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Re: Akathisia? Restless Leg Syndrome? Need Some Advice Scleme1

Posted by SLS on June 30, 2015, at 7:43:24

In reply to Re: Akathisia? Restless Leg Syndrome? Need Some Advice, posted by Scleme1 on June 29, 2015, at 23:12:09

"Dirty" does not mean undesirable. One person's dirty equals another person's remission. It is very often the case where someone needs more than one pharmacological effect to get well. Luvox is often the most effective SSRI for OCD. However it can also be sedating and sleep-promting. Luvox might have the lowest risk of producing akathisia precisely because it is dirty (sigma-1 receptor agonist). Luvox is somewhat sedating and might help with insomnia and anxiety at bedtime.

Adding Remeron would be interesting. It can be anxiolytic for some people and very often sleep-promoting at low dosages. Remeron might also make an SSRI or SNRI more effective for depression, especially at higher dosages.

I can see how CBT might be very helpful for you, particularly because you seem to have a psychological association between being in bed the triggering of anxiety.

http://www.health.harvard.edu/newsletter_article/overcoming-insomnia

Ulltimately, you may need to switch antidepressants and add CBT. You might as well begin CBT now and create a plan for sequencing medication trials if necessary.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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