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Default Jan 23, 2020 at 12:04 PM
  #1
So, I'm on it now. For now, anyway. Just wondering about it. Don't know anything, really. Any experiences or thoughts appreciated. Already had one person share their brief experience with it. It was supposed to knock me on my butt. It did not. Just a wee bit drowsy is all. No real sleep.

Anyway, any input of any kind greatly welcomed.

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Default Jan 23, 2020 at 12:30 PM
  #2
Hi bpcyclist. I have never taken Thorazine, but wanted to send a few sheep to count your way, in hopes that you do get some sleep tonight. I have taken other 1st generations, but not sedating ones. Out of curiosity, can you put your finger on some of the main reasons you can't sleep? Racing thoughts and/or extreme energy levels at night, etc? Have you tried combining this new tool with other sleep hygiene tactics? I'm talking, really bombard the insomnia from all angles. Sometimes that is what it takes for me, when I'm manic or very hypomanic and even higher doses of my Seroquel XR (or added regular Seroquel or Ativan) don't fully help.

Last edited by Anonymous46341; Jan 23, 2020 at 03:30 PM..
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Default Jan 23, 2020 at 02:55 PM
  #3
I take 400mg of Thorazine along with another AP and a moodstabilizer. It's been a wonderful/effective medication for me with hardly any side effects.

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Default Jan 23, 2020 at 07:17 PM
  #4
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Originally Posted by BirdDancer View Post
Hi bpcyclist. I have never taken Thorazine, but wanted to send a few sheep to count your way, in hopes that you do get some sleep tonight. I have taken other 1st generations, but not sedating ones. Out of curiosity, can you put your finger on some of the main reasons you can't sleep? Racing thoughts and/or extreme energy levels at night, etc? Have you tried combining this new tool with other sleep hygiene tactics? I'm talking, really bombard the insomnia from all angles. Sometimes that is what it takes for me, when I'm manic or very hypomanic and even higher doses of my Seroquel XR (or added regular Seroquel or Ativan) don't fully help.
Thank you, BirdDancer. Well, I really have no idea if everything I am doing is correct or not. Here is a totally non-ordered list of what I can remember:

1. Bedroom is basically silent about 90% of the time. I have very rarely been awakened by music, but really uncommon.

2. Bedroom is super-dark this time of year,

3. Temperature is easily controlled and seems comfortable. Not waking up on top of covers with shirt off or freezing to death beneath it all.

4. Invested in 2 new, good-quality down pillows and a quality 20-lb. weighted blanket. Sheets are fairly new and changed regularly.

5. No exercise or caffeine anywhere near bedtime.

6. Making sure I am not getting hungry before bed, because I have sometimes awakened hungry in the past.

7. Once in bed and comfortable, I do my prayers and then begin my Buddhist breathing technique. It helps with the racing or even if I'm a little psychotic, it can help a lot.

8. I try hard not to judge myself as to how well my sleep attempt is going. I just breathe.

9. The decision then becomes how long to give myself. I've tried making myself stay until I sleep no matter what--gave up after 4 hours finally. Nowadays, I tend to give it about an hour or so and if I am clearly still not remotely falling asleep, I just get up. Why beat a dead horse?

10. Am taking my lithium, Abilify, Depakote, and Thorazine 40ish minutes before alleged bedtime, as Dr. C suggested.

11. Once sleep attempt #1 fails, I stay up for a few hours, then, give it another shot, maybe 4 hours later. Rinse and repeat. This is what I have been doing recently.

12. Once I have a failed attempt, I make very sure not to judge myself and to watch any negative self-talk. I just accept it and move on.

13. If I do not try to sleep and just stay up until I basically pass out, that will take about 26 hours or so, and then, I may be able to sleep for as long as five or even six (once) hours. Importantly, other than last night with my first-ever dose of Thorazine, I am virtually never drowsy. I feel that kind of fried feeling I used to get when I was on call and up for 36 hours, but not drowsy.

I think that is about all I know. The only thing I have not tried that gets discussed a bit is melatonin. I did a lot of reading and concluded there is not enough evidence that it works and it is expensive here.

Thanks so very much for taking the time to read this overly long post!

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Default Jan 23, 2020 at 07:20 PM
  #5
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Originally Posted by Blue_Bird View Post
I take 400mg of Thorazine along with another AP and a moodstabilizer. It's been a wonderful/effective medication for me with hardly any side effects.
That is good to know, Blue_Bird--thank you very much!!

