Low-dose Seroquel (25mg) for insomnia?

[badlydrawnboy]

Hello,

I have intractable sleep maintenance insomnia. Usually no trouble falling asleep, but I awaken at 2:00 or 2:30 and can't fall back asleep. In my case the insomnia seems to be related to inflammation caused by Crohn's Disease. This manifests as fibromyalgia-type symptoms - a dull, aching pain in my muscles and a sensation of wanting to crawl out of my skin.

I'm not on any meds, but I've tried Restoril and Lunesta for very short periods. Restoril works fairly well but causes constipation and I don't want to be on a benzo. Lunesta doesn't always work and causes funky side effects I don't like. I've also tried Xyrem but I couldn't sleep for more than 1&1/2 hours each dose and it was just too erratic and hard on my system.

My doctor suggested taking 25mg of Seroquel for a period of 2-3 months so I can get out of this viscious cycle I've been in. I'm wondering if the risk of serious side effects for Seroquel is significant at this dose and for the length of time I'm planning to take it. I'm generally very averse to meds and try to use natural substances when possible... but I'm quite desperate here.

Thanks for your advice,
Chris

[Perchance Dreamer]

Hi, Chris. I hope you get more replies to your question.

The Talk About Sleep forum has great archives. Have you done an Advanced Search using the keywords Seroquel and Insomnia? On the Advanced Search page, be sure to click "Search for all terms."

I've never used Seroquel, but I'd really look into it first if I were you. Moss is one of our members who is a pharmacist with a doctorate in neuropharmacology, I believe. Here's his take on doctors prescribing Seroquel for off-label uses:

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"Pardon my directness but your shrink is an idiot and that prescription is close to the line of malpractice. Seroquel is (1) an anti-schizophrenia drug and (2) an anti-mania drug often given in combination with lithium. So, unless you are nuts (i.e. schizophrenic) or manic (tappin your toes like you just did 20 mg amphetamine) Seroquel ain't gonna help squat with your problem. In many ways, it may intensify it, and intensify it severely.

Your first clue that your shrink had shrunk was when he said "I don't want to go there". When a physician says "I don't want to go there" your correct response is to say "Up yours, doc, I don't want to come here. You appear to be uninformed of the state of the science and I am not paying for your quackery". Before I started taking a potent psychotropic medication like Seroquel that can lead to all kinds of brain dysfunction (some, like tartive dyskinesia, unreparable), I'd get a second opinion. Hopefully from somebody not so obviously in the pockets of the drug companies.

Seriously, go to the site www.rxlist.com and look up Seroquel. Read what is under each tab. Look at the side effects (the major ones are agitation and anxiety). Look at the precautions and, most of all, look at the warnings. I find it totally unethical that any physician could prescribe Seroquel for somebody with your symptoms and drug history. This guy hasn't a clue.

Whatever you do, don't start the Seroquel before you learn more about what it is for, how it works, and what it can potentially do to your brain. Powerful antipsychotics like Seroquel were intended for people who are living just beyond the cusp of reality. They derive benefits that make prescribing poisons like Seroquel the lesser of two evils.

Moss"
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If you've never tried Trazodone, you might ask your doctor if you could try it first. So many people don't find it helpful or can't put up with the side effects, but for some of us it's a god send. I'm having minimal side effects and much improved sleep at 100 MG.

Of course, Trazodone is another drug that's off label for insomnia. But from what I can gather, it's considered pretty safe.

Is Xyrem clearly not doing the trick for you? How much sleep do you get on it?

[badlydrawnboy]

Thanks a lot for your reply.

I did some research on Seroquel on this board, and elsewhere, and from what I gathered a low-dose of 25mg in rotation with other meds (i.e. only taking Seroquel 2x/week) and for a short period (3 months or so) didn't seem to pose the same risks as taking the full dose (150mg) for a long period of time.

That said, I would love to hear from anyone who thinks otherwise. I am generally extremely averse to meds and I would not even consider taking them unless nothing else under the sun worked. Unfortunately, that's exactly where I am. I've tried every natural remedy and lifestyle modification possible, but my condition is so severe that my doctor is now telling me that I absolutely MUST find a way to get 7-8 hours of quality sleep each night for a period of 6 months at least... or I will just continue to get worse.

