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Effects - Long-term use and tolerance

Discussion in 'Downers and sleeping pills' started by Flatliner, Aug 1, 2013.

  1. Flatliner

    Flatliner Newbie

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    When I first started using Stilnoct (Ambien) years and years ago I would get extremelly high from a normal 10mg dosage. I would then fall asleep extremely quickly and feel fresh the morning after. Now, many years later, 10mg is hardly ever enough, I take 20mg minumum. Sometimes 30mg. I even take another one if I wake up too early. The most I've taken are 5 during the course of one night. Obviously I've developed tolerance, and going through once prescription of 30 pills doesn't take long.

    So, I depend too much on it and don't taper down. The first few days after I've finished my prescription I feel very nauseated and anxiety.

    Anyone experience this?
     
  2. out_there

    out_there Newbie

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    Yes. This is withdrawal as you probably know. It happens to many people on benzos or associated drugs and as you noted, can be helped by tapering down.

    The drug will still work at the lower dose but it just won't give you the same feeling as you also noted. But keep in mind that it 'is' still working at the lower dose. Your body has just become used to the 'feeling'.

    Be very careful about running through your prescription too early as you may be in danger of severe withdrawal that could lead to seizures or worse. Perhaps explain what's been happening to your doctor so that you can either switch drugs or get prescribed a higher dose so that you don't run out.

    Most doctors understand the problems associated with these drugs but just don't explain the problems associated with tolerance and withdrawal. It is likely that if you have a long term relationship with your doctor and haven't asked for more scripts before, that he/she will give you an alternative option which may work better for you. It's worth a try and definitely worth explaining your situation.
     
  3. A_Grant

    A_Grant Newbie

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    Yes, this is withdrawal, and it can be pretty dangerous. You can have life thretning seizures and the like.

    Tapering down is one way to go trough it, but medical supervision is mendatory. They will most likely switch you to a long acting benzo and taper down, so that you will avoid potentially dangerous side effects and be more comfortable troughout withdrawall.

    Once this part is over, and I believe that with Ambien that shouldn't take more than 2-3 weeks, you will have to find an alternative medication for your insomnia. You need something that isn't addcitive. Trazodone (Desyrel) is something that might be effective. If you talk about it to your doc, he might even give you some to help you sleep during withdrawall, once they taper down.

    So, all in all, you should seek medical supervision ASAP. Addiction to prescription medication is nothing to be ashamed of, and can happen with a number of products. Doc tends to underestimate Z-drugs adiction potential, but if yours is just halfway competent he will listen to you and help you go trough the W/D.

    Best of luck pal!
     
  4. Flatliner

    Flatliner Newbie

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    Thanks out_there and A_Grant! I greatly value your input.

    You mentioned something interesting out_there, that it still works even though the high doesn't come on. I've always associated the high with the effectiveness of the drug, and when I don't feel it I tend not to even try to fall asleep. Well, I've got enough left of my prescription now and last night I managed with 20mg and not taking more even when I woke up during the night.

    I originally got my prescriptions from my psychiatrist but I'm no longer seeing one because there really isn't need for it. He just left me with my home physician who's really nice and has gotten to know me throughout the years. He's much more careful when it comes to prescribing drugs. My psychiatrist would prescribe me 20 pills available every 12 days. My home physician prescribed me 30 pills available every two months.

    Now I'm seeing a different psychiatrist regarding ADHD (actually ADD, I'm not hyperactive) and because I was getting stomach ache from withdrawal from zolpidem my stomach would completely go nuts when taking Concerta 54mg. Needless to say this is not a situation I want to be in.

    A_Grant says being addicted to prescription medication is nothing to be ashamed of, yet I really am ashamed of it. I have half admitted it to my then-psychiatrist and home physician and they've supported me. I'm just afraid he will cut me short and not prescribe me anything. Having had sleep disorder for years and now working shifts, it would be really difficult to have nothing to rely on.

    Thanks guys! Any further suggestions would be greatly appreciated. I've never truly been able to talk to anyone about this openly, so anonymous chat like this is extremely helpful.
     
