Protracted Insomnia

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Hi:

 

I am in protracted withdrawal from benzos.  I withdrew from 30 mg temazepam nightly ending in October.  I am still having a severe sleep disturbance.  I get little if any sleep on a nightly basis and I don't know what is going on.  I also changed from the medication seroquel to the medication olanzapine at about the same time.  This is getting to be ridiculous and I can't explain it.  Has anyone got any suggestions?  I have been told by a buddy that this is all part of withdrawal and to just accept it as part of the recovery, but I have never had sleep problems this bad ever.  I am wondering if it is an effect of the removal of the seroquel in addition to the withdrawal from the temazepam.  Hard to know with so many factors to take into account.  I am in a murderous mood as well with all kinds of early morning morbid self-condemning thoughts like I will never recover and that I am possessed or something.  I have had chronic sleep problems in the past but never to this degree.  I am also taking the drug doxepin which is virtually having no effect on the insomnia although I read that it should help with sleep.  I have been on a pretty toxic cocktail of medication for over two years now and the main symptom I have had is terrible intractable insomnia.  Don't know what to do or what to say to my doctor when I see her tomorrow.  I guess I will just report the symptoms.  I also have severe tinnitus in my left ear which is really strange as well.  I don't know how much more of this I can take and I really don't know what could be causing such disturbed sleep.  Most references say that the insomnia should resolve, but it seems in my case to be getting worse as time goes on.  No sleep is the worst thing I have ever gone through.  Any suggestions?

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Hi Shakeyhand,

 

Sorry to hear you're struggling so badly.

 

I'm not a doctor but in my experience and having read many posts on this board and others, the more meds you're taking the more complex the situation. Adding, changing and coming off medications all affect your CNS and leave it unbalanced and I'm not surprised that you're not sleeping well after stopping the seroquel.

 

In my own situation, withdrawing from citalopram (which I fully reinstated nearly 2 years ago) made me highly sensitive to other meds and that's why I had, and continue to have, withdrawal symptoms 18 months after stopping Valium. (if you look at my signature I hardly took any Valium)

 

If I were to offer you any advice it would be:

 

stay put. Don't add, remove or change any medications and ride out the storm.

 

Insomnia is my only remaining symptom and it's gotten much better for the most part because I've accepted that nothing, and I mean NOTHING will help this except time. In 18 months I have not changed, added or removed any medications. I take zero supplements because I am hypersensitive to those as well.

 

I know when you're suffering the most logical response seems to be 'how can I fix this?'  - but in my experience only NOT trying to fix this has helped me.

 

I wish you all the best and hope you get some sleep very soon.

[[Sh...]]

Shakeyhand - How long were you on 30-mg temazepam, and what method and how long did you take to get off of it? I'm wondering, because that's a hard benzo to taper from, and I suspect at least part of your problem may be due to withdrawing from it way too quickly.

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Hi:

 

I went from 30mg to 22.5mg to 15mg to 7.5mg, then off. I don't remember how quickly I tapered, but I was forced to do it due to the cost of the 7.5 mg dosage.  For some reason the 7.5 mg pills were way more expensive than the 30mg pills so I had to stop the drug pretty quickly.

 

I see my practitioner again this afternoon and we need to address the insomnia.  Even though it was a semi cold turkey withdrawal, I did try and hold a few days between dosage changes.  I have been off the temazepam since October 1.

 

I tried to cross over to diazepam, but it was way too sedating at the 15 mg equivalent dosage.  It just wasn't going to work.  One of the problems was that they tried to cross me over very quickly when I was in the hospital.  They went from 30 mg temazepam to 15mg valium virtually over night.  It really shocks me as to how much ignorance there is in the medical community over how to properly do this. I was on the temazepam every night for almost two years so I was pretty heavily dependent on it. I know that this could be the problem, but the damage is done and I would be pretty resistant to reinstating at this point.

 

Has anyone tapered over to the 15 mg valium equivalent and felt hugely over sedated? I really felt more lousy doing this than I do now.  Very hard to tolerate.  I know that tapering should be done really slowly.  Maybe I should approach my nurse to reinstate some valium and try a slower taper.  I am very hard-pressed to know what to do at this point.  She is not really cooperative with the way I handled my previous taper. Unfortunately, she has been out of the office during the past month and communication broke down while I tapered off the drug.

 

Ken

[[Sh...]]

