What's the best medication for withdrawal related insomnia?

[bkwrm679]

I've been prescribed damn near every drug imaginable for insomnia - none of them seem to really work for withdrawals. The sleep is still fitful even into the PAWS period. Here's my experience, please let me know if you have a better suggestion:

Trazadone: makes me extremely drowsy - get about a half-hour sleep, then RLS in my arms the rest of the night.

Mirapex: makes my arm RLS sort of go away, get hypersexuality followed by about an hour and a half of sleep, then wake up with my arms feeling hot and full like they're going to burst the rest of the night.

Lunesta: haven't tried it in withdrawals yet - it was effective normally, but I don't think it's as strong as Ambien.

Ambien: got some today - last time I took it I woke up at midnight, ate a bunch of ice cream and went for a walk. Not good. Going to give it another try tonight.

Clonidine: helps overall, gives me anywhere from 1/2 to 1 hour sleep, but I want to stay off of this because of the blood pressure issues.

Any suggestions for what the best mix is, especially for RLS in the arms? If my damn arms would just stop, I think I could sleep like a baby.

[Peacherino]

I have been on 30 - 40 mg. of Valium for over 7 months following spinal surgery on my neck.  It's the drug of choice for severe muscle spasms following this type of surgery. Prescribed by me neuro-surgeon.  I'm reaching the point where I need to start tapering off the Valium, as the muscle spasms are subsiding.  I am already experiencing pretty bad withdrawal symptoms if I'm late taking my pills.  

I am prone to panic attacks, and I don't deal well with withdrawal discomfort, so this slow weaning sounds like a winner to me.  I am going to print it out and show it to my neuro-surgeon.  I hope she is agreeable to a slow withdrawal like this.

Thanks again for posting this great link!!.  

[Hfung]

I've never posted before, but I've followed this thread closely while jumping off suboxone. Briefly, I've been on subs 2 years, and I jumped off 8 days ago at approximately .5mg. I chose to taper over 6 mos. from a max of 24 mgs despite my pain doc's advice to continue at 8 mgs indefinitely - for pain management, he said. Yeah, right.

What worried me most was my inability to sleep without subs plus massive doses (truly, lethal doses) of Tylenol pm. I was taking 20 to 30 tablets every night while on subs just to sleep a few hours. (death wish? It is weird that at the time I did not care a bit.)  I've struggled with insomnia since childhood, so this was a major fear of mine with jumping off. I think much of my original pain meds addiction was just seeking sleep, sleep, and more sleep, you know? I still have chronic pain issues associated with degenerative spine disorder, but I found non narcotic remedies on my own. Yet, when using it was nice to be able to nod off and sleep for hours. I struggled with dysphoria throughout my sub use because sleep was so hard to find.

Luckily, I stumbled upon an understanding doc when I quit subs who prescribed me 10 mg Lexapro for the days and .5 Xanax for nights (by the way, benzos were never an issue for me; definitely not my DOC). I took Xanax pretty heavily the first 3 days, up to 2mgs per night, but haven't needed any since. I've worked 8-10 hour days in a very high energy environment just about the whole time (weekends to recuperate and be slothful, weekdays devoted to work). Honestly, the busy days are easy compared to the nights.

I learned early the antihistamines exacerbated withdrawal symptoms exponentially! I would take Tylenol pm and go into full wd symptoms within 30 mins when I tried to jump from subs before. I would have to double my subs dose just to ease the horrible body aches and heebie-jeebies. When I saw posts suggesting Benadryl and such for wd insomnia I was amazed. I guess every experience is different. I learned from that mistake, for sure.

For those of you with body chemistry similar to mine, I have early jump advice. Hot showers, every few hours if necessary...sleepy time tea is a lifesaver, not just for relaxation but for chills and body aches...a sleep agent that works for you...an antidepressant for the inevitable blues...and a recognition that freedom is so much more important than comparatively brief pain and discomfort. I'm not through the tunnel yet, but I definitely see the light at the other end! Good luck to you all.

(Obviously, I am not a medical professional, and any suggestions I give are from personal experience only - NOT medical advice.)

[scared627]

I was on serquel for 1 wk I was on 700mg wont decreasing just get me hooked

[bkwrm679]

I was thinking about what you were saying about the Ambien. I remember reading somewhere that Lunesta is very similar at the molecular level to benzodiazepines. After taking Lunesta pretty much every night for 2 years, I tried to stop taking it and had some minor withdrawals. Only for about one or two nights though, and not too bad. Right when I would get close to sleep, my hand would jerk and I would get a surge of adrenaline. It took me about four nights off and on using it to get off of it. Ambien seems a little worse to me, being an addict, because it has some abuse potential.

