![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by survivin bpd on September 23, 2006, at 23:11:14
Hi
I have biploar disorder and manage this by using just a small amount of chlorpromazine now and again if I get the first hint of a prodrome coming on. this seems to work well and I am pretty lucky that I don't get the sort of regular mood swings that makes this impossible, and has only happened 2 oe 3 times since my last illness. I have been well for 5 or 6 years. The only other meds I take are temazepam sometimes - 10mg or if really bad 20mg - as I seem to go through patches of insomnia that are really disabling. I then go through weaning myself off the temazepam after needing it for 3 or 4 nights to get my sleep back into a pattern. Last couple of weeks have been very stressful so ended up on the 20mg for a couple of nights, now down to 10mg. I am commuting an hour or so at the end of each day so just have to get that sleep - means I stay on the temazepam longer than I want to as I don't want to risk not sleeping and having to drive / work / manage to look after kids on no sleep.
Sleep was better on carbamazepine which I had a few years ago, but couldn't concentrate - felt fogged and I have a big academic workload. Withdrew from carbamazepine about 4 years ago under advice of consultant who thought I could manage the illness without it. I am sort of wondering whether I am paying the price for choosing not to take a mood stabiliser by going through patches of bad insomnia. Put loads of weight on and felt really nauseous all the time on lithium (before the carbamazepine and a long time ago).
I have just bought some melatonin. Took for the first time last night at around 10pm. Well - it is now 4.43am! my mouth tastes kind of milky, I have a banging headache which is not unusal when I can't sleep and it gets to this time in the morning. I dozed lightly for an hour or so and that is about it. I took 2 mg of melatonin- from reading other posts not sure at all whether that is too much, not enough, or it just plain didn't work, in which case I am pretty upset and feel like the thing I thought would save me from all of this is just plain useless.
Could be a rebound insomnia cos I didn't take any temazepam last night after taking it for a week or so.
I was worried about taking the temazepam together with the melatonin..... so thinking of either going to only 10mg of temazepam, withdrawing from it (usually have to reduce by a quarter of the dose at a time or I can't get off the stuff - a pain breaking up the tablets but the only way - if I go to fast the insomnia rebounds in full force) and at the same time starting the melatonin -no idea what dose to go for apart from the 1 or 2mg suggested on the packaging. other alternative is to keep taking the temazepam until this bad sleep patch goes away (though unlikely for a while I have too many stressors) and then getting going with the melatonin in the hope that it prevents the insomnia next time,
now that's the background, here are the more specific questions
1 has anyone taken temazepam and melatonin in combination? cross tapered off the temazepam and replaced with melatonin? any effects?
2 has anyone had a hypermanic / manic episode that they believe to be triggered by taking melatonin and not other factors? if so, please could you tell me a bit more about it
3 would be great to get some advice / support on getting the melatonin dose right - any would be really appreciated.
4 would be great to hear from anyone who manages bpd without a mood stabiliser
5 any advice/ suggestions most welcome
Thanks in advance
Maria
Posted by Jost on September 24, 2006, at 11:47:48
In reply to sleep - melatonin, temazepam, bipolar management, posted by survivin bpd on September 23, 2006, at 23:11:14
Hi.
I can't say much about bipolar per se. I do know, though, that recent studies suggest that melatonin is not effective for insomnia.
(It may help with jetlag, but not insomnia.)
There's a new product, Rozerem, which is a melatonin agonist-- ie gets your brain to produce more melatonin a few hours after your take it. It doesn't work for me, but it does seem to help some. It's a prescription med.
Don't know about melatonin and your meds, but my pdoc definitely didn't want me to take it with Parnate. That's an MAOI-- an AD that has a lot of drug interactions-- so that might be a very different case--but suggests that melatonin is not a completely non-problematic drug.
Maybe you could ask your pdoc about melatonin, or rozerem.
Jost
Posted by survivin bpd on September 24, 2006, at 11:54:54
In reply to Re: sleep - melatonin, temazepam, bipolar manageme » survivin bpd, posted by Jost on September 24, 2006, at 11:47:48
Hi Jost
thanks for that - do you have any refs for the studies that suggest melatonin is ineffective? would like to have a look.
unfortunately am in UK and Rozerem looks to be quite a long way off here -from what I can gather it is raising some interest as a longer term prospect but not pending. would be keen to look at refs - have read a few studies but thought the evidence presented didn't lead to much of a conclusion
Maria
Posted by Jost on September 24, 2006, at 12:42:48
In reply to Re: sleep - melatonin, temazepam, bipolar manageme, posted by survivin bpd on September 24, 2006, at 11:54:54
The melatonin study I had heard about was done at the U of Alberta.
