Mental Health Insomnia or Medication That Induces Anhedonia

[LookingForSelf]

I'm taking mirtzapine for sleep as it's the only thing that works; melatonin, ambien, belsomra, valerian root, gabba, 5htpc, etc doesn't work for me.

I take it as needed for sleep but every time I take it I feel really bad. I don't want to go out or do anything the day after taking it, it sucks the life out of me. I guess this is called anhedonia? After a couple days off of it I'm ok again but I dread the next time I have to take it for sleep.

Is there some coping strategy for insomnia? Like just being ok with the fact that you can't get much sleep? I go without sleep for 2 days or 3 days sometimes right now. Should I be worried about psychosis if I've had psychosis before? That's the only thing that's stopping me from stopping mirtzapine.

I feel like this antidepressent is going to put me in a worse place in this life.

People say that an antidepressent needs to be taken regularly before it's effects start, but why do I get this horrible effect even before I commit to being on it regularly? Name me another drug besides drugs for the brain that make you feel like complete death before they "kick in"?

Nevertheless I feel stuck. Take it or don't take it. Theres repercussions to both. But I feel so good when I haven't taken mirtzapine that sleep deprivation doesn't phase me so much at the moment.

 

[AlphaMethylPhenyl]

Are you sure that you're taking the minimum dose that will ensure a restful sleep?

There are a number of ways to combat insomnia.
-not using devices with artificial light before bed
-only using bed for sleep and sex
-not eating 2-3 hours before bed
-exercising a few hours before bed
-being active (mentally and physically) in the daytime
-not napping during the day
-getting up earlier than usual, and going to bed later than usual

And there are more.

No, sleep is essential. Without it, your mind and body will be under extreme pressure.

Yes, otherwise perfectly healthy people will become psychotic without sufficient restful sleep.

Those aren't the only medications used for sleep. That said, others can produce just as much of a hangover.

The human brain isn't just another organ. It has specialized cells and functions that make it largely unique and superior to other body parts. It's like comparing a car's engine to it's exterior. The rules are different. More precise tinkering is warranted. That question is irrelevant. Unfortunately, too many people stop taking their medication because it doesn't make them feel wonderful whenever they take it. That's the logic of an addict. You have to be able to see a wider picture.

 

[LookingForSelf]

I've done all of those to no avail. Believe it or not their is insomnia out their for which none of these sleep hygiene tips will treat.

The human brain isn't just another organ. It has specialized cells and functions that make it largely unique and superior to other body parts. It's like comparing a car's engine to it's exterior. The rules are different. More precise tinkering is warranted. That question is irrelevant. Unfortunately, too many people stop taking their medication because it doesn't make them feel wonderful whenever they take it. That's the logic of an addict. You have to be able to see a wider picture.

1) Precedence is given to the drug makers and our faith is put in them knowing how the brain works and how the drugs work with it. But I don't think putting our trust to a person in a lab coat is always the best decision and thats where all the horror stories of medications come from.

2) I see what your saying here but the way this drug makes me feel right now leads me to believe thats how I will always feel but it will be going on for so long by then that its all I will know and be none the wiser to question it; hence the "zombie" state we here ever so often.

 

[Ligaturd]

Mirtazepine is one of the only medications that actually increases REM sleep, along with Temazepam. It sounds counter intuitive though. My mom was on it and she said it was extremely effective for her depression and anxiety but there was an adjustment period where she was just out of it for a couple months. It disappeared though. Maybe try a smaller dose if it is too much for you. My Mom found it more than worth it to stay on it and get past that initial zombie state.

 

[silverwheel]

Thing is, by not taking it everyday you're making it much harder for your body to get used to the medication. Taking it sporadically means that you are re-introducing it to your system every time, which doesn't help you to get over the initial side effects. The lack of quality sleep on the nights when you don't take it also isn't good for you. I can tell you from personal experience that mirtazapine is one of the best things you can be on - it's one of the only medications that can help you get quality sleep instead of just knocking you out. I have severe sleep disturbances from fibromyalgia, and nothing has been anywhere close to the effectiveness of mirtazapine - not just getting me to sleep, but good REM sleep. My dreams also became more vivid and less unpleasant, which is where they were before the fibro came along. I got the heavy side effects as well when I started on it, but those passed within a month. You'll never get over the initial hump if you only take it sporadically - take it everyday and give it a real chance to do its work.

