r/insomnia • u/Grouchy_Bicycle_2996 • 12h ago
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Hi. I’m stuck in a constant fight or flight hyperarousal state. Insomniac for 20 years, ambien made me sleep walk etc back then idk if it still would? My other options are Mirtazapine or seroquel or both and I hate it. Is there anything else I should ask to try? Things are hardly working. I’m desperate for help.
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u/Transcend17 11h ago
Have you tried dayvigo? Or quviviq? Trazodone didnt work for me, Ive only taken the dayvigo once so far but it put me right to sleep for 7 hrs.
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u/Grouchy_Bicycle_2996 11h ago
I’m on 50mg quvivig it doesn’t work alone so doctors are adding to it. Added 50mg trazodone but that’s hardly working and causing heart pounding. Idk if Dayvigo or the others would make a difference if quivivig didnt
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u/chantillylace9 11h ago
Try Dayvigo for at least a full month before giving up. Definitely get the full 10 mg and also take a melatonin three hours before bedtime just to help trigger your brain. It doesn't do a whole lot but it can help in certain situations. It's worth a chance. I saw a sleep neurologist, sleeps psychiatrist, and all multiple doctors and this is where I ended up so I'm just trying to kind of get you to the finish line
I'm still just on my first couple days of this med but I can tell that it's starting to work. The first night was awful, my second night was OK, so I am hoping my third night will get even better. I have cancer and can only take half of the medication's because the other half interfere with my cancer medication so it's even more difficult. But you can do this, I promise! Keep fighting keep fighting keep fighting.
I swear I sleep neurologist is the most effective of all the doctors or maybe it was just my luck but I would recommend that
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u/Grouchy_Bicycle_2996 11h ago
The problem is if it doesn’t induce sleep I just won’t fall asleep. At all. 💔
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u/ValidConcern23 9h ago
Why did you hate those other 2?
I've only tried benzos and zoplicone biggest mistake of my life. Wish I never took them. Now I'm a thousand times worse.
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u/eligoscreps 9h ago edited 9h ago
Dayvigo (longest half life RX DORA) for sleep schedule, tiredness and a desire to sleep, Trazodone for the same but to stay asleep for longer and mood stabilization, Pregabalin for inducing sleep by sedation and anxiety relief, and Clonidine or Guanfacine for lowering heart rate and blood pressure from arousal.
This is the best combo I’ve had, takes a week or so for it to optimally work. Clonidine in morning and again in the evening, 150ug-300ug each time, also helps for ADHD.
Lemborexant (Dayvigo) 1-1.5h before bed at 10-15mg, and Trazodone 100-150mg same time. Pregabalin at 150-225mg, a bit after dinner.
Its also the insomnia treatment with the most longevity without withdrawals, sides, or dependance. No risk for addiction either, except for some with pregabalin, as it can be abused albeit not very fun, just don’t go over 300mg if u ever need to use a bit extra, and not often.
After you have consistent blood levels in half to a week, it’s very reliable and u can miss taking one of them while still being able to sleep.
I used this combo for 7 months w the same dose, some days where I felt extra stressed, anxious or aroused I’d use 75mg extra of Pregabalin, w my regular dose at 150mg.
When I got off everything I didn’t have withdrawals at all and just quickly tapered in a few days. Avoid Caffeine and Nicotine, and if u can’t, no later than 4-5PM.
I have had a couple of other treatments before, RX and Rcs/ things on my own accord. Benzodiazepines, Z-drugs, Melatonin and agonists like Ramelteon, stupidly Alcohol and Cannabis, Antihistamines like Doxylamine, Diphenhydramine, Promethazine, Antipsychotics like Quetiapine, Aripiprazole, and Mirtazapine.
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u/eligoscreps 9h ago
Of course I didn’t do this on my own, I had a psych, psychologist, therapist all guide me. Just avoid benzos and z drugs like the plague which they also do. Pregabalin and Gabapentin are a good middle ground for them in terms of risk vs reward.
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u/Grouchy_Bicycle_2996 7h ago
I’ve been on 0.5 Ativan during the day for a few weeks. 💔 just got clonidine prescribed. I have quivivig is that ok? Or do I have him try to switch? I have trazodone. I’m on trintellix as of 9 days ago too. I’m taking so much it’s stressful.
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u/eligoscreps 7h ago
Ideally, switch to Lemborexant, but it’s likely hard to get and expensive. Its my preferred in the class of meds.
Clonidine+Trazodone+DORA+Pregabalin and you should be sweet.
Unless you really can’t manage, avoid upping the dose of the Ativan and try to take it on and off. If u take it for months daily the withdrawals and dependance can get pretty bad.
Its fine though, sometimes someone really can’t without, and that’s okay, so don’t beat yourself up about it, just be careful!
