What influences nightmares?
KnightMayor
have no fixed topic(s), and 'hence' are not treatable by common methods
(I have been tested and 'treated' for four years without any success).
Because of the immense effect on my life, my physicians suggested to
take anti-depressants (ADs), in order to try to get out of the downward
spiral.
ADs have helped me somewhat in that they increased my energy and
improved my mood, but they did little or nothing for the nightmares.
The reason for this posting is that I have seen two *negative* effects
of ADs on my nightmares, and am thinking/hoping that if there is a
negative effect, there might also be a positive effect somewhere.
The negative effects are:
- When trying Remeron (Mirtazapine), 15 mg per day, the first nightmares
came almost immediately (+/- 20 minutes) after going to bed, instead
of 'normally' after some 3 to 4 hours.
Because side-effects take time to wear off, I persisted two weeks, but
there was no change at all, so I had to stop.
- My last AD was Paroxetine, 2 times 10 mg per day. Because of
(other) side-effects, I wanted to switch back to Efexor XR
(venlafaxine), which had worked (for depression) reasonably before.
So I needed to scale down my use of Paroxetine.
The plan was 1 week 10 mg per day and then 1 week 10 mg every other
day.
But as soon as I went to 10 mg per day, the severity and frequency of
my nightmares increased and they started earlier in the night.
That negative slope continued over the whole week.
(Because I don't have the energy for another, probably even worse
week, my doctor agreed that I start with Efexor XR, i.e. after one
week instead of two.)
Does this make sense to anybody? Any conclusions, suggestions,
questions, <whatever>?
Thanks in advance for any and all responses.
Linda
The Serotonergic System, the Pineal Gland & {Nightmarish]
Side-Effects of Serotonin Acting Anti-Depressants -Part 1
http://www.antidepressantsfacts.com/pinealstory2.htm
KnightMayor
Nom dePlume
well-understood area. I have a few thoughts.
First, nightmares may be a symptom of sleep apnea. I suggest that you hvae a
sleep study done, at a sleep disorder clinic, to see if this is the case. If
it is, then fixing the problem is fairly straightforward, albeit a bit time
consuming. I suggest starting with this study, since medications and
psychological techniques will not help sleep apnea.
Second, if your nightmares become worse when you use serotonergic
antidepressants, or don't improve, then you might be better off with a
different category. (You can read about all of the categories and
medications at my Web site.)
Third, withdrawal effects from Paroxetine are particularly nasty, and I
could believe they are associated with your worsening nightmares when you
scale down Paroxetine. If so, the problem should go away within a few weeks.
Fourth and last, here is an interesting article about a medication that
helps nightmares in some situations:
http://ptsdcombat.blogspot.com/2007/04/study-drug-may-ease-combat-ptsd.html
--
Nom dePlume, Ph.D.
Why, yes, in fact, I am a rocket scientist.
Find my book, Medicines for Mental health, and free drug information, at
www.MentalMeds.org
=====
"KnightMayor" <no...@none.invalid> wrote in message
news:c9de2$4b0187ea$5351cc6c$18...@cache3.tilbu1.nb.home.nl...
KnightMayor
> I think the lack of response to your psot indicates that this is not a
> well-understood area. I have a few thoughts.
Thanks a lot for your response, 'Nom'.
> First, nightmares may be a symptom of sleep apnea. I suggest that you hvae a
> sleep study done, at a sleep disorder clinic, to see if this is the case. If
> it is, then fixing the problem is fairly straightforward, albeit a bit time
> consuming. I suggest starting with this study, since medications and
> psychological techniques will not help sleep apnea.
I didn't want to make my OP too big, so I did not mention it, but I
have had two full sleep-tests (i.e. nightly monitoring at the hospital)
and a Multiple Sleep Latency Test. Nothing was found, i.e. also no sleep
apnea. I had only one nightmare (which they could see on the EEG, etc.),
because of the unfamilar surroundings. I.e. I slept only a few hours,
hence only one nightmare. (BTW, I'm skinny, i.e. sleep apnea is unlikely
(but not impossible).)
> Second, if your nightmares become worse when you use serotonergic
> antidepressants, or don't improve, then you might be better off with a
> different category. (You can read about all of the categories and
> medications at my Web site.)
SSRI and SNRI antidepressants don't make my nightmares worse or
better. The only antidepressant which made them (much, much) worse was
Mirtazapine (Remeron), which as you know is a NaSSA. On Mirtazapine I
got nightmares after just 20 minutes after going to bed and they kept on
coming the whole night, several one per hour. I kept on using
Mirtazapine for two weeks to see if it became any better, but it didn't
and I stopped and went back to Efexor XR (Venlafaxine).
About a different category of antidepressants: I'm thinking of asking
for the NRDI Bupropion. That might also help with the undesired side
effects of the SSRIs (Paroxetine and Fluvoxamine ) and SNRI
(Venlafaxine) I've tried. For the moment *adding* another medication is
a no-no, because my doctor is my family doctor (GP) and he does not want
(is not qualified?) to prescribe combinations of antidepressants.
> Third, withdrawal effects from Paroxetine are particularly nasty, and I
> could believe they are associated with your worsening nightmares when you
> scale down Paroxetine. If so, the problem should go away within a few weeks.
After a week of scaling down Paroxetine, I switched (early) to
Venlafaxine 'XR', 37.5 mg a day. First night was quite good, hardly any
(noticed) nightmare. Rest of first week was again back to usual. First
night on my next (planned) higher dose of 75 mg a day was again good.
Second/last night was slightly less good, but still good. (BTW, because
of insurance aspects, I'm now on generic Venlafaxine 'XR', not on the
Efexor brand.)
So at the moment I'm hoping that Venlafaxine 'XR' might give me *some*
good/better time and it looks like I might have to go higher than 75 mg
(I have been on 75 mg Efexor XR before for 3 months).
> Fourth and last, here is an interesting article about a medication that
> helps nightmares in some situations:
> http://ptsdcombat.blogspot.com/2007/04/study-drug-may-ease-combat-ptsd.html
Thanks. That looks interesting. As I mentioned, my nightmares are not
stress-related, i.e. also not PTSD-related, but what helps for PTSD
might help for me as well. If and when the time comes, I will discuss
this with my doctor.
Thanks again for your response. And thanks for your excellent
(on-line) book. It helped me a lot to (try to) figure this stuff out.
[Quote of my OP deleted.]
Nom dePlume
>> Fourth and last, here is an interesting article about a medication that
>> helps nightmares in some situations:
>> http://ptsdcombat.blogspot.com/2007/04/study-drug-may-ease-combat-ptsd.html
>
> Thanks. That looks interesting. As I mentioned, my nightmares are not
> stress-related, i.e. also not PTSD-related, but what helps for PTSD
> might help for me as well. If and when the time comes, I will discuss
> this with my doctor.
>
> Thanks again for your response. And thanks for your excellent
> (on-line) book. It helped me a lot to (try to) figure this stuff out.
You are welcome, and thank you for the kind words. I hope one of the
approaches you are investigating works out for you. It sounds like you are
doing the right kind of things, asking questions and doing research. If you
make progress, I hope you'll let us know. I'd like to hear what works for
you.