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Re: Help for Insomnia Plus Anergy » beccab

Posted by Mitch on November 25, 2001, at 13:18:53

In reply to Help for Insomnia Plus Anergy, posted by beccab on November 24, 2001, at 23:26:32

> Hi, everyone.
> I'm new to psycho-babble. I am 21 and have been depressed since I was in grade school. My main symptom is pretty severe anhedonia, and my second worst is poor sleep/insomnia. I tend wake up a lot and dream a lot and sleep very very lightly. I don't feel like I ever get deep sleep. Under certain circumstances it will take me several hours to fall asleep and then I will wake up in the middle of the night absolutely wide awake (yet exhausted) and not be able to get back to sleep.
> My depression is the extremely anergic type and I have a lot of problems with disabling fatigue and mental cloudiness. I do have some anxiety, but it is not so bad as the other symptoms. So, I am trying to find a drug or drug combo that will rid me of the anhedonia and anergy, whil simultaneously allowing me to actually sleep at night.
> I started taking reboxetine 2 weeks ago I don't think I am up to a therapeutic dosage. This drug is not helping my sleep, but is not hurting it too much either, since I have been titrating slowly. I was really interested in reboxetine's supposed ability to increase motivation and social functioning (which is a huge problem for me- I am unable to feel the feeling of "like" towards other people for the most part).
> I am thinking about adding remeron for its sleep inducing properties, but I am concerned about two things: 1. Will remeron necessarily increase REM sleep? I don't need any more but would probably accept more if I could just get some deep sleep too. 2. I really don't want increased appetite. The reboxetine has blessedly decreased my appetite. I wonder if a remeron/reboxetine combo might give me good sleep, motivation and no increased appetite. Can anyone else think of a better sleep drug for me?
> I am also seriously considering mirapex for the anhedonia. It sounds really good.
> One other thing is that I am trying to get back to college in about 5 weeks and I know that is not a lot of time. If anyone can offer me any advice about getting better ASAP, I would really appreciate it.
> Here is what I have taken previously: Prozac, Paxil, ( no effect good or bad for either), Tofranil (nothing), Wellbutrin (nothing), Elavil for sleep (poor quality sleep and hangover), 5-HTP and St. John's Wort, stupidly taken in higher than recommended doses (ANxiety and sleeplessness for three days with suicidal ideation).
> That's about all I can think of. Thanks a lot.
>
> Beccab
>
>

Hi Beccab,

You might ask your doctor about a Dexedrine spansule (a pstim) to take in the morning. Then, just let yourself "crash" on it later in the day. I have a similar problem with sleep quality during my seasonal major depressions (but Wellbutrin is helping me this time around). The amphetamine tends to "contrast" your sleep/wake cycles (if you don't take too much and take too late in the day). It seemed to work well to produce about a 7-hour dense restful sleep without much dreaming. If you got a hang-over from Elavil you probably won't like Remeron, either.

Mitch


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