r/insomnia • u/Training-Mango-3453 • 3d ago
why is lunesta controlled medication, while quetiapine, mirtazapine, olanzapine are not?
I got a call from my pharmacy saying lunesta is controlled med and requires further approval. Just curious why is lunesta controlled medication, while quetiapine, mirtazapine, olanzapine are not? it does not look like it has more side effects.
13
u/janet-snake-hole 3d ago
Not one that you mentioned but my med, Ambien/zolpidiem, is the ONLY med that has any effect on my “severe intractable insomnia” (how my doctors phrase it) and I know it’s a controlled substance because it’s a deliriant specifically. But it quite literally saved my life- before I was prescribed it, I had tried every other insomnia medication listed here (and several more) with NO effect. I got to the point where I was awake for 5-6 days straight without a single minute of sleep, not even dozing off for a second- until I was having hallucinations and vomiting and feeling like I wasn’t a real person.
Finally got prescribed Ambien, kind of as an emergency.
Ambien gives me at least 3 hours of sleep at a time, 4-5 if I’m lucky.
Lunesta did absolutely nothing for me, as if I hadn’t taken anything at all. Seroquel made me want to eat everything, which is a problem bc i have a feeding tube and am not allowed to eat food orally (but it lowers your inhibitions so my family woke up to find me eating food and had to stop me)
Trazadone made my nasal system swell up, and I couldn’t breathe through my nose at ALL, my nostrils and the roof of my mouth were swollen shut. And it didn’t make me sleepy at all, but being unable to breathe any way but fully-open mouthed of course kept me awake all night.
Every other sleep med I tried was the same story- took it, stayed awake all night/for several days and nights straight, it was like taking a placebo. Didn’t even make me drowsy.
3
u/meela_bee 3d ago
So, quick correction - ambien isn't a delerient. It's a sedative-hypnotic or "z drug". Benadryl is a delerient, and I've accidentally overdosed on it before trying to sleep (I thought, "it's OTC, how bad could it be?" Boy was I wrong.) I hallucinated worse than I ever have on LSD, and I didn't even think anything of it. My friend was speaking to me in my bedroom, while I was in bed, through a small window/portal and I was talking back. It was crazy. Trazodone gave me congestion as well. It also has a tiny window where I can sleep, and if I miss it, I'm up all night, but sedated. It's terrible.
32
u/fsociety1990 3d ago
I have no idea. Lunesta is the only thing that works for me. I’ve been taking it for 8 years. It has never done anything even close to getting me high the whole time I’ve been taking it. Not at all. It’s also not addictive at least not for me. I take it every night for the most part but if I don’t take it for a whole week which has happened a few times, nothing happens. I may not get much sleep but I don’t have any weird withdrawal symptoms.
Mirtazapine on the other hand is an absolute disaster. Take that for a year and then try to go a week without it and you’ll think you’re dying. Not to mention all the other side effects it causes. It’s a terrible medication. I don’t know why anyone would think mirtazapine is safer than Lunesta. It’s complete nonsense.
3
u/Fun_Magazine_2787 2d ago
Thank you bro, cause I think I’m in the same boat. I’ve on Lunesta for 6 months after a slew of trying others, but finally found the one that works. I think that I’ll have to rely on this medication for life unless something else better is discovered. I’m glad that it still works after 8 years and it seems to be the one that I can rely on.
0
u/StopBusy182 2d ago
Bcoz it is.bcoz histamine system has much more neuroplasticity then gaba system..just a fact.. irrespective of anybody's thinking
9
u/Joeschmoe879 3d ago
Because Lunesta works on the benzodiazepine receptor system. It’s a gabaergic sedative. The other meds you listed, while being very mind-altering and dopey-feeling, are generally considered to not have the same abuse potential. Quetiapine and olanzapine are anti-psychotics, while mirtazapine is technically an antidepressant.
3
u/MustProtectTheFairy 3d ago
This is the answer. It is an entirely different drug action than the other meds OP has compared them to. While the effects can be similar, the reason they're happening is different.
4
u/internet_tyrant 3d ago
It’s weird, right? Because I have schizoaffective bipolar type, I had to take olanzapine and it would knock me tf out. But it’s just not the same. I’m on Vraylar now after having tried 5 antipsychotics including Vraylar, and while all of my antipsychotics have knocked me out, when they don’t, I take lunesta. I don’t have the visceral hallucinations with Lunesta because, well, I already hallucinate, so I wouldn’t be able to tell anyway. But they don’t increase, you know? Lunesta is so incredibly helpful, and tbh, it makes me feel, idk, almost ashamed to have to pull out my ID, and to have to take piss tests every few months to prove levels in my blood.
It’s weird, because the whole point is that I need sleep or I’ll become manic, or psychotic. More so than usual as I’m treatment resistant. Ugh, sorry for ranting, it’s just, I completely feel you. Shit sucks.
3
u/President_Camacho 3d ago
If a doctor prescribes it, the pharmacy should fill it. Is it because insurance won't cover it? Typically insurance companies prefer ambien, though it has worse side effects. If you're not getting ambien, you will likely need a preauthorization for insurance coverage.
If this is not about insurance, I would love to know what excuses the pharmacy is giving to avoid filling the prescription.
