What can I ask for? Nothing is strong enough

I suffer horrible insomnia. And when I do sleep, my sleep is riddled with awful nightmares.

I've been on Ivedal 10mg for a few years now. (Zolpidem I think). Doctor says it should knock me out in 15 minutes. If I take it at 8pm, I'm still wide awake at 12. If I sleep, it is short and troubled.

I have no side effects and most sedation doesn't do much to me (tranquilizers etc). I have started supplementing my nightly tablet with over the counter sleeping meds which are basically just anti-histamines and which are costing a fortune (way more expensive that the Ivedal). I am afraid if I go to my doctor and tell him this, he may discontinue sleeping meds altogether. He did say that Ivedal is addictive, but I have never taken more than prescribed. I have no trouble obtaining them. I just phone the doctor's in-house pharmacy and they give it to me and I pay at the end of the month.

I am also on Trepiline for the sleep problem. It is an anti-depressant though but I can't remember the reasons he said it would help me sleep. Recently, it was also prescribed to me for my carpal tunnel so it has something to do with relaxation or whatever.

I need a good solid sleep med. Either I must ask the doc to up my dosage, in other words, take two, or ask for something stronger or different. I don't know what to do. I am permanently exhausted.

PS - I was also prescribed Tramadol (state / day hospital) for my carpal tunnel and I believe it is a very strong and addictive pain killer. I don't bother to take it - it has no effect whatsoever.

Yes, this is a frequent issue.
I was once on Zolpidem and after only a few uses it was like it did nothing.

The first time was when it hit me like a storm. I couldn't believe how drowsy it made me. Then it got ineffective rather quickly.

Another hypnotic can be tried- zopiclone, zaleplon etc. but is likely going to have the same thing happen,

A low dosage of a neuroleptic may be prescribed because of the sedative effect it has.

Hi Sabrina,

I'm not on it anymore, but I took seroquel in the past for sleep and it worked well.

For nightmares, I recently began a blood pressure medication called prazosin. It was recommended to me by a friend who also suffers from nightmares and it works for them. I didn't have high hopes but I have not had a nightmare since starting it 4 days ago. Maybe it's worth trying for yourself. Nightmares are definitely not fun!

hi. it really depends on your doctor and his/her prescribing habits. Here where I live, a lot of psychiatrists are still using the older, benzodiazepine-type sleeping pills. They're not supposed to be used long term, but...hey. Its America. Pills a go go!

There's temazepam (restoril), dalmane, pro-som, even halcion. Halcion has something of a shady reputation because it can cause psychosis now and then, but some people swear by it. Of course, day time benzodiazepines can be used for sleep, too. xanax and ativan seem popular around here. I had a friend who was briefly on valium, and his doctor had it set up so he could take an extra valium at night, to lull him to sleep. I don't know if that worked well or not. He's on Klonopin now.

There's hydroxyzine. Its an antihistamine that's been used with some success in insomnia, sometimes alone, back in the day mixed with other drugs. Seroquel, as other people have pointed out. trazadone. gabapentin. maybe lyrica?

there's remeron (mirtazapine, I think). At sufficient doses, that might also help your overall mood and anxiety levels.

zolpidem is an odd drug. I was on it for a while, and it just...stopped working. Tapering wasn't very hard, I didn't much miss it when it was gone, but after that, it didn't even work when I tried it again, years later. sonata was never that great for me, but it does help some people. I think there's an xr or sr or er sonata now, that might keep you asleep all night (or not...).

I hope you can find a treatment that works well for you. BTW, tramadol isn't regarded as terribly addictive here in the US. For a long time, it wasn't a controlled substance. Now I think it might be Schedule IV or something (not very controlled, only kinda addictive, according to the gov't). Does it help at all? When I was on it for pain, I found it helped my mood and anxiety. Turns out, its kinda similar to an antidepressant, chemically, plus it relieves pain. Fun fact.

Anyway, I hope you can get something that works and keeps on working well for you.

Could you be having a bad reaction to one of your medicines?

I'm on Seroquel, Lamictal and desipramine. Falling asleep usually isn't a problem. The stupid psych NP added Trileptol on top of all that and I stopped sleeping. A different doctor decided I was having a bad reaction to the Trileptol and took me off of that and the first night I slept 12 hours straight.

Seroquel (low dose) really knocks me out.

My pdoc has put me on Doxepin recently.

Seroquel knocked me out, too. It's strange how medications affect us differently.

I do take Tramadol. It's not as sedating to me as it is to some people, though. I couldn't do without it because of my pain. (I did wean off of it one time and discovered how much it helped!)

I hope you find something that works.

