Mental Health Medicine to treat recurring nightmares incl. waking up screaming (urgent)

[dopamimetic]

Lost more than one room now because of this shit and am truly afraid of going to mental hospital because last time they just told me I had to "deal with it" and with the roommate threatened to beat me. They eventually moved him but guess it was a random decision.

This started slowly while I was on morphine substitution. Quit opioids over two months ago, the first days were fine, then the condition came back slowly. Now it's as bad as it was on the worst days, maybe because of kratom but without that I'd do really stupid things I guess.
What helped - for a whole week (sigh) - was diphenhydramine. Then it lost any effects. Clonazepam was a total failure, guess 2mg were too low.

Origin is as far as my guessing goes, PTSD and chronic acute stress which I can't escape from anytime soon.
Heard that clonidine might help for PTSD but is it strong enough?

Anybody having had a similar thing and found something which works? I have maybe one or at max two chances to make proposes, after they will just put me on a random antipsychotics and again tell me that it was just life. -They- don't have to deal with it, yeah.

 

[Jabberwocky]

@SnafuInTheVoid just posted having a similar horrible experience. I almost feel lucky I’m an insomniac and never dream. Do you think it might actually be caused by substances like dissociative you have been consuming or is it more psychological. Really feel for you man - sleep is so precious.

I’m prescribed clonidine - I doubt that it would be helpful in this situation. As with some of your other posts in the last few weeks it sounds like your life is wrapped a bit too tight and you are n to going to be healthy until you find a context in which you feel safer and more comfortable. Hang in there. Happy to chat by PM if it helps - I’m always awake.

 

[dopamimetic]

Thanks for the response @Atelier3 Finally had an appointment with the local addiction clinic where I had been in treatment (well, 15-20min talking every week and pill handout, I don't like their chronic lack of time and not really helping with anything but what keeps me there is that they usually don't think twice before handing out all sorts of pills you like as long as they fit into what usually is given.) before recent travel and got now clonidine and lorazepam. Will try and hope ... memantine really helped, not only with the nightmares but mood in general and to keep opioid tolerance down but it's too far off from usual prescriptions. Heard from somebody though that it might be possible (she got exactly this, memantine, from that clinic but it didn't help her because they limit dose to the 20mg which are recommended in Alzheimer's but in the studies with addicts / psychiatric patients up to 60mg were used and well tolerated).

I don't know the origin for sure, just thought it would be damage done by over-/abusing dissociatives for escaping reality which isn't what they are here for, at least not in such excess (between 2016-19 maybe 2/3 of the days on some kind of dissociative) and that this caused an imbalance in excitation vs. inhibition. We have papers around where they found such changes in ketamine addicts, loss of GABA producing interneurons for example.
But yeah, you shouldn't self-diagnose, I know but also know that without access to the really educated Dr.Prof.'s which are out of reach for a mean individual like myself, I can comfortably save the time and energy to bother with trying to talk straight with random docs..
So, what I found today might well be it - norepinephrine dysfunction caused by chronic stress. I didn't fully read the paper yet, but it is about exaggerated response to stressful stimuli, eventually causing a state of constant stress.

You are absolutely right about the current situation of my life, and the dreams indeed are always and over and over about these topics. It's not random violence like maybe somebody not supporting late night horror movies - I actually like such things, they distract my mind from the real horror.. but as there is no magic fix for RL, it would really, really help much when I find something to stop at least the part of these nightmares that disturbs others.

If this now doesn't work, think I'll try zopiclone as this one was very reliable in knocking me out in the past and had no withdrawal after roughly 3 months of daily use.

Oh, here is 3 a.m. ... should find some sleep soon, I'll take more clonidine (37.5ug were taken one hour ago, no noticeable effect) now and see how it goes.
May I ask how the clonidine affects you, for which symptoms or situations does it bring relief? Do you get daytime fatigue from it, and which dose?

 

[Jabberwocky]

Thanks for the response @Atelier3.

Oh, here is 3 a.m. ... should find some sleep soon, I'll take more clonidine (37.5ug were taken one hour ago, no noticeable effect) now and see how it goes.
May I ask how the clonidine affects you, for which symptoms or situations does it bring relief? Do you get daytime fatigue from it, and which dose?

Very glad to hear back from you - you seem a bit more on top of things now (though hard to tell from a post).

Do you think that your relentless self-diagnosis / research might be contributing to your anxiety. It’s easy to get stuck ruminating about all the possible theoretical causes while working yourself up into a state. The reality with exotic polydrug users is that causality may be impossible to determine - which makes focusssing on survival / recovery strategies the critical thing to focus your mind on.

I hope that doesn’t come across as patronising. I really didn’t mean it to be and I respect your experience and knowledge which far exceeds my own plain vanilla drug awareness.

