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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by lady fever on April 19, 2003, at 16:48:46
Question:
If SSRI's increase serotonin, and increased serotonin causes sleep, how come every time I take Celexa, not only do I stop feeling sleepy AT ALL, but I also wake up 3 hours after I go to sleep (on 20 mg of ambien w. 1 mg xanax at that), wide awake and like I just drank a pot of coffee? It's also taking me a few hours to fall asleep... as opposed to a few minutes.
Shouldn't the increase in serotonin make me sleepier?
Isn't Celexa supposed to be sedating?
Also, my muscles are twitching very, very severely, but I already suffer from myoclonus (twitching), it's just badly exacerbated by the Celexa. It's obviously stimulating something. My stomach is jumpy also. And my teeth are badly clenched, as well as my hands, hard to type. I hear this is a normal effect though.
I have major depression, and panic disorder. My insomnia is from the myoclonus, not the panic.
??? Really curious about the neurochemistry behind why I can't sleep on SSRI's (and yet, the Celexa is helping a little, I don't want to go off of it, nothing else even touches my depression, this has helped me stay a little calm if nothing else, I tend to get very aggravated with my depression, and I don't feel like driving my car into a tree over the phone bill right now, which is nice).
Posted by linkadge on April 19, 2003, at 16:59:55
In reply to Not sleeping on Celexa, posted by lady fever on April 19, 2003, at 16:48:46
It's unfortunate but this is a potential side effect of all the SSRI's.
The SSRI's increase serotonin availablity at all serotonin receptors in the brain. Some of those recptors are involved in sleep, but others, especially 5ht-2 are involved in alertness and anxiety regulation. Too much serotonin at these receptors and you can be anxious and have slight activation.
This side effect does lessen over time and can be emproved by morning dosing. Certain meds like trazadone and remeron block these receptors resuting in better sleep. If you are still not sleeping, the adition of trazodone usually helps
Linkadge
Posted by lady fever on April 19, 2003, at 17:12:37
In reply to Re: Not sleeping on Celexa, posted by linkadge on April 19, 2003, at 16:59:55
Thank you! I may try to add some trazadone to the mix (I had a bad reaction to remeron once, I'm very medication sensitive, don't know why, I'm very petite, I presume that's part of it, I'm just under 100 lbs, not anorexic or anything though, just petite). It seemed like it had some neurochemical basis to it, and if that will help, well good, I'll try it, because the Celexa DOES help my depression.
This is exactly what I was hoping to have explained to me :)
Posted by lady fever on April 19, 2003, at 17:15:05
In reply to Re: Not sleeping on Celexa, posted by linkadge on April 19, 2003, at 16:59:55
One more question: are there any antidepressants that won't bind to the 5ht-2 receptors, but will bind to some of the other serotonin ones? SSRI or otherwise?
Thanks in advance.
> It's unfortunate but this is a potential side effect of all the SSRI's.
>
> The SSRI's increase serotonin availablity at all serotonin receptors in the brain. Some of those recptors are involved in sleep, but others, especially 5ht-2 are involved in alertness and anxiety regulation. Too much serotonin at these receptors and you can be anxious and have slight activation.
>
> This side effect does lessen over time and can be emproved by morning dosing. Certain meds like trazadone and remeron block these receptors resuting in better sleep. If you are still not sleeping, the adition of trazodone usually helps
>
> Linkadge
Posted by linkadge on April 19, 2003, at 20:45:00
In reply to One more question for Linkadge, posted by lady fever on April 19, 2003, at 17:15:05
There are some drugs that block the
5ht-2 receptor, thus preventing the
side effects associated with its
overstimulation.The main drugs are Trazedone, Serzone and Remeron,
some of the old tryciclics do this but I am
not sure just which ones.So, what a lot of people with this problem do is:
Add a little trazodone (usually 12.5-50mg)
at bedtime (with a 9 hour half-life it is
a nonadictive way to really help you sleep)Try Paxil. It has a shorter halflife then
Celexa, and if taken in the morning, can
cause less insommnia than other SSRI's.I'm doing some some research on Periactin,
an antihistamine which also blocks a 5Ht
receptor (I have to find out about)
But definately talk about Trazodone,
and get back to us if thats a no go.Linkadge
Posted by lady fever on April 20, 2003, at 16:11:28
In reply to Re: One more question for Linkadge, posted by linkadge on April 19, 2003, at 20:45:00
thank you again.
I am trying a morning dose today, to see how it goes w. just changing that.
Never tried Paxil, that sounds promising too.
And I haven't heard much bad about trazadone, that sounds good as well.
This is the end of the thread.
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