Some of these I haven't heard of and will research. Most anxiety meds don't do a thing to me. Ativan may as well be an M&M. Valium too. Dormicum made me "high" when Amy was put down (I was only given one). But still no sleep.

I've been on Lamictal, no success. I'm interested in the blood pressure med mentioned for nightmares. Going to research that too.

Thank you.

I take Tenex for nightmares and it works pretty well and does make me a bit sleepy since it lowers blood pressure, I have learned that when I take it I need to be in bed and no distractions.

Hiya, I've been on low doses of Seroquel/quetiapine for insomnia in the past (my body hated that medication, but it did knock me out every night without fail), but melatonin can also work very well for insomnia. I know some people that swear by it to help with their sleep problems, and while I had a weird reaction to it, my body doesn't seem to like much in the way of medications so my experience shouldn't be taken as an example of how you might react. It is, after all, something that's already found in the body naturally, so it can have some very positive effects.

Restoril works pretty well for me. It works the best of the several that I've been on

Where I live they use levomepromazine for severe cases. I think it is more common other places to use thorazine in those cases. They are both supposed to pretty much knock you out.

I heard that people who have suffered any sort of depression should avoid melatonin as it triggers depression. Even though it is normally in the body, apparently too much melatonin in the body is a depressant.

Olanzapine (doses 7,5 mg and higher) and clozapine (not sure which dose I need, current evening dose is 225 mg but I'd probably also sleep with a lower dose) both help me sleep

Melatonin had no effect on me.

So, the doc has changed my sleeping med to Dormonoct (Loprazolam) It is only 2mg but supposed to be stronger than the 10mg Zolpidem ??? Only 15 days worth. If there's no immediate change then I will switch back to the Zolpidem.

Doc also put me on a half dosage of Zytomil (escatalopram) anti-depressant to treat my anxiety. I have not had a panic attack yet but am internalizing my anxiety so badly that it left me bed ridden for two days.

And I got meds for gastro esophageal disease which is probably weight related but which is really getting in the way of my opera singing and I've left it untreated too long.

So all in all it was a pretty expensive day. I do so hope I sleep tonight!

I hope you finally get some sleep.

It was no better, no worse last night. The research said the dormonoct should knock me out before I can even get into bed. I was still awake 3 hours later. I don't feel drowsy this morning though. But then again, I've got so much to do, I can't afford to.

It seems like you have unusual reactions to meds, and that the doc needs to understand that. If you had the best luck with antihistamines maybe you should look for medication that has a lot of that effect.

It looks like you don't have propiomazine there, or it could be worth a try. I wonder what other antihistamines you have. Prescribed they are often cheap.

Well, I had no luck with the antihistamines, I was just supplementing with them in the hopes that it would work. I'm sure I wasted more money that anything else.

But something did happen - I'm going to start a new thread for that.

Ah, I probably misunderstood.

Like I said, thorazine could knock out an elephant. But there are long term effects that might be on the scary side. It is nothing I would use for years on end.

low doses of Thorazine aren't terrible, from what I've read. It got a really, really bad reputation because a lot of doctors tended to high dose it for a long period of time. Apparently, for a long time, shrinks would deliberately induce eps with antipsychotics (including thorazine) because that was thought to be part of effective drug treatment. Sounds like pure sadism to me, personally.

I had 10 months of insomnia thanks to a MAOI. Unfortunately I didn't respond to more traditional sleep meds (Lunesta didn't do anything and Trazadone was too harsh) so unfortunately my pdoc at the time started me on Xanax XR for sleep. I know what everyone says about its long-term usage but it does its job most nights. Tomorrow is a month of being off the MAOI so my new pdoc is going to start me on 1 new med to hit that anxiety (which I needed the Xanax for and what the MAOI failed to address) so that I can wean off the Xanax XR.

OP, this is probably a silly question and I'm sorry if it is, but do you have curtains in your bedroom that completely block out light? The lights outside my apartment window drove me crazy, the blinds didn't shut everything out. I got a blackout curtain and it helped me stay asleep better...but it backfired on weekends because I wouldn't set my alarm and it threw off my clock - I would wake up at 11am and still feel like it was 6am due to the darkness. I hope you get the sleep issues figured out soon, it's a living hell.

I took high doses of Thorazine and it made me stupid. I couldn't remember what I was saying half way through my sentence. The hospital doc put me on it along with everyone else. I think they use it to make people compliant. It was a horrible experience and I would never take it again. Again I was on a high dosage so I don't know how it would be in lower doses for insomnia.

I don't have blackout curtains but it is sufficiently dark for me at night. No streetlights outside my window. But I do prefer the dark and total silence. Total silence? Not always achievable.