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fADHoDy,
To address your three questions....here is my story.
1. No sleep disorder, before I got diagnosis of ADHD 16 years ago.
I developed a sleep disorder immediately when I began use of
stimulants.

2. I started out with 20 mg. of Ritalin instant release (methyphenidate)
times 3 tabs per day, one every 4 to 6 hours. My M.D. also started
me out with 1 mg. of Xanax (Alprazolam) take at bedtime to help me
"wind down". I developed a tolerance to the Xanax, which worked at
the beginning, but my dose requirements increased to 2 mg. @ bedtime,
by 18 months the Xanax would only put me to sleep for about 4 hours,
and I would wake up and could not go back to sleep, now I have
middle of the night chronic insomnia. I take increase dose of Xanax to
another 2 mg. "bar" and that puts me back to sleep for another 4 hrs.
Within 24 months, my tolerance increases to 6 mg. of Xanax per day,
as I take 1 mg. doses twice during the day from the up and down
regiment of the Ritalin, to try to balance out my mood swings. My M.D.
places me on a 4 month detox (tapering down of the Xanax) until I get
completely off all Alprazolam. Reduce dose of Ritalin to 10 mg. x 3 daily.
After 3 years of Ritalin, and withdrawal from Xanax, I substitute the
anti-depressant Desyrel 150 mg. at bedtime. Pro's? Within 1 hour, I
go to sleep and stay asleep 8 hours minimum. Con's? I have now a
negative, syrup like hangover, in a stupor for 90 minutes every day at
awakening. I reduce dose to 100 mg. of Desyrel (Trazodone) and my
M.D. allows me to switch stimulants to Dexedrine Spansule 15 mg. ,
I further reduce Trazodone to 75 mg. at bedtime and take Dex Spansule
at awakening. I also begin taking one 10 mg. Adderall instant release tab
between 4PM and 6PM at the latest. Pros's When Dexedrine Spansule
wears off gradually late in afternoon, I get scattered and unmotivated,
the Adderall 10 mg. usually lasts for 4 to 5 hrs, thus, by 10PM to 11PM
I go to bed, but still need the Trazodone. Con's? I still need at least 75
mg of Trazodone to go to sleep (a minimum) eventually go back to 100
mg. to put me to sleep and keep me asleep for 8 hours, but the next
day hangover's return. Drink coffee to jump start the Dexedrine Spansule
This routine I keep for about 10 to 11 years. I develop Anxiety & issues
with Depression, due to a Divorce, and loss of employment, my M.D.
observes my struggles with inability to adjust, in the meantime, I have
also, been taking Ambien 10 mg (Zolpidem) at bedtime, beginning about
2002 until the present. Pro's? Aids to helping me go to sleep without
having to take 150 to 200 mg. of Trazodone, thus Ambien+Trazodone
combination works until I develop lifestyle changes I describe earlier.
M.D allows me to substitute the atypical anti-psychotic "Seroquel" for
the Trazodone for 6 months. Pro's, No more Anxiety issues, but I sleep
12 to 14 hours per day on 200 mg of Seroquel at bedtime, and my next
day hangovers, are worse than Trazodone, I am a zombie for 2 1/2 hrs
after waking up and taking Dexedrine Spansule, now, I add on 10 mg.
of Adderall with the Dexedrine Spansule together, to try to clear the fog.
Pro's I reduce the hangover from 2 1/2 hrs to 1 hour, but, now I need
a 2nd Adderall 10 mg. by 6PM to function. Con's: I develop a serious rash
Urticaria and now need Atarax (hydroxyzine) 20 to 30 mg. + Allegra 180mg
to control persistant itching on face, and scalp and arms.

3. About 6 months ago, the side effects of Seroquel are unacceptable,
my M.D. allows me to try Klonopin 2 mg (Clonazepam) at bedtime +
10mg. of the Ambien (Zolpidem) for my insomnia. Pro's: Hangovers,
are only about 45 minutes long at awakening, sometimes only 30
minutes. Cons: I develop a need to increase dose of Klonopin to 4 mg
at bedtime. I still take Dexedrine Spansule 15 mg at awakening, and
my sleeping time has more normal from 12 hours per day to 9 hrs per
day. My anxiety levels and depression still continue, inability to adjust
to loss of a marriage, and only a part-time job of 2 days a week. I
continue to take 10 mg. of Adderall with AM Dexedrine Spansule, and
a 2nd Adderall between 4PM to 6PM at the latest, due to inability to
focus in late afternoon, scattered, as the stimulants wear off, and
the Klonopin has a mild mood elevator effect (good) but tolerance is
increasing again. I most recently have been rotating one week of
nighttime Ambien, then one week of 10 mg. of Valium (diazepam) to
aid in my need to treat my insomnia. Seven to eight years of using the
Ambien makes it seem to not work much anymore, even dosing up to
20 mg. at bedtime, with the 4 mg. of the Klonopin. I rotate the 10mg
of Valium, every other week for 7 days, then go back to Ambien for
7 days to avoid the danger of building up a tolerance. I have recently
stopped use of allergy medications Atarax (hydroxyzine) and Allegra
(fexofenadine). :(





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