I'm dealing with Crohn's Disease, FMS & CFS (all different labels I suppose for a general syndrome) and this is the basis of my insomnia. I haven't had a sleep study yet but I strongly suspect I have little to no stage 3 & 4 sleep due to alpha intrusions. So I need to use sleep meds that don't interfere with deep sleep.

Xyrem only gives me about 1&1/2 hours of sleep per dose, even at fairly high doses, and I wake up feeling anxious and spacey. I'm not taking other meds, nor am I withdrawing from any, so I know these effects are due to Xyrem. They disappear immediately when I stop taking Xyrem.

So, I'm trying to come up with a few meds I can rotate that don't interfere with stage 3 & 4 sleep. I'm considering Lunesta (works decently and side effects aren't too bad), Remeron (tried it a while back and worked pretty well at 1/2 15mg tablet) and possibly Seroquel, since they work on different mechanisms. But if someone could suggest an alternative to Seroquel in this rotation, I'd appreciate it.

Thanks,
Chris

[badlydrawnboy]

One more thought occurs...

Advil has actually been one of the most effective sleep aids for me. I suspect that is because insomnia in my case is predominantly caused by pain.

I'm not very familiar with FMS/pain medications, but I wonder if something like that would help me sleep better?

I've checked a bit on the FMS forum here, but I'm not sure which meds would be appropriate. If anyone has any ideas, I'd appreciate it.

Thanks,
Chris

[Perchance Dreamer]

"Xyrem only gives me about 1&1/2 hours of sleep per dose, even at fairly high doses, and I wake up feeling anxious and spacey. I'm not taking other meds, nor am I withdrawing from any, so I know these effects are due to Xyrem. They disappear immediately when I stop taking Xyrem."
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Hi, Chris. My experience with Xyrem sounds much like yours. I got about 1 to 1 1/2 hours of sleep per dose The next day I felt depressed, anxious, and spacey. My blood pressure and pulse shot sky high, even on the lower dose.

My impression is that if you take Xyrem and don't get enough sleep on it, the next day makes you feel worse than you do with ordinarily sleep deprivation. Puzzling, though, because this drug gives so many people their lives back. I've only read of a couple of people not sleeping or getting very little actual sleep on Xyrem.

Were you ever on a benzo for an extended period of time? I think maybe the Klonopin I was on for so long contributed to Xyrem not helping me.

[badlydrawnboy]

No, the maximum I was ever on a benzo was about six weeks of restoril (and that was a medium dose - 15 mg). That was over two years ago, with no benzo use in between except the occasional 15 mg of restoril when I've gotten totally desperate (maybe twice a month).

Sigh. I wish this was easier.

[Perchance Dreamer]

Hi, Chris. There are a couple of other places to look for people's experiences with Seroquel for insomnia.

sleepnet.com has public forums. Try a search there. The user interface is pretty crappy, I think, but there are a lot of interesting postings.

immunesupport.com also forums. Go to the Fibro message board and do a search.

Good luck!

[h0mebodty]

Hi,

Have you tried the seroquel yet? Does your doctor have samples for you? It is best to test the drug for a few nights to make sure the side affects are not bad for you. I will say for such a low dose you should be ok with it. I know it may cause some lethargy and hunger for sweets and carbs. (not real sure on such a low dose)

I know it has helped me to sleep again but I am taking a very high dose and hope to cut down every few months, as my body learns to sleep again. I took ambien for about 6 years, and toward the end it was bad. I will tell you with higher doses of Seroquel that it does cause a brain fog, and it is hard to wake up early, without feeling groggy and fuzzy. I have been on this med for about 3 months now, not without side affects, weight gain, foggy brain, and some short term memory loss.

I will admit my case is not normal for most, I do suffer insomnia induced from bipolar II,. I do believe most of it was caused by the over abuse of ambien too. I have been giving myself time to sleep again but its about time to cut down again.

I advise anyone who wants to try seroquel to see if they can get samples first, and use only at a low dose, with a drug rotation of some kind.

Doctors do not always know how you will react to a med, so be an advocate for your self, because no one else will be.

Hang in there not sleeping has to be on of the hardest things to deal with for an individual, you begin to hate those around you that can sleep, and when you go for about 3 months or longer with little to no sleep at all its amazing what you will do for sleep.

