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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I'm in a manic state of sleep resistance. My doctor said

Customer Question

I'm in a manic state of sleep resistance. My doctor said this could go on for months. I'm on a lot of meds. Most nights I sleep okay but some nights are rocky. I would like to get a medication review. Can u help?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

*This website DOES NOT constitute treatment and only provides information and advice in a Q&A format. For treatment (therapy and/or medications) you must go to a licensed professional in your area. Please note that anything said here is not private or confidential, as this is a public forum.

Hello again and thank you for using JustAnswer. I can take a look at your medications if you like, and provide my comments on them, but any decision to adjust your regimen will have to be up to you and your doctor. What are the current medications, doses, and how long have you been taking each medication for?

Customer: replied 1 year ago.
I've been on these about a month
Lithium 300 mg 2 tablets a night
Tegretol 200 mg 3 tablets a night
Rozerem 8mg
Klonopin 2mg
Benadryl 25 mg 3 tabs
Expert:  Dr. Z replied 1 year ago.

Thank you for your response. Now are you only having issues with insomnia or do you have any Mania related issues in the day time? Also you mentioned that you tried Seroquel, have you tried Trazodone, Doxepin, or Gabapentin as well?

Customer: replied 1 year ago.
I have insomnia. No mania in the day. I'm not allowed to take trazadone. My doctor said it won't help the sleep resistance mania. I don't know about the other drugs. All I know is I'm In a manic state of sleep resistance. Some drugs will make it worse.
Expert:  Dr. Z replied 1 year ago.

So if this a Manic related issue than at least one of your mood stabilizers (the Lithium and Tegretol) should be increased in dose, because they are at very low doses right now. Typically a mood stabilizer will stop and prevent Mania, but that usually occurs once they are at an effective dose. Another option would be to consider adding Geodon, Risperdal, or Latuda to your regimen as these are atypical antipsychotics that can lessen Mania symptoms and have some sedative properties to help you sleep too if they are taken at night. For your added information, Trazodone or Doxepin would not make your Mania worse because you are taking a mood stabilizer so it negates any side effects from the Trazodone or Doxepin. Antidepressants when taken alone can make Bipolar Disorder worse, but not when used as an adjunct to a mood stabilizer and/or an atypical antipsychotic medication. It is doubtful the Rozerem is helping so it may be better to consider asking your doctor about adding Vistaril or Gabapentin at night as these have some sedative properties to help you sleep. Overall though if your doctor believes that this insomnia is due to mania than you need to be on a more significant dose of the mood stabilizer (at least one of them) or an addition of another atypical antipsychotic that is good at stopping Mania would be effective too.

Customer: replied 1 year ago.
Thank you. This helps a lot.
Expert:  Dr. Z replied 1 year ago.

You are most welcome, I wish you all the best and I hope your insomnia due to Mania lessens very soon.

*Please do not forget to leave a positive rating at the top of the page so that I can get credit for helping you. Thank you, ***** ***** appreciate it.

Customer: replied 1 year ago.
I have 1 other question. I feel uncomfortable about being on klonopin to sleep. I also take it in the day for my nerves. I know it's highly addicting but used for manic symptoms. Is there anything else you recommend? They are using it to help me sleep but I don't feel comfortable with that.
Expert:  Dr. Z replied 1 year ago.

You can try Gabapentin. It works in a similar fashion as Klonopin only not as strong and it is not as physically addicting.