[bkwrm679]

I took 1 x 3mg melatonin, 3 x 450 mg Valerian root, and 1 x 500mg L-Tryptophan and then went to bed. Everything was cool for about 30 minutes. I was reading, drowsy as hell, and then I tried to sleep. For some reason I had night sweats and stuff like I was on day 2. My whole bed (my half at least) was soaked in sweat, and I kept having those crazy dreams. Finally at 2:30am I got up (decided to give my wife a break) and put a robe on, grabbed a light blanket and headed to the couch. I took half a trazadone, found this crazy position with a body pillow where my hands are interlocked so it keeps constant pressure on them, and with the exception of waking up throwing up at about 4:30am, I slept almost continuously until 6:30am. So, I'm a happy camper. I know why I threw up (ate a rare "black and blue cheeseburger" at a restaurant last night - not sure what I was thinking - my body can't digest that stuff right now). So, I had a midnight snack of some tums to put the fire in my stomach out and went back to sleep.

Hopefully I can figure out how to make this combination work in my bed tonight so I don't have to spend my nights on the couch.

[troubleinohio]

i sure do bad on the "watch what you eat and drink" measures myself. i drink so much coffee! and sugars..haha Im addicted to the new coconut M&M's and DARK chocolate Reeses PB cups..

[Florida_Guy737]

Exercise, limit caffeine, and more exercise.  The exercise will cleanse your body via sweat and help start with the re-regulating process again. Drink plenty of H20, eat the right foods (protein, carbs and good fats), stay away from sugars (watch for some for fruits (grapes, etc) and did I mention exercise :-)...

Take Care

[Kevin_Bacon]

Well, this might not be too popular, but we're talking about short-term insomnia relif. I've been tracking the relapse problems for about two months now, and combined with my personal experience, insomnia is #1 when it comes to going back on opioids.

So, if you're not strung out on Valium (how long you been taking it?), remember: this is for Days 2-5 or 6. Valium will help with the extreme anxiety and will relax you enough to get by; it might help you sleep early on. Maximum 7 days, with a quick taper.

Next: Despite all the hit-or-miss herbal remedies (I still find melatonin helpful, though I'm taking a bit more than the recommended dose -- no O.D. potential, as far as I know ... just don't go nuts with it), see about getting a week's worth of Seroquel, an anti-psychotic drug that's often mixed with anti-depressants, and for extreme sleep problems. If you go to Google and punch "Seroquel  opiate  withdrawals " you'll find a journal paper on the usefulness of this drug for same.

I know this post won't be endorsed by quite a few people here, but your body's polluted with opioids, and we're talking about getting to Day Five or so; adding a few more chemicals in the short term isn't going to get you addicted, so extreme measures for exreme situations ...

Seroquel comes in many formulations -- get the 25mg non-time-release version and find your dose. Insomnia is the killer.

Of course, keep in touch with your doctor, even if it means calling in every day to give a status report. Don't do this alone -- you want medical help at this point.

Hope it works out for you.

-- KB

[troubleinohio]

if you still cant sleep let me know I'll send you some stories I wrote. that'll put ya into a coma =)
g'nite and good luck.
im off to get myself some sleep right now (im utterly exhausted each night so bad i can barely see straight)

[bkwrm679]

I think you're right - I tend to overthink stuff and want everything to be perfect right now. That is a good point  - I might as well be doing something with my time if I can't sleep.

[GA Guy]

You're just going to have to give this some time. From the list of medications and the way you were talking, I thought you were like a month out. This is just a devil part of withdrawals. You just need to wait this out. Trust me, when your body needs to sleep it will. Trying every medication in the book will only get you into trouble. Do what I did, read the NA basic text, the 12 and 12, and the AA Big Book and 12 and 12. If they don't put you to sleep, they'll teach you a lot. Good luck.

[bkwrm679]

The only problem with benedryl is that when I was in suboxone withdrawal last time I went to the ER twice and first the Phenergan put me in RLS hell and then the Compazine did it the second time. For some people (especially when in opiate withdrawal or otherwise susceptible to RLS), antihistamines and antinauseants can majorly exacerbate RLS symptoms. I've taken Phenergan before while on opiates with no issue, but off them is another story.

