posted
I know I've mentioned my insomnia in the past. I don't quite know if I've said anything about my fragmented sleep architecture problem. Basically, unless I'm medicated, I don't get level 3 or 4 sleep at night. Well, last night, I wasn't able to take my medication, and I'm getting totally weirded out by what is happening. While I was working today, I actually lost the ability to properly process visual information. I saw stuff, but I had to concentrate to actually realize I was looking at something. Naturally, my boss was a little concerned, so I ended up coming home early. Later on, it started feeling like my hands were on backwards. There have been all sorts of weird things going on that are just kinda freaking me out, too. What really amazes me is the fact that I lived with this problem for several years without noticing a single problem. I'm frankly amazed that I am not currently in a mental institution.
[ June 26, 2005, 10:54 PM: Message edited by: Boris ]
Posts: 3003 | Registered: Oct 2004
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posted
Boris, if your meds work, there would be absolutely no reason for you to be in a "mental institution." Actually, there are far fewer institutions left in the US because the drug therapies have made it less and less necessary to house patients at all, or, when necessary, for much shorter durations.
Usually skipping one dose would not be enough to allow full-blown symptoms to show to a casual observer. You personally might notice, but those around you would probably not.
However, stress can certainly lower the effectiveness of some meds. It is also the case that many meds require a certain titre in the bloodstream to be effective.
It is also true that sometimes dosages need to be adjusted or meds taken in combination to remain effective over the long term.
The advice to get in to see the doctor is the right advice. You may have been building toward this episode for months and the missed dose was just enough to make it be more obvious.
Good luck. And don't worry about the institution. You have a condition that requires you to take a bit better care of yourself (in specific ways) than the general run of humanity.
Posts: 22497 | Registered: Sep 2000
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Bob's right, ESPECIALLY about the last part. Taking care of yourself is incredibly important. Taking care of yourself includes seeing the doc when odd stuff happens (specially what happened to you the other day), taking your meds on time and every day (like making sure you take your sleep med), getting enough sleep, exercising, eating right, etc.
Another thing to take into account is if you didn't take whatever sleep med that night, just how MUCH sleep did you get? Lack of sleep can do weird things to anybody. But if you're on meds for anything and weird stuff happens, call the doc.
Hell, if you ask the question, "Do I need to call my doctor?" 90% of the time the answer is yes, because you thought of it.
I, um, speak from experience. Posts: 14745 | Registered: Dec 1999
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Another good reason to see the doc: Today's symptoms could be unrelated to your ongoing condition or problem. Low probability, of course, but something that should be checked out. Oddball neurological symptoms are not to be ignored.
I think that some of us become complacent about things if we can attribute them to meds or underlying conditions so even if we notice a change in feelings or symptoms, we just figure it's got to do with the meds.
I was on a BP medication that they told me was a diuretic. As a result, I didn't much attend to the frequency of, well... Turns out I had become diabetic since my last doctor visit.
That was months ago, and it really made a huge difference to know. It's pretty obvious now. Sugar = Bob's asleep in 5 minutes. That sort of thing.
posted
Yep. It's fairly borderline, but knowing means I can maybe avoid getting worse and needing to carry insulin around all the time.
Posts: 22497 | Registered: Sep 2000
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posted
Boris, I went 20 years only getting 4 hours of sleep a night. Are you sure that you aren't making it worse by obsessing about how little sleep you are getting? You can live on 4 hours of sleep, I would think.
Bob, have you been trying Atkins? Has it helped at all? I know someone who went from high blood pressure, high cholesterol, and diabetes, to 60 pounds lighter, no high blood pressure, no diabetes and no high cholesterol and no medication. I know you were thinking about it, or trying it, or something. And I know the stress of a move can make it impossible, but I was just wondering.
Posts: 9871 | Registered: Aug 2001
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Atkins wasn't working for me. I never go very far into ketosis during the induction phase and it just doesn't work without really going deep into ketosis.
