 2C9 substrate Inhibitor 0.5816

CYP450 2D6 substrate Non-inhibitor 0.8059

CYP450 2C19 substrate Inhibitor 0.6604

CYP450 3A4 substrate Inhibitor 0.7409

CYP450 inhibitory promiscuity High CYP Inhibitory Promiscuity 0.8396

Ames test Non AMES toxic 0.6203

Carcinogenicity Non-carcinogens 0.6871

Biodegradation Not ready biodegradable 1.0

Rat acute toxicity 2.6599 LD50, mol/kg  Not applicable

hERG inhibition (predictor I) Weak inhibitor 0.9254

hERG inhibition (predictor II) Non-inhibitor 0.6427

 

No interactions with benicar and my meds showed up

I go to sleep around 2:00 AM.  Alto  I have delayed sleep phase disorder. (late night bedtime)   So I take the sleep meds (doxepin, valium)at my bedtime.

I take the benicar at 10:00 AM and the afternoon Wellbutrin at 2:30 PM ( i posted AM by mistake)

[vetdoc]

Vetdoc, I don't see any reason you need to split the diazepam, though it will not hurt anything.  But I am wondering why you also take that at night.. at 2 mgs, it's not sedating except when added to everything else.  How about moving the diazepam to the daytime?

 

Skylar

 

I thought maybe taking the 2mg valium with the doxepin and melatonin might help with sleep.  I can certainly move the valium to the afternoon.  Any particular time better?

Thanks

[Skyler]

 

Vetdoc, I don't see any reason you need to split the diazepam, though it will not hurt anything.  But I am wondering why you also take that at night.. at 2 mgs, it's not sedating except when added to everything else.  How about moving the diazepam to the daytime?

 

Skylar

 

I thought maybe taking the 2mg valium with the doxepin and melatonin might help with sleep.  I can certainly move the valium to the afternoon.  Any particular time better?

Thanks

 

 

Take it at whatever time is convenient.  I don't think that 2 mgs of valium is enough to have much of any impact on your sleep at this point.  You are taking it to forestall withdrawal, but that's not a player in this picture now.  You might want to move the dose by a couple of hours a day as your system is used to taking it at bedtime.  So if you take it now at 1 AM, take tonight's dose at 11 PM, then tomorrow at 9 PM, etc. 

 

If it does not work out for some reason, you can always move the dose back.   Equivalencies are not an exact science, that said, you were on the K equivalent of 40 mgs of valium, now you are at 2 mgs.   This does not mean you will not have to taper off the remaining 2 mgs. (as you know). but you really are close to the end on this one. 

 

When you are ready, come back to the benzo forum and we'll talk about how to finish up.. I was able to reduce a little differently at the end of the benzo taper which made the calculations, etc. a easier.  In the meantime, perhaps just think of the valium as something you are taking to forestall withdrawal as opposed to any significant clinical effect.  The lamactil and the ADs are the elephants at this point, while the valium is (relatively speaking) a bit player.

[vetdoc]

Skylar

 

I figured the valium at that low dose, plus tolerance to the drug at this time  isn't doing anything, sedating for me.  I will move it back gradually to take it earlier in the day.

  I will come back to the Benzo board and have you help mewith my final valium taper.  It might not be for awhile at the pace I have to go with the Lamictal and Wellbutrin. 

Skylar how is your tinnitus doing.  Mine is a real pain in  the @%$.  If I am really stable its very faint and tolerable, however any stress from withdrawal symptoms and off it goes.  That's why I'm hoping to find the right taper schedule to minimize symptoms, especially the insomnia.

I appreciate your help as always.

 

Thanks

[Skyler]

  I will come back to the Benzo board and have you help mewith my final valium taper.  It might not be for awhile at the pace I have to go with the Lamictal and Wellbutrin. 

 

Skylar how is your tinnitus doing.  Mine is a real pain in  the @%$.  If I am really stable its very faint and tolerable, however any stress from withdrawal symptoms and off it goes.  That's why I'm hoping to find the right taper schedule to minimize symptoms, especially the insomnia.

I appreciate your help as always.

 

Right... I did not mean anytime soon... not until after you get the other psychotropics settled.. they are at doses high enough to cause more problems, so should go first.

 

Tinnitus is hanging in there, but now I'm getting to really low doses on Lyrica, it seems to be a little better.  One can always hope that when this taper odyssey is over, the tinnitus will disappear.  Prolly not, but you never know!

[Altostrata]

Why do you have delayed phase sleep disorder? Did you work at night? Were doxepin and Valium prescribed for this?

