Sleeping and Seroquel Update

It has been a while since I’ve blogged and I will give an update on my life shortly but today I want to talk about the sleep issues I’ve been having lately.

So as you know if you’ve been reading my blog I was previously taking a maximum dose of zeldox to get to sleep and that worked for about a year, but in October last year that stopped working, and so did the temazepam that I had to take on nights when it didn’t work.  I happened to have an appointment with my inpatient psychiatrist after one of my sleepless nights and she gave me 50mg of seroquel to see if that would help.  It did, and when I saw my regular psychiatrist later that week she prescribed seroquel to be taken regularly.

For a while that worked well.  I was sleeping for about ten hours a night and waking up refreshed with no hangover drowsiness.  But it wouldn’t last.

It started with a few nights where I would have to boost my dose of seroquel to 100mg.  Bizarrely the 50mg of seroquel seemed to not work when I had a full stomach, so I had to watch how much I ate.  I’m aware that increasing your medication without notifying your doctor isn’t a wise move but I do know a bit about my medications and 100mg of seroquel is not a high dose.

Then a few months ago I began waking up during the night at around 3am.  Sometimes I would go back to sleep, sometimes not.  I don’t mind being up in the middle of the night too much because I wasn’t tired and I could have some quiet “me” time.  However is was very disruptive for Pea who is trying to sleep while I’m moving around, watching youtube videos on my phone (albeit with headphones) eating snacks etc.

The waking up was getting earlier and earlier until I was only getting about two hours of sleep.  Sometimes when I woke up I would take another 50mg of seroquel but I was in denial that we had a problem.

Then I started having to take an extra 50mg when I hadn’t eaten too much, or hadn’t woken up.  I would take a 50, lie in bed for a hours trying to sleep, give up then take another 50.  Suddenly 50mg wasn’t putting me to sleep any more.

After going a whole week of needing 100mg to sleep I was willing to admit we had a problem.  Then on Sunday I took 100 and it didn’t work.  So I took an extra 50.  Nothing.  I took another 50 again putting me at 200mg of seroquel.  I went to sleep and woke up feeling pretty flat.

I was despairing of the prospect of seroquel working at all the next night by that point so I called my psychiatrist and told her what I had done, and said I didn’t know what to take that night.  She told me to come in for an emergency appointment.

In the appointment she said that seroquel is used as a sedative but it is primarily a mood stabiliser and when you are taking in regularly the sedating effect will wear off.  Also apparently seroquel does not have a greater sedating effect above 200mg so me taking more than that out of desperation won’t do any good.

She said she will keep the seroquel in my medication regime because I need it for my mood disorder, but she prescribed a new drug for my sleep disorder, gabapentin.  I was surprised because I mistakenly thought this drug was for people with parkinson’s disease.  But apparently it’s used for epilepsy, mood disorders and sleep.

She told me she wants me to get to 300mg of gabapentin a night, but to start with 100mg, go to 200mg the next night then 300mg the night after that.  If 100mg that night didn’t work by midnight, she said, I could take another 100.

I went home and did wh

at she said and even though I was incredibly anxious about whether it would work or not it did and I didn’t have to take that second 100.  I went up to 200 the next night and 300 last night and have enjoyed long unbroken sleep with no hangover effects.

Before I left she told me to call her on Thursday – today – which I will do, and update her on how I went with it all.  I will do that, and keep you updated.

 

Mac

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A Very Sober Christmas

I got my antabuse script refilled for the first time the other day marking my first month on the drug.  That makes one month into my six month sobriety challenge.

My sleeping has been amazing.  I seem to need to do a lot of it, and will sleep between 11 – 13 hours a night.  When I was drinking I would go to bed around 8 and wake up around 1 in the morning.  Sometimes I would go to bed on my own, sometimes I would need to take the other half of my seroquel tablet.  I don’t get much of a hangover any more, but I was experiencing dry mouth.  That has stopped now.

My mood has been up and down.  I’ve been stressing out because of this time of year and all the things I need to do and I find I’m taking seroquel to sleep and to calm down.  I’ve also been skipping meals due to being busy and this has a major effect on my mood.  I cannot cope when I’m hungry.  I get edgy and light headed.  The other day I had a hair appointment at 11, which lasted until 3, and drove straight to Pea’s house which in holiday traffic took the best part of an hour.  On the freeway I started to feel lightheaded and was wondering why then it hit me – duh, I haven’t eaten today since having a protein bar at 8 in the morning.

To combat my low mood my doctor has increased my fluoxetine from 10mg to 20mg but I won’t start seeing the effects of that for a few weeks. This is done cautiously because some antidepressants can cause rapid mood cycling in bipolar patients.  So far it hasn’t done that to me, and has been a huge help with my anxiety but we’ll see what an increased dose will do.  The doctor says the detrimental effects of binge drinking on my mood can take up to six weeks to lift.

