Medication and sleep

[Dying_Swan]

Just to update, they wouldn't prescribe me anything else for sleep. The psych wasn't familiar with doxepin and for whatever reason wouldn't give me amitriptyline. He thinks my sleep will improve when my mood improves, so is increasing my quetiapine. Thank you to everyone who replied. I really appreciate it.

[panic_down_under]

The psych wasn't familiar with doxepin

Sigh. This is the problem with the profession these days. Too many psychiatrists only know about SSRIs, SNRIs, plus a couple of novel meds such as mirtazapine so go direct to antipsychotics when the limited number of ADs in their bag of tricks fail instead of trying the older *ADs which are often more effective than the newer ones.

* although doxepin probably doesn't qualify as an AD

[Dying_Swan]

Thank you for your reply. I was surprised he wasn't familiar with it, although I think I'm going to have a med review with the NHS psychiatrist so maybe he will have some other ideas.

[WiseMonkey]

Thank you for your reply. I was surprised he wasn't familiar with it, although I think I'm going to have a med review with the NHS psychiatrist so maybe he will have some other ideas.

I completely agree with Panic Down Under, the older tricyclics can work much better plus they're tried and true meaning they've been around since the late 1950's. I'm surprised that your physc hadn't heard of Doxepin (cousin of Ami and chemically similar)! Unfortunately it's not being imported to NZ anymore, so I'm switching to Ami. As stated before they have a significant anti histamine effect, which is why they're so beneficial for those of us who have autoimmune conditions. Ask your own Dr about Doxepin.

ps. they reason I know a lot about tricyclics is because I'm older and they were the most popular AD's used in the 1980's. They suited me whereas the other certainly didn't!

[MyNameIsTerry]

I have a funny feeling this med isn't used in the UK but checking the BNF site shows it's there. And the MHRA have recently passed a new generic form in March 2019. Maybe he knew it as Sinepin? Still no excuse though. It's supposed to be expensive (would have to check this...but maybe he does know about it and doesn't want to have the conversation which happens with some doctors ) but hopefully the generics will bring it down. But if not many use it that might explain why it's expensive, a drug companies way of discouraging you in the same way a builder giving an inflated estimate because he doesn't want the job.

EDIT: I think it might have been Dosulepin that wasn't available in the UK. Only for those already on it otherwise it has to be prescribed by a specialist initially.

[Dying_Swan]

Thanks guys. He basically just said I'd already tried drugs which have an antihistamine effect (mirtazapine and trazodone) so I think he thought if they don't work, others won't either. After a few good nights, last night I increased quetiapine and didn't sleep well at all. I will ask the NHS psych about something else to help, though I have a feeling they're going to switch me from quetiapine to something else

[pulisa]

My son is an inpatient and has been switched to risperidone from quetiapine. The psych says that with ven it's a good combination. Mind you he now needs lorazepam and zopiclone to sleep...

[Dying_Swan]

I'm really sorry to hear that Pulisa. It is supposedly a good combo, or so I'm told. Quetiapine is also supposed to be sedative but as you know, that hasn't been my experience. Once I'm asleep it does tend to keep me asleep, but getting to sleep isn't always easy. How long has he been on it, and at what dose?

[pulisa]

He's been on 2mg risperidone for about a week to help with ruminations but I think the plan is to increase. He has ASD so things are quite complex.

[Dying_Swan]

Sorry, I read it wrong and thought he'd started quetiapine. I really hope the risperidone will help him and he'll soon be better able to sleep. It makes such a difference.