This following seems to have the same general info, not sure of the relationship to the Alberta study.
http://www.ahrq.gov/clinic/epcsums/melatsum.htm
or in PDF
http://www.ahrq.gov/clinic/epcsums/melatsum.pdf#search=%22melatonin%20effectiveness%20studies%22Main point:
Overall, the one area where melatonin affected sleep onset was in those with the primary sleep disorder Delayed Sleep Phase Sydrome (DSPS) where people tend to stay up much later (ie the "nightowl" type of pattern).
For other disorders, particularly insomnia, it had no clinically significant effect.
On the other hand, given that you're using some powerful drugs that affect sleep, I'm not sure how melatonin would interact to affect sleep onset.
Btw, melatonin didn't improve sleep after onset- ie awakenings, etc-- which you seem to have experienced.
``
Ramelteon is marketed as Rozerem by Takeda Pharmaceuticals North America. I haven't heard much about it.One issue for you with Ramelteon, since you take carbamazepine:
"Another important metabolism consideration for the prescriber is to evaluate concurrent medications that may be inducers and inhibitors of the CYP 1A2 system. Because of ramelteon’s extensive metabolism by the CYP 1A2 enzyme system, providers must be cognizant of medications that may either induce or inhibit this system, therefore leading to an altered metabolism of ramelteon. Ramelteon does not appear to exert an inducing or inhibiting effect on the CYP 1A2 system; rather, other medications that affect this isoenzyme system can affect the levels of ramelteon. 4 For example, ramelteon should not be used in combination with fluvoxamine, ciprofloxacin, niacin, mexiletine, norfloxacin (Noroxin), tacrine (Cognex), and zileuton (Zyflo), as they are all CYP 1A2 inhibitors. Efficacy and availability of ramelteon may be reduced when given concurrently with CYP 1A2 inducers such as rifampin, barbiturates, carbamazepine, and smoking. When administered with rifampin, there was a mean decrease (80%) in blood levels of ramelteon. 4 Finally, providers should use caution in prescribing ramelteon to patients who are using kava kava, as this has been reported to inhibit many CYP isoenzymes and may increase levels of ramelteon."
Also noted in this paper was that median peak serum concentration is about 45 minutes after ingestion and half life is 1-2 hours. So it's important to take right before sleep.
If you're interested, here are some references from the article (which was on Medline, if you have access):
"Ramelteon (Rozerem) a Novel Approach for Insomnia Treatment
[Departments: Drug News]Laustsen, Gary PhD, APRN, BC, Drug News Editor; Andersen, Megan RN, MS, OCN..."
Their references were:
1. National Center on Sleep Disorders Research: U.S. Department of Health and Human Services. 2003 National Sleep Disorders Research Plan. Available at: http://www.nhlbi.nih.gov/health/prof/sleep/res_plan/sleep-rplan.pdf . Accessed February 2, 2006. [Context Link]
2. National Center on Sleep Disorders Research and Office of Prevention, Education and Control. Insomnia: Assessment and Management in Primary Care. Available at: http://www.nhlbi.nih.gov/health/prof/sleep/insom_pc.pdf.Accessed February 2,2006. [Context Link]
3. Takeda Pharmaceuticals.Rozerem [package insert]. Takeda Pharmaceuticals. Lincolnshire, IL; 2005. [Context Link]
4. Clinical Pharmacology – Customized Monograph. Rozerem: ramelteon. Available at: http://cpip.gsm.com . Accessed October 28, 2005. [Context Link]
5. Cada DJ, Levien T, Baker DE. Ramelteon. Hosp Pharm. 2006; 41(1):59–69. [Context Link]
6. Kato K, Hirai K, Nishiyama K, et al. Neurochemical properties of ramelteon (TAK-375), a selective MT1/MT2 receptor agonist. Neuropharmacology. 2005; 48(2): 301–310. Bibliographic Links [Context Link]
7. Roth T, Stubbs C, Walsh JK. Ramelteon (TAK-375), a selective MT1/MT2-receptor agonist, reduces latency to persistent sleep in a model of transient insomnia related to a novel sleep environment. Sleep. 2005;28(3): 303–307. Bibliographic Links [Context Link]"
I'm not sure about melatonin dose. Also, are you sure about the pharmaceutical purity of the melatonin you have? If from a health store, it could be of questionable contents. (Don't know how that works in UK, but in US, health food products don't have to meet governmental standards.)