 

[apatheist]

Mirtazapine's side effects went away with time for me as well. The munchies lasted longer than the zombie thing; it does still take some willpower to get out of bed in the morning, but once I get up and have some caffeine I'm good to go.
There is no coping strategy for inadequate sleep. It'll take years off your life.

 

[Ligaturd]

Absolutely. Sleep is important for brain function and lack of sleep will increase sttess, cause memory deficits and impede brain function. I am trying to get on Mirtazepine as of right now as I have been using various sleep aids that lower sleep quality for years as I know that without them I probably wont sleep much at all anyways

 

[LookingForSelf]

Welp, it worked a total of three times and now it doesnt put me to sleep anymore. Took it three more times one day after the other and nothing. I just stay up feeling fatigued and plain bad. Chalk up another med that doesnt work for me. I dont know if I should be sad or happy about this given how the drug makes me feel.

Only thing left right now is Trazodone and I have a feeling results are going to be similar.

I could put my trust in exercise to help but one study shows it takes 16 weeks before the effects of exercise on better sleep occur and that seems like of a hell of a long time to endur dragging myself to the gym on those days Ive had no sleep the night before.

 

[silverwheel]

Given the severity of your sleep problems, I think exercise alone probably won't be sufficient. Yes, you should do it, and it certainly will help you somewhat, but your insomnia seems to be pretty intense, probably more than just an exercise regiment could cure. You might want to ask your doc about adjusting the dosage of mirtazapine - if it worked for you for a little bit, I'd stay with it, but your dosage may need to be adjusted. I know it's frustrating, but you really need to think about it on a longer timeframe than just a few days - it's still too early to make a judgement about whether it's ultimately going to work for you.

 

[LookingForSelf]

Given the severity of your sleep problems, I think exercise alone probably won't be sufficient. Yes, you should do it, and it certainly will help you somewhat, but your insomnia seems to be pretty intense, probably more than just an exercise regiment could cure. You might want to ask your doc about adjusting the dosage of mirtazapine - if it worked for you for a little bit, I'd stay with it, but your dosage may need to be adjusted. I know it's frustrating, but you really need to think about it on a longer timeframe than just a few days - it's still too early to make a judgement about whether it's ultimately going to work for you.

Tried it two more times and upped the dosage to two 15 mg pills and it had the opposite effect of making me alert than sleepy. And not to mention you feel worse if you go without sleep on the med then if you just go without sleep.

Trazadone seems to be the next one to try. Doubt it will help so Ive held off getting it and just endured the sleepless nights. I think I have to get over the fact that most people get sleep and I dont and that may end up helping me. But thats like getting over everyone getting presents except you.

 

[paranoid android]

Have you tried any of the more sedating Tricyclic anti-depressants such as Amitriptyline, Doxepin or Trimipramine to help you sleep? I have found them to work great for sleep as well as in treating Bipolar depression as well. If you are getting that bad of a reaction from Mirtazapine i would suggest stopping it asap. The only thing worse then laying awake all night miserable is waking up in the morning totally fucking miserable imo. I also had a pretty bad reaction to Mirtazapine back when i was taking it in doses of 30mg's a night (starting off with 15mg's and with Mirtazapine less is more if you want the sedative effect) along with Risperdal to help Bipolar disorder. I started to get more and more depressed in a way i had not experienced before. The best way i can describe it is as a sort of nihilistic depression where i saw no hope or reason to carry on.

I got so down that i was nearly hung myself one morning as i felt literally nothing emotionally except a overwhelming feeling of numbness. I wouldn't call it anhedonia as it felt far beyond that. It was not only that i felt no pleasure in anything but in my mind at the time i felt as if life was simply not worth living and that i didn't find worth or pleasure in enough to justify living really. To say this is all self centered self loathing is certainly more then true but i remember that at the time it all seemed perfectly rationale to me which is rather scary if you think about it. I had the noose up and the lot and was thinking of any possible reason not to off myself and of course i instantly thought of one of my family members who would likely find my corpse and of course the pain i would inevitably inflict on friends and family members. As someone who has had friends and family kill themselves i know how awful it is. So that went flashing through my mind and thankfully knocked some much needed sanity into me.


