Nighttime Is Not the Right Time

I hate the night.

I guess I shouldn’t say “hate.” Hate is a very strong word. But I definitely don’t like nighttime. My vision is impaired. Bugs come crawling out of their daytime hidey holes. And for me, it’s too quiet.

That gives my mind plenty of room to play. And by play, I mean play clips of songs in my head over and over. This happens during the day, but I don’t mind it as much because I can focus on other things. For some reason, darkness removes all concentration I have and leaves my mind vulnerable.

Right now, my mind is playing back every song I’ve heard or thought of today. “Wake Up, Little Susie,” the theme to “Star Trek: Deep Space Nine,” “Have a Holly, Jolly Christmas” (Burl Ives and Michael Buble versions), “Silver Bells,” and “White Christmas.” I’m sure there are others in the mix, but these are the most prominent.

When I am preoccupied with a cacophony of songs that I can’t get rid of, I can’t sleep. I think the Trazodone, which is supposed to help OCD and sleeplessness, is not working anymore. It didn’t take long, and I’m thinking that it is because I have so many medications in my body already that my tolerance level is too high for Trazodone to work anymore.

But that doesn’t mean my days are miserable. I went and had my car tuned up and didn’t have a panic attack while I waited. And I finished Lee’s Jayne Hat, complete with pom pom. I had never made a pom pom before. It was fun.

But now it’s night. It’s silent outside, but an eclectic concert inside my head.

And the List Keeps Growing…

The picture in this post shows just a few of the medications I take. I don’t necessarily take everything on my list every day, but the number of pills I do take seems like a lot. If you are what you eat, then I’m a walking pharmacy.

Pills Pills Pills

Here’s my list:

• Effexor XR (generic brand is Venlafaxine HCL ER): 150 mg every day. This is the antidepressant that I started on 10+ years ago. When I’ve been feeling lower than normal, my psychiatrist and I have decided twice to raise the level to 225 mg. It may help for a few days, but acid reflux attacks with a vengeance and I have to go back to 150. While it initially helped me break through some boundaries, missing one dosage or forgetting to take it with food will make me extremely sick. Many people have had horrible experiences with trying to taper off, even while ramping up with some similar drug, including me. I crash every time. I’m going to make another attempt in the future to switch, but it’s going to be a while before that happens again.

• Clonazepam (also known as Kolonapin): 1.0-1.5 mg every night. This is an anti-anxiety drug that I started taking a few years ago. When I started on this medication, it was only as needed for panic attacks. I now take it at night to help me fall asleep, but I have developed such a high tolerance that it doesn’t work very well.

• Zolpidem Tartrate (also known as Ambien): 10-20 mg every night. I started taking this sleeping aid when one of the other medications I tried for depression gave me insomnia. It is a very addictive drug that I have been taking for a few years. There have been stories of people doing crazy things on Ambien. The main side effect for me was late-night binge eating. One night I went into the kitchen, got a Pepsi and a bag of tortilla chips, and brought them into bed with me. According to Lee, I was shoving my hand down into the bag and then cramming the chips into my mouth. He asked me whether I should be eating all of the chips and I proceeded to glare at him. I don’t remember this. I have, however, gained a considerable amount of weight. Thanks, Ambien!

• Omeprazole: 40 mg twice a day for acid reflux. This I can thank for Effexor and for a different drug that I tried to pair with Effexor to help my mood. Sometimes it helps and sometimes it doesn’t. When it doesn’t, I get terrible chest pains due to excessive gas.

• Dicyclomine (also known as Bentyl): 20 mg tablets as needed. I’m supposed to take this for my chest pains, but it doesn’t help much. If the chest pain rears its ugly head, I usually take a combination of Dicyclomine, Pepto Bismol, GasX, and Ibuprofin. I usually feel like my chest is in a vise for several hours, even with all this “help.”

• Loestrin 24: once a night for birth control. I take this more because I need it than want it. When I’m not on birth control, I have severe abdominal pain for more than a week. I tried Yaz, but ended up not having a period for five months which freaked me out. Not because I thought I could be pregnant, but because I didn’t think it was normal. My gynecologist wasn’t worried about it, but I switched because I was scared. There have been no problems since.

• Zyrtec: Once a night for allergies. I don’t take this every night, but on the nights I do, I feel extremely hungover the next day.

• Nasonex: I have to use this nasal spray once every morning for allergies. I’m fighting allergies all year round, according to my allergy skin test.

• Xanax: 0.5-1.0 mg as needed for panic. I initially took this for going on trips. I haven’t left Texas since 2005.

Let’s face it. My purse sounds like a maraca. The funny thing is that I don’t take a multivitamin. But I digress…

Here’s a list of medications I have tried to either replace or pair with Effexor and failed: Zoloft, Celexa, Lexapro, Lamictil, Wellbutrin, Cymbalta, Pristiq. There may have been others that I can’t remember. But you get the gist.

I told my psychiatrist that every time I have tried to move on from Effexor to another medication, Effexor physically and emotionally hurts me. It doesn’t want to let go.

It makes me shaky, nervous, nauseated. It drains me emotionally to where I feel like I’m drowning in a sea of hopelessness.

And I end up coming back. Over and over.

“But maybe,” I said, “I haven’t given these other medications long enough to take hold. Maybe I have realize that I will have to go through hell before I can get back to some normalcy.”

Some breakups are like that. It takes a long time for the heart to heal, and even then there’s the occasional sting.

But I want to breakup with Effexor. Initially I thought it was a wonder drug. And it was. It helped me make the biggest move of my life. I actually changed zip and area codes. I was impressed.

There is no love between us anymore, however. I think it sustains me like oil sustains an engine. It keeps me going just enough to keep going.

My psychiatrist believes that such a drastic change would not be good for me right now. I agree. So before I leave Effexor behind, hopefully for good, I’ve been given a plan of attack to aid my sleep and boost my mood.

By adding more medication.

This is also to help taper off of Ambien at some point, so I’m not complaining.

1. Night 1: Take 50 mg of Trazadone 30-45 minutes before bed, along with the Clonezapam and Zolpidem.
2. Night 2: If 50 mg of Trazadone doesn’t work (it didn’t), try 2 Trazadone. I did this and believe I got some sleep. I definitely didn’t feel as shaky as I did yesterday and I wasn’t stuck on one song lyric all night.
3. 3 to 4 days later: After I know how Trazadone affects me, add 2 mg Abilify at night (1/2 tab for first three nights, then one tab each night). This is to boost my mood. Ever seen the commercial with the gray cloud that follows the depressed woman and then she takes Abilify and she’s all better? That’s me. Hopefully.
4. Reduce Clonezapam by 50 percent. I hope this will be easy to taper off of. We’ll see.

I have a follow-up appointment in three weeks. I hope I have a little skip in my step by then. But whatever the steps are now, they all lead to my ultimate goal.

To not sound like part of a marachi band every time I dig in my purse. Ay yi yi.