# The need for sleep



## TDX (Jul 12, 2014)

I really miss the Clozapine. Yesterday I was unable to sleep. I was awake until 6 AM. I had this problem at home until I got Quetapine, which I later replaced with Mirtazapine and then Clozapine. Clozapine was the most effective.

I really need something to sedate me.


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## Ianar (Oct 31, 2015)

Can you not take mirtazipine again at a small dose? The only drug I take is 7.5mg mirtazipine, normally every other night, purely for sleep. Still I do not sleep well every night, but would rather have some lengthy sleep at least a few times a week, than build a tolerance and not sleep at all in the long term. As I'm sure you already know, mirtazipine is more effective for inducing sleep at smaller doses, so you should probably be able to take a smaller amount with lamotrigine- though obviously you'd need to speak to your psych of this. I actually find 7.5mg more effective for sleep than 30mg, which also gives me severe restless legs.

I understand though as sleep is incredibly important for escapism and remaining "sane". I was even more suicidal in the initial months where was only sleeping 1-4 hours a night, until I tried mirtazipine.


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## TDX (Jul 12, 2014)

> Still I do not sleep well every night, but would rather have some lengthy sleep at least a few times a week, than build a tolerance and not sleep at all in the long term.


This is the advantage of Clozapine over Mirtazapine and Quetiapine: I took it for some months and it did *not* build a tolerance. Unfortunately Clozapine is much more risky, so I decided to not take it for at least some time.



> Can you not take mirtazipine again at a small dose?


I will have to wait for my next appointment to get it prescribed.



> As I'm sure you already know, mirtazipine is more effective for inducing sleep at smaller doses, so you should probably be able to take a smaller amount with lamotrigine- though obviously you'd need to speak to your psych of this. I actually find 7.5mg more effective for sleep than 30mg,


I already know this. It might be because at higher doses Mirtazapine might have a noradragenic effect.

Before replacing it with Clozapine I took 15 mg/day. Don't know if 7.5 mg/day is more effective. Before I took 60 mg/day. I could still sleep with this, but it also had an activating effect which didn't get on my nerves like on Duloxetine.



> I understand though as sleep is incredibly important for escapism and remaining "sane".


With Clozapine I could sleep 10 hours per day instead of the usual 7 hours. I used it as a "time machine".


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## Ianar (Oct 31, 2015)

15 is more sedating than 7.5 but there doesn't seem much difference for sleep maintainence, so I stick to the lowest dose possible for tolerance issues an mentioned. 30 was worse and made me eat any sugar in the house. I believe I now have some kind of yeast infection now for this reason. Regardless of dose sleep architecture always remains that of a depressed person: little to no deep sleep and no matter the amount I wake totally unrefreshed or better mentally for it. Used to be ready to take on the world after 6 hours, now even after 10 I wake up like a dementia patient.

I understand the time machine thing. I would remain asleep until better or dead if possible. I hope you get your prescription soon; anhedonia + insomnia is a rare form of torture.


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## TDX (Jul 12, 2014)

> Regardless of dose sleep architecture always remains that of a depressed person: little to no deep sleep and no matter the amount I wake totally unrefreshed or better mentally for it. Used to be ready to take on the world after 6 hours, now even after 10 I wake up like a dementia patient.


At least I can sleep normally. But without something to sedate me I cannot sleep regulary. My sleep time shifts and then goes to something like 6 AM to 12 AM or even later.



> 30 was worse and made me eat any sugar in the house.


It increased my weight by 25 kg. But this wasn't an issue for me because I was very thin before.


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## Ianar (Oct 31, 2015)

TDX said:


> At least I can sleep normally. But without something to sedate me I cannot sleep regulary. My sleep time shifts and then goes to something like 6 AM to 12 AM or even later.


Yes this is the problem I have. The other difficulty in maintaining a normal sleep schedule is the lure of unconsciousness is to great so I try and sleep as long as possible. Most likely not helpful but then again when you're anhedonic nothing is.


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## Disruption (Apr 24, 2016)

i had only 3-5 hours when i was at my worst of dp/dr and then i started taking valerian which just helped me to sleep deeper but not as long as i wanted and lavender which helped me to sleep longer instead of deep...it was amazing...i slept like usual from 7 - 9 hours again...


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## Greenapple (Jun 5, 2015)

Hello TDX, did the Clozapine help with your dp/dr in any way? I am about to start with Clozapine as a last resort drug. I am really scared it will not help with my dp/dr. Please respond to me, you will help me a lot. Thank you in advance!


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