Insomnia 2+ years. on pristiq, (desvenlafaxine) lithium for bipolar. no sleeping pills work. valium does not work. a high dose xanax can. 2 to 5 mg. what can i do?

Not drugs alone: Xanax, (alprazolam) especially at high dose, is not a healthy long-term option for you. Evidently you have a good bit of tolerance already. If you're using other substances in addition to your meds (including alcohol), stop. Use good sleep hygiene steps in your day-to-day life. Find more info about this at: http://www.Sleepfoundation.Org/article/ask-the-expert/sleep-hygiene also yoga such as yoga nidra.

Insomnia suggestions: Regular sleep schedule, especially time to get up. Minimize light before sleep period, including tv & computer. Don't go to bed hungry or right after a big meal. Avoid or minimize caffeine & alcohol. Exercise regularly, but not within 3-4 hrs before bedtime. Use relaxing pre-sleep routine (warm bath, light snack, reading). Bedroom temp at 60-68f. Learn relaxation skills. Find sleep specialist.

INSOMNIA: There are excellent medications for insomnia. A Psychiatrist can guide you to the best one. Insomnia might be due to several different reasons. First have a complete physical exam by a Dr. to rule out underlying biological problem. If no problem consult with a Clinical Psychologist for psychotherapy help & possible referral to a sleep study.