Awesome thread, BD!! Well, as my sig indicates, right now I officially have just the Zyprexa as a prn for 'emergency' sleep issues, which is hilarious, because every single night is a sleep 'emergency.' I just can't sleep anymore. We've tried nearly everything. I do have a 20-lb blanket on back order. Maybe that will help. Buying a really nice pillow for myself for the holidays. And, just in case anyone wonders, we have stopped the Provigil (and the Adderall before it) and the sleep did not budge. Sigh.

As some are aware, I became quite manic and psychotic last week. Dr. C first resumed the Abilify, which I had unwisely stopped due to some hand movement SE. It's now back at 30 mg/day. When symptoms worsened, he then added Seroquel at just 25 mg qHS (bedtime), hoping that it might help me sleep, which in turn, might budge the psychosis a bit. It helped for a few days and then, no more sleep help. My pattern. Now, whether at this very low dosage there is any other benefit, I dunno. I was on 200 before. I doubt it is doing anything but making more expensive urine.

A good example of how complex it is to take care of people like me is that the 'emergency sleep' Zyprexa was supposed to be d/c'd when the Seroquel started at the time of this big relapse. The pharmacy didn't get the message and they keep texting me to come pick up the Zyprexa. Supposedly 10-15 mg qHS (prn). It is extremely tempting as someone who can't sleep, and who gets psychotic and manic when sleep-deprived, very tempting to go fill that rx and take it every night. Because I am suffering.

But I don't. The pharmacist b****ed at me the other day when I was getting my Provigil for not picking up the Zyprexa. Had no idea how to respond to that in, like, ten words or less.

This is way too long! Sorry! But I guess it illustrates how tough it can be to figure out how to manage these prn's in an illness that is by definition, cyclical. Oh well. What are you gonna do...