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Default Jan 23, 2020 at 07:52 PM
  #6
Hey bpcyclist I hope you don't mind me chiming in with some research that I came across online (take with a grain of salt) about thorazine:

Side Effects of Thorazine (Chlorpromazine), Warnings, Uses

Medical Editor: John P. Cunha, DO, FACOEP

Last reviewed on RxList 4/23/2019
Thorazine (chlorpromazine) is a phenothiazine anti-psychotic medication used to treat psychotic disorders such as schizophrenia or manic-depression, and severe behavioral problems in children. Thorazine is also used to treat nausea and vomiting, anxiety before surgery, chronic hiccups, acute intermittent porphyria, and symptoms of tetanus. The brand name Thorazine is discontinued in the U.S. Generic forms may be available. Common side effects of Thorazine (chlorpromazine) include:

Quote:
dizziness,
drowsiness,
anxiety,
sleep problems (insomnia),
breast swelling or discharge,
changes in menstrual periods,
weight gain,
swelling in hands or feet,
dry mouth,
stuffy nose,
blurred vision,
constipation,
impotence, or
trouble having an orgasm.
Dosing of chlorpromazine depends on severity of the condition, and the patient's response to the drug. Chlorpromazine may interact with atropine, lithium, phenytoin, antibiotics
and

Common and Rare Side Effects for Thorazine Oral

Quote:
If experienced, these tend to have a Severe expression

A Feeling Of Restlessness With Inability To Sit Still
Blurred Vision
Extrapyramidal Disease, A Type Of Movement Disorder
Fainting
Low Blood Pressure
Pigmentary Retinopathy
Tardive Dyskinesia, A Disorder Characterized By Involuntary Movements Of The Face, Mouth And Tongue

If experienced, these tend to have a Less Severe expression

Constipation
Decreased Sweating
Dizziness
Drowsiness
Dry Mouth
Excessive Saliva Production
Orthostatic Hypotension, A Form Of Low Blood Pressure
Stuffy Nose
Sorry that you have all these meds and they negatively effect your life and sleep. Have you considered having a sleep study done? Maybe you are a segmented sleeper and can't sleep naturally 7 to 8 hours.. Maybe your time in medical school (med students never sleep, as I recall) permanently messed up your circadian rhythm?

Segmented sleeping is actually how humans used to normally sleep. I sleep segmented until 3 to 4 a.m. every night, am wide awake until 5 am. then sleep soundly until 7-9 a.m. I had to get 2 sleep studies to confirm my segmented sleeping pattern. Been that way my entire life since I was a baby.
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Default Jan 24, 2020 at 04:36 PM
  #7
Interesting about the segmented sleep. I do that, too.

Thorazine. It was prescribed to me many years ago and I remember feeling somewhat upset because of what I'd heard about Thorazine...how it was known as a "chemical straight-jacket" way back in the history of IP treatment.

It turned out that nowadays Thorazine is prescribed in much smaller doses. It did help me sleep, and I recall being surprised because I had no unusual side effects from it. Most likely I stopped taking it because my insurance changed and the new pdoc prescribed a newer AP.

Your sleep environment sounds very good. Please don't be harsh on yourself because you can't sleep.

The only thought I have is probably an obvious one. Would your pdoc raise the dose, at least for a while so your body can get back into a sleep rhythm?

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Default Jan 24, 2020 at 05:56 PM
  #8
Quote:
Originally Posted by StreetcarBlanche View Post
Hey bpcyclist I hope you don't mind me chiming in with some research that I came across online (take with a grain of salt) about thorazine:

Side Effects of Thorazine (Chlorpromazine), Warnings, Uses

Medical Editor: John P. Cunha, DO, FACOEP

Last reviewed on RxList 4/23/2019
Thorazine (chlorpromazine) is a phenothiazine anti-psychotic medication used to treat psychotic disorders such as schizophrenia or manic-depression, and severe behavioral problems in children. Thorazine is also used to treat nausea and vomiting, anxiety before surgery, chronic hiccups, acute intermittent porphyria, and symptoms of tetanus. The brand name Thorazine is discontinued in the U.S. Generic forms may be available. Common side effects of Thorazine (chlorpromazine) include:


and

Common and Rare Side Effects for Thorazine Oral


Sorry that you have all these meds and they negatively effect your life and sleep. Have you considered having a sleep study done? Maybe you are a segmented sleeper and can't sleep naturally 7 to 8 hours.. Maybe your time in medical school (med students never sleep, as I recall) permanently messed up your circadian rhythm?