Hope that helps a little.
Jost
Posted by Phillipa on September 24, 2006, at 13:22:16
In reply to Re: sleep - melatonin, temazepam, bipolar manageme, posted by Jost on September 24, 2006, at 12:42:48
Do they even have pharmacitical melatonin? Love Phillipa
Posted by Jost on September 24, 2006, at 13:34:59
In reply to Re: sleep - melatonin, temazepam, bipolar manageme, posted by Phillipa on September 24, 2006, at 13:22:16
I assume it exists-- but don't know how anyone can get it. Probably they don't make much-- and certainly it isn't available to the average consumer.
They do clincal studies on melatonin for various things-- so I would think the physicians doing the test know exactly what they're giving. Where or how to get it--?
Unless you know a particularly reliable OTC brand. There are people who do testing on those brands, maybe not for melatonin, but various products. They have websites, probably reporting the results. The highly reliable brands are a good bet.
Jost
Posted by johnnyj on September 24, 2006, at 19:37:46
In reply to Re: sleep - melatonin, temazepam, bipolar manageme » survivin bpd, posted by Jost on September 24, 2006, at 11:47:48
Rozerem did not work for me either. I take Lunesta right now and am weaning off lithium. I am unipolar depressive. Lunesta works ok. I do get some headaches and this has become a problem as it appears to be worsening.
Posted by Jost on September 26, 2006, at 19:41:47
In reply to Re: sleep - melatonin, temazepam, bipolar manageme » Jost, posted by johnnyj on September 24, 2006, at 19:37:46
One thought on Rozerem, is that iI realized yesterday, that it has a very short peak plasma concentration, and half life (about 45 min. for the first), 1-2 hours for the second.
So it's recommended to take it about 30 minutes before sleep. This wasn't what I had thought, so I plan to give it a second trial.
Did you take account of that, when you were using it? After a couple or hours, any effect could be minimal.
Jost
Posted by johnnyj on September 26, 2006, at 21:20:43
In reply to Re: sleep - melatonin, temazepam, bipolar manageme » johnnyj, posted by Jost on September 26, 2006, at 19:41:47
To be honest I don't remember. I did feel sort of "high" on it. I took a lunesta after about 3 hours of so of not sleeping. I was dog tired just kind of loopy feeling but could not nod off.
Posted by Fungalfoot on September 28, 2006, at 4:40:05
In reply to sleep - melatonin, temazepam, bipolar management, posted by survivin bpd on September 23, 2006, at 23:11:14
> Hi
>
> I have biploar disorder and manage this by using just a small amount of chlorpromazine now and again if I get the first hint of a prodrome coming on. this seems to work well and I am pretty lucky that I don't get the sort of regular mood swings that makes this impossible, and has only happened 2 oe 3 times since my last illness. I have been well for 5 or 6 years. The only other meds I take are temazepam sometimes - 10mg or if really bad 20mg - as I seem to go through patches of insomnia that are really disabling. I then go through weaning myself off the temazepam after needing it for 3 or 4 nights to get my sleep back into a pattern. Last couple of weeks have been very stressful so ended up on the 20mg for a couple of nights, now down to 10mg. I am commuting an hour or so at the end of each day so just have to get that sleep - means I stay on the temazepam longer than I want to as I don't want to risk not sleeping and having to drive / work / manage to look after kids on no sleep.
>
> Sleep was better on carbamazepine which I had a few years ago, but couldn't concentrate - felt fogged and I have a big academic workload. Withdrew from carbamazepine about 4 years ago under advice of consultant who thought I could manage the illness without it. I am sort of wondering whether I am paying the price for choosing not to take a mood stabiliser by going through patches of bad insomnia. Put loads of weight on and felt really nauseous all the time on lithium (before the carbamazepine and a long time ago).
>
> I have just bought some melatonin. Took for the first time last night at around 10pm. Well - it is now 4.43am! my mouth tastes kind of milky, I have a banging headache which is not unusal when I can't sleep and it gets to this time in the morning. I dozed lightly for an hour or so and that is about it. I took 2 mg of melatonin- from reading other posts not sure at all whether that is too much, not enough, or it just plain didn't work, in which case I am pretty upset and feel like the thing I thought would save me from all of this is just plain useless.