  5. out_there

    out_there Newbie

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    I'm glad you were able to trust your body and not redose during the night! That's great because if you/we continue to take more our bodies get used to higher amounts and the cycle just keeps going upward.

    There are a few older anti-depressants that are also good for sleep such as mirtazapine and amitriptyline. I'm not sure if you've tried those. Seroquel (quetiapine) is also good for sleep at lower doses but not sure how it would go with your ADHD. maybe it's worth asking your doctor about.

    Good luck with everything!
     
  6. Flatliner

    Flatliner Newbie

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    Yeah, it's terrible getting into a vicious cycle like that, constantly needing more, when the regular dose is required just to not feel horrible but not enough to work as it's supposed to do.

    I'm not familiar with mirtazapine and amitriptyline, but I have tried Seroquel. Seroquel was horrible, I would always get nightmares and frequently experience sleep paralysis. I'm currently on escitalopram but tapering it down veeeeeery slowly: down from 30 to 10, and soon 7,5

    Thanks for everything, man! I really appreciate it!
     
  7. A_Grant

    A_Grant Newbie

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    Yeah, I have had issues with seroquel myself (and any other anti-psychotics).

    As far as antidepressants are concerned, Trazodone (Desyrel) is also prescribed a lot for insomnia. For me, it is far more sleep-inducing than mirtazapine.

    Pregabalin is also sometimes prescribed for long term treatment of insomnia and might be something worth checking out.
     
  8. out_there

    out_there Newbie

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    Certainly seroquel has its problems. I remember having out of body dream experiences that were absolutely terrifying which ultimately caused me to stop using it. I didn't have the same experiences on mirtazapine and amitriptyline, but they made me really nauseas. Most anti-depresants do. I suggested those however because some people find them really helpful.

    As A_Grant said, pregabalin can be good but it is more for neuropathic pain rather than insomnia. Do you mind me asking what you were on escitalopram for? Was it depression? If so why are you coming off it? I don't mean to be overly probing but I was just wondering what the alternative will be if you do suffer from depression.
     
  9. Flatliner

    Flatliner Newbie

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    I have tried pregabalin (marketed as Lyrica where I live) which was to help me with anxiety and neuropathic pain. I did indeed help me a lot with the pain but the side effects were too much for me: I was constantly dazed and couldn't focus very well, I had two car accidents in just one month which I related directly to the drug's side effects. I still have some of it left and will use it occasionally, but I've been pursuing other means of minimizing this pain I have in the three lower-most cervical joints.

    I've been on escitalopram or other anti-depressioni drugs for, what, 14 years or so. But I've not really suffered so much from depression as from anxiety. Then again, anxiety can cause depression which it probably did first when I had a panic attack four years before I started taking any anti-depression drug. I didn't start taking them earlier because I was quite young (16) when I first had my first panic attack. Anyway, my then psychiatrist said it was okay for me to taper it down very slowly, which I have done, going from 30mg to 10mg now, and soon 7,5.

    The thing is, escitalopram has so incredibly many side effects, like all other depression drugs, that I don't know if I'm just dealing with side effects from it and not really gaining anything but using it - because I've been on one or another for so long.

    I'm 34 now.

    I'm dead tired of doctors and others attributing every fault I have with anything in life to anxiety. That's why I started thinking more and more seriously that I might have ADD, and ADD can often cause a lot of stress/anxiety. For me it has affected my academic progress the most, making things very hard for me, mainly in staying focused. Inevitably I'd get dragged behind and by the end of the semester I'd have A LOT of things to cover were I to pass the course. Oftentimes I wouldn't pass, sometimes just barely.
     
  10. out_there

    out_there Newbie

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    Hmm your situation sounds almost exactly like mine. I also have had surgery at C5-6 cervical and have degenerative beginnings of arthritis in the lower cervical area. I've been given exercises to do by the physio from the hospital to try and correct some of the cervical issues which are helpful (when I do them).