Segmented sleeping is actually how humans used to normally sleep. I sleep segmented until 3 to 4 a.m. every night, am wide awake until 5 am. then sleep soundly until 7-9 a.m. I had to get 2 sleep studies to confirm my segmented sleeping pattern. Been that way my entire life since I was a baby.
Yeah, it obviously has a lot of risks. If it's not going to work, we'll just stop it, I guess. Thank you very much for all the helpful information--I am really grateful.

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Default Jan 24, 2020 at 05:58 PM
  #9
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Originally Posted by BethRags View Post
Interesting about the segmented sleep. I do that, too.

Thorazine. It was prescribed to me many years ago and I remember feeling somewhat upset because of what I'd heard about Thorazine...how it was known as a "chemical straight-jacket" way back in the history of IP treatment.

It turned out that nowadays Thorazine is prescribed in much smaller doses. It did help me sleep, and I recall being surprised because I had no unusual side effects from it. Most likely I stopped taking it because my insurance changed and the new pdoc prescribed a newer AP.

Your sleep environment sounds very good. Please don't be harsh on yourself because you can't sleep.

The only thought I have is probably an obvious one. Would your pdoc raise the dose, at least for a while so your body can get back into a sleep rhythm?
Thanks, Beth. Interesting and encouraging that you had no SE really.

Yeah, the pdoc will do anything reasonable to make this go away. Will be texting him tomorrow morning for an update and we will go from there.

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Default Jan 24, 2020 at 06:00 PM
  #10
One more thing, Beth and Blanche, I really do think this segmented sleep situation is a part of me now. I think my brain is jus wired this way now. If that was all it was, I could totally deal. But I also cannot fall asleep, which is the much bigger problemo right now...

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Default Jan 24, 2020 at 06:31 PM
  #11
BPcyclist, don't give up hope. I thought I'd never sleep normally again when I landed on clozapine. I sleep more than normal now but much prefer that too too little, messed up sleep. Something will help you, it just is so hard to find what that is. I hope the thorazine is it for you and all you need is a higher dose. I remember being so desperate for sleep and then one morning in the hospital the nurse woke me apologizing because she'd let me sleep as late as she could before she was required to give me my meds. I had slept nearly 13 hours and it was amazing. I was in there cross-tapering high dose Seroquel and clozapine and since I hadn't been sleeping before I went into the hospital it just got worse until that marvelous day that the right level of medication was in my blood. That day can happen for anyone if it did for me. I hope tonight is better.

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Default Jan 24, 2020 at 06:34 PM
  #12
bpcyclist I did a Google search of your meds that you list on your profile. Provigil, Wellbutrin, Abilify, Depakote, Restoril all cause insomnia, anxiety, excitability, and agitation as a common side effect. I included links to the side effects for each one below.

So, 5 of your meds for your bipolar disorder could be the cause of your inability to fall asleep because of their insomnia-like side effects on your brain. Do you need all 5? Which ones could you live without taking, that you could taper off of? Is that even an option for you?

If not, then I don't even know if Melatonin or Chamomile tea or Valerian Root tea would help you stay asleep. All 3 will relax you and help you fall asleep but are not designed to keep you asleep. I have used all 3 for my own insomnia bouts, and the Melatonin relaxed me but I still woke up around 4 a.m. when I used it for insomnia.

I don't think you should even try a sleeping pill. Those are dangerous in and of themselves. It sucks that you can't stay asleep. I just wonder if its not all 5 of these meds' common side effects of insomnia and excitability that's causing your insomnia, or at the very least, exacerbate your segmented sleep pattern (if indeed that is what you have from your med school days -- overnight workers become segmented sleepers b/c of the way those hours mess up circadian rhythm).

I think a sleep study could really show insight into what is happening to your brain at night. That may be the only solution, if you can't decrease your medication list down to 2-3.

