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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 vic80 on April 23, 2010, at 13:47:05
Dx: MDD, Anxiety
Rx: Escitalopram 10mg, Venlafaxine XR 37.5mg, Lorazepam 1mg, Eszopiclone 1mgI have been trying to look into REM sleep supression caused by SSRIs