>
> Could be a rebound insomnia cos I didn't take any temazepam last night after taking it for a week or so.
>
> I was worried about taking the temazepam together with the melatonin..... so thinking of either going to only 10mg of temazepam, withdrawing from it (usually have to reduce by a quarter of the dose at a time or I can't get off the stuff - a pain breaking up the tablets but the only way - if I go to fast the insomnia rebounds in full force) and at the same time starting the melatonin -no idea what dose to go for apart from the 1 or 2mg suggested on the packaging. other alternative is to keep taking the temazepam until this bad sleep patch goes away (though unlikely for a while I have too many stressors) and then getting going with the melatonin in the hope that it prevents the insomnia next time,
>
> now that's the background, here are the more specific questions
>
> 1 has anyone taken temazepam and melatonin in combination? cross tapered off the temazepam and replaced with melatonin? any effects?
>
> 2 has anyone had a hypermanic / manic episode that they believe to be triggered by taking melatonin and not other factors? if so, please could you tell me a bit more about it
>
> 3 would be great to get some advice / support on getting the melatonin dose right - any would be really appreciated.
>
> 4 would be great to hear from anyone who manages bpd without a mood stabiliser
>
> 5 any advice/ suggestions most welcome
>
> Thanks in advance
>
> Maria
Hi MariaThis is a bit off the tracks but have you considered a small dose of an anti-psychotic to get you to sleep? There may be a chance that you are hypomanic or even hypermanic and a bit of Olanzapine or maybe Seroquel could lower your mood and allow you to get some sleep.
I am a manic depressive on Lithium for 30 years, no lies, and four years ago I had bad insomnia for which my pdoc gave me 2.5 mg or 5 mg, I can't remember which, Olanzapine (Zyprexa). Well the 5 mg gave me thirteen hours sleep and the 2.5 mg gave me eight. It was bliss. I carried on with 5 mg Olanzapine for four years - the last two years it was not working anymore. I was waking at 5.00 am and unable to get back to sleep again despite going to sleep at 11.00 pm. I am weaning myself off the Olanzapine now, with some difficulty - terrible insomnia, and now I am taking Seroquel (Quetiapine)100 mg at night.
I don't know if you are hyper-manic. The fact that you take Chlorpromazine suggests that you
you may get manic mood swings. Is it possible that a manic mood swing has crept up on you without giving the usual warning signs? For me the usual warning signs are extreme irritability, inability to sleep, racing thoughts, hyper-acitivity, grandiose ideas.You might want to try some Olanzapine or Quetiapine. You can read some comments about the latter at http://askapatient.com/viewrating.asp?drug=20639&name=SEROQUEL
I suggest if you do take Seroquel or Olanzapine you take a small dose to start with or else try it out on a weekend when you can have a good lie in.
I only mention this alternative as you stated you are bpd. I hope you beat the insomnia. Be aware that Olanzapine and Seroquel can make you put on weight and they are, in my opinion Olanzapine definitely, habit forming. Perhaps you could use it sparingly say only three or four times a week or else cut up into small doses, see askapatient on this.
Good luck
Alan
Posted by Fungalfoot on September 28, 2006, at 7:33:00
In reply to Re: sleep - melatonin, temazepam, bipolar management, posted by Fungalfoot on September 28, 2006, at 4:40:05
Something I forgot....
These atypical anti-psychotics can cause diabetes, especially Olanzapine aka Zyprexa. You will get most of the side effects from askapatient.com
Alan
Posted by survivin bpd on September 29, 2006, at 14:06:56
In reply to Re: sleep - melatonin, temazepam, bipolar management, posted by Fungalfoot on September 28, 2006, at 4:40:05
> > Hi
> >
> > I have biploar disorder and manage this by using just a small amount of chlorpromazine now and again if I get the first hint of a prodrome coming on. this seems to work well and I am pretty lucky that I don't get the sort of regular mood swings that makes this impossible, and has only happened 2 oe 3 times since my last illness. I have been well for 5 or 6 years. The only other meds I take are temazepam sometimes - 10mg or if really bad 20mg - as I seem to go through patches of insomnia that are really disabling. I then go through weaning myself off the temazepam after needing it for 3 or 4 nights to get my sleep back into a pattern. Last couple of weeks have been very stressful so ended up on the 20mg for a couple of nights, now down to 10mg. I am commuting an hour or so at the end of each day so just have to get that sleep - means I stay on the temazepam longer than I want to as I don't want to risk not sleeping and having to drive / work / manage to look after kids on no sleep.
