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Insomnia and anxiety and valium/clonazepan


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So, I've had severe problems sleeping for over 10 years.  I have tried everything natural.  I am now trying progesterone at night since my levels were pretty tanked overall.  It's helped with the daytime jitters I was feeling (I felt like i was drinking tons of caffeine every day even though I don't), but I've discovered that night time, my anxiety is in full bloom and I don't sleep because of it.  I'll wake up with anxiety to the point I have to practice deep breathing to try and calm myself down.  There is nothing that I'm thinking about - I usually have worship songs going through my head.

Anyway, I was given Clonazepan (in the valium family) to sleep -0.5 mg.  It worked great for two months.  I slept through the night for the most part which hasn't happened in years.   Then can time for a refill and my doctor doesn't want to continue it in reality.  I understand - it is addictive in nature.  I've tried lowering the dose to wean myself off of it and it just doesn't do the trick.  I am a redhead and have found medication is synthesized by my body very quickly.  I'm not one to insist that a doctor give me a control substance for life, but is there a different alternative?

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I went through this. 

I told my primary care that while I understand her reasoning for not wanting me to keep taking lorazepam for night anxiety/insomnia, it's me who has to cope with zero sleep and anxiety through the roof (which is exacerbated by poor sleep in my case, so just a couple nights of low/no sleep can trigger really intense anxiety for a week or so). Our agreement was that the lorazepam (0.5 mg before bed) was working. And if, at any point, I felt like that low dose was no longer effective then I would wean off it and try something else. And that's what we did, ultimately. 

I used the 0.5 lorazepam for probably 2 years, with regular check-ins to keep my doctor posted as to how I was feeling about it. About six months ago, I noticed I was not sleeping as well, and the Ativan didn't feel like it was doing the trick anymore at that dosage - so, I went in to see my doctor and now we're pursuing other options. In the interim, I'm taking 5mg of zopiclone to sleep which we also don't wantme on long term, but I have kids to raise and a life to live and for me sleep is a huge priority. So, I'm taking this for now, while keeping our eye out for other treatment possibilities. 

I'm REALY sensitive to meds, so the lowest possible dose of anything usually works for me for a good long while. 

 

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I was concerned about taking clonazepam too often for PTSD related anxiety.  Mostly due to not wanting to build an high tolerance or dependence.  

My doctor listened to my concerns about that and prescribed Hydroxyzine.  That knocks me flat.  Literally flat so I can ONLY take it at bedtime.  

Prazosin is also used for night time sleep related anxiety for those with PTSD, I have a prescription for that which I use when my sleep issues seem to be waking up/nightmares. 

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If you want kind of a different way to approach it, what I've been doing with a friend is rooting out some genetic stuff. If you run the 23andme ($69) testing, they run a SNP for the TPH2 gene, which is responsible for conversion of tryptophan to 5HTP. The 5HTP then converts to serotonin and melatonin, which is why you get the two-fer of insomnia and anxiety together. Unfortunately, having methylation defects makes it even harder, because the 5HTP needs methyls for that conversion to serotonin and melatonin. But, if you nail it, yeah, you get both the anxiety and the insomnia to improve. 

 

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The thing with benzos is that it wouldn't be just a half mg for life. You'd have to keep upping the dosage over time to get the same effect, and eventually you'd find yourself in a situation where you're popping three or four mgs a night just to keep the massive withdrawal at bay, and it doesn't even help you sleep anymore, but you can't take anything else because it's going to interact with the Klonopin and you'll quit breathing in your sleep. Benzos are lovely in the short-term, but it really is better to find something else for long-term use.

I agree that you should give hydroxyzine a try.

Have you had all your vitamin levels checked? I know that when I get really, really low on vitamin D, middle of the night panic attacks are one of the first symptoms. Low iron seems to make my anxiety worse, too.

 

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Have you tried Amitryptiline?  It’s technically an antidepressant, but I take it for IBS symptoms (intestinal spasms and nausea that wake me up at night) and it does help me fall asleep and stay there, even if my digestive system wants to wake up to play like a baby with its days and nights confused.  It took a couple weeks to not completely drop as soon as it kicked in, but I adjusted fine.  Main side effect I’ve had is very vivid, detailed, memorable dreams.  I don’t wake up tired in the morning though.

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