Thursday, August 4, 2011

Day 27: Lamictal, Vyvanse, or Zoloft: Which Is Causing My Insomnia?

I've been writing a lot lately about the insomnia/delayed sleep phase that's been brought on by the lamictal.  Actually, I naturally have a delayed sleep phase; if my body does what it wants, I would sleep from roughly 3:30 to roughly 11:30.  We've reached a compromise with the rest of the world in which I sleep from roughly 2 to roughly 10.  For some reason, the lamictal seems to be reasserting my inherent biological clock.

But is lamictal the real culprit?  After all, I'm on two other drugs for my brain.  One of them, Vyvanse, is a dextroamphetamine to treat my ADHD.  Amphetamines are sold on the street as "speed".  I'm also on Zoloft, an SSRI, which has a paradoxical effect on me -- it is simultaneously agitating and sedating.  I'm only on 12.5 mgs at the moment, but back when I used to take it at 100 mgs, I could never fall asleep before 2 am, and my usual bedtime was more like 3 ... and waking up, even at noon, was excruciatingly difficult.

In an effort to isolate variables, my pdoc is having me try two days at 50 mgs of Vyvanse instead of 70.  In the past, 50 has been my "summer" dose; my attention and motivation are much better during the longer days of Spring and Summer than they are during the winter, when I go up to 60 or 70 mgs.  I believe that the lamictal could be improving my energy and overall cognitive functioning, both of which suffer during any mood disorder, rendering at least some of the Vyvanse superfluous.

Once we figure that out, I get to go off Zoloft -- a month early!  Yay!  While Vyvanse is the obvious culprit for insomnia, Zoloft has actually has more going for it, at least in my case (see what it did to my sleep phase in high doses above).  Also, like many people with ADHD, stimulants help me sleep.  That's right.  The meds that keep the "normally brained" awake for 36 hours straight help us sleep like babies.  A few people on the ADD Forums actually use Adderall as a sleeping pill.  ADHD, like mood disorders, is almost always accompanied by sleep troubles.

This is my second day on the 50 mgs of Vyvanse.  Last night I had an easier time falling asleep, and I slept in an extra hour, so I'm not as tired.  Both yesterday and today I notice that my brain seems like its calmer.  On the other hand, I had no trouble falling asleep on Tuesday night because I'd had a long run/walk earlier in the day.  Wheels within wheels.

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