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    Old 05-27-2008, 04:07 PM   #1
    TexMom85
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    Does taking/stopping your pain meds cause insomnia?

    Hi All,

    While I know insomnia is discussed on another board (Sleep Disorders), I was wondering how many of you have experienced it due to either taking a pain medication or when you stopped taking something.

    I have suffered from chronic insomnia for 17 years now, and have probably tried more things than I could possibly remember. However, it's been relatively controlled the last two years or so, as long as I take my meds (Ambien CR, Promethazine 25 mg (generic Phenergan) and occasionally Xanax .5mg, along with Mirapex for RLS. I also have a CPAP machine for apnea.

    So, on to my question....To control pain from fibromyalgia, bulging disks, a pinched nerve and an extreme case of tendonitis, I've been started and stopped on a few different things. The main thing I had been on since January was Lyrica, which I stopped taking nearly 2 weeks ago, replaced by Neurontin. I have also tried and stopped Ultram ER, Relafen and Daypro (the latter I took for about 10 days, then stopped due to tummy problems).

    For the first time in quite a while, I have experienced 4 nights in a row of severe insomnia, i.e. go to bed and 5-6 hours later, not asleep, despite being comfortable and sleepy. I have had to take an extra Xanax (.5 mg) and Promethazine (12.5 mg), and even that didn't whisk me off to dreamland.

    The last time I experienced a stretch this severe, it was a reaction to an OTC herbal supplement. Once I stopped taking it, my sleep improved immediately. Could this be a delayed reaction to going off the Lyrica suddenly? (I stopped it cold turkey and started the Neurontin immediately). I also experienced delayed sleep onset when taking the Ultram and the Relafen (not at the same time!).

    I have an appointment next week with the Orthopedic Surgeon to review my current medications. I am experiencing some BT pain since switching to the Neurontin, and my tendonitis is also not responding well to anything I've tried. I am so tired I can hardly function and depression is not far off if I don't start sleeping soon. Last night, I experienced an anxiety attack after dinner, and those are usually due to something chemical, at least for me.

    Has anyone else experienced severe insomnia from either taking a medication or stopping it? Any suggestions? I am ready to start taking leftover Klonopin in an effort to sleep....desperate!

    Thanks all,
    Tex

     
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    Old 05-27-2008, 05:20 PM   #2
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    Re: Does taking/stopping your pain meds cause insomnia?

    A Unisom tablet, taken an hour before bedtime, will help you get over short term insomnia

     
    Old 05-27-2008, 05:55 PM   #3
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    Re: Does taking/stopping your pain meds cause insomnia?

    I actually find 2 Benadryl tablets about an hour before bed helpful as well.
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    Old 05-27-2008, 05:59 PM   #4
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    Re: Does taking/stopping your pain meds cause insomnia?

    same same.... benadryl and Unisom are both sedating antihistamines, just one is labled as an allergy med, and one as a sleep aid.

    benadryl is shorter acting, so it wont leave you hung over, but it might not keep you asleep all night, depends on the individual as to which one is best..... maybe try both, and see which one suits your needs.

     
    Old 05-27-2008, 09:32 PM   #5
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    Re: Does taking/stopping your pain meds cause insomnia?

    I wish the OTC stuff would work for me, but unfortunately, none of it does. In fact, Benadryl has the opposite impact on me--I get wired. Alcohol does the same thing, and some vitamins/supplements do as well. No valerian root or St. John's Wort for me. My sleep problems have baffled many a "sleep" doctor, and no one has ever figured out a cause for my ultra-sensitive sleep problems. Most of the time, I am not nervous, worried, etc.; just can't drift off.

    Has anyone experienced sleeplessness as a direct result of their pain meds? Or, conversely, when they stopped a med? I am trying to figure out what has triggered my recent bouts of insomnia so I can act accordingly. For example, when going off Lyrica, have any of you suffered rebound insomnia? Has taking Neurontin made anyone sleepless?