I honestly don't know how much of a part the Mirtazapine played there but that was really scary. I was not on a actual mood stabilizer at the time as i had yet to go on Lamictal so no doubt that didn't help. Also i don't find Risperidone to work great compared to Olanzapine or even Quetiapine or Chlorpromazine. I find it to be the most unpleasant of all the anti-psychotics i have taken as it's not really sedating so much as zombifying. Sadly besides Quetiapine it's the only Atypical my stupid insurance covers so if i want Zyprexa which works much better i have to pay for it . But i have not had that type of effect from any other med combo and that is another anti-depressant that made me wary of that class of drugs.

TCA's in low doses are used for sleep though and i have to say that they do work pretty good. Amitriptyline helped me get about the best sleep of my life when i was taking it for pain and i didn't get any hangover effect from it after a few days if anything i felt more awake. Trimipramine is another one i took and it's a weird Tricyclic that's sort of a Anti-Depressant and Atypical anti-Psychotic in one. It's pretty sedating at first to alot of people and for some i have heard it makes Seroquel look like a stimulant. Personally i never found it unpleasant but it certainly helped me sleep well.

Just saying there are still other options out there rather then putting up with unpleasant side effects.

 

[Pretty_Diamonds]

Are you seeing a psychologist? I think you should consider trying to learn from relaxation and mindfulness techniques to help with your insomnia. Medications are only for the short-term, long-term, lets get to the root of your issues.

 

[LookingForSelf]

Have you tried any of the more sedating Tricyclic anti-depressants such as Amitriptyline, Doxepin or Trimipramine to help you sleep? I have found them to work great for sleep as well as in treating Bipolar depression as well. If you are getting that bad of a reaction from Mirtazapine i would suggest stopping it asap. The only thing worse then laying awake all night miserable is waking up in the morning totally fucking miserable imo. I also had a pretty bad reaction to Mirtazapine back when i was taking it in doses of 30mg's a night (starting off with 15mg's and with Mirtazapine less is more if you want the sedative effect) along with Risperdal to help Bipolar disorder. I started to get more and more depressed in a way i had not experienced before. The best way i can describe it is as a sort of nihilistic depression where i saw no hope or reason to carry on.

I got so down that i was nearly hung myself one morning as i felt literally nothing emotionally except a overwhelming feeling of numbness. I wouldn't call it anhedonia as it felt far beyond that. It was not only that i felt no pleasure in anything but in my mind at the time i felt as if life was simply not worth living and that i didn't find worth or pleasure in enough to justify living really. To say this is all self centered self loathing is certainly more then true but i remember that at the time it all seemed perfectly rationale to me which is rather scary if you think about it. I had the noose up and the lot and was thinking of any possible reason not to off myself and of course i instantly thought of one of my family members who would likely find my corpse and of course the pain i would inevitably inflict on friends and family members. As someone who has had friends and family kill themselves i know how awful it is. So that went flashing through my mind and thankfully knocked some much needed sanity into me.


I honestly don't know how much of a part the Mirtazapine played there but that was really scary. I was not on a actual mood stabilizer at the time as i had yet to go on Lamictal so no doubt that didn't help. Also i don't find Risperidone to work great compared to Olanzapine or even Quetiapine or Chlorpromazine. I find it to be the most unpleasant of all the anti-psychotics i have taken as it's not really sedating so much as zombifying. Sadly besides Quetiapine it's the only Atypical my stupid insurance covers so if i want Zyprexa which works much better i have to pay for it . But i have not had that type of effect from any other med combo and that is another anti-depressant that made me wary of that class of drugs.

TCA's in low doses are used for sleep though and i have to say that they do work pretty good. Amitriptyline helped me get about the best sleep of my life when i was taking it for pain and i didn't get any hangover effect from it after a few days if anything i felt more awake. Trimipramine is another one i took and it's a weird Tricyclic that's sort of a Anti-Depressant and Atypical anti-Psychotic in one. It's pretty sedating at first to alot of people and for some i have heard it makes Seroquel look like a stimulant. Personally i never found it unpleasant but it certainly helped me sleep well.