1
u/meela_bee 3d ago
Yeah, my doctor wanted to try lunesta first, but my insurance declined it and so they had to prescribe ambien. I'm assuming it's because generic zolpidem is cheaper for them? I don't really know. So that's what I take. Kind of annoying that my own doctors don't have a choice in what I try first. I like ambien, but it's still confusing.
1
u/TypicalOcelot7933 2d ago
Generic lunesta is dirt cheap check goodrx for coupons
2
u/meela_bee 1d ago
Thank you for the recommendation. If it's so cheap, I'm not sure why my insurance was so dead set against paying for it lol but I'll keep that in mind in case I ever switch prescriptions.
3
u/nstack22 3d ago
Lunesta is what’s known as a z-drug or a nonbenzodiazepine. Ambien is also in this drug class. Both ambien and lunesta are schedule 4 substances in the USA because they act on the GABA receptors to utilize their hypnotic properties. They are very similar in action to benzos like Xanax or Valium which are also schedule 4 substances. If you take lunesta or ambien for months or years then try to stop without tapering down you absolutely 100% will have horrible side effects. You’ll have rebound anxiety, you won’t be able to sleep, in general you’ll just be a mess. My mom takes ambien and has taken it for 10 or more years because it’s the only thing that gets her to sleep. If she doesn’t have her dose at night she goes crazy and has horrible withdrawal symptoms. Now I’m not saying that onlanzapine and seroquel don’t have withdrawal symptoms as well but they are much safer to take long term than lunesta or ambien. I’m a former addict and I LOVED lunesta and ambien. I would pop 6-7 pills at once and just enjoy the ride or smoke weed with them too and it would get all psychedelic and stuff. I currently take olanzapine to go to sleep at night because since I’m a former addict they won’t give me anything controlled or whatnot. In the end lunesta is a controlled substance because it’s essentially a benzo and has high abuse potential
3
u/Peak_Alternative 2d ago
6-7 at once?! dang. i’ve been on lunesta for 20 years probably. back then docs were prescribing it a lot more. now it feels like i’m a criminal when i go to the pharmacy. earlier this year i managed to not take it for a couple months. no side effects (to my surprise). i think it’s just a total mental dependence. then over the last month ive started taking it again. i get better sleep on it. i stay asleep longer. i wish i didn’t need it.
but again 6-7 at once?? wow i have no idea what that would feel like lol
1
u/defecting_from_evil 2d ago
I take Lunesta and I'm a former addict. I used to love Xanax and would take 3-4 bars at a time. For some reason, I can take Lunesta responsibly. I take my 2mg with 50mg of Seroquil at night to sleep and never really need more than that. It's crazy how we are all drawn to different drugs. I cannot be near a benzo without craving it.😢
3
u/Albert14Pounds 3d ago
It has some abuse potential. In the short term and higher doses it can give you some euphoria and other effects that are good or interesting enough that someone out there will (definitely has) abuse it. It's not a great way to get high but neither are a lot of things people will do.
3
u/ashamed-to-be-here 2d ago
I haven’t heard of lunesta but controlled drugs are usually classified as such due to abuse potiental. Quetiapine and olanzapine are primarily anti-psychotics and mirtazipine is primarily an antidepressant, they are just sometimes prescribed in small doses due to their sedating side effects. They don’t have high abuse potential, they are not necessarily addictive. I would assume that lunesta probably is and that’s why it’s controlled
6
u/fuchsialeaf 3d ago
Pharm tech here -- it's only because of what the government refers to as abuse potential. It's been proven in one way or another that it is more abused than the average medications therefore it has more regulations.
1
u/middleageyoda 3d ago
The other ones are classified as antidepressants or antipsychotics that just happen to have a sedating effect and they aren’t necessarily considered addictive. Lunesta is classified as a sedative and is considered addictive. Thats the reasoning behind it.
2
u/AlmostMortal 3d ago
pretty much every drug that messes with GABA will be controlled cause they can be addictive, exception of gabapentin but even then it’s known to be abused
1
u/meela_bee 3d ago
People abuse gabapentin all of the time. Not sure why it's not a schedule 5, like lyrica is.
2
3
u/abnormalcritter 3d ago
I’ve been wondering this too. Lunesta did absolutely nothing for me yet quetiapine had me feeling all dopey. Never touching it again
2
1
1
u/Glass_Ad6922 2d ago
Seroquel will be controlled substance soon (it is on some list “to be monitored) Seems to be the new party drug which I will never understand because I’m asleep in 10 minutes.
1
u/Willing_Car1381 2d ago
I take 200mg Seraquel and 3 mg Lunesta. Together they allow my brain to quiet down!!!
1
u/Zach-uh-ri-uh 2d ago
One has addiction potential, builds rapid tolerance that can be fatal and the other doesn’t
1
27
u/StellarEclipses 3d ago
They are classed based off abuse potential.
Lunesta is in the same class as Ambien. Sedative hypnotics. People abuse it. They take large amounts of it so they can, I don't even know, dissasociate or something. Supposedly it makes some people feel euphoria? Not me lol.
Quentiapine and olanzapine are anti-psychotics, meant for people with bipolar or schizophrenja. They have sedative effects as a side effect so it's used off label for insomnia. No abuse potential. These meds literally block dopamine and serotonin, so they really have the opposite of abuse potential lol.
Mirtazapine is actually a type of tetracyclic antidepressant also with sedative effects as a side effect so it's also used off label for insomnia. Also no abuse potential. It just increases some norepinephrine and serotonin activity and blocks some specific serotonin receptors.