To answer your question I was prescribed 100 ug clonidine nightly as a counterbalance to my 30 mg daily dexamfetamine. It’s a common practice to aid new stimulant users () in getting sleep while they get used to the stims. It also had an off-label nootropic use in ADHD cases, aiding concentration.

To be honest the only thing it ever did for me was make me dizzy if I stood up too quickly. I tried much larger doses to get a sleep effect but never got one. It has probably benefitted me a few times when I was overamped by lowering my blood pressure.

 

[dopamimetic]

Yeah, I'm really much better for the moment, thanks to the new old meds (methadone 30mg again, was off stronger opioids for around 2,5 months now - with the aid of memantine quitting is pretty easy but not the time after, when you begin to realize how much the opiate had 'protected' you and all the insecurities, anxiety, stress come back with full force ... I was on vacancies and couldn't get more than tramadol, so I went with the memantine which was OTC over there. It's a pretty nice med for some conditions but requires higher doses than those for its currently only indication- Alzheimer's - which is hard to get.)

(Think that) I am mostly aware of the risks about self-diagnosis and nocebo effects. Don't worry, it's an obvious question - saw/see how it influences the one or other individual from time to time but would say I am pretty non-hypochondriac. At least what I don't see or feel, doesn't worry me (about my health). Rather think that knowledge, plain info and data helps me to see things more .. technical and just from the basics like how incredible biology is at self-managing and -repair can e.g. outbalance statements like neurotoxic, or 'fries your brain'. Knowing the relevant receptors and transmitters does a good job in avoiding avoidable things with medication, of course there is always a much bigger bunch of stuff I don't yet know than all I might know, but my experiences with docs both first- and second hand were that in too many cases too many little or not-so-little details go unnoticed.

Stress leads to paranoia sometimes and this is a real pitfall that catches me from time to time though.

Curiously clonidine doesn't relevantly influence my blood pressure. It causes a bit of orthostatic hypotension at more than 75ug but the BP/bpm remain almost unchanged even with 150ug - when I got it prescribed the first time during rehab, they first refused because of my tendency for lower-ish blood pressure (like 110/70) but anxiety elevated it, so I had maybe 130/85 and with clonidine it went back to usual. It's no wonder drug by far, for me the downsides are that dosing is very difficult, a tiny bit too much and it makes me a bit lethargic and anhedonic, takes the drive out for which NE is responsible but at the same time is an excellent aid to prevent or interrupt panic attacks. Makes me crave for stimulants.

We should have a similar drug with a much shorter half life, which lasts just during night. There is one but I don't remember the name and didn't find it by a quick search.
And an even shorter acting one to take against panic.
Would say it doesn't put you asleep like benzos or z-drugs but if it works for the nightmares then I'm happy for the moment.

Never heard of clonidine being used along dexamph, but the docs here didn't even know that it helps with withdrawal. Nor about memantine, but at least he is interested in what I tell him. Just chronically out of time, too many patients.
As I react very sensitive to the physical push of stimulants which heavily limits their use and dosage range, it might be worth a try for the case that I should want/need to get back on lisdexamphetamine for focus and/or drive (pure d-amph isn't available here anymore, was years ago before El-/Vyvanse hit the market).

 

[Deru]

@dopamimetic As I read your thread, I find the exact same issues with my medical condition (heart failure, etc.) I have and self-diagnosing, discussing things with doctors and being severely frustrated by lack of time. It is absolutely baffling how over full the cardiovascular specialties are, and for something that really requires some time to assess and dig a little deeper, the cardiologists and electrophysiologists just don't have it. A typical appointment with my cardiologist is I wait for 1 hour + because he's so behind, have 10+ things I want to discuss, he comes in and speaks for 3 minutes while he has a personal [can't remember their title] type for him and then he runs out of the room and the person explains what the doctors dictated in 3.7 seconds. It is beyond frustrating, I've been through 3 different cardiologists hoping it would get better and it doesn't. It's truly sad to realize we're all just dieing and modern medicine just isn't as great as we like to think it is when we believe we're invincible and even if we do hurt ourselves, science and medicine will save us. There is a huge difference between being alive and having a quality of life worth being alive. With all that said, I relentlessly research too in hopes of being able to treat myself better as well, and all it ever winds up doing is causing me greater anxiety and complete disappointment when no doctor is willing to listen. The only pleasure I get is from the process of learning, in and of itself, because that is fulfilling for me. I completely understand the struggle, though, and hope you find something to help with what's going on.

 

[kush407smoke]

For my ptsd and nightmares

3mg xanax
3mg lunesta
600mg seroquel

Worked for me all this taken at night

Previous post was deleted as I suggested this combo instead of just saying it worked for me so this is a correction post