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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by LindaBelcher on April 12, 2012, at 22:15:26
Hello all. I am encouraged by this site, and the idea of hearing everyone's input.
right now I am taking the following meds for ptsd, depression, anxiety:
cymbalta 60 mg
prozac 20 mg
prazocin, 2mg 2 times a day, 4 mg at night
nuerontin 300 mgs 3 times a day
ambien 20 mg at night
ativan PRN
Ive been on pretty much the same combo for a number of years, but adding the prozac 2 years ago destroyed my sleep. I had been using trazadone for at least 10 years and suddenly it became useless. switched to ambien, which is a nightmare (so punny!) not only do I get up and eat when I'm "asleep", it doesn't help me get deep sleep at all (not to mention the things I say to my husband when it starts to kick in at night...!)
so I'm titrating off the ambien, thinking of adding doxepin or going back to trazadone.
regardless of that choice, I am feeling like I should dump the prozac...recently tried to stop taking it and cried every day for a week. My husband was worried I was headed back to hospital so I started again. I do have a pdoc who is marginally helpful, med-wise.
thoughts, anyone?
sorry this post is so long, and all over the place!
thanks very much,
LB
Posted by tensor on April 13, 2012, at 5:11:02
In reply to Lots of meds on board but NO SLEEP!, posted by LindaBelcher on April 12, 2012, at 22:15:26
> Hello all. I am encouraged by this site, and the idea of hearing everyone's input.
> right now I am taking the following meds for ptsd, depression, anxiety:
> cymbalta 60 mg
> prozac 20 mg
> prazocin, 2mg 2 times a day, 4 mg at night
> nuerontin 300 mgs 3 times a day
> ambien 20 mg at night
> ativan PRN
> Ive been on pretty much the same combo for a number of years, but adding the prozac 2 years ago destroyed my sleep. I had been using trazadone for at least 10 years and suddenly it became useless. switched to ambien, which is a nightmare (so punny!) not only do I get up and eat when I'm "asleep", it doesn't help me get deep sleep at all (not to mention the things I say to my husband when it starts to kick in at night...!)
> so I'm titrating off the ambien, thinking of adding doxepin or going back to trazadone.
> regardless of that choice, I am feeling like I should dump the prozac...recently tried to stop taking it and cried every day for a week. My husband was worried I was headed back to hospital so I started again. I do have a pdoc who is marginally helpful, med-wise.
> thoughts, anyone?
> sorry this post is so long, and all over the place!
> thanks very much,
> LBThere is also Seroquel, which I think is very good for sleep, 25-100mg. I do not get sleepy enough, or at all, from TCAs or Remeron anymore but fortunately Ambien 20mg works for me. And there is really no need to titrate Ambien, it has too short halflife to build up in your system, unless you're taking it more than once aday.
/t
Posted by bleauberry on April 13, 2012, at 6:29:28
In reply to Lots of meds on board but NO SLEEP!, posted by LindaBelcher on April 12, 2012, at 22:15:26
Low dose remeron....as in 1mg to 7.5mg. The lower the dose the more powerful sedative.
Low dose amitriptyline.
Not sure why doc keeps you on cymbalta if it isn't doing much (obviously isn't because didn't prevent or soften the darkness when stopping prozac). Better choice in that class....savella. My opinion.
Herbs don't have the focused knock out power of meds but do offer good health benefits and sleep aid. Usually they don't work by strong sedation but rather by overall relaxation that allows deep sleep to happen. Might want to experiment with some teas such as lemon balm, passionflower, skullcap, valerian, combo of any 2 or 3 of them, or better yet take them in tincture form....easy to custom dose and generally more potent than the pills. I just think adding in some of these herbs could help the overall situation in the sleep department.
Posted by Phillipa on April 13, 2012, at 9:41:34
In reply to Re: Lots of meds on board but NO SLEEP!, posted by bleauberry on April 13, 2012, at 6:29:28
I wouldn't think the prozac would effect you for a few weeks after stopping it as the halflife is so long. Are you positive it's the prozac as it's used for withdrawal of meds in some. Agree ambien and the z meds don't do much for a lot of folks. For some reason I now sleep on low doses of benzos. Phillipa
Posted by LindaBelcher on April 13, 2012, at 15:48:12
In reply to Re: Lots of meds on board but NO SLEEP! » LindaBelcher, posted by tensor on April 13, 2012, at 5:11:02
well, chalk it up to no sleep, but it is the cymbalta I tried to ease off of, went from 60 to 30 for a few weeks. Now I'm thinking perhaps the prozac is "droppable"...I have not been in hospital for a year and a half. Yay!!
I don't want to set myself up to relapse. I also want to sleep someday.Seroquel was a disaster for me- I took it a few years ago and had huge weight gain and after stopping had a terrible histamine flare up that persists to this day.
About herbal remedies- is it laughable that I am fearful of mixing "herbal medicine" with my psych drugs? I am worried about interactions and know /have seen very little by way of data about herbal interactions.
thanks again, for responding :)
LB
Posted by phidippus on April 14, 2012, at 21:17:35
In reply to Re: Lots of meds on board but NO SLEEP!, posted by LindaBelcher on April 13, 2012, at 15:48:12
Mirtazapine @15 mg should be helpful. Thorazine is one of the best.
Eric
Posted by LindaBelcher on April 16, 2012, at 14:14:37
In reply to Re: Lots of meds on board but NO SLEEP! » LindaBelcher, posted by phidippus on April 14, 2012, at 21:17:35
I had a meeting with a pulmonologist, (who is the gatekeeper for sleep studies, which I thought maybe I need) and he said a few things that really triggered me- namely that depression and anxiety are not true psychiatric illnesses, and that its no wonder I'm not sleeping because "don't I know what all my meds are doing to me brain?".
usually I can just reject ignorance and stay focused on what I need, which I am still doing, and, I feel so helpless about sleep.
Eric, you suggested mirtazapine, do you mean instead of prozac, or just as a sleep aid? I don't know about thorazine, I'm, not psychotic. just tired :)
LB
Posted by phidippus on April 16, 2012, at 15:37:31
In reply to Re: Lots of meds on board but NO SLEEP!, posted by LindaBelcher on April 16, 2012, at 14:14:37
Mirtazapine can be used alone as a sleep aid-7.5 to 15 mgs a night.
Thorazine can also be used much the same way-in a low dose to help one sleep. It doesn't mean your psychotic.
The pulmonologist making comments on depression and anxiety is as silly to me as the garbage man telling me schizophrenia is not a 'true' psychiatric illness.
What drugs are you on?
Eric
Posted by LindaBelcher on April 16, 2012, at 17:25:22
In reply to Re: Lots of meds on board but NO SLEEP!, posted by phidippus on April 16, 2012, at 15:37:31
haha, yes, think the pulmonologist I saw was just awful..and deluded.
meds are:
cymbalta, prozac, neurontin, prazocin, ativan and ambien.
prozac was added roughly two years ago, around the same time trazadone stopped working.
Trying to find the "magic mix" of meds to treat ptsd, anxiety and depression is such a crapshoot. Factoring sleep into the mix makes it feel insurmountable.LB
This is the end of the thread.
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