Posted by Sunbath on August 18, 2009, at 15:20:07
In reply to Re: New pdoc, new meds (anxiety, trouble sleeping, ..), posted by zatar on August 17, 2009, at 10:29:47
Hi zatar!
Thnx for your message. I'm very sorry you have the same sleep problems plus fibromyalgia! This really sucks!Not getting enough sleep for months already drives me crazy> Low dose doxepin (10mg) kept me asleep through the night until recently when some issues increased my anxiety and I was unable to fall asleep (never a problem until now) and I started waking up 10-15 times a night.
I tried doxepine (12,5mg) once but I couldn't tolerate the daytime fatique it gave me.
Also the Trazodone isn't working anymore, or isn't enough anymore.. I tried weaning off by reducing by just 20mg for 2 weeks, but this rebound insomnia or withdrawal insomnia just didn't improve, so I'm again taking those 150mg of trazodone (xr).
I then tried Seroquel which let me feel a bit like a zombie whole day but I slept well.. now I changed it for amitriptyline which is also very sedating.. not quite as much as doxepine but right after it I suppose :)
This is working well too, but again the daytime fatique..Did you try Seroquel or amitriptyline?
To me it seems like a hunt for the right balance: good, continous sleep vs. daytime fatique..
> Per my pdoc's recommendation, melatonin 3mg helps me fall asleep and raising doxepin to 40mg keeps me asleep. My pdoc is very good about writing prescriptions for flexible dosing, so I tried increasing the doxepin until I found a dose that worked.
I never tried Melatonin, maybe I should give it a try one day too..
> Sleep hygiene is very important. When my anxiety and sleep issues act up, I must avoid ALL caffeine (even decaf coffee,which still contains some caffeine), alcohol and chocolate. These prevent me from falling asleep and/or cause me to wake up in the wee hours when anxiety is rearing it's ugly head. I also avoid anything containing aspartame, MSG and other excitotoxins.
I second that! For me it's especially alcohol and caffeine (don't eat chocolate often, but thanks for the warning ;) )
I also didn't know about aspartam in this regard! Thanks!> My pdoc says that usually doxepin has an anti-anxiety effect starting at around 75mg and he is a big proponent of doxepin for sleep. But I am extremely sensitive to medications and cannot tolerate higher doses of many meds, so I don't take enought to get an anti-anxiety effect. Raising the doxepin dose increases my daytime fatigue and "spaciness", so I stick to the lower dose to help my sleep.
Anxiety is a real problem, I also don't know if the Zoloft will help, but maybe the doxepine will still work for you although you're not taking "the full dose"? Maybe you're a slow metaboliser and don't need such a high dose?
> I believe the trick for any medication is to find a dose that works for you. Start low, and titrate up slow.
you're right! Once that were those 150mg trazodone for me.. higher than 150 > daytime fatique, lower > cannot sleep well..
> Good luck to you. And may you find the sleep that you need.
>
Thanks a lot! I wish you all the same! Luck is really what we need in this med and conditions jungle.. And don't give up hope! The day will come when we'll feel well again! Just let's hope that it will be soon :)
poster:Sunbath
thread:911312
URL: http://www.dr-bob.org/babble/20090818/msgs/912862.html