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Tamara Tami

Tamara Tami

Student
Sep 15, 2021
106
i cant continue like this, 3 days with out sleep, im in hell
 
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Insomniac

Insomniac

𝔄 𝔲 𝔱 𝔦 𝔰 𝔪
May 21, 2021
1,357
At this point, you might as well get heavily drunk + sleeping pills. Sorry if this sounds like a bad advice but sometimes there's no choice.
 
hankbank3928

hankbank3928

Student
Dec 30, 2021
186
I was prescribed seroquel and that got rid of the insomnia for me.
 
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Ethereal Knight

Ethereal Knight

Seja um bom soldado, morra onde você caiu.
Jan 10, 2022
816
if I was in this position I'd ask my doctor for mirtazapine or amitriptyline.

either one of them is great.

mirtazapine can give you the best sleep of your life.
amitriptyline is great too.

neither of them create physical dependence (as opposed to benzodiazepines and Z-drugs, like alprazolam, clonazepam, diazepam, zolpidem etc)

however both can make you gain weight, feel tired during the day and they can also cause dementia (neurogenerative diseases / cognitive decline) when you're older, if you take them long-term, so there are definitely trade-offs.

but poor sleep can also cause weight gain, tiredness and dementia, so you have to take that into account too when assessing the risk:benefit ratio of these drugs for your situation.


At this point, you might as well get heavily drunk + sleeping pills.
this actually is bad advice, as alcohol decreases sleep quality. it changes sleep architecture (sleep stages and cycles) in a way that ends up making sleep less efficient.

there are sleep drugs that don't change sleep architecture in a negative way. alcohol is not one of them.
 
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FuneralCry

FuneralCry

Just wanting some peace
Sep 24, 2020
43,275
I can imagine that it must be so awful and unbearable what you are going through, I'm sorry that you are suffering so much. I wish you the best.
 
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Sunset Limited

Sunset Limited

I believe in Sunset Limited
Jul 29, 2019
1,352
mirtazapine can give you the best sleep of your life.
True. I am using mirtazapine + melatonina. It's not like being knocked down with benzos. I would say it is natural sleep.
 
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Pain In The Ass

Pain In The Ass

Wizard
Feb 10, 2022
638
if I was in this position I'd ask my doctor for mirtazapine or amitriptyline.

either one of them is great.

mirtazapine can give you the best sleep of your life.
amitriptyline is great too.

neither of them create physical dependence (as opposed to benzodiazepines and Z-drugs, like alprazolam, clonazepam, diazepam, zolpidem etc)

however both can make you gain weight, feel tired during the day and they can also cause dementia (neurogenerative diseases / cognitive decline) when you're older, if you take them long-term, so there are definitely trade-offs.

but poor sleep can also cause weight gain, tiredness and dementia, so you have to take that into account too when assessing the risk:benefit ratio of these drugs for your situation.



this actually is bad advice, as alcohol decreases sleep quality. it changes sleep architecture (sleep stages and cycles) in a way that ends up making sleep less efficient.

there are sleep drugs that don't change sleep architecture in a negative way. alcohol is not one of them.
for me, mirtazapine is so powerful, but I would only take a small dose 2 - 3 times a week, so you don't put weight on or build a tolerance to it and need more, and so you don't build a psychological dependence - best would probably be - mirt / day off / benzo / day off / repeat
 
Ethereal Knight

Ethereal Knight

Seja um bom soldado, morra onde você caiu.
Jan 10, 2022
816
True. I am using mirtazapine + melatonina. It's not like being knocked down with be
for me, mirtazapine is so powerful, but I would only take a small dose 2 - 3 times a week, so you don't put weight on or build a tolerance to it and need more, and so you don't build a psychological dependence - best would probably be - mirt / day off / benzo / day off / repeat
what's your dose? increasing it to something like 30 or 45mg is probably fine, you probably won't have to increase it further ever again.
I know some people say it's better for insomnia at lower doses, but many people sleep well with higher doses too.

the weight gain is a tough problem, though. this thing can make one obese or diabetic rather quickly.

overall, are you guys happy with mirtazapine? @Sunset Limited
 
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Sunset Limited

Sunset Limited

I believe in Sunset Limited
Jul 29, 2019
1,352
what's your dose? increasing it to something like 30 or 45mg is probably fine, you probably won't have to increase it further ever again.
I know some people say it's better for insmnia at lower doses, but many people sleep well with higher doses too.

the weight gain is a tough problem, though. this thing can make one obese or diabetic rather quickly.

overall, are you guys happy with miratapine? @Sunset Limited
Just using 7.5mg. Enough for me. I don't have a weight problem. I have tried many drugs. Unisom, atarax, amitriptyline, passiflora... Mirtazapine is best. I use 300-500 mcg of melatonin with mirtazapine.
 