Basically the diet right now involves staying away from most carbs, but having some...like wheat pasta or whole wheat bread.
I feel a lot better, and have slowly been losing weight. Which is probably better in the long run.
Posts: 22497 | Registered: Sep 2000
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I was talking to my mother about this problem this morning, and she told me to look up the medicine I'm on (Should have done this a LONG time ago). Aparently, you're only supposed to take it for 4 months at a time. I've been on it for a year straight. Apparently, suddenly not taking it actually makes things much much worse than if you had never been on the medication in the first place. So I'm going to have to get weened off of this medicine. Looks like I get to see the doctor a little early this week...The good thing is that I'm not going to die Posts: 3003 | Registered: Oct 2004
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posted
No. Not a medication intended for long-term use. I have heard of people using Ativan for sleep but my mom (and lots of others) use it to "chill out" and it really helps her TMJ (her tight jaw).
At the Alzheimer's home I used to work at, we called it Vitamin A and gave it when a resident would not relax and repeated attempts to calm their behavior were ineffective.
Are you on a higher dosage? We only used .5mg at time (as does my very petite mother). I'm talking 2mg or higher.
Posts: 2064 | Registered: Dec 2003
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It's seriously lost its effectiveness. I'm at 3mg right now. I probably should have gone to see the doctor a long time ago about it. I don't have insurance that will pay for this particular doctor, and haven't had for a year. Each time I went in to get a refill I kept expecting the Pharmacist to say, "The doctor says you need to see them," But it didn't happen until a few weeks ago. The doctor prescribed it originally because he suspected my sleep problems to be due to anxiety.
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Yes, it is a controlled substance, and the pharmacy was required to call my doctor each month to get a new prescription. That's why I kept expecting them to say I needed to go back.
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Hrm. You never used to have trouble, now you have trouble. Logically, you should ask "what's different now?"
That almost sounds like withdrawal symptoms. Which wouldn't be unexpected with what's supposed to be a short-term drug.
Speaking as someone who's largely allergic to doctors and headshrinkers myself: you really should consult an expert.
Posts: 196 | Registered: May 2005
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3 mg of Ativan? Is that just at bedtime, or do you take it at other times as well?
You must have built up quite a tolerance, m'dear. That is a large dose.
Are you on other medications, or is that your only one?
Generalized anxiety disorder (as well as insomnia) is not best treated with benzodiazapines (the class to which Lorazepam belongs). And I am suspicious of a doctor who would keep prescribing such a high dose of the medication for so long. Lorazepam has a high potential for abuse and addiction. What kind of pill-pushing MD would do that?
SSRI's (think of Prozac) have a lower potential for abuse and addiction, and are helpful in treating anxiety. There are insomnia medications that are useful in the short term, but you sound like someone who is in this for the long haul.
My advice: get thee to a different doctor for an evaluation and a second opinion. Perhaps your primary doctor can help you, or refer you to someone who can. Is there a mental health clinic around that can refer you to a doctor? Or your student health clinic?
posted
The prescribed dose was 2mg. I should have gone back to the doctor when that amount stopped working properly. And now, as a night with only 4 hours of sleep will attest to, 3mg doesn't do anything either. I'm going back to the doctor tomorrow, and am going to get this figured out. I'm going to take in a list of side effects and things and show them exactly which ones I'm having (From the list I saw, about half have been occuring over the past week).
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3 mg of Xanax is a more potent dose than 3 mg of Ativan. But they are both benzodiazepams, both inappropriate for long-term use for insomnia, both addictive and subject to abuse.
After 8 years, you are have certainly built a tolerance and are habituated to it. It is no longer performing the function of "sleep aide", it is just a maintenance dose keeping you from having withdrawal symptoms.
This bears discussion with a doctor, and perhaps NOT the one who keeps prescribing the drug.