    I slept so well on the Lyrica....I wish I didn't have the other side effects so I could stay on it and keep sleeping, but it was just too dangerous to keep taking.

    Tex

    PS I would list everything I've tried for insomnia, but since this is the PM board, I don't want the thread deleted. I am trying to find connections between pain meds and insomnia, so that's why I posted here. I do appreciate your suggestions, though! It's very thoughtful of you all.

    Last edited by TexMom85; 05-27-2008 at 09:33 PM. Reason: sp

     
    Old 05-27-2008, 11:43 PM   #6
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    Re: Does taking/stopping your pain meds cause insomnia?

    I have Tex. When I'm low on meds and when I switched from Vicodin to Percocet. Since I've started percocet, my insomnia has worsened - it started 2 years ago. I've been in bed for 4 hours now and I can't sleep - contemplating an Ambien (5 mg) as I have to be up in 4 hours.

    I hope you're sleeping by the time you read this.

     
    Old 05-28-2008, 07:55 AM   #7
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    Re: Does taking/stopping your pain meds cause insomnia?

    Tex, I am so sorry this insomnia has reared it's ugly head again. I had been having some problems, myself a few weeks back and my psych doc actually prescribed klonopin for me. It has definitely helped. I had to cut down the origional dose, because he Rx'd 2mg. It was just too much, so I take 1/2 a pill when I get that feeling that I won't be able to sleep. I also have Xanax, that he prescribed for anxiety/panic attacks a while ago, but as he explained to me, the Xanax has a much shorter half life and wasn't good at letting me stay asleep.

    My husband has recently been weaning down off some meds (not pain meds) and has had some rebound insomnia. I think when you are changing meds, whether pain meds or psych meds etc., this tends to happen. I don't know if it's the neurontin or just rebound from the lyrica. I do know when I took neurontin, several years ago, it made me feel so ambivilant all the time. It was like I had no emotions. I was just kind of a zombie. Not woozy or dizzy or anything. I just didn't really care about anything, one way or another. That is why I stopped taking it. Plus, it really didn't help with my pain.

    I hope and pray that you can find a balance again. I pray for you and all of my friends here, every day. God Bless and I'm sending you some hugs, CMP/MM (((((Tex)))))

     
    Old 05-28-2008, 09:44 AM   #8
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    Re: Does taking/stopping your pain meds cause insomnia?

    I take trazadone when I can't sleep and my hubby is prescribed amytriptiline. He quit taking it and now is afraid to start again because it takes two weeks before you can get up in the morning without being totally exhausted.

    One of the side effects of stopping pain meds is insomnia. I think Shore told me it can take up to 6 months before your sleep returns to normal. I know that when my pm was using me as a guinea pig and trying a bunch of different meds I had trouble sleeping. Except with the Lyrica which gave me horrible, vivid nightmares. Then I was afraid to go to sleep!LOL

    Good luck finding something that helps you. I know a few days of no sleep makes me a miserable, cranky, &*$%#y, bear!!~Mush
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    Old 05-28-2008, 10:47 AM   #9
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    Re: Does taking/stopping your pain meds cause insomnia?

    Cmp and Tara,

    So sorry to hear you're suffering like me. I agree with Mush, when I don't sleep well, I get cranky and just don't have the fortitude to handle the rest of my ailments.

    Last night I took a Klonopin (I had lots left over, went off of it last year), and that did the trick. Slept like a baby. One of my doctors once told me that if you get into a cycle of not sleeping, sometimes all you need to do is be able to break that cycle once, and your body is better able to sleep again. I am hoping that proves to be true and I don't have to take the Klonopin again tonight. At least I found something that worked, even if it was just for a night.

    The other night, I took double my usual Xanax dose (and I don't even take it all the time), double my Phenergan and then ended up taking a Vicodin a couple of hours after that. I did finally fall asleep, but I was so dopey the next day, I was completely useless (even more so than usual). I also get nervous when I take so much, since I am on CPAP for my sleep apnea and wouldn't want to increase my chances of extended non-breathing episodes due to the heavy sedation.