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Ethereal Knight

Ethereal Knight

Seja um bom soldado, morra onde você caiu.
Jan 10, 2022
816
Just using 7.5mg. Enough for me. I don't have a weight problem. I have tried many drugs. Unisom, atarax, amitriptyline, passiflora... Mirtazapine is best. I use 300-500 mcg of melatonin with mirtazapine.
I'm glad you found something that worked for you.

and wow, it's rare to find somebody that don't have a weight problem while taking mirtazapine. many people tell that this drug makes them gain weight continuously.

I have had insomnia for 12+ years. my type of insomnia is premature awakening, or terminal insomnia, I basically wake up too early and then suffer the countless painful symptoms of sleep deprivation the next day.
I have a history of C-PTSD, I'm an adult survivor of narcisistic abuse (for extra context).

I used amitriptyline for about 4 years. it was a weird story: amitryl worked well for the first 3 years, made me sleep almost 10 hours every night, and then I decided that I couldn't tolerate the extra fat on my belly so I stopped it to try to sleep with drugs that don't interferes with body weight, like trazodone. trazodone didn't work for me. then I came back to amitriptyline, but now it was not the same. it didn't have the same effect, and it started to stop working overtime, like if my body started to compensate and to create some weird tolerance to it. it came to a point where I was using 75mg and it felt like less than 25mg, and then even the 75mg were starting to feel like nothing - I was almost only left with the side effects, with little benefits.
I find it particularly weird that this change ocurred after I stopped taking it and switched to trazodone, then came back and nothing was the same. I have no idea what happened.
trazodone is such a crazy drug, that I don't doubt that it could have caused some epigenetic change in the way I metabolize amitriptyline, but that is just speculation. the fact is that amitriptyline stopped working.

then I stayed some time using over-the-counter promethazine to sleep, but it's needless to say how much this is a bad idea. so I quickly realized that and went drug-free, which is where I'm at now.

I currently sleep well about 50% of the time and terribly the other 50%.

when I sleep well, it's more like mediocre, I sleep between 6 to 7 hours and I still feel a little tired the next day, I yawn a good amount.

when I sleep terribly, it's very bad and ruins my days.

my typical schedule is to start my sleep at 10:30 PM and wake up 4:45 AM every day.

right now I'm considering asking my doctor for a prescription. I researched deeply and I know a couple of options.

at the end of the day I'm between choosing doxepin 6mg, which is very mild drug and unlikely to cause much side effects, but certainly is not very strong and won't give me the sleep of my dreams, and mirtazapine (not sure about the dose), which is an atomic bomb and is gonna give me a lot of side effects but is surely gonna give me "beauty sleep".

doxepin is probably not suitable for long-term daily use, cause it's basically an anti-histamine, and our bodies can develop tolerance to anti-histamines within as little as 3 days. the biggest study they did on doxepin was just 90 days long, they don't know what happen longer than that, and the studies were mostly sponsored by drug companies anyway lol.

if I want to be fit, lean, active, energetic and to use a drug that interferes minimally with my life, doxepin is the day to go, cause it's so mild, it barely has any side effects. I never used it, only studied, but I studied this thing a lot. ideally I'd have to test, because like trazodone, it may be good in theory but a disappointment in real life..

mirtazapine can help to treat depression and anxiety alongside with insomnia, so I may feel more serene, calm, and kinda "kill two birds with one stone". it's only considered an antidepressant at higher doses though.

I'm really having a hard time deciding. my doctor is gonna give me the prescription of whatever I ask him (except morphine and fentanyl I guess, lol), so I really can choose.

I'm very proud of being able to sleep naturally, however I feel like I'm still slightly chronically sleep deprived - having a "sleep deficit" without noticing, and that this is influencing my mood and even my suicidality in sneaky ways, because it's not as big of deficit, so it's not as easy to perceive as bigger ones.
sometimes perceiving sleep deprivation could be like asking the fish what water is. the fish is in water all the time, they don't have anything to compare to. if you're slight sleep deprived every day, this may as well become your "new normal" and you may get used to it, you may not know what good sleep is until you get some!

amitriptyline and mirtazapine are so similar in theory, that I guess I know what to expect.
I was pretty happy using 25mg of amitriptyline (while it worked). I had at least 9 hours of sleep every night, close to 10 hours. it made me gain weight, made it impossible to diet down and lose body fat, made me tired and lazy, but man, that "beauty sleep" was worth every side effect.

I'm not worried about gaining weight at all, not even a little bit, cause I'm closer to CTB than I ever was in my life and improving my sleep could improve my quality of life tremendously, maybe it could even reduce my suicidality.
at the very least, even if I end up CTBing, sleeping well on the last parts of my life 100% of time instead of just 50%, would be a huge improvement in quality-of-life, it'd be like giving heroin to terminal cancer patients: at least they ease the pain and feel good at their last moments.

in my decision, I'm leaning towards mirtazapine, because I want a "beauty sleep" and I'm kinda willing to pay a high price to have it, since I don't have much to lose anyway.

did you feel like mirtazapine was that much better than amitriptyline, @Sunset Limited ?

I'm sorry for the long post and for kinda hijacking this thread! my appointment is in 7 days and I still haven't decided what I'm going to ask my doctor.
 
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