Just saying there are still other options out there rather then putting up with unpleasant side effects.

Sorry to hear of your troubles. Seems like your doing well now. Yes Ive tried Doxepin, did nothing.

Now Im even more warry of trying trazadone because it sounds like its a game of use one drug and once it stops working move on to the next. Thats what I see from a lot of people that recommend medications.

 

[LookingForSelf]

Are you seeing a psychologist? I think you should consider trying to learn from relaxation and mindfulness techniques to help with your insomnia. Medications are only for the short-term, long-term, lets get to the root of your issues.

Im planning to but it may not be anytime soon. I am highly pessimistic of mindfulness for sleep though. Ive tried to do it on my own and all it did was make me watch the time pass by while giving effort at something- the tiredness and exhaustion still being present. I guess Ill mention it to the therapist ill see though.

 

[cheffy]

Im planning to but it may not be anytime soon. I am highly pessimistic of mindfulness for sleep though. Ive tried to do it on my own and all it did was make me watch the time pass by while giving effort at something- the tiredness and exhaustion still being present. I guess Ill mention it to the therapist ill see though.

I've been on mirtzapine for about a year, made me gain weight and groggy the whole next day , really hard to get out of bed .

Been dealing with insomnia most of my life .

What helped me to cope with my lack of sleep , taking it as a project :
Mindfullness meditation twice a day

two hours before sleep id close all the lights and electronics and prepare things for tommorow

kept a dream journal next to the bed and started investigating my dreams , practiced lucid dreaming .

3 hours before bed no eating bla bla bla .


these helped me cope with the lack of sleep , but i still had hard time having a good sleep.

What did help , was doing a vipasana retreat , i slept like a baby .
now i supplement with l theanine , bacopa ,niacin , tryptophan, aaand - Glycine which really helps with the grogginess in the morning .

For me there are certain times during the day i feel like i can fall asleep, if i go past 11 , its a no sleep night for me.


Those are the things which helped me , but each case is individual :

I'd say experiment with it , take the fact that you are not sleeping well as it is , and just try what ever you can : meditation , yoga , other supplements , sleep journal . (meditation and yoga , and bacopa , to kill your bodies cortisol response during the day, which they do , cortisol kills you ability to sleep.)

Stay the fuck away from SSRIs , SNRI , benzos , The Z family like zopiclone , all of these would get you in such a mess you would'nt know if the problem is you or the drug , and when you'll decide to come off of them , you'll be so mentally odd , you'll start looking for a treatment to that , its just a cycle you dont want to go into, as much as you want to have a goodnight sleep.

As for supplementation , beware of gaba agonists , id recommend :

Methylcobalamin in the morning ( you're not getting enough of it anyway)

Vit D 2k ui or more in morning (Important for circadian rhythm , not getting enough anyway)

B100 complex (optional)

Niacin(b3) 500 mg daily followed by 1.5-3g tryptophan seperated to more than 3 doses during the day (Niacin so tryptophan wont be to be converted to it by the body , and tryptophan for the synthesis of serotonin > melatonin)

Magnesium malate or eposm salt bath before sleep , 1.2 g before bed , or couple of times during the day if you have anxiety. ( Magnesium , seriously , has an almost benzo effect on me , your body needs it for more than 300 enzymatic functions , it'll relax your muscles and ease your mood.)

Bacopa twice a day , or reishi , to help with stress response

L theanine 100mg before sleep ( optional , see how it works for you)

Glycine 3 gram an hour before sleep - wont help you fall asleep , but i feel less tired waking up with it.


This may seem very demanding , or even expensive , but - therapy would cost you much more , and the treatment can do more harm than good .

" melatonin, ambien, belsomra, valerian root, gabba, 5htpc"

Gaba only works for some people , it probably does not cross you blood brain barrier
Valerian is a gaba agonist , you'd want to cycle with it anyway .
5htp can get you too much serotonin because the body automatically converts it to serotonin(unlike tryptophan) , which can harm sleep aswell.

If you feel unsure , go for magnesium and yoga for start.
Tell me how it goes.

 

[paranoid android]

Sorry to hear of your troubles. Seems like your doing well now. Yes Ive tried Doxepin, did nothing.