    Thanks for the prayers....I appreciate it and do it for all of you, too!

    Blessings,
    Tex
    PS Do you think that the sudden stoppage of Lyrica could be the problem? I did immediately start on Neurontin afterward and my sleep didn't start to react until about a week later....

    Last edited by TexMom85; 05-28-2008 at 10:48 AM. Reason: ps

     
    Old 05-29-2008, 08:28 AM   #10
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    Re: Does taking/stopping your pain meds cause insomnia?

    Tex,

    Any change of these meds, whether narcotic pain meds, or meds like Lyrica can certainly cause insomnia when you stop taking it. Up until recently when I had to start back on pain meds due to a major surgery, I had tapered off of oxycontin AND cymbalta at the same time! Let me tell you, that is NOT easy. One of the worst things I experienced was insomnia and exhaustion the next day.

    My GP said that even a small dose decrease can do this to you, and it can take your body weeks or months to "make it's own chemicals" that regulate your mood, sleep, appetite, ect.

    Just remember that changing and/or stopping any of these meds is going to effect your sleep. Stop slowly by tapering whenever possible, and I would suggest a sleep aid such as Ambien or Lunesta over klonopin and/or xanax. I was also prescribed Klonopin, but was so drowsy the next day, and xanax made me feel hungover.

    My GP explained that Klonopin has a very long half-life, so it stays with you for 18 hours! Xanax works immdiately, but that can cause rebound sleepiness, anxiety, headaches, and that awful hangover feeling.

    My GP agreed to let me try Ambien CR. It has helped more than anything, and I do not have any side effects or leftover effects the next day. And no, I do not get up and eat and/or drive! I would highly recommend it. I hope some of this helps. At least now you know that you were right on target making the connection between stopping these meds, and your problem with insomnia.

    Good luck and keep us posted!

    Your Friend,

    Amanda

     
    Old 05-29-2008, 09:31 AM   #11
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    Re: Does taking/stopping your pain meds cause insomnia?

    Amanda,

    That must have been a rough time for you, tapering off two meds at the same time. I admire your perseverance!

    My usual bedtime "cocktail" consists of Ambien CR, Promethazine (aka Phenergan), Flexeril, Mirapex (for RLS) and Neurontin (a recent substitution for Lyrica). I take Xanax in addition only if I am really worked up and cannot relax, which has been a little more frequent in recent weeks, but still not every night. I suspect I've been taking the Flexeril so long that it no longer does much for me. Ambien alone doesn't work for me, and unfortunately, neither does Lunesta, or Rozerem.

    My OS had me stop Lyrica, cold turkey, and replaced it immediately with Neurontin. I asked him specifically about tapering off the Lyrica and he said it wasn't necessary since I was going to the Neurontin right away, and they work similarly on the nervous system/

    I did not experience insomnia immediately; it took about a week after making that change. At that same time, I also started on Daypro, to help with pain from the tendonitis in my arm. Perhaps it is the culprit. I have stopped taking the Daypro to see what, if anything, changes. I go back to the doc next week, but it is doubtful he will be very helpful because when I complained about insomnia from Ultram and Relafen, he was so surprised because "no one has ever experienced that before" when he's prescribed them. I may be living in pain for quite a while, and sleepless on top of it.

    I had taken Klonopin for about a year and went off of it last summer because I found myself experiencing rage that was totally out of character for me. It went away when I went off the Klonopin. I was also taking Topamax, and besides being totally loopy and forgetful, I started getting depressed, so we had to stop that one as well. My nerve pain kicked into high gear after that. I guess those two meds were keeping the pain at bay. After three cervical injections, two rounds of oral steroids and about 3-1/2 months on Lyrica, the nerve pain was pretty much manageable, but the side effects were just too severe (extreme swelling, horrible muscle pain, weight gain). On the Neurontin, I am experiencing breakthru pain by the end of the day but my swelling is less and my muscle pain is improved somewhat. I really need to find a PM doctor.