> >
> > Sleep was better on carbamazepine which I had a few years ago, but couldn't concentrate - felt fogged and I have a big academic workload. Withdrew from carbamazepine about 4 years ago under advice of consultant who thought I could manage the illness without it. I am sort of wondering whether I am paying the price for choosing not to take a mood stabiliser by going through patches of bad insomnia. Put loads of weight on and felt really nauseous all the time on lithium (before the carbamazepine and a long time ago).
> >
> > I have just bought some melatonin. Took for the first time last night at around 10pm. Well - it is now 4.43am! my mouth tastes kind of milky, I have a banging headache which is not unusal when I can't sleep and it gets to this time in the morning. I dozed lightly for an hour or so and that is about it. I took 2 mg of melatonin- from reading other posts not sure at all whether that is too much, not enough, or it just plain didn't work, in which case I am pretty upset and feel like the thing I thought would save me from all of this is just plain useless.
> >
> > Could be a rebound insomnia cos I didn't take any temazepam last night after taking it for a week or so.
> >
> > I was worried about taking the temazepam together with the melatonin..... so thinking of either going to only 10mg of temazepam, withdrawing from it (usually have to reduce by a quarter of the dose at a time or I can't get off the stuff - a pain breaking up the tablets but the only way - if I go to fast the insomnia rebounds in full force) and at the same time starting the melatonin -no idea what dose to go for apart from the 1 or 2mg suggested on the packaging. other alternative is to keep taking the temazepam until this bad sleep patch goes away (though unlikely for a while I have too many stressors) and then getting going with the melatonin in the hope that it prevents the insomnia next time,
> >
> > now that's the background, here are the more specific questions
> >
> > 1 has anyone taken temazepam and melatonin in combination? cross tapered off the temazepam and replaced with melatonin? any effects?
> >
> > 2 has anyone had a hypermanic / manic episode that they believe to be triggered by taking melatonin and not other factors? if so, please could you tell me a bit more about it
> >
> > 3 would be great to get some advice / support on getting the melatonin dose right - any would be really appreciated.
> >
> > 4 would be great to hear from anyone who manages bpd without a mood stabiliser
> >
> > 5 any advice/ suggestions most welcome
> >
> > Thanks in advance
> >
> > Maria
>
>
> Hi Maria
>
> This is a bit off the tracks but have you considered a small dose of an anti-psychotic to get you to sleep? There may be a chance that you are hypomanic or even hypermanic and a bit of Olanzapine or maybe Seroquel could lower your mood and allow you to get some sleep.
>
> I am a manic depressive on Lithium for 30 years, no lies, and four years ago I had bad insomnia for which my pdoc gave me 2.5 mg or 5 mg, I can't remember which, Olanzapine (Zyprexa). Well the 5 mg gave me thirteen hours sleep and the 2.5 mg gave me eight. It was bliss. I carried on with 5 mg Olanzapine for four years - the last two years it was not working anymore. I was waking at 5.00 am and unable to get back to sleep again despite going to sleep at 11.00 pm. I am weaning myself off the Olanzapine now, with some difficulty - terrible insomnia, and now I am taking Seroquel (Quetiapine)100 mg at night.
>
> I don't know if you are hyper-manic. The fact that you take Chlorpromazine suggests that you
> you may get manic mood swings. Is it possible that a manic mood swing has crept up on you without giving the usual warning signs? For me the usual warning signs are extreme irritability, inability to sleep, racing thoughts, hyper-acitivity, grandiose ideas.
>
> You might want to try some Olanzapine or Quetiapine. You can read some comments about the latter at http://askapatient.com/viewrating.asp?drug=20639&name=SEROQUEL
>
> I suggest if you do take Seroquel or Olanzapine you take a small dose to start with or else try it out on a weekend when you can have a good lie in.
>
> I only mention this alternative as you stated you are bpd. I hope you beat the insomnia. Be aware that Olanzapine and Seroquel can make you put on weight and they are, in my opinion Olanzapine definitely, habit forming. Perhaps you could use it sparingly say only three or four times a week or else cut up into small doses, see askapatient on this.
