Expert: Ivan Goldberg, M.D. - 6/1/2009

Question
QUESTION: why is it so hard to sleep with bipolar disorder ? what is wrong with me , low serotonin ? What is the best depressant for sleeping with bi polar ?

ANSWER: Hi Johnny . . .

People with bipolar disorder may sleep too much or too little. When depressed many people with bipolar disorder oversleep. During periods of elevated moods sleep is often difficult.

Serotonin is just one of the 350 chemicals that allow the brain to function. It is not clear which of these chemicals (neurotransmitters) are most important when it comes to sleep).

The antidepressants Remeron and trazodone probably do the most to facilitate sleep. During periods of elevated mood, tranquilizers such as Seroquel often help sleep.

Best regards . . .

Ivan
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---------- FOLLOW-UP ----------

QUESTION: I was depressed for 10 years but i am no longer depressed . Is seroquel safe? I really dont want to take any of these medicines . Im not depressed .

Answer
Hi . . .

I am not sure I made myself clear in my last reply. My suggestion that Seroquel might be helpful when one is manic or hypomanic ("in an elevated mood") does not mean that it should be taken to help with sleep when one's mood is not disturbed. Seroquel is an antipsychotic medication that has some potentially serious side-effects.

For sleep problems when not manic or depressed a program of sleep hygiene, rather than medication, makes the best sense. See:

http://www.stanford.edu/~dement/howto.html

http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.2422637/k.5B7E/Ask_the_Sleep

Best regards . . .

Ivan
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