Mental Health Can't Stay Asleep And Lucid Dreams, Dopmaine Issue? Venlafaxine v Agomelatine

[Rybee]

Hi Peeps, I've been diagnosed with clinical depression, general anxiety disorder, delayed sleep phase syndrome.

I have a lovely Psychiatrist, we click very well, so I'm unable to be open and honest with him about everything - including all of my drug abuse.

Im in the UK by the way, and was being treated by my GP on Venlafaxine 375mg Pregabalin/Lyrica 600mg Diazepam 40mg and Propranolol 160mg At that point in time I was quite a heavy Codeine 300mg/Tramadol 400mg user - every day. I felt my GP had given up his only solution was to increase my dosage on anything and everything. Opioids aside, I was drugged out of my face and lead a very horrible life because of it.

I gave up with the NHS and went private at the Priory as an outpatient, not only for my opioid habit, but for their brilliant psychiatry services. He soon tapered me off of the Venlafaxine, Pregabalin, Diazepam and Propranol, quite rapidly, over 4 weeks. Anyone who's withdrawn from Venlafaxine or Pregabalin can probably sympathise with how horrible coming off of 375mg and 600mg to 0 in 4 weeks felt... hell! He basically wanted to make a fresh assessment of me drug free in my normal state, he gave me a lot of support with my opioid habit and that was gone within the 4 weeks too.

Although Venlafaxine was working for the anxiety (it wasn't for depression) I was having incredibly lucid dreams and woke up dripping at several points throughout the night. Unfortunately my mum passed away ~5 years ago and I often woke up questioning whether or not she was still alive, which was incredibly distressing. Now these dreams started to take effect at around 300mg, and got much worse at 375mg of Venlafaxine. From basic research I know that Venlafaxine starts to knock about with Dopamine transmitters and I'm sure that this was to blame. The strange dreams subsided once I tapered off of Venlafaxine and everything looked okay.

We talked about alternatives, and it was a toss between Fluoxetine/Prozac or Agomelatine/Valdoxan. After weighing up the Pro's/Con's I went for Agomelatine Because:
- I had always suffered from a bad sleep cycle and have Delayed Sleep Phase Disorder, so Agomelatine could prove very advantageous in that area
- Having been on Citalopram and Venlafaxine I'd been put off of SSRI's due to their side effects
- Apart from keeping an eye on my liver with regular blood tests Agomelatine should come with side effects
- I could have my sex life back! The sexual side effects of Venlafaxine meant for me that I was unable to ejaculate, which mad sex a chore
- I quite liked the novel way in which Agomelatine worked, he said other patients had received good results with it, and it had widely been accepted as a good drug to use in treating depression/anxiety that hadn't been addressed with other SSRI's

I started off on 25mg and everything went very smoothly. My depression had started to lift, my anxiety had improved although this still remains an issue and I rely on Lorazepam daily. Since I seemed to respond fairly well to it he decided to increase it to 50mg and this is where things all seem to have gone wrong. Now I'm not as clued up as some of you guys out there but from what I understand, Agomelatine mimics the action of Melatonin and in higher doses >25mg increases dopamine levels in the frontal cortex. I'm back at the stage where I'm having wildly lucid dreams, waking up sweating and not being able to stay asleep throughout the night, although inducing a sleep isn't such an issue.

He was keen to keep me on 50mg because it had been doing wonders for my anxiety/depression so we tried 15mg Zopiclone to try and keep me sedated throughout the night, but this didn't work. We did the same for Lorazepam/Diazepam but this didn't work either. We then tried 25mg Quetiapine then 50mg but I'm STILL having broken sleep cycles and lucid dreams. The Quetiapine worked for a week at 25mg then wore off, and then worked for a week at 50mg and then wore off. Though I'm still taking it.

Now I'm not a psychiatrist, but I do champion patient autonomy and I'm *sure* that I'm experiencing the broken sleep cycle and lucid dreams because such as when I was on 375mg of Venlafaxine, whilst I'm on 50mg of Agomelatine, the increased levels of dopamine were the cause. I have suggested this to him and he's dismissed it and reassured me that the dreams/broken sleep should settle. But they're just not.