Benzpdiazepams are appropriate for short term use and symptom managment. We certainly employ them liberally in palliative care. But this just sounds like inappropriate prescribing, to me.
posted
Having worked at a doctor's office for many years, I can tell you that's it's the nurses who call in the refills, not the doctors (now I realize that isn't always the case). Chances are, the bad nurses refilled you without a second thought (because that's easier than getting you to come in) and then a good nurse noticed that you hadn't been in for a long time and told the doctor who then denied the refill.
Posts: 2064 | Registered: Dec 2003
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I see my doc and he writes the scripts. It's really just to get me to sleep. I can't get to sleep. It sucks. Of course, once asleep, I can't stay asleep, but that's another story altogether.
I've also taken beta-blockers and SSRIs. Actually, about 9 years ago, I spent a year going through about 80 different medications, 5 different shrinks, 3 neurologists and whole mental hospital that nearly killed me. (You'd think that since they are doing the liver function tests, they'd let you know the results, rather than sending you a letter in the mail six weeks after you've been hospitalized for it.)
The most current night-time med with the xanax is nadolol. Actually, it's specifically supposed to help the shaking in public thing, but it's usefulness is dubious at best. I still look like a high strung Dalmatian about to pee on the carpet most of the time. Posts: 9871 | Registered: Aug 2001
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quote:Originally posted by Valentine014: Having worked at a doctor's office for many years, I can tell you that's it's the nurses who call in the refills, not the doctors (now I realize that isn't always the case). Chances are, the bad nurses refilled you without a second thought (because that's easier than getting you to come in) and then a good nurse noticed that you hadn't been in for a long time and told the doctor who then denied the refill.
This is the case with me. It actually happened that I had my mother call in to set up payment for the bills that had piled up from going to this doctor, and they then realized that I hadn't been in to see them. I had several appointments scheduled, but had to cancel them because of work/school. I'm going to be seeing the Nurse there tomorrow, rather than the doctor. This is because the doctor is known as the best sleep doctor in Idaho, and happens to be booked solid for the next 3 months.
Posts: 3003 | Registered: Oct 2004
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posted
ambien worked great for me, but my doctor was careful to make sure I didn't get dependent on a sleep aid.
Paradoxically, what has helped me sleep the best in years has been treating my ADD with Adderall. One would not expect better sleep patterns on a type of amphetamine.
At any rate, now is a good example. I was up late working on my mid term study guide in one of my classes. Got too tired to stay up, went upstairs, slept really well, and now I'm back up and feeling great. Without the Adderall, I would normally work until the wee, wee hours of the morning, then crash and sleep til 10 or so. Not good for me, not good for the kids, not good for anybody.
For some reason, the Adderall helps my circadian rhythmn keep me in check, when I get sleepy, I can't shrug it off and keep going like I used to. I have to SLEEP. And I always wake up feeling very rested.
Posts: 14428 | Registered: Aug 2001
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Belle, it's the same way with me and the Adderall. The difference was that I could FALL asleep (I couldn't before without some difficulty) and sleep for a solid 3-4 hours, but would keep waking up and waking up. The seroquel keeps me asleep for usually 7 solid hours, then I'm up and at 'em after 8. The key is making sure I take the seroquel at such a time that it will kick in at the same time that the adderall wears off. Then I'm OUT. I'm also on just a TINY dose of Seroquel (25mg) that wouldn't even make most folks blink. Right now I've got the best sleep pattern going that I've had in a long, long time. I take the seroquel by 9:30-10, fall asleep around 11:15-11:30 (earlier if I've had a hard workout that day) and I'm awake and ready to go by 8-8:30 and take my Adderall just after that. I'm awake during the day, productive, and feel pretty good.
posted
Okay, I just got back from the doctor. I have "Delayed Sleep Phase Disorder." Basically, every day is like flying across the country for me. I have permanent Jet lag. They're taking me off the ativan, which was meant to let me sleep, so I could wake up and go walk around in the sun to reset my sleep paterns. I'm being put on Provigil to just wake me up in the mornings so I can do the same. I think that's probably a better approach. Anyway, that's how things are going now.
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