>
> Good luck
>
> Alan
Hi AlanMany thanks for that. No change in mood whatsoever - I have tried using a small amount of chlorpromazine to help me to sleep, but have found that if I take it and there is nothing at all wrong with my mood, it simply makes me feel a bit flat and tearful - so basically if I can keep the sleep ok and don't rock the boat using antipsychotics unless I do actually have some warning of being hyper ( I take an antipsychotic at the level of one single altered thought or desire to do a little more for example - not needed for years), my mood doesn't shift at all.
Not sure if I would get the same effects from a newer antipsychotic. How low a dose of e.g. olanzapine do you think might produce a sedative effect? Do you think it would have a weight gain effect using a small dose at night in order to help sleep? Have you experienced any mood shift when using chlorpromazine or quetiapin to help you to sleep?
Last time I discussed with a doc he thought I was probably taking the most appropriate medication with the temazepam it is just so addictive!
Not had much luck with the melatonin. I found it made me feel calmer than usual - I don't get particularly anxious but if a few worries around I would say it destressed a bit. It made me feel sleepy at the right time of day when my sleep had been bad for a while, but didn't help at all with the mechanism of getting to sleep or staying asleep.
So back to the temazepam with a long long withdrawal....
Maria
Posted by ronaldo on October 1, 2006, at 14:13:12
In reply to Re: sleep - melatonin, temazepam, bipolar management, posted by survivin bpd on September 29, 2006, at 14:06:56
Hi Maria
Sorry the melatonin did not work for you. If you want to try the Olanzapine try the 2.5 mg tablet for starters. You may find that you can cut the 2.5 mg in half. Such a small dose will not cause any weight gain with a bit of luck.
Mood shift: I rarely use chlorpromazine (largactil); olanzapine did not have much effect except long term it made me feel sedated and wooden (5 mg). Seroquel seems to have lifted my depression and placed me on the border of hypomania - I started on 25 mg, the lowest available, and ramped up to 100 mg but it did not help me sleep so I have come down to 50 mg again which is what the pdoc originally prescribed. 100 mg of Seroquel was horrible, gave me a hangover the next day. All I know is Olanzapine when I first tried it gave me wonderful sleep and that was just with 2.5 mg. Never experienced any weight gain or elevated blood sugars with it.
I hope you have better luck with the temazepam.
I've had a change of name. Fungalfoot was not very hygienic so he got the chop - amputation...
Alan
Posted by survivin bpd on October 1, 2006, at 18:22:55
In reply to Re: sleep - melatonin, temazepam, bipolar management » survivin bpd, posted by ronaldo on October 1, 2006, at 14:13:12
hi again Alan
yeah your new name does sound a bit more user friendly lol.
Thanks for the info - is very useful. Just wondering what effect the olanzapine might have other than on helping sleep. Did it affect your mood at all when you took that very small dose? was it at a time when your mood was stable? I can imagine that as you suggested with the chlorpromazine for me, if at a time when was even pre-hyper in a prodrome stage it would be beneficial for slowing down as well as sleep - just wondering what it might do if mood is entirely stable. I have to be pretty careful not to shift my mood artificially when it stays stable very nicely if I watch it like a hawk without a mood stabiliser or any other meds apart from the odd one off early dose of chlorpromazine if looking suspicious!
Maria
Posted by ronaldo on October 2, 2006, at 6:02:57
In reply to Re: sleep - melatonin, temazepam, bipolar management, posted by survivin bpd on October 1, 2006, at 18:22:55
Hi Maria
When I first used Olanzapine, the end of 2002, I was only using it for sleep and then only occasionally. 2.5 mg gave me a very good night's sleep. 5 mg knocked me out for 12 hours. At that stage I was hypo-manic and I used it once or twice a week - just to get some guaranteed good quality sleep. My mood was unaffected.
Later on, with the encouragement of a new pdoc I started taking it regularly at 5 mg every night, sometimes 7.5 mg. By August 2003 it started to flatten my mood. I felt apathetic disinterested unmotivated lethargic poor concentration - all the signs of depression. I went through a variety of anti-depressants none of which did me any good: Amitryptiline, Trazodone and Fluoxetine. Possibly my GP did not have the courage to prescribe a decent dose for fear of sending me manic. I was waking up at 4.30 am and not getting back to sleep again. I didn't know if I was not sleeping because I was depressed or if I was depressed because I was not sleeping.I am trawling through my old diaries. It's a real eye opener. I have forgotten what it was really like. I've got one note that says "Olanzapine...generally not used long term in Manic Depression with exceptions." Don't know which book I got that out of .