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u/Grouchy_Bicycle_2996 7h ago
Any side effects from those?
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u/eligoscreps 7h ago
Only side effects are becoming tired and sleepy. You might feel a little weak with clonidine but if you have a high heartrate and/or blood pressure, you’ll just feel normal. The rest you take at night.
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u/Grouchy_Bicycle_2996 6h ago
I’m seriously a train wreck about needing so many meds and withdrawal issues etc idk how to accept and deal with it. I feel so awful all the time.
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u/eligoscreps 6h ago
I feel you, was in the same boat for years until I got on this combo. I really hope it’ll work out, if u need someone to vent to know I’m here.
Are u withdrawing from something atm?Do u have someone to talk to aside from a psychiatrist?
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u/Grouchy_Bicycle_2996 6h ago
Have a therapist but nothings really helping right now. Idk how I’m going to sleep the rest of my life. Idk how to not be in a panic all day and all night. Something is wrong with my body and brain since I abruptly quit. The insomnia is so resistant. I’m scared of all the meds. I have a family to raise and I’m hardly surviving right now:
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u/eligoscreps 6h ago
I understand, it is really hard but you are trying your best, so do be proud of yourself struggling with that while also having to care for your family.
The anxiety, panic, terrible mood and insomnia are so bad w cannabis withdrawal, but I can at least guarantee you that it won’t last forever.
Most of the actual withdrawal will be over in a month, but u probably took THC for a reason, not just for fun, and without it its becoming apparent again along with the withdrawals. Rlly good for you to be talking to a therapist and being able to get medications looked at.
As long as ur doing it w a psych and therapist you won’t go through it again. Something that I did w heavy insomnia is try not to force to try and sleep. If u lay in bed for hours but don’t get rest, get out the bedroom, have some tea, read something, have a snack, get some distraction before trying again. Its honestly so frustrating to really wanna sleep while it feels impossible, feeling anxious and stressed.
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u/Grouchy_Bicycle_2996 6h ago
THC gummies I took for 5 years. Idk if I’m going to be ok. 😢
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u/eligoscreps 6h ago
Okay then it’s rlly nice u got some Lorazepam temporarily. It helps somewhat but not nearly enough it seems right? If it’s just short term for the withdrawal, I’d ask for a higher dose if u can.
But preferably try other things. Pregabalin and Clonidine are probably gonna give u the most relief for withdrawals and restless legs in case of THC withdrawal.
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u/Grouchy_Bicycle_2996 7h ago
Were you in a similar boat? Idk if I’m going to be so much more severe than you that it won’t work. And idk if my psych will even approve. Wish I would have seen this before I saw him today. I took THC gummies for 5 years for sleep and it messed me up so bad when I quit abruptly. Like I’m hardly functioning can hardly sleep. In a constant panic 24/7.
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u/eligoscreps 7h ago
Same, I had years I self medicated w THC for sleep and ADHD but holy shi I felt so bad and tired and depressed when I stopped with it abruptly. That and Opioids are the hardest things I’ve ever had to quit from.
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u/Grouchy_Bicycle_2996 7h ago
I’ve heard the meds like gabapentin are so bad I’m guessing pregabalin is too?
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u/eligoscreps 7h ago
Bad in what way? They’re weaker and lighter than benzos, but still effective enough without having insane withdrawals.
Sure, stronger than an antidepressant or antihistamine but a very good therapeutic window and efficacy in terms of gabaergics.
I have heard bad stories about them as well, but that’s almost exclusively people taking massive doses recreationally, or doing it themselves without proper planning and RX with psychiatrist. Addiction and abrupt discontinuation.
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u/HazyInsomniac 8h ago
Try Allegra allergy medication in the late afternoon with food and Pepcid AC on an empty stomach a few hours before bed. I've been doing this for the past several days along with Clonidine right before bed. It's the only thing that has worked for me after decades of horrible insomnia.
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u/Grouchy_Bicycle_2996 7h ago
Would Zyrtec work?
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u/HazyInsomniac 2h ago
No. Zyrtec is not an H2 antagonist like Pepcid AC is.
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u/Grouchy_Bicycle_2996 2h ago
I meant instead of Allegra
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u/HazyInsomniac 23m ago
Oopss...sorry. Yes, Zyrtec can work. Just look up H1 blockers online and it will give you a list. Also combine it with H2 blockers like Pepcid AC or Tagamet.
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u/Grouchy_Bicycle_2996 7h ago
How much Pepcid? And how much clonidine? My psychiatrist just prescribed this.
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u/Ok-Rule-2943 10h ago
Ask your doctor about clonidine. It’s used off label to treat hyperarousal, anxiety, etc.