As for temptation, it’s hard to be sober at this time of year.  On one hand, the control has been taken away from me; it’s not really a matter of self control as there are real life threatening consequences stopping me from drinking.  If I were to stop taking the antabuse I would still have to wait a week to start drinking.

Alcohol is everywhere.  On Friday Pea and I went to his company Christmas party.  They had booked a restaurant with a bar that served a variety of cocktails that I would have been all over had I not been on Antabuse.  Instead I drank my mocktails and found I couldn’t have too many of them as they were so sugary.  As everyone at the party got drunker I found it hard to join in on the conversations and ended up retreating into the corner on my phone.

We had parties at my parent’s house on Christmas eve, Christmas day and boxing day.  There was and abundance of beer and my dad’s sangria.  And one thing the antabuse has done is made me suspicious of food.  I’m not sure to what extent that alcohol evaporates out of food when it cooks but I don’t want to take any chances.  But still I get caught out.  My sister passed out some rumballs on Christmas eve and I nearly ate one until mum stopped me.  Luckily I didn’t have to forgo trifle as my aunt doesn’t put alcohol in hers.

New year’s eve is approaching and that will be another challenge but I guess I have to pull out the mocktail recipes I amassed when I was in hospital for new years two years ago.

 

Mac

The Strange Episode Explained

So I went to my doctor yesterday.  Dad was meant to come with me but he was late because he went to the old address that he has in his address book at work.  Which is funny because my psychiatrist has been there for six years but oh well.

After my episode on Tuesday night, Dad sent my doctor a fax detailing what had happened, concluding with the statement that, in his professional opinion as a doctor, I was on too much seroquel.

She asked me if I was still drinking a lot and I said I was.  She said that, in her opinion as a psychiatrist who has dealt with many problem drinkers on seroquel before, my Dad’s conclusion was incorrect.  What he described, she said, sounded like delirium brought on by alcohol withdrawal, compounded by seroquel on top.

I’m on 50mg of seroquel at night.  By accidentally doubling it I had taken 100.  That is a lot for me but, as she explained, not a high dose of sedatives at all.  That alone wouldn’t account for the sleepwalking.

She asked me I if was getting any other symptoms of alcohol dependence like shaking. I said I wasn’t, but that I felt anxious on days where I wasn’t drinking.  And when I do drink, I can’t stop at one.  So I thought that I would have to so something that I have been putting off but now I feel like I’m out of options – go on antabuse, the drug that makes you violently ill when you drink.  She said that if I’m going to do that we need to talk to Dad about it because to take a step like that you need family support.

At which point my Dad entered, apologising profusely for being late.  She reiterated what she had told me about her diagnosis of my episode.  He shot an accusatory look at me and asked if that meant I had been drinking at home.  She said no, I was experiencing withdrawals from drinking heavily at Pea’s place the night before.

We talked to Dad about me going on antabuse and he was a little taken aback but agreed that I needed to take that step to stay sober.  She said that taking this drug meant that I was committing to six months of sobriety, and laid out the facts – I can’t start it until 48 hours after my last drink, and I can’t start drinking until 7 days after to stop it.  And if I do drink while on it, the effects are life threatening.

Because taking this drug is such a big commitment she made me sign a contract stating that I understood the nature of this drug and the ramifications of drinking on it.  That’s a new one – never had to sign anything for any of my meds.

My doctor ended the appointment by telling me to come back in three weeks and telling me that if anything goes wrong, she could get me in that day if need be.  She thanked my Dad for his involvement and told me I was welcome to bring any of my family members to my appointments, including my mum (I’m not sure I’m ready for that.)

Afterwards Dad and I went for lunch at the pub on the corner of the street my psychiatrist’s office is on and I had the most amazing burger (huge beef patty, crispy bacon, American cheese, onion rings, pickles, barbecue sauce and ranch dressing.)  Dad was joking that I should have one last drink but I wanted to start antabuse the next night.  I couldn’t start it that night as I had been drinking the night before.

Well, that’s all for now.  I will be back to talk about my experiences when I start taking the antabuse.

 

Mac

A Strange Episode

I woke up this morning to the familiar sound of my fan humming but something didn’t feel right.  I opened my eyes and sat to see that I was in fact in my sister’s room, in her little single bed, not my own.  I can’t remember how I got here.  Ominous.

My dad came in.  “oh you’re awake.  Do you remember what happened last night?”

“no…”

“I think you’re on too much seroquel.  I want to go with you to your doctor’s appointment tomorrow to talk about this.”

He left me, still feeling confused and I went into my room.  The sheets had been stripped off the bed and there was a towel on the floor.  I went to take my tablets…and found that was impossible because my whole medication drawer was missing.  Someone had taken it right out of the cabinet.

The presence of the kitchen scissors on top of the cabinet gave me pause for thought.  I used these scissors to cut my seroquel, but I remembered putting them away.  Yet I got them out again.  It looks like I might have accidentally taken a double dose of seroquel.