Provigil

Wellbutrin

Abilify

Depakote

Restoril
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Default Jan 25, 2020 at 02:58 PM
  #13
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Originally Posted by BeyondtheRainbow View Post
BPcyclist, don't give up hope. I thought I'd never sleep normally again when I landed on clozapine. I sleep more than normal now but much prefer that too too little, messed up sleep. Something will help you, it just is so hard to find what that is. I hope the thorazine is it for you and all you need is a higher dose. I remember being so desperate for sleep and then one morning in the hospital the nurse woke me apologizing because she'd let me sleep as late as she could before she was required to give me my meds. I had slept nearly 13 hours and it was amazing. I was in there cross-tapering high dose Seroquel and clozapine and since I hadn't been sleeping before I went into the hospital it just got worse until that marvelous day that the right level of medication was in my blood. That day can happen for anyone if it did for me. I hope tonight is better.
Thanks for the encouraging words, Rainbow--I needed those. Right now, I'm on 75 mg and it does not make me drowsy in the least. I could run a marathon on it. Will talk to pdoc on Monday and see. I think Clozaril may just be in my future.

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Default Jan 25, 2020 at 03:07 PM
  #14
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Originally Posted by StreetcarBlanche View Post
bpcyclist I did a Google search of your meds that you list on your profile. Provigil, Wellbutrin, Abilify, Depakote, Restoril all cause insomnia, anxiety, excitability, and agitation as a common side effect. I included links to the side effects for each one below.

So, 5 of your meds for your bipolar disorder could be the cause of your inability to fall asleep because of their insomnia-like side effects on your brain. Do you need all 5? Which ones could you live without taking, that you could taper off of? Is that even an option for you?

If not, then I don't even know if Melatonin or Chamomile tea or Valerian Root tea would help you stay asleep. All 3 will relax you and help you fall asleep but are not designed to keep you asleep. I have used all 3 for my own insomnia bouts, and the Melatonin relaxed me but I still woke up around 4 a.m. when I used it for insomnia.

I don't think you should even try a sleeping pill. Those are dangerous in and of themselves. It sucks that you can't stay asleep. I just wonder if its not all 5 of these meds' common side effects of insomnia and excitability that's causing your insomnia, or at the very least, exacerbate your segmented sleep pattern (if indeed that is what you have from your med school days -- overnight workers become segmented sleepers b/c of the way those hours mess up circadian rhythm).

I think a sleep study could really show insight into what is happening to your brain at night. That may be the only solution, if you can't decrease your medication list down to 2-3.

Provigil

Wellbutrin

Abilify

Depakote

Restoril
Wow--thanks for alll that awesome information, Blanche! Greatly appreciated!

Yes, there have been fairly exhaustive conversations about each of my meds and its role. We have "played" with all but the lithium which I would never stop, as the last time I did, it precipitated a huge recurrence.

I am slowly coming to the place that this is likely multifactorial, that there is more than one thing going on, and that it will probably require a few or even several independent steps to fix. Maybe a sleep study, though mine is just likely to show that I cannot fall asleep, so that might be a waste of money.

I also have given what Christina said a lot of thought and I agree that, even if I don't meet full DSM 5 criteria for PTSD, I do have significant trauma from my on'call days and nights. It was really scary at times. I believe that will need to be addressed as well with EMDR or whatever.

So, a lot going on. A lot to do. I'm not going to give up Just keep plowing ahead. Thanks to everyone for the support and insight--I can't thank you enough.

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Default Jan 25, 2020 at 09:32 PM
  #15
Number 1 there is no reason not to try Melatonin, it’s OTC and offers some people a lot of help, 3-5–10mg are usually easy to find

When someone has ongoing insomnia there is really no Med that is going to just immediately work and consistently work right away. I would imagine your body has a higher than normal inflammation levels , insomnia is often also caused by the “ fight or flight” and it takes time for your brain to realize that it doesn’t need to be on high alert. My body actively rejects sleep ,

I have also had trouble anytime I am receiving anesthesia, I take at least double the normal amount used to intially knock me out and keep me under, I advise anesthesiologist everything I have needed surgery, most think I only “think so “ , but every time after surgery they come to me asking a gazillion questions.

Regardless if you sleep or not it is important to truly just lay in bed at least 6 hours and allow your muscles to relax, your eyes closed, insomnia often has us online, watching tv or reading sometimes 24+hours, they need closed and not needing to focus on anything.

I’m sorry you struggle with this ongoing stressful situation. You are likely getting what’s called Micro bursts of sleep and no know it tho.