    I also had panic attacks but not until a bit later in life. More like my late twenties. And then after my ex-wife moved my children interstate the panic attacks and depression really hit hard. I basically dealt with it by drinking heavily up until it drove me into a psyche unit after an OD. I do understand the system - doctors/psychologists/psychiatrists/counselors.....etc.

    At this point I have a good pain management doctor and a good psychiatrist but it takes a lot of work to find the good ones. But it does sound like you are happy with your doctors? Apart from the feelings of frustration that you have regarding finding something that works for you.

    I know you found it hard to concentrate on pregabalin or (lyrica). I have the same problem so I never drive on it. Gabapentin is the other alternative which may not affect you so badly. Worth a try.

    In terms of ADD, that could be as a result of the side-effects of the anti-depressants. You won't know until you are off them though. So that's a question mark at the moment. What to do then...

    Maybe get off the anti-depressant, see how you feel, work out what your attention is like off anti-depressants and whether you feel as depressed as well. Then you can work on a new plan of action which may include a hard fast acting anti-anxiety medication just for emergencies and a neuropathic pain killer like gabapentin 'at the right dose' to deal with your cervical pain. I'm not really sure what else to suggest but I do empathise and feel like we have a lot of similar issues so don't hesitate to talk to me or ask anything you would like to ask. Best wishes.
     
  11. Flatliner

    Flatliner Newbie

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    I've been using Tramadol for the pain but it doesn't work so much anymore for the neck pain. I've started exercising and see a physiotherapist once a week but I feel like it can't start to work fast enough. I've also been injected with cortisone twice in my neck and am probably going for the third (and last) time this fall. It worked well the second time but it eventually faded and I started feeling painful again. It's incredibly how much a pain in the neck, literally, can affect you so much in everyday life.

    I did try gabapentin a long time ago, I can't really recall how well or not it affected me. As I said, Lyrica worked well for the pain but made me somehow slow. Perhaps I was on too high dose, but I did take it as prescribed by the doctor. I'm rather satisfied with my home physician and my psychiatrist, yes, although my home physician isn't all the pill happy (which can be a good thing, though) and I'm seeing this psychiatrist purely for ADD. I've only seen him once. I'm not sure how ADD therapy works.

    I'm definitely getting off the anti-depressants and I've got some fast acting anti-anxiety drugs. I try to keep everything in moderation, but sometimes I'm just too stressed. I am, however, going through a change of routine in my life. A change for the better.

    I just wish I didn't have to take any pills at all.
     
  12. out_there

    out_there Newbie

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    Ah yes the cortisone injections. I remember those well. A doctor sticking a bludy big needle in your neck a few times and telling you not to move unless you want to become a quadraplegic. Fun times. They didn't work for me which is another reason I had surgery.

    I know you don't want to take any pills, but at the moment it seems like a necessity if you want to have some sort of life. I don't want to be taking pills either really but they do help when you get the right dose. If Lyrica worked well for pain then maybe just experiment with the dosage until you don't feel so out of it. Pregabalin (lyrica) does have that effect but it does improve as your system adjusts.

    It's good you're seeing the physio. I was given some good exercises to do. The ones that strengthen the muscles between your shoulder blades are good. They bring your shoulders back and straighten the cervical spine.

    As I said before it's good that you have doctors you like and trust. That helps a lot. And yep - a pain in the neck really does mess up your life a lot!
     
  13. Flatliner

    Flatliner Newbie

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    The problem with working aggressively out is that I will get an enormous pain from it, yet I love pushing myself. But the pain I get in the neck deters me from going again, so I postpone it and postpone it and... That's why I think I need good painkillers do help me over that hurdle until I get those cortisone shots for the third time (but when that will be is entirely uncertain right now).

    I have an appointment with my physician next week and I'm going to pitch this idea to him.

    I've all but stopped using fast acting anti anxiety drugs after I started using Concerta. It took awhile to get used to Concerta, and I'm not entirely in the safe zone yet, but I feel really satisfied that I don't have to take a bloody pill every day because I'm stressed. Then I can have it ready for those rare occasions when I do really need them.