What you described does sound almost like a C/T. But since you've been benzo-free for a few months, it seems like it wouldn't make sense to reinstate. It might just set you back in the healing process and make things worse. Maybe you can ask your doctor about going on one of the anti-depressants that have hypnotic properties to get you through the worst of your insomnia. The ones I know of are mirtazapine, trazodone, and doxepin. You can find more info on the Other Medications board.

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Hi Shirah:

 

Yes, it was close to a cold turkey withdrawal.  I saw my doctor today and I am keeping the medications the way they are for now. Not going to go back on a benzo.  I don't know if you noticed but I am on the sedating antidepressant doxepin already.  It doesn't really work for me as I have been on all the sedatives they have except maybe phenobarbital. My doctor also said that there is no way that I could be experiencing any withdrawal effects from the benzos because I stopped them a couple of months ago and they should be out of my system by now. Do you think that I could still be in withdrawal after almost two months off?  Man, this insomnia is really hard on me and I don't know if I will be able to handle the taper at this point. I also have severe tinnitis in my left ear.  I just thought I would add that caveat as well.  My mind really is starting to play tricks on me.  Early morning is the worst time of the day for me.  All those horrible thoughts come when I haven't been able to sleep the previous night.  Is there any hope for me?

 

[[Sh...]]

Definitely it would make sense for you to still being suffering from withdrawal. And insomnia and tinnitus are two very common benzo withdrawal side effects. From my experience (and from everything I've learned from others), most doctors do not understand the need for slow tapering off benzos or the side effects and recovery time involved. It takes the brain a long time to get back to working like it used to, pre-benzos.

 

There's a lot of info on this website that explains what happens to the brain on benzos and during tapering/withdrawal. Reading about it won't make recovery happen any quicker, but I think it helps to understand what's happening and why. I'd say the Ashton Manual is a "must read" for anyone going through this. Other suggested reading on this website: go to the Withdrawal Support board and see one of the highlighted posts called something like "What's Happening to Your Brain on Benzos," which is written in very simple layperson's terms; and the scientific publications posted at the top of the "Chewing the Fat" board. There's also a free downloadable book called The Benzo Book that I found very informative (just google "The Benzo Book PDF").

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Hi Again Shirah:

 

Thanks for he suggestions.  I found the benzo book pdf file and am reading it now. It explains the dichotomy of are benzos safe for long term use or are they to be used for only short term symptom relief.  Unfortunately this dichotomy has only one answer. Either they are safe for long term use or they are not. I have gotten hooked up with a prescriber who prescribed long term and now has cut the cord. I hope I can survive the insomnia. It is horrible. Never had problems this bad with sleep. Thanks again.

 

Ken

[[Sh...]]

There's a lot of debate on here about what percentage of the population is highly sensitive to benzos to the point of going through terrible withdrawal when stopping. But even if we are a small minority -- which I have my doubts about-- I don't think doctors should be prescribing them to anyone long term, especially without giving a warning about the potential for physical addiction. There are much less potentially harmful ways to deal with anxiety, insomnia, etc.

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Shirah:

 

You know the thing that gets me is the hypocrisy involved in the debate. In my particular case the doctor went from being extremely cautious about withdrawing the temazepam.  I was continually told that the drugs are dangerous to withdraw from.  I was told this whenever I suggested that I wanted to go off the drug.  My prescriber would never want to approach withdrawal and kept telling me I needed to withdraw ever so slowly. Once I made the jump off the drugs then it became an issue that I need to stay off the drug.  How did it go from being useful and I needed to stay on it to now it isn't doing you any good and you need to come off and stay off.  The attitude of the physician seems to change based on where one is in the process of withdrawal. I spoke with her yesterday and it seems as though she won't even entertain the possibility that the drug could be eliciting any memory effect now that I am off.  I think it is all too common as well that we are many times sold a bill of goods with regard to long term efficacy which regard to risk/benefit.  I am banking on the fact that this memory effect with regard to GABA receptors is real and hopefully will improve with time.  I need to sleep and I am not getting it and I don't think it is fair to think that it is all in my head or my fault in some way.  Thanks for the referral on the benzo book.  I have read a few chapters and it really is scary that so many folks are being hooked long-term.

 

Ken

[[Sh...]]

Glad you found The Benzo Book...Another good explanation can be found on the "Chewing the Fat" board on this website -- the article towards the top called "A Layman's Explanation of Neurons, Benzos, and Recovery."

 

And of course, it is "all in our heads" -- in our brains, that is! There's a physiological explanation for all of it.