[avisg]

make sure to  only take that ltyro 1st thing in the am I never took it after 10 am or it messed with my site

[bkwrm679]

I happen to have melatonin and valerian root - I'll give those a try tonight. I'm just on day 5 here. Last time trying to come off of suboxone I finally gave up because of RLS - it was just intense and I was getting 1.5 hours sleep max on day 8 and having major stress at work. I agree with what was said about not getting on a bunch of other medications trying to detox off opiates. I'm working the NA program and trying to get off everything. I'm just taking B-Complex, L-Tyrosine (with B-6 to aid absorption), a multivitamin, and Vitamin C with Rose Hips. I literally bought anything and everything this time because there was no way I wasn't getting clean. I have a baby on the way in a month in a half and he's not going to see his dad all glassy eyed (unless it's from lack of sleep). Aside from that I'm down to 1/2 of a .1mg Clonidine a night and whatever sleep aid I try on that particular night. I'm going to give the natural stuff a try tonight - hopefully it will work. I know I'm getting more sleep than with the suboxone w/d's because I didn't see the clock until 3:30am this morning and I know I didn't lay in bed for 5.5 hours awake, but it's a terrible fitful sleep. The upside is I took two weeks off work and I'm getting some aftercare in (making meetings, etc.). It's pretty badass to go to a meeting first thing in the morning and then watch the sun come up afterwards. One of the few perks of insomnia I suppose.

[bkwrm679]

Yeah, benzo's are the devil. I'm hoping like hell I'm not hooked on Valium. I've been off it for two days, but it has a 200 hour half-life (read 8.2 days) so I don't know for sure yet. The ones with long half lives (Valium aka Diazepam specifically) are the best to taper off with. Here's the absolute best site I've found on Benzo tapering. This lady knows her stuff. Check out the chart that has the dose comparison for the different benzos. It's an eye-opener.

http://benzo.org.uk/manual/index.htm

[ideal4u]

I have just came from a Detox hospital a week or so ago. I got a real education there and learned something that I never knew. I have taken pain meds for years from spine problems like L5/S1 fusion, DDD and then a implanted morphine pump.

Research Hyperalgesics, this is where your brain amplifies your pain enormously from discontinuing certain opiates and anxiety medications. What they did to me was immediately discontinue the use of Xanax, they said that this medication was the DEVIL FROM HELL. It has such a short Half Life, it goes into your system fast, and the effects of it leave very quickly as well that is why you have to keep taking it. They put me on Valium for me to get some rest and relaxation for 3 days, then changed it to Klonopin (clonazepam) after that. They say the half life of Klonopin is much better and longer than Xanax. They say you wouldn't believe the problems that Xanax creates in our society, I can attest to this personally. I have been doing much better since the medication was changed, but would like to quit taking it if all possible. I have read where a normal brain produces a naturally a substance, maybe it was serotonin, to thwart off anxiety. When you start taking Benzo's for anxiety, your brain quits producing this natural defense and it takes awhile for your brain to wake up or get back to working right. This has been the worst thing I have ever went through by attempting to quit taking this medication. I have had amplified pain, and terrible sleepless nights and I think a lot of my issues are a result of the oral pain medications that I have taken over the years. You would never think that something that is supposed to assist or help you could turn into your worst enemy. Hope this helps and I am open to any comment as to how to overcome this dependency, I see my doctor in 3 days, so I will hopefully know more then.

Please add any comments if you have any suggestions as to how to quit taking any type of Benzo's permanently.

[avisg]

Here is the thing not the best idea to being taking all sorts of drugs to get off of one. Some that are additive it defeats the purpose. I agree with whitie try some of the supplements with exercise in the long run alot of the above mentioned pills will make you feel more crappy then you already do.

[daisy699]

I have been prescribed seroquel for sleep while I was wd I was on a 25mg dose. I have 70 days clean now and my dr. upped my dosage but I think it definately helped me get some sleep in the beginnig. I have wd before without anything but benadryl and got NO sleep with the seroquel I have been sleeping since I started it. I was wd from opiates I'm not sure what your situation is but I was told ambien has the opposite effects for someone coming off opiates so I wouldn't count on that,I have tried ambien and had no luck..Hang in there I hope you get some sleep!!: )

[whitie]

sounds like your going through WD's with RLS

skip those pills and try malatonin and take 4-5 valarian root..........knocks me out  on those hard to snooze nights.

[GA Guy]

Have you tried Requip? It in the same drug class as Mirapex. Be careful of the Ambien. It's a so called "Z" drug that has addictive properties and acts exactly like a benzo. You can get in trouble with these quickly if you have an addictive personality. How long have you been clean? You say that it's withdrawal induced, so I'm wondering how long you've been clean.