I am finally getting rest again, but every thing comes with a trade off for some other side affect . Its all about what you want for your life at that moment and what your willing to do to ensure your sanity and get your life back under some normalcy again.

Good luck to all who try Seroquel. Be advised that no drug comes without some kind of side affects. It is about what you are willing to put up with to get sleep again.

[oceanblueskygirl]

I notice you mentioned that you have CFS/Fibromyalgia. I was just wondering if you have ever been investigated for lyme disease & co-infections? CFS&Fibro are caused by many things and Lyme disease is one of them.

I am being treated for Lyme disease & co-infections and sleep is a huge problem for me. I have the alpha wave intrusion too. My last sleep lab showed 51 awakenings in 2.5 hours of sleep.

I hope you find something helpful.

[RWG]

Moss either lies about his background or needs to go back to school. Seroquel is prescribed for people that suffer from Schitzophrenia and other psych tropic disorders. Normally for these problems it is prescribed at 800 to 1200mgs. 25mgs. is the lowest dose made and probably will not affect you at all. Most people that weigh more than 125lbs would not even notice the effect of 25mgs. Seroquel is widely prescribed off label for insomnia with very positive outcomes. A person near or over 200lbs would need from 150 to 400mgs for insomnia. It is not a narcotic and is not addictive. However, that said, anything that you psychologically get used to can be addictive albeit not physically addictive. There are only five psychiatrists that specialize in sleep disorders in the US and they all prescribe Seroquel on a regular basis. Seroquel can also help with the depression and anxiety that often accompany chronic insomnia.

[Perchance Dreamer]

RWG, I think we should be able to disagree with one another on this board without suggesting members are liars or ignorant. From reading about low-dose Seroquel for insomnia on immunesupport.com and sleepnet.com, it seems to work well for some. Others, however, report even at the 25 MG some troubling side effects such as minor convulsions, feelings of unreality, and liver problems that developed after taking the Seroquel.

I haven't always agreed with Moss, but I value his input and hope he keeps posting.

[RWG]

I really don't mean to be insulting, but when I see someone giving advice and telling someone not to listen to their doctor, it really makes me suspicous that he has a doctorate in pharmacology. He also said that one of the main side effects is nervousness. In comparison to a placebo, the placebo ranked almost even with Seroquel when it came to nervous anxiety. Anytime someone on the internet tells you not to listen to your doctor and accuses your doctor of borderline malpractice, and you know nothing of his credentials, arouses suspicion. Seroquel isn't for everybody and can have some side effects. Any drug can. Drugs in the ssri class cause a large number of people to have terrible side effects while they work wonderfully for others.

I'm just saying listen to your doctor, not me or any other faceless person on the internet. Seroquel has been a life saver for thounsands of chronic insomniacs. When taking the hippocratic oath, the first rule for docters is "First, do no harm." I can't stress enough how important it is for people to listen to their doctors. If you don't like what your doctor says, see another doctor, not some guy named moss on the internet.

[Randy]

Hi Folks, Been awhile since I have been here. A few thoughts.
Seroquel is an anti psychotic medication. That is what it is approved for. As a bipolar person I have used it in the past. I found that even at a low dosage it was effective at inducing sleep but it has a long hangover period. It is not very addictive but is not the most pleasant drug around.
Most of the side effects noticed with Seroquel have to do with long term high doses given to hospitalized patients. TK will not happen to you for using a low dose at bedtime.

Still if it works for you, then it works. Many drugs are used off label and most bipolar medications started off as anticonvulsants.

We are all very lucky to have these modern medications. Older medications (doxepin, trazadone and other antidepressants) had a nickname. They were called "dirty" because of the side effects. Obesity, high blood pressure and such.
Today your worst problem is rebound insomnia.

[RWG]

My sleep doctor prescribed Seroquel 150mgs. plus an Ambien before bed. I could deal with the side effects, but it doesn't seem to make me sleep very often. Any ideas?

[Randy]

Wow if 150 mgs can nott knock you on your kister RWG then I dont know what will.
I think you might give Doxepin a try. It is cheap.
I tried Lunesta a year ago and it did not do much for me. I tried it again a few weeks ago and it works fine. Everybody metabolizes differently and you have to tinker around a little bit. Soma would be another possible sleeping agent.