The more I look through my old diaries the more ugly this drug Olanzapine gets. It was great when I first started to use it, when I only used it sporadically; but when I had used it every night for six months or more it started to make me feel depressed - not severe depression but still depressed. On 22 August 2003 I wrote in my diary "I am beginning to feel depressed. Is it time to reduce Olanzapine?" It seems I never bothered to read my own notes and I just believed blindly whatever the pdoc told me. He told me the Olanzapine helped the Lithium to work...! I've got rid of him now.
I think Seroquel is probably better for sleep. There are some pretty favourable comments on this at askapatient.com. Seroquel has not worked for me but that may be because I am still withdrawing from the Olanzapine. I've only been off it for just over a week now. I was on it for nearly four years. I changed my pdoc to come off Olanzapine. There are some unpleasant things that I would like to do to my old pdoc who pushed the Olanzapine on me full time.
I am sorry Maria. I seem to have gone the full circle from praising Olanzapine to cursing it. I reckon it is safe enough if just used occasionally in small doses to get a good night's sleep. But I would not recommend anyone who is Bipolar to take it continuously, long term. Not from my experience of it.
Posted by survivin bpd on October 2, 2006, at 10:02:28
In reply to Re: sleep - melatonin, temazepam, bipolar management, posted by ronaldo on October 2, 2006, at 6:02:57
Hi Alan
many thanks for that - is good to hear the good and the bad. Think that tho the temazepam is so irritatingly addictive I am probably better off not rocking my mood with an antipsyhotic when it is ok if left alone. If things get worse with the insomnia I might go down the occasional antipsychotic route...will have to do something and anything rather than get ill. if I find anything useful I will pass it on!
take care
Maria
Posted by survivin bpd on December 22, 2006, at 17:35:40
In reply to Re: sleep - melatonin, temazepam, bipolar management, posted by survivin bpd on October 2, 2006, at 10:02:28
Hi Alan / followers of thread
Just to let you know I tried half the min adult dose of olanzapine due to the sleep problems - after a couple of weeks my mood started to slide down and ended up depressed for the first time in years - back to the temazepam!
Maria
> Hi Alan
>
> many thanks for that - is good to hear the good and the bad. Think that tho the temazepam is so irritatingly addictive I am probably better off not rocking my mood with an antipsyhotic when it is ok if left alone. If things get worse with the insomnia I might go down the occasional antipsychotic route...will have to do something and anything rather than get ill. if I find anything useful I will pass it on!
>
> take care
>
> Maria
Posted by ronaldo on December 23, 2006, at 11:42:40
In reply to Re: sleep - melatonin, temazepam, bipolar management, posted by survivin bpd on December 22, 2006, at 17:35:40
Hi MariaI'm sorry that the olanzapine did not work out for you. How much did you use? 2.5 mg? Strange that it should have made you depressed. I hope the temazepam still works for you. Should do considering it has had a bit of a rest.
I am still withdrawing from the olazapine. I am now down to 3.75 mg from 10 mg. On my previous withdrawal Sept/Oct I got down to zero and stuck it out for 3 weeks against fierce insomnia but finally I crumbled and relapsed to 10 mg. This time I am making a slower more gradual taper and hope that this time the rebound insomnia will not hit me so hard. It feels good on 3.75 mg, sleep is OK, not wonderful but adequate.
Merry Xmas and a Happy New Year!
Alan
> Hi Alan / followers of thread
>
> Just to let you know I tried half the min adult dose of olanzapine due to the sleep problems - after a couple of weeks my mood started to slide down and ended up depressed for the first time in years - back to the temazepam!
>
> Maria
>
>
>
> > Hi Alan
> >
> > many thanks for that - is good to hear the good and the bad. Think that tho the temazepam is so irritatingly addictive I am probably better off not rocking my mood with an antipsyhotic when it is ok if left alone. If things get worse with the insomnia I might go down the occasional antipsychotic route...will have to do something and anything rather than get ill. if I find anything useful I will pass it on!
> >
> > take care
> >
> > Maria
>
>
This is the end of the thread.
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