 

On the assumption this is overkill, I might move doxepin to midnight. Give that 4 days and then try reducing the Wellbutrin again.

 

At what point and for what reason was Benicar prescribed?

 

When did you move 35mg Wellbutrin IR to 2:30 PM?

[vetdoc]

Alto

 

I went to a sleep DR to check out my insomnia problem just recently  and told him I always went to bed late thruout my adult life.  He did a test actigraphy and said I probably have delayed sleep disorder( circadian rhythm disorder).   I told him about the meds I was tapering and the withdrawal symptoms I encounter.  He didn't know much about that of course.  I told him my main symptom at this point is insomnia and I become  extremely anxious when I can't sleep for more then a couple of days..

He did suggest some meditation, and learning mindfulness and emotional regulation skills.

 

     I was put on doxepin and klonopin (l switched over to valium)  for sleep by my P Doc after he diagnosed me with  "bi polar." in 2012.  I was also put on Lamictal and reinstated on Wellbutrin after being off for  4 months.  I did sleep quite well for 1.5 years while tapering my valium until I developed withdrawal symptoms at 1.5mg 6 months ago.  Then the Wellbutrin seemed to turn on me about the same time as my valium withdrawal symptoms developed.  It was presumed at the time that  the brand switch from Canadian to American brand precipitated   the marked activation , so I started my Wellbutrin taper.

 

Benicar was prescribed as  BP med, and I have been on it for about 7 years.

 

I always took my 35mg IR in the afternoon(2:30) while I was taking the 225mg of Wellbutrin for several months.   When I dropped 2 weeks ago to 200mg Wellbutrin  I was taking 50mg IR in the afternoon, then I reinstated back to 225mg 4-5 days ago.

 

Alto I just realized I was on the 225 mg for 2 months before I made the cut to 200mg afew weeks ago.  I don't know why I became symptomatic with insomnia symptoms after that long a hold.  It's just a nightmare  trying to figure this out.

 

Alto after moving the Wellbutrin back to midnight for 4 days should I cut back to 200mg or try  212mg.

I can't tell you how much I appreciate your time and expertise in trying to help me find some balance with these meds.

 

Thank You Alto

[vetdoc]

In the following post I said after moving back Wellbutrin to midnight  It should read:

 

"Alto after moving the doxepin back to midnight for 4 days should I cut to 200mg or try  212mg on the Wellbutrin"

[Altostrata]

I would move the doxepin to midnight for at least 4 days. Let's see how you feel then.
 
By taking melatonin at 1:30 a.m., you are reinforcing your unusual sleep cycle. The body naturally releases melatonin at nightfall. If you are taking melatonin at 1:30 a.m. and staying up with bright lights until 2 a.m., you are telling your body that nightfall is at 2 a.m.
 
This works against your body's natural circadian rhythm, and it can't establish a normal sleep cycle.
 
I'm surprised your sleep doctor didn't know about this.
 
To assist your body in running a sleep cycle, if I were you, I'd move the melatonin to 10 p.m. (at least), turn off all the lights, and definitely get off the computer. You might even want to wear amber glasses. See
 
Light-sensitive? Try blocking out blue light

TV or computer use in evening can disrupt sleep

Computer Program Adjusts Blue Light to Time of Day

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

Please read our topics about circadian rhythm and melatonin in the Symptoms and Self-Care forum.

 

I'm suggesting this because to get you off the drugs -- Wellbutrin being a stimulating drug that often causes sleeplessness -- you need to reinforce your ability to sleep.

[vetdoc]

Alto

This all makes sense to me.  I did do some reading on circadian rhythm and melatonin, so taking it earlier makes sense to get me tired earlier.  Also I will get off the computer by 10:00 and turn the incandescent lights down.  I just got a pair of amber glasses to filter out any bluelight.  I think taking the Doxepin at midnight will definitely help get me to sleep earlier. . 

 

I have recently noticed when I take the valium, doxepin and melatonin   together I felt less tired instead of more tired  taking the drugs..  Alto like you said it may be overkill for my brain taking all at once.

 

I am moving my 2mg valium to 9:00 PM, 1 mg melatonin at 10:00PM and 7mg Doxepin at Midnight,  This sounds like a much better balance  and timing of these drugs. Hopefully this helps me establish a better sleep pattern and improves my insomnia.  If I can get 6-7 hours of decent sleep I would be very happy.