    I don't want to rely on the Klonopin to sleep....I want to figure out what, in my recent routine, is the factor that caused the insomnia switch to get turned back on. I'm sure most of you PMer's know what it's like to go without sleep, but when it stretches into many consecutive nights without sleep, you simply cannot cope with any of life's stresses, especially chronic pain.

    Thanks for the info; I appreciate it. I really need to find out more about each medication's half-life and other properties, but my attention span is not usually long enough for me to accomplish much. I get more information from the board members than from my own research. It's a very valuable resource!!

    Thanks again!

    Blessings,
    Tex

     
    Old 05-29-2008, 09:45 AM   #12
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    Re: Does taking/stopping your pain meds cause insomnia?

    Tex,

    Amanda is right, as usual.

    Going off of meds, especially narcotics, and to a lesser degree meds like Lyrica can have profound effect on sleep patterns.

    When I was detoxed off of fentanyl I spent a whole month studying the ceiling in depth. Got to know all the bumps by heart - even named 'em. Not a good thing.

    steve

     
    Old 05-29-2008, 09:46 AM   #13
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    Re: Does taking/stopping your pain meds cause insomnia?

    Tara,

    Percocet activates an "excitatory pathway," which tends to jack people up. Hydrocodone does this also.

    Is there any way that you can take your Percs earlier? The earlier the better.

    steve

     
    Old 05-29-2008, 09:56 AM   #14
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    Re: Does taking/stopping your pain meds cause insomnia?

    Steve....and PMer's,

    Do you think the abrupt change from Lyrica to Neurontin could be the problem? It didn't happen the first few nights after the change, it was more like a week later. The meds I have recently used and discontinued were taken for only a few days--Relafen (two days), Ultram (two days), and DayPro (two weeks). These are NSAIDs and I was surprised that the first two irritated my insomnia. The last one didn't seem to, and I was befuddled as to what caused such a horrible string of sleepless nights.

    Yes, I have stress in my life. Who doesn't? When have I not? It's not as though I am laying there, obsessing about life. I am relaxed, sleepy, comfortable, etc., but my body just doesn't make the transition to sleep. Like you, I know my ceiling well, as well as the schedule of TV shows after 2:00 am. (most are infomercials and I want to buy lots of these things, they look nifty....but I digress)

    I have taken a Vicodin here and there over the last month, but never two nights in a row, so I don't think that's it. I'm not on any hormones and since I had a hysterectomy several years ago, I can confirm that it's not PMS or anything like that. (LOL I can't blame being in a witchy mood on my hormones)

    Waghhh! Isn't it enough to suffer with pain, weight gain, sleep apnea and the rest, and then not sleep too? Pity party at my house today....

    Tex

     
    Old 05-29-2008, 10:40 AM   #15
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    Re: Does taking/stopping your pain meds cause insomnia?

    Quote:
    Originally Posted by TexMom85 View Post
    ...The meds I have recently used and discontinued were taken for only a few days--Relafen (two days), Ultram (two days), and DayPro (two weeks). These are NSAIDs and I was surprised that the first two irritated my insomnia...
    Tex,

    Ultram is not an NSAID, in fact it's much more like an anti-D, and remotely similar to Lyrica. Did you know that Lyrica is pregabalin, which is the precursor for gabapentin (Neurontin)? So Lyrica is supposed to be like Neurontin on steroids. Stopping Ultram after extended use should cause insomnia, but not after a few days of use. Stopping Lyrica should definitely cause insomnia, dependent on other meds being taken.

    Quote:
    Originally Posted by TexMom85 View Post
    ...Pity party at my house today....
    Can I come?

    I'll bring snapshots of my ceiling and we can compare the two and see which one is best for staring at...

    steve

     
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