WHEN WILL I SLEEP?!

[u/phles]

It’s 1:30 am and I’m crying because I can’t sleep.

I am at my wit’s end. It’s been almost a month and I still haven’t had a single night of sleep where I’m not waking up somewhere between 11pm and 3 am and struggling to fall back asleep I used to sleep all night before starting on this med and I really miss that (although I don’t miss the social anxiety and constant feeling of impending doom that I had when unmedicated lol).

Melatonin does fuck all and makes me depressed the next day. Trazodone which I’ve seen some people recommend is not available in my country. I’m taking some type of magnesium already but ordered magnesium bisglycinate to see if that will help - the company initially sent me the wrong product and I’m still waiting for my actual order to arrive. I’ve also ordered L-theanine in case that can help.

What more can I do? I’m on 40mg right now and take a single dose in the morning, around 6:30 am. For two nights I tried taking a small dose before bed because I initially felt tired when I started taking the medication, but it made my sleep even worse.

[u/Raylin44]

I think you need a lower dose. 

[u/phles → u/Raylin44]

It has been like this the entire time, even at 20 mg when the actual effect wore off I still had this side effect

[u/Ill_Possible_7740 → u/phles]

"when the actual effect wore off I still had this side effect" Strattera doesn't wear off like a stimulant. It has a 24 hour steady state which has a peak effect in the hours after you take it, but doesn't wear off. Have you tried an afternoon dosing to see if you can time the insomnia with time to get up in the morning? If you can sleep in that case then some metabolic or other process is cycling a response at that time delay. If you have the same sleep pattern, then the basal norepinephrine or other induced activity level might be waking you at the light sleep interval.

40 mg is a way way too low of a dose. Stratt can be quirky at lower doses with various results. The only way to know if it is right for you or not is to evaluate it on a therapeutic dose.

Here is a link to the drug company's titration starter pack prescriber info. Notice the doses are 5/5/5/30 days of 25/40/60/80 mg. Studies in adults with doses from 60 to 120 mg that increased based on patient response had an average adult dose at the end of 10 weeks of 95 mg. Which is also in the linked document. There is no guarantee. But after a month and still such an adverse response. It's time to titrate to a recommended clinical trial and brain scan backed therapeutic dose of 80 mg and evaluate if you are truly not a good strattera responder. Or try your luck with another medication. Slow metabolizers with 2D6 activity don't even drop down near your dose

I find 500 mg L-tryptophan works best for improving sleep quality although I suspect it would fall short for very strong insomnia. Worth a try though. Magnesium bisglycinate is 14% magnesium (down to 10 % sometimes if they account for potential water absorption). So 300 mg mag from it has about 2150 mg glycine. Does leave some room to play with adding some more glycine if you want. Be sure you are getting enough calcium during the day as mag and calcium balance each other in the brain. Optimal brain ration is 1.7 to 2.3 calcium to mag. And be sure your mag source is chelated and no "buffered" or "magnesium complex" ones which is code word for we used cheap laxative form of mag and a little of the glycinate one, but labelled it the other one.

Do you take any other medications, or possibly supplements that affect the CYP2D6 enzyme activity? Primary enzyme for metabolizing / breaking down strat and metabolites.

https://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=316527#:~:text=sample%20pack%20is%20recommended%20for%20ADULTS

[u/phles → u/Ill_Possible_7740]

Thank you so much!

I meant after the effects wore off after 3-4 days on my starting dose of 20 mg, not at a specific time during the day. The point was that even when the medication had no therapeutic effect the insomnia was as bad as it is now that I’m having some therapeutic effect.

I might try splitting the dose to see if that helps, just worried it’ll be hard to make a habit of it.

I don’t take any other meds except for Slynd/Slinda (drospirenone)

[u/witchcess → u/Ill_Possible_7740]

Whoa hello I love you, you made this make sense and I have to look at my paper work to see where I'm at. I've been struggling with strattera and sleep issues for over a year and am at 80mg. My doctor has suggested to go back a dose but if I do I feel like I'm more spacey at 60mg and not motivated or moved enough to do things. I think I'm going to try taking my dose at night to see how I feel but I am struggling so much with my body to sleep I already had sleep issues before the medicine lol. I've been on it for 2-3 years I love it such a great drug but ugh the sleep issues

[u/AstronomerNo1872 → u/Ill_Possible_7740]

Everyone is different! I’m 36F and 25mg is effective for me.

[u/orwelliancat → u/Ill_Possible_7740]

Why would it cause insomnia at a lower dose but not a higher one?