Now Im even more warry of trying trazadone because it sounds like its a game of use one drug and once it stops working move on to the next. Thats what I see from a lot of people that recommend medications.

Well i have been doing alot better except for a few bad spots the winter due to SAD. Granted my SAD didn't act up nearly as much this year as in past years. In regards to the insomnia that battle is still ongoing sadly. I never tried Doxepin but from what i have heard it's more sedating then Amitriptyline for alot of people but everyone reacts differently. Personally id recommend trying Trimipramine (Surmontil is one brand name for it) as it's one med that not only helped my sleep but improved the quality of my sleep so i felt far more rested and in less pain then when my sleep is shit. For some it's a total knockout med but i didn't find it a whole lot more sedating then Amitriptyline.

I think it actually one of the few anti-depressants that does not alter REM sleep and according to a study actually caused depressed patients suffering from insomnia to have more positive emotions while dreaming. I also experienced this rather pleasant and unexpected side effect which was a welcoming change from the depressing dreams i often get when i am already sufferig that make me feel totally depressed and hopeless as fuck upon waking. It's bad enough being depressed as fuck during the day but having a actual really depressing dream where you feel as miserable in your dream as you do in real life then dealing with the emotional fallout from that at say 4AM when you wake up in a cold sweat is pure fucking torture. I have woken up from these depressing dreams dripping cold sweat with my heart racing and in a state of despair that beggars description really. When you can't even escape from your depression in your sleep when you can actually sleep it is a truly miserable state of existence to not even want to sleep anymore for fear you will wake up in a suicidal depression. So needless to say finding a medication that actually gave me good dreams and thus brightened my mood upon waking was awesome hence why i recommend it .

I have never taken Trazodone for fear of the much dreaded and truly terrifying but fairly rare side effect of priapism. I have had a few doctors recommend it to me but i have always flat out refused for fear of that side effect. Not to mention just about everyone i know who has tried Trazodone has said not only is it shit for sleep but it also causes Migraine headaches in alot of people and just a general shitty feeling upon waking that takes a long time to go away. One of the major metabolites of Trazodone is MCPP a drug used to induce migraines and also studied for it's anorectic (appetite suppressing) effect as well. This is thought to be the reason why Trazodone can trigger Migraines in certain people and as i sometimes get Migraines i don't want to risk triggering them off for a anti-depressant that doesn't work and is used almost exclusively as a sleeping pill because one of it's side effects is sedation. MCPP was also sold briefly as a legal version of MDMA though why anyone would willingly take it. But yeah Trazodone is one of those drugs where the benefits just don't seem to outweigh the potential risks for me or anywhere close to it really.

You are of course right about having to change meds for insomnia as they do crap out rather fast usually. Sometimes taking a sort break is enough to get them working again like with certain anti-histamines. Amitriptyline did work for me for about 2 years in treating my nerve pain, insomnia and Bipolar depression. Unfortunately it stopped working on everything at the same time and i was left at square one.

 

[Pretty_Diamonds]

Im planning to but it may not be anytime soon. I am highly pessimistic of mindfulness for sleep though. Ive tried to do it on my own and all it did was make me watch the time pass by while giving effort at something- the tiredness and exhaustion still being present. I guess Ill mention it to the therapist ill see though.

Because you weren't doing it right, lol! I mean, probably. I've done mindfulness with a therapist and without and trust me, with is waay better. The first time was with a therapist, so I really did it "properly" in a sense so when I tried to do it at home, I knew how to do it in a sense.

I think you should definitely reconsider doing it sooner rather than later. People are so quick to place insomnia at the chemical level. I had insomnia for a couple years, on meds & anti anxiety drugs. It worked. I was able to sleep, but it actually made my anxiety worse in a sense. I tried exercising, but just wasn't that into it. Then, I went through issues with my bf and saw a therapist. I mean, really indirectly or inadvertently, my insomnia disappeared. I felt more motivated to work out and felt better after each therapy session, feeling a sense of relief. It's weird to describe and I didn't expect that at all. I felt to be just overwhelmed with emotions and bringing up trauma and issues from the past... but I didn't expect to be able to think about it and then move past it so well. I mean, just that huge sense of relief and feeling good about yourself... really made me able to just sleep peacefully, with motivation to get up early and exercise.