Adventures in Sleep and Pharmacology

Last night I slept the whole night through.  It was amazing!  You see, I recently changed medications (I tapered off of Seroquel XR and onto something new), and I haven’t slept through the night since.  Part of why I came off the Seroquel was that it knocked me on my ass.  I would sleep like the dead all night long, and half of the morning, and then kind of sleepwalk through my day in fog.  It was all a bit much.  But at least I was sleeping.

When I got sick, when I was preggers, one of the things that happened to me was that I stopped sleeping.  I would fall asleep, sleep for about an hour, and then wake up crying.  And stay up crying for hours and hours.  It was pretty bad.

When I finally got in to see a doctor who was even a little bit competent (another whole story for another time), they didn’t give me a lot of options, due to the fact that I was pregnant.  Basically, they gave me the choice of either Seroquel or Zyprexa.  I chose the Seroquel because Zyprexa has a reputation for really nasty metabolic side effects and I didn’t want to increase my risk for the Fetus Beetus (a.k.a. gestational diabetes).

The Seroquel was kind of a nightmare.  Apparently, I metabolize that s*** REALLY slowly.  My prescriber said to take it ten to twelve hours before I needed to be up.  For me, it turns out to be more like fourteen to sixteen.  I learned this after I had to call out of work repeatedly.

At first, they wanted me on 400 mg a day, probably because of how sick I was by the time I finally got help.  They titrated me up from 100 to 200 to 300 to 400.  My prescriber said that I would probably be more sedated at the lower doses than the higher because Reasons Having to Do With the Affinity of Seroquel for Different Receptors at Different Doses.  This turned out to not be so much true for me.  At 300 mg, I was so dizzy and foggy and out of it that I couldn’t drive a car.  At 400 mg, I could barely take a shower.   We eventually backed off to 200, a dose at which I was f***ing stupid and slow and groggy, but also functional-ish, sleeping at night, and not as actively suicidal, so I guess that was a win?

Anyway, I started this post to talk about insomnia, but clearly got off track.  The reason I wanted to write about the insomnia to begin with is that now that I’m off the Seroquel, I have been sleeping really poorly, and every time I wake up, I am completely TERRIFIED that I will go back to where I was, that I am getting sick again.  For all I don’t feel like my normal self now, this is like a vacation compared to where I was.  I don’t know how I would make it through if I went back to where I was, and when I’m lying awake at night (for much shorted periods of time than I was), my mind starts racing, and it’s like I’m falling and falling and falling down this hole that doesn’t stop.  I have been through some scary s*** in my time, and this feeling of fear is…well, it’s something I might wish on my worst enemy because I’m not the kind of altruist that says things like “I wouldn’t wish this on my worst enemy.”

I don’t know how long this fear of the insomnia will last. I don’t really have words to do it justice, to explain it to another person, to do anything to help myself feel less alone with it.  Is it going to fade or will I spend the rest of my life in sheer wordless terror every time I have a bad night’s sleep?  I don’t know, but f*** you very much for this particular gift you’ve left me with, depression.




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