Have Mental Health Questions? Ask a Psychiatrist Online
are you taking any other sleep aids?
I can take Promethazine if needed but I don't like to use that all the time as it leaves me feeling groggy the next day
If you're taking any antidepressants at the moment?
Yes, I take Agomelatine (50mg)
Thank you for clarifying. Antidepressants can suppress your REM sleep cycle
Are you having difficulties falling asleep, staying asleep/early waking up?
I usually get to sleep okay but I struggle to stay asleep
Occasionally I don't get off easily but normally I do
Once I am awake my head is too busy to sleep again
There are few different options for sleep both medications and natural? Are you open to natural options?
The less drugs I take the better
There are herbal options such as : Valerian, Lemon Balm, Lady's Slipper
As well as aminoacids- GABA and L-trytophane
Then there is Melatonin but your Valdoxan already should be acting on the Melatonin receptors
Another non medication option is self hypnosis prior to bed time.
Ok, is this something easy to do?
Unfortunately the Valdoxan also can increase the production of dopamine and norepenephrine which, could cause this early/frequent waking up
Because those are chemicals associates w/ the fight or flight response
Yes, you could either use a pre-recorded self hypnotic CD/MP3 from amazon
Or you could also work for a few sessions w. a hypnotherapist. Some insurance covers hypnosis
Another option is autogenic training (a form of self hypnosis)
I've never heard of that
This is the manual for that
Something else that could be helpful is the use of Blue UV spectrum light box
Is the introduction of Aripiprazole likely to cause problems with getting off to sleep?
I will check that website
How does the light box help?
Sorry, too many questions!
The light box works by its light triggering the melatonin in the brain and thus currecting the sleep cycle
The one by Aplo was researched by NASA
There may be a self assessment on their site that would tell you when to use it and for how long. It differs for each person
Okay. That sounds a possibility.
It just feels like every time I mention it's a problem for me that the doctors just want to throw more tablets at the problem!
Are you taking your meds in the AM?
I take Olanzapine, Agomelatine and Promethazine at night
Some things to avoid prior to bed time would be- watching TV, using the computer, eating heavy meals or drinking coffee or alcohol
I have tried varying the times slightly but nothing seems to work too much
You know, you may want to ask your MD if some of these you can take at night. Those meds that trigger dopamine and norepenephrine can keep you up
I take them at night already
You may still take the natural Melatonin (it's cheaper than the light box)
Can I buy that across the counter?
I just mentioned the AM because if any of those could be taken in the AM, that may possibly let you have a restful sleep
You would not want to have your brain excited at bed time
Ok, sorry, I mis-read that
Yes, you can buy Melatonin in the pharmacy or online
Is the Aripiprazole likely to make any impact do you think?
Yes, because it activates the norepenephrine/dopamine and these are what can cause one to feel restless/irritable or wake up
I'm in 2 minds about changing the anti psychotic but both have their disadvantages it seems!
Your prescribing MD could look into something else though since you're not sleeping well. That can make you feel not only tired but it can affect your memory/concentration.
There is also a link b/w sleep disorders and depression
She suggested Quetiapine as an alternative but that has a problem with weight gain!
This may be a sleep disorder too like sleep apnrea. A neurological sleep study can check it out
Yes, unfortunately some psychotropics/antipsychotic meds can lead to weight gain
Okay, thanks. I have a meds review in 10 days time so I think I need to discuss ALL my options with her
That's why they are swapping them because I gained so much weight with the Olanzapine
You're your own best advocate. If something does not work well for you, change it by/ consulting w. her