I went downstairs and found mum with my medication drawer sitting on the kitchen bench.  She told me what happened last night from her perspective.

Mum and dad got home to find me trying to get out of my bed room but the wardrobe doorknob was jammed under the door handle so my door wouldn’t open.  My dad fixed the door from the other side and opened it to see why I was unable to do it myself and realised that I was…not awake.  Mum said “Mac, go sit on the bed”  Which I apparently did, then Mum noticed where I was standing there was a puddle.  Of urine.  I pissed myself and now I was sitting on the bed in my wet pjs.

Due to all this activity in my room I started to wake up, but I was groggy and not talking sense.  Mum found some dry pjs and sent me into the bathroom to get changed which I did.  They decided to put me to sleep in my sisters room.  As they were taking me in there, Dad said something about me being on too much seroquel and I said “oh I need to go take my seroquel” to which they both said NO!

Mum took the medication drawer because she reached the same conclusion as I had; that I had taken and accidental overdose.  She wants to keep my meds with her until they can fix me up with a Webster pack or something.

I’m not sure why but I’m surprised my parents aren’t mad at me for peeing on the floor.  I guess it wasn’t really my fault – well it kind of was, if I was more on top of my medications that wouldn’t have happened.  But still, I’m a little old to be wetting myself.  I guess what I’m feeling is embarrassment.

I will see my doctor tomorrow and Dad is either going to come with me or write a note, he hasn’t decided yet.  I’m hoping he isn’t going to try and convince her to take me off it because apart from this episode I have been sleeping well on it.

I will be back tomorrow with more.

Mac

Seroquel Update

So I’ve been on seroquel for a couple of weeks now and this is what I’ve noticed.

The main thing I was worried about was increased appetite and weight gain but to counteract that we increased my Topamax to 50mg twice a day.  That seems to have worked to a point.  Most times of the day I don’t feel increased hunger but at meal times I find I’m feeling less satisfied after I eat.  I just use some CBT and tell myself that I won’t feel satisfied no matter how much I eat and the urge passes after a while.  So far I haven’t gained any weight, even though it’s been only two weeks.

I’ve taken seroquel before and it knocked me for six every time.  I would be out straight away and wake up groggy fourteen hours later and this was just on 25mg.  I’m taking 50 now, and it takes me a little while to get to sleep and I tend to sleep for eleven hours without much hangover effect.

Normally I take my regular tablets at about six thirty like I was before and take the seroquel at eight thirty and get into bed straight after.  The first few days on it I was on my phone in bed then I had a night where I didn’t sleep at all despite taking it so I had to come to terms with the fact that I had some shitty sleep hygiene so now I just get into bed and turn the lights off without doing anything to stimulate myself

It seems that 50mg is a good dose of seroquel for me, and I seem to be getting rest on it for now.  I only hope this lasts.

I Need Some Sleep

I’ve just been to see my doctor and we’ve made some major changes because I’ve stopped sleeping.  After all the trouble we went through to get me onto zeldox I hoped that regime would have lasted longer but nope.

The whole thing started last Monday when I had a follow up appointment with my inpatient psychiatrist at the hospital but I showed up having not slept at all the night before.  I explained to her that I took my PRN temazepam and it didn’t work so she got me some seroquel from the hospital pharmacy and told me to take that.  I did, and it worked after a couple of hours.

I showed up at my psychiatrist’s office and she said she had received a letter from the hospital doctor detailing my sleeping troubles.  I told her what had been happening – my sleeping had been varied, but generally I’ve been getting to bed late, or waking up at midnight and not being able to get back to sleep.  I feel that my mood is suffering because of it.

She told me what I had been dreading, that we had to start regular seroquel again.  I had really been wanting to avoid this because I gained so much weight on it last time I was taking it, plus previously I;ve been super sensitive to it and it has knocked me out for about sixteen hours at a time.

She said that weight gain on seroquel was not a guarantee; just because I might get an increased appetite doesn’t mean I have to give into it.  But to try and assist me she raised my topamax from 50mg a day to 100mg because of its appetite suppressant properties.

She also reduced my zeldox from 160mg to 80mg and ceased my valdoxan.  The only reason I was on so much zeldox was to sleep and it wasn’t working but I still need some for my anxiety.  Valdoxan, the melatonin tablet was originally prescribed when I wasn’t on any antipsychotic but starting on lamotrigine caused me to stop sleeping.  That clearly isn’t doing its job, and may be contributing to some bipolar symptoms so it had to go.  And considering it isn’t on the PBS and was costing me sixty-five dollars every month, I can’t say I’m sad to see it go.

She told me to come back in two weeks instead of my usual six to update her on how the sleep situation is going.  If I’m still not sleeping on 50mg of seroquel, she said we will have to consider hospital again.

I will post again in a few days to update on how I’m going on seroquel.

 

Mac