How would you reduce these?

[BabyGurl3171]

My psych has me on entirely too much at night. How could I reduce the amount of meds I take at night without causin me to become an insomniac again? Here's what I take at night: Trazodone 100 mg, Ambien 10 mg, Seroquel 300 mg, Neurotin 1,200 mg, Valium 10 mg. I do have a lot of problems fallin asleep but I would think I could thin this list a bit. Any opinions? And thanks!

 

[gearfiend]

you could try 5htp and melatonin supplements... none of the drugs you mentioned have ever helped me sleep. i have tried most of them. i usually just take melatonin, 5htp, fish oil, and down a beer or two if its really bad. the other thing you can try, i know it works like a charm for me, is taking 100mg of diphenhydramine (benadryl). always makes me REALLY sleepy. get rid of all that shit, its just all bad in general.

 

[BabyGurl3171]

I will try those, thanks! The only one that won't work for me is dph. I've used it so much in the past, before I discovered opiates lol, that even 200 mg don't phase me. Stupid tolerances.

 

[Geaux Tigers!]

My psych has me on entirely too much at night. How could I reduce the amount of meds I take at night without causin me to become an insomniac again? Here's what I take at night: Trazodone 100 mg, Ambien 10 mg, Seroquel 300 mg, Neurotin 1,200 mg, Valium 10 mg. I do have a lot of problems fallin asleep but I would think I could thin this list a bit. Any opinions? And thanks!

Consult your PDOC.

I'd discontinue Seroquel first; you're already getting mood stablilzation from the Gabapentin. Right now you're risking a plethora of serious side effects with that. Why are youtaking Gabapentin anyway? If you're taking it only at night once a day for sleep, it's not really a stable state if you need the anticonvulsant properities. If you're taking this only nightly for sleep --> phenobarbital would definitely be better in your case.

You don't need two (non)benzos. If you have problems going to sleep then I suggest staying with the zolpidem; if you're having problems staying asleep I'd go with the Valium. You need just one benzodiazpeine type drug. Quazepam is perfect and actually improves sleep quality. You may consider Estazolam (ProSom) but it is habit forming.

Do you suffer from major depression? If not, lose the Trazodone. I'd supplement with Rozerem, a novel melatonin agonist drug.

Please note, my advice is not the same as a doctor's advice but I am extremely well educated.

My revised meds, in order from most important to least important:

#30 Quazepam (Doral) 15mg. PO HS
#30 Ramelteon (Rozerem) 8mg. PO HS
#30 Phenobarbital (Solfoton) 64.8mg. PO HS
#30 Clonidine (Catapres) 0.2mg. PO HS
#15 Estazolam (Prosom) 2mg. PRN PO HS

Doxlyamine Succinate (Unisom) 25mg. PRN --> if you insist that you have a tolerance to antihistamine ^^^ and above doesn't suffice.

 

[gearfiend]

yeah tolerance is a bitch that never goes away.

 

[BabyGurl3171]

Geaux Tigers, I'm on the Gabapentin bc I was wakin up with back pain from hell. Psych said this would stop it, which it has, and would be a good sleep aid. I do have depression but I'm on several other meds for that and panic/anxiety oh and bi-polar. I take Geodon, the Seroquel of course, Valium day and night, Effexor XR 300 mg and I believe that's all. I don't have all my bottles in front of me but I'm pretty sure that's it on the psych meds.
I will look further into all the info I have got and talk to my dr further, and hopefully more informed, Saturday. Thank you!

 

[Geaux Tigers!]

Geaux Tigers, I'm on the Gabapentin bc I was wakin up with back pain from hell. Psych said this would stop it, which it has, and would be a good sleep aid. I do have depression but I'm on several other meds for that and panic/anxiety oh and bi-polar. I take Geodon, the Seroquel of course, Valium day and night, Effexor XR 300 mg and I believe that's all. I don't have all my bottles in front of me but I'm pretty sure that's it on the psych meds.
I will look further into all the info I have got and talk to my dr further, and hopefully more informed, Saturday. Thank you!

OK, Bipolar 1 or 2? Still, the way I see it, you need a mood stabilizer, a PRN benzo for breakthrough anixety and sleep, and an -- reluctantly -- an antipsychotic. I'd taper off Effexor and Seroquel immediately. You shouldn't need both Geodon and Seroquel antipsychotic wise. I'd suggest Lurasidone (Latuda), it seems to be less damaging to cognitive functioning. PDOCS are oblivious to this atypical. Also, they have so many side effects; I'd suggest Clonidine for this which may also be beneficial for your aniexty. Antidepressants don't do much for Bipolar patients even if you have DSM-IV Major Depression. Major depression for bipolar patients is best treated with an antipsychotic that would prevent hypomania or a mixed state. The effect of Effexor on NE is negligible for you condition. I do think a TCA like amitriptyline could help your depression symptoms and the Limbitrol DS has Chloradiazepoxide to help you sleep.

Due to the sedative nature of the drugs, I believe a psychostimulant such as Provigil would be efficacious.

THE MOST IMPORTANT thing is the mood stabilizer. Seroquel is not exactly my choice and for good reason; I'd go with Lamictal, the only anticonvulsant beside lithium carbonate that has an effect on depression. The Gabapentin is also serving as a mood stabilizer (but you still need a "real" one) and it helps with you pain and is good for treatment resistant depression.

Morning:

#30 Lamotrigine (Lamical) 150mg. PO q1d
#30 Lurasidone (Latuda) 80mg. PO q1d
#60 Clonazepam (Klonopin) 1mg. PO PRN
#30 Modafinil (Provigil) 100mg. PO q1d
#30 Clonidine (Catapres) 0.2mg. PO HS

Night:

#60 Gabapentin (Neurotin) 600mg. PO BIS q.h.s.
#30 Amitripyline (Elavil) 25mg. and Chlordiazepoxide (Librium) 10mg. (Limbitrol DS) PO q.h.s.
#30 Ramelteon (Remeron) 8mg. PO q.h.s.
#15 Estazolam (Prosom) 2mg. PRN PO HS

 

[Pjkt2501]

Tiger!, damn good posts mate.

 

[FlippingTop]

I take 6-9mg of melatonin a night and it is very effective, I would definitely give it a try.