 

Alto the Wellbutrin even at the 225mg dose is still quite activating.  I have a constant buzz in my head and feel a little wired all day.  I would like to try another smaller cut down to 210mg instead of 200mg. 

 

What do you think about me moving my afternoon dose of 35 mg IR  back to 1:00 PM instead of 2:30PM.  I usually take my morning 150mgSR+35mgIR at 10:00AM when I get up.

 

Thanks Alto

[Altostrata]

Yes, I would take the Wellbutrin earlier.

 

You might as well take the melatonin at 9 p.m., too. That is nightfall at this time of year.

 

I hope that if we get a more solid foundation for your sleep, you'll be able to go off the Wellbutrin easier.

[vetdoc]

Hi Alto

 

Ok last night was the first night of the new regimen.  I took my valium at 9:00 PM and my melatonin at 10:00 and doxepin at midnight.  I also turned out the lights at 10:00 PM except a small lamp and used my amber glasses.  I was able to get to sleep at 1:45 and slept thru till 8:00AM.  That's pretty good for the first night on this regimen, I'll take it.  I also felt pretty good today, got into town ran some errands and did some food shopping. 

If I improve  so I get to sleep a little earlier and can get 7 hrs sleep it would be terrific.  When I know I can sleep my stress level drops tremendously.  It's like a huge weight off my back!!

 

I think if I can get sleep it will definitely help me cut my Wellbutrin and definitely make my life much more tolerable.

 

I will move my melatonin back to 9:00 PM

 

If I get stable with my sleep I would like to try a small cut on the Wellbutrin in a week or so?  I know you mentioned that possibility.

 

Thanks Alto

[Altostrata]

Good to hear. Yes, give it at least a week. Expect some ups and downs.

 

You might as well fire your sleep doctor.

[vetdoc]

 

 

You might as well fire your sleep doctor.

 

Lol, yes he is officially fired.  He was a nice guy but didn't have a lot of expertise. 

 

Once again I appreciate your help immensely Alto.

Thanks

[vetdoc]

Alto

 

Just checking in.  Last night was the third night on the med dose time changes.  I turned down the lights and used my amber glasses and took the meds on the new time schedule.   I got sleepy earlier around 2AM and went to bed and fell asleep in around 10 minutes.   I slept till 10:00PM, getting up once to go to the bathroom and back to sleep.  The quality of the sleep was pretty good, except for the vivid dreams the lamictal causes me.  So far so good.  I'll check in again in a few days.

 

Thanks Alto

[Altostrata]

That seems promising!

[vetdoc]

 

   

 

   

 

 

 

                                                           

 

                                         

                                                    bed            awake       time to          times     amount of       sleep

                                                                                                            awake       sleep             efficiency

                                                                                      fall asleep      restless

Sun

 

1:30AM

8:59AM

16min

    3

7hrs 2min

97%

Mon

 

1:26AM

10:19AM

17min

    9

6hrs 27min

76%

Tues

 

2:10AM

9:53AM

23min

    9

5hrs 44min

78%

Wed

 

1:39AM

8:30AM

49min

    4

4hrs 46min

83%

Thurs

 

1:58AM

9:39AM

11min

     6

5hrs 59min

83%

Fri

 

2:00AM

10:35AM

7min

    10

6hrs 32min

78%

Sat

 

2:17AM

9:39AM

33min

     8

5hrs 30min

81%

 

Alto I'm Checking in after 7 days,   My sleep pattern for the week recorded in  above table

 

Evening med times:

 

melatonin  at 10:00PM

valium at 10:00PM

doxepin at midnight

 

Well Alto the good news is I am getting decent amount of sleep, averaging almost 6 hrs.     The bad news it is extremely restless sleep, tossing and partial awakenings thru out the night.   I would like to eventually get 7 hrs with minimal restless sleep thru out the night.   I won't know if that is possible until I am off all meds I assume. 

 

I used a Fit Bit flex device to actually monitor my sleep pattern daily and get the table above.     It senses movement and the amount of time restless or  awakened  thru out the night. It also monitors activity thruout the day and the amount of calories burned.  

 

Alto I do have really vivid  nightmares pretty much every night every night.   I  am wondering if such vivid  nightmares would add to restless sleep?   I have read Lamictal can cause these vivid dreams well as some activation and insomnia.    I am very suspicious of this drug causing me some issues, definitely weakness and fatigue, but possible sleep issues as well.