When you lay down just throw your hands up and say “ I’ll sleep or I won’t” and honestly mean it.. your body has shown you over and over that a point comes where you will indeed fall asleep, so use that as a bit of comfort to yourself.

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Default Jan 25, 2020 at 10:42 PM
  #16
I think there is a lot to be said for having trauma coupled with unusual work hours. Either one can screw with sleep; both together can, in my experience, seriously impact our brains sleep wiring.

Let us know how it goes with your pdoc on Monday.One way or another, I believe your sleep will regulate.

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Default Jan 26, 2020 at 01:53 PM
  #17
hi. thorazine is nasty stuff at high doses. at 200-600mgs or so, it seems...well, its just another low-potency (requires hundres/mgs to get the job done...sedation, less EPS than high potency) antipsychotic. oh, and its a potent antihistamine, from the old school.

before Thorazine became an "anti-Schizophrenic" drug, then an "antipsychotic," it was...on the market, mostly for (if I recall correctly...) sleep and as a mix-in drug for pre-op cocktails. Then the old school psychiatrists got a hold of it, and...

-sigh- details from the original psych studies, in the early 50s, are horrifying. people given grams of the stuff, daily...left an odd, blue-ish tint on their skin (that happens with some phenothiazines, the chemical group for Thorazine). that says more about a total disregard for human rights than it does about Thorazine, per se...

because, from what little I've read on the subject, if the dose is kept in a reasonable range, the TD risk is not that much different from many (most? all?) 'atypicals' on the market, and lots of people way back when who were discharged from hell hole state hospitals did better, outpatient, on an OK dose of Thorazine and social support than in the madhouse. true story.

EPS happens, but its a low potency drug and it has anticholinergic stuff going on, so its not too bad (again; dosage, individual susceptibility, other drugs on board make a difference). The "Thorazine Shuffle"-stiff gait, sometimes with akathisia and/or EPS- can be an issue, but...again: dosage. for whatever reason, the old school psychiatrists were taught to increase an antipsychotic dose until EPS and Parkinsonism popped up, then either reduce a bit (outpatient, I'm guessing) and/or add Cogentin. fun, huh?

melatonin has actually been studied, here and there, to help people with established TD. seems to help at least a subset of people/'patients,' sometimes a whole lot, especially at 10mgs+ per night, based on my little bit of Google-ing into it. some people claim(ed) that melatonin has or could have other health benefits, but the melatonin-mania of years past has largely subsided.

I think its far less toxic,in terms of metabolic disorders and weight gain, than seroquel or zyprexa or clozapine. A -lot- of former 'mental patients' report intense depression on Thorazine, others...don't. again, that's probably from excessive dosing, other Rx drugs involved, etc.

hope this helps a bit.
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Default Jan 28, 2020 at 07:31 PM
  #18
You mentioned the wiring of your brain. I was wondering if maybe you could rewire it subconsciously. Have you tried sleep meditations? I used to have a couple I worked with. It is similar to breathing techniques, but you breathe and listen along to a guide who would lead you and there is music as well. I'm sure there are tons on YouTube.

Your brainwaves essentially end up in the hypnotic range and maybe that would help things on a subconscious level. Something to try maybe if you haven't looked into it before. I could maybe dig some links up for you if you're interested.

ETA: I came across this article with several to try. There are basic meditations, biurnal beats, meditations to induce delta wave state, hypnosis meditation. Maybe one of these options might assist.

20 Best Guided Meditations for Sleep and Insomnia

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Default Jan 28, 2020 at 10:53 PM
  #19
I have very segmented sleep. I sleep in 2-3 hour blocks. I have tried pretty much every sleeping pill which none of which have helped except for thorazine. 300mg of thorazine would knock me on my behind enough to get a solid 8 hours of sleep. I had to stop taking it because I was having cardiac arythemias from it. I hope it works for others as well as it did for me.

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Default Jan 29, 2020 at 04:40 AM
  #20
Yeah, thank you. Scary about your heart. Glad you maed it through that.

The Thorazine is not going to be any kind of answer. I pushed it to 100 mg and it was like drinking a Coke. It had just the slightest drowsiness affect that first night, but otherwise, it's water. Expensive, too. I added up all my lifetime psych meds as best I can remember them. Sure I am missing some, but it has been 51 different medications over the years for me and many, many, many of those were sleep-directed.

Just not sure where to go.

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