To the GP on an hour of sleep

June 13, 2007 at 2:28 pm 6 comments

So, I went to my GP today as my current sick note is running out and we’d agreed that I’d come back around now to give the GP a progress report. Short story:

I talk about feeling much better, much more energised and cleaning the flat top to bottom, going out and buying things, as triggered by sleep deprivation. I tell the GP I got one hour of sleep last night. GP is aware rapid cycling has been induced by an SSRI for me in the recent past. GP is also aware this ended up with me in hospital with my wrist slashed. GP, indeed, prescribed the citalopram and was supposedly monitoring it while I went crazy. I express my doubts about the long term success of the sleep regime.

GP suggests I go back to work.

Now, I’d quite like to get back to some kind of normal life, but would it be possible for me to establish whether this sleep thing is going to cure me or send me crazy first? My next appointment with the sleep specialist is 6 weeks. GP says “too long,” and signs me off for four (I’ve been on 8 week notes for the last four months). After that she thinks monitoring me on a 1-2 week basis will be appropriate.

The sum total of treatment I’ve had so far is a horrible week on sertraline, the disastrous month on citalopram under the auspices of the GP, and the sleep thing which has been going a week and has had a major effect on my moods. GP seems to think it’s “all coming together” for me now.


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Quick Sleep Update crying / wandering in the rain / going nowhere

6 Comments Add your own

  • 1. patientanonymous  |  June 14, 2007 at 2:12 am

    Okay, sure…going back to work sounds like a fine idea if you can’t sleep! Oh come on!

    I’ve been out of hospital for what…around six weeks now and I’m still not back at work! The “proposed” date is the beginning of July–and even that is negotiable. If I’m still not deemed up to snuff or even if I don’t feel up to it myself, I can stay off for longer!

    Second: if the Citalopram caused you so much grief why the hell the Sertraline? Sertraline/Zoloft has pretty much the WORST record for causing cycling in people that are Bipolar (not to freak you out…anecdotal evidence only…) Oh well, give it a shot, I suppose. I ran the gamut with ADs until I could finally get to ACs.

    It takes so long to find the “magic bullet” or “magic cocktail” anyway…even if you can. I’m still mucking about (again) even though I was stable for several years. Yay Bipolar for being able to morph and change…

  • 2. experimental chimp  |  June 14, 2007 at 10:18 am

    PA: The sertraline was back in January – It was the first medication I was on. It did horrible things to my body and brain. Then the GP tried citalopram, which caused the rapid cycling. I’m not currently on any medication.

    But nobody is willing to consider the possibility that I’m bipolar. There’s absolutely no attempt to trial different medications.

  • 3. patientanonymous  |  June 15, 2007 at 12:34 am

    Okay, that is totally fucked. I’m sorry–totally irresponsible from a a medical perspective in *my* perspective. I’ve had the opinion that the psychiatric community is way behind the times in the UK for a long time. Maybe I’m wrong. I used to co-moderate a message board that were all things disordered in the head and we had people from all over the world (it was the internet after all) and some of the things I heard from people from the UK! Shit!

    I also heard things from people that emigrated and could not get proper meds without jumping through major hoops (the things that they used to be on from they’re own country.) I’ve also heard that UK doctors are also not very benzo friendly. Here, it’s kind of hit or miss. It might depend upon the doc. I had a GP who supplied me with benzos to no end!

    I’ve never had a benzo problem. No abuse and no “high”…they just quell the anxiety and help with sleep. Whatever, eh? I know some people have problems but let’s not get super “paranoid” about them! They are a drug that can provide good relief.

    I mean, here’s a “crazy” example. I’m on a hypnotic as opposed to a benzo that is equally NOT supposed to be used for long term but I’ve been on it for about seven months because my insomnia is fucked. It seems like docs over here more easily prescribe at least some sleep meds.

    My ex-partner has terrible sleep problems. Not quite as bad as me and maybe I have an easier time getting the meds because I’m a psych patient but still…I’ve never had a problem getting something to sleep when I’ve needed it. Shit, I should mail you some of my Imovane or my Seroquel (just joking for the drug police out there!)

    Keep persisting if you can…you do need some pharmacotherapy. I’ve said that for a long time.

  • 4. experimental chimp  |  June 15, 2007 at 3:28 am

    I’ve been prescribed benzos twice, but I do have a tendency to abuse them. Only a little bit though. Then again, it might just be an attempt to compensate for the tiny doses. UK doctors used to prescribe lots of benzos, but getting them to prescribe them for more than a couple of weeks is pretty much impossible these days.

    To be honest, I think doctors tend to be dismissive of sleep problems due to the ridiculous hours they had to work when training.

    I’ll keep persisting. Next up is the CPN on Monday.

  • 5. patientanonymous  |  June 16, 2007 at 1:07 am

    That’s kind of a funny comment re: doctors during their training and being sleep deprived. Let’s hope that isn’t the case! What a ridiculous bias that would be…oh dear!

    I know that most docs here usually only prescribe benzos/hypnotics for short term use as well. I am so surprised that I’ve been on them for as long as I have! I guess special circumstances warrant it? I mean, if I can’t sleep then it’s not good and it’s a definite risk for Bipolar slippage. There’s no denying that. So perhaps the benefit outweighs the risk? It’s like, just keep PA doped up a night and not worry about any long term effect of dependency?

    Some of the other options are (as feartheseeds posted) Seroquel/Quetiapine for sleeven though I’m on that and a hypnotic–lordy, eh? and I still wake up early. It’s a better Atypical for that (supposedly although Zyprexa/Olanzapine knocked me out for hours and hours…the former does not.) Everyone’s different, however. Seroquel comes with less side effects too (generally.)

    They also used to do the Serzone/Nefazodone thing here a lot as that one (for me anyway) really sedated me but I took it during the day. They recalled it here, however, due to potential hepatic ugliness. I think (insert brand name)/Trazodone can also be used but surprisingly that is one SSRI that I haven’t taken!

    But you probably know all of this already haha. Consider this post for any readers who may not?

    Anyway, I think it’s still ridiculous that you’re not sleeping. I mean, my insomnia and sleep problems are NOTHING compared to yours and I’m completely medicated. Sheesh.

  • 6. experimental chimp  |  June 16, 2007 at 4:03 pm

    PA: It does feel like there’s some kind of anti-medication conspiracy going on. The psychiatrist refused to prescribe anything and referred me to a sleep specialist who doesn’t medicate. I think my best option is to get through the six weeks until I see her again and let her know a) it’s not working and b) Give me drugs now!

    Of course, this sleeplessness would be considered kind of risky if I was diagnosed with bipolar, but I’m not and have been diagnosed with borderline traits, so naturally, I’m just being manipulative and histrionic if I mention things like this.

    (OK, brief moment of bitterness over.)

    I’m know quite a bit about the SSRIs and atypicals, but not so much about tricyclics and related things, so the information about serzone and trazodone are interesting.

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Hi, I'm James. I'm a 26 year old guy from England with bipolar disorder (currently well controlled). I also have a circadian rhythm sleep disorder (not so well controlled). This blog has charted my journey from mental illness, through diagnosis and, recently, into recovery. It's not always easy, but then, what is?


Self-righteous note about smoking

As of 12th September 2008 it has been forty five weeks since I quit smoking. So in another seven weeks it'll have been a whole year.

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