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Re: TCA's and sleep

Posted by JohnL on October 10, 1999, at 10:00:56

In reply to TCA's and sleep, posted by PAT on October 10, 1999, at 8:20:29

> I am moderately depressed/w anxiety and can't sleep. Tried Serzone, helped at one time but then got off it. Since then I have tried to go back on with no luck. I become agitated, less people friendly. (Could be lack of sleep). I have also tried remeron (15 mg or 7.5 mg) which made sedated and restless, didn't wear off until late the next day. Didn't sleep that well on it. Same thing with Trazodone. I get the benefit of sedation without restful sleep. Any suggestions or info/experiences on TCA's for sleep or anything else would be helpful.

Hi Pat. Most all TCAs are fairly sedating, with the exception of Vivactil (Protrityline). The secondary TCAs such as Nortriptyline and Desiprimine are usually more tolerable than others.

I too have some experience with Trazodone, Remeron, Serzone. I tried low dose of the TCA Nortriptyline with Zoloft for a month. The Zoloft was so bad for sex I had to give it up. The ONLY time I've ever felt total euthymia was with the addition of Nortriptyline, and since that whole cocktail was abandoned (intolerable sex probs, not sure if Zoloft and/or Nortrip, probably just the Zoloft) for trials of other things, I may actually return to Nortriptyline with my Prozac if the current Naltrexone disappoints. To make a long story short, the best sleep of my life was with the TCA Nortriptyline. The sedation during the day does indeed lessen with time, unlike Remeron or Serzone or Trazodone which seemed to cause drowsiness for me that dragged on month after month.

I think a TCA would be a fine choice for sleep. But you'll probably need your doc's intuition to choose the right one. I like Nortriptyline for sleep. Not sure, but I think the most sedating is Clomipramine. Be prepared to wait out some daytime sedation for a month or two. Depends mostly on what dose you take. Sometimes all it takes is a little in late afternoon or dinner. Just food for thought. Sleep on it. :)


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