 

I was thinking of making another small wellbutrin cut ,but I think I'' wait.  Our family has 2 trips planned to visit relatives in other states in July  and I'm not sure how I will fare  being away from home base for a few weeks.  I haven't been away from on any trip home in over a year, and I'm pretty anxious about it.  I need to get away though for a spell and test the waters some, otherwise I can feel myself becoming agoraphobic!  Whats incredible to me up until these drugs, I had so much energy and would look forward to these kinds of trips, not dread them. Oh well.

 

Let me know what you think about my sleep pattern thus far.

 

Thanks

[Altostrata]

It sounds like your sleep has improved.

 

Yes, Lamictal could be affecting your sleep. So could the benzos. Where are you in your Wellbutrin dosage?

[vetdoc]

Alto I'm at 225mg Wellbutrin total.  150mg SR and 75 mg IR split morning and early afternoon.  I could go down to 212.5mg total,  150mg SR, _62.5 IR, a 5% drop.     I just don't want to get unstable  before my trip, the third week in July.

 

I was at  225mg for about 2 months and then cut to 200mg and thought my sleep was disturbed from to large a cut.   I up dosed back to 225mg after about 10 days on 200mg.     I probably should have up dosed to 212.5mg instead of back to 225mg.   What do you think is best?

 

Thanks

 

Alto

 

 

PS                                                                                                               

Here is a better sleep report

 

                                                                                                                      Sunday

 

1:30AM        bed

8:59AM        awoke

16min          get to sleep

    3X            restless

7hrs 2min    sleep time

97%             efficiency

Mon

 

1:26AM            bed

10:19AM          awoke

17min              to get to sleep

    9X               restless

6hrs 27min     sleep time

76%                efficiency

Tues

 

2:10AM             bed                                           

9:53AM           awoke

23min            till fall asleep

    9X              restless

5hrs 44min    sleep time

78%               sleep efficency

Wed

 

1:39AM           bed

8:30AM           awoke

49min             till fall asleep

    4X               restless

4hrs 46min     sleep time

83%                efficiency

Thurs

 

1:58AM            bed

9:39AM           awoke

11min              till fall asleep

     6X               restless

5hrs 59min      sleep time

83%                  efficiency

Fri

 

2:00AM             bed

10:35AM          awoke

7min               till fall asleep 

    10X             restless

6hrs 32min     sleep time

78%                efficiency

Sat

 

2:17AM            bed

9:39AM            awoke

33min              till fall asleep

     8X               restless

5hrs 30min      sleep time

81%                 efficiency

[Meimeiquest]

I have a question. Have you tried going to sleep any earlier? There are distinct advantages in getting some sleep in before midnight in growth hormone production if you can pull it off. I certainly defer to Alto on the when to drop question.

[vetdoc]

I have a question. Have you tried going to sleep any earlier? There are distinct advantages in getting some sleep in before midnight in growth hormone production if you can pull it off. I certainly defer to Alto on the when to drop question.

 

Meime

 

You know when I was on high levels of valium early on I did go to sleep before midnight.  When I started my valium taper my sleep time started to get a bit  later.  Then when I got down to 2mg of valium I tapered to quickly and had bad sleep withdrawals, where I wasn't sleeping well.  Then around the same time I had the Wellbutrin change in brand, from canadian to US which really caused major sleep issues.  I have struggled with sleep issues ever since then.. 

Now at this point Meime I'm happy if I can get 6 hrs sleep whenrver I can. I don't think I could fall asleep before midnight at this time.  Maybe after getting lower on the Wellbutrin and lamictal things will change for the better.

 

Altos helping me change my med times around and giving me some sleep hygeine tips has definitely helped so far. 

[Altostrata]

vetdoc, your sleep times aren't too bad. Are you getting at least a half-hour of gentle exercise a day?

 

Getting up at the same time each morning may help you get to bed earlier. This may mean going a little short on sleep for a while.

 

If your vacation includes exercise, it might be a good time to try a little sleep restriction -- getting up at the same time each morning.

[vetdoc]

vetdoc, your sleep times aren't too bad. Are you getting at least a half-hour of gentle exercise a day?

 

Getting up at the same time each morning may help you get to bed earlier. This may mean going a little short on sleep for a while.

 

If your vacation includes exercise, it might be a good time to try a little sleep restriction -- getting up at the same time each morning.

Alto

I do try to get exercise everyday, treadmill, walking outside, go to gym 2-3 times a week.   I will  try and get up within a half hour of the same time every morning. 

I should be able to get some exercise on my vacation, going to Colorado.  I can do light hiking and walking in the mountains.

 

Do you think I should make another cut in my Wellbutrin , or wait another month after the trips.

 

Thanks