I'm now finding myself going back to opioids, mainly oral morphine, to sedate me throughout the night (2x60mg doses) mixed in with 20mg Diazepam but hey ho it's 3AM (or it was when I first woke) and I wake up during a crazy lucid dream. It's really taking it's toll on me and is making me feel wired and more anxious throughout the day. Has anyone experienced lucid dreams/broken sleep? I've sent him on a quick e-mail last night requesting a prescription for some Xanax before he goes on his Xmas break as it's a more potent Benzo I'm hoping it'll sedate me more then the likes of Diazepam.

By the way, if anyone has had the heart to read all of this down to the bottom in the genuine interest of helping me, in Christmas Spirit I'll PayPal the first person to quote me in this thread saying Pink Dinosaur with £10. It's quite common where I'm from to 'do a Cracker at Christmas' - Christmas Random Acts of Kindness! (CRAK!)

So yeah, any suggestions on anyone who's had similar experiences? What do you think to my theory on dopamine? Is a higher dose of Quetiapine a solution or am I going to just have to cut back down to 25mg Agomelatine and see how I go before trying Fluoxetine/Prozac, which was one of our other original shortlisted choices.

I'm trying to finish my dissertation for my masters degree so constantly feeling wired from lack of sleep, but also tired from too many benzos is really making life hard for me.

So yeah, please share any thoughts/similar stories and also a Pink Dinosuar if you want that £10 Xmas Act of Kindness \o/

Much love al always BL!

Rybee x

 

[ad lib]

Hey Rybee

The Venlafaxine is known for disrupting sleep patterns, it's given me SUCH bad insomnia.

Have you ever been for a sleep study? Perhaps there is something else going on that needs to be addressed like a sleep disorder.

Here's an interesting article I found-

http://m.psychologytoday.com/blog/dream-catcher/201207/lucid-dreaming-and-lucid-nightmares

It seems like there is no known cause of lucid dreaming, but the prefrontal and parietal cortical networks are activated during sleep, so perhaps the drugs are stimulating this?

 

[Abject]

Have you read the studies that suggest increased activity?
Looking here it has been hypothesized to be from antagonsim of 5-HT2C, which many SSRI's affect.
Furthermore, there is evidence that Norepinephrine carries some Dopamine since DA is inactivated by NE reuptake in the frontal cortex.

As for something a but more practical, it seems obvious that all of this knowledge means near nothing compared to the knowledge that 25mg is good for you and 50mg isn't.

Also

Pink Dinosaur

I don't want the money, but feel encouraged to give it to the next person you come across who seems like they need it

 

[ad lib]

Very interesting study ^

 

[Rybee]

ad lib, & abject, thank you both for your great replies. I'm going to read up on the sources that you've both provided.

I couldn't cope with feeling so wired and on edge anymore so I've completely stopped taking my Agomelatine/Valdoxan - my Psych is unaware of this, not seeing him until Jan 4th, and to be honest I've thrown him a few concerned emails and he's been very out of touch with my situation so I felt I had to take it into my own hands. It's was my 4th night of no Agomelatine/Valdoxan last night and coincidently my 4th night of lovely natural sleep. No bizzare dreams. No sporadic waking up momentarily. Nothing. I can only assume that the Agomelatine is indeed to blame for the poor sleep and the lucid dreaming.

I do feel a little on edge as this is the first time I've been off of anti-depressants for a long, long time so naturally I'm a little bit scared. I seem to be coping alright so far though, I used to chew on Xanax like skittles but I've not had any in the last 3 days, I've just not felt that I needed to take any. That said, I started lyrica/pregabalin and Fentanyl patches for chronic pain a week ago and they've definitely spaced me out quite a lot, which is surprising because I'm very tolerant to opioids.

Maybe in 2014 I'll turn over a new leaf and decide to go medication free... I tried that at the turn of 2013 and it lasted about 3 weeks before I was back on the Venlafaxine. I'd like to think I can cope without a daily pill and would like to give it a go. Maybe it'll work, maybe it wont. Who knows.

But for now I'm gonna read up on the material you've kindly posted