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New pdoc, new meds (anxiety, trouble sleeping, ..)

Posted by Sunbath on August 10, 2009, at 11:22:59


first: sorry for my bad English and my very long post!!

I was reading babble since a few months now and thought it was time to post my medstory + some questions :)

I'm 27 and am having these problems for about 3 years now:

After some very stressful events @work I got a really hard time sleeping.. waking far too early and not being able to fall asleep again.. also waking 1-3 times / night.
This happens although -since 2.5 years- I'm taking 150mg trazodone xr at night.
The trazodone has improved this condition to some extent though, it was far more severe before..

Also I'm experiencing daytime anxiety with a bit of SAD and one of my biggest problems is: "not being able to relax"!
So even when I'm extremely tired and feeling sleep-deprived, I'm NOT able to sleep during the day.
Other problems are: having a constant feeling of muscle tension.. + sometimes feelings of derealizations + fear of going mad et.c.
This is even worse on days I have slept worse..
everything's stress because of feeling stressed, in a bad mood and spacy/foggy in my mind and being quite irritable when meeting ppl or even getting out of my house.

So I became quite the avoiding kind of personality..

Now I'm quite desperate to get some kind of relief or maybe even remission because this really really sucks and I'd really like to study. It feels like I'd miss out whole life.

It would be really great if some of you would suggest some meds..

<8 years ago I also had OCD (without the "C") and some kind of depression which lasted about 3 years and finally responded on paroxetine.>

I already tried:

8yrs ago period:

sertraline, ssri + mirtazapine,
ssri + venlafaxine, mirtazapine + venlafaxine,
ssri+reboxetine, <combi of ultra-lowdose melitracen + flupentixol>,
risperidone + ssri, ziprasidone + ssri,
amisulprid + ssri...
and then finally got to paroxetine which helped the OCD to some noticeable degree until it "faded" more into the background (where it more or less stays)..

3yrs->now period:

citalopram, escitalopram,
trazodone (still taking), mianserin (was far toooo sedated over the day, also don't want to take this since I gained about 7kg on mirtazapine),

Since 12/2008 I'm taking the escitalopram+trazodone combo and also started psychotherapy + started exercising 3 months ago (2-3 times a week).

I didn't feel the ssri was working, but I had already given up on medications since I didn't think that anything would help (that's why I started exercising and psychotherapy feeling so desperate).
So I was taking the escitalopram für 9 months now without a noticeable effect nor response.

Now, because again I'm feeling desperate (exercising + psychotherapy not improving my somatic symptoms), I visited a new pdoc who was astound about that none of my previous medications trials seemed to work..
She's a big fan of seroquel so she prescribed sertraline 50mg (instead of my 15mg escitalopram which I reported to her as not working) + seroquel 25mg in addition to the trazodone 150mg.

This was 1 week ago.. and, although I'm sleeping MUCH longer now, I feel much worse on the seroquel. My mind is/feels cloudy the whole day and I'm quite irritable and tired the whole day! When I wake up I don't feel refreshed (maybe I'm having some rebound REM and/or nightmares?)

Does anyone think that this would improve beyond the 1 week I'm taking it at sleep time? Or is seroquel simply the wrong med for me?
I was thinking about maybe trying lowdose amitriptyline instead of the seroquel?

And regarding the sertraline.. I really can't imagine that any ssri nor SNRI could be of REALLY much help anymore.
Having had nothing but disapointments and having read a whole lot on, especially Dr. Gillmans opinion about the "newer generation meds", I think I'd really like to try something COMPLETELY different..

Would any of you think parnate would be an option (for my symptomcluster?), or would it (too much) exacerbate the restlessnes/cause more insomnia?
Also in my retarded country (Austria) no MAOI is available (except the "~" moclobemide)
and I don't know whether a pdoc was able to get it from i.e. Germany (where tranylcypromine is available).

Or would you suggest to try something different before I try a MAOI anyway?
Maybe lamotrigine?

Thanks a lot for reading and again sorry for my bad English + thanks for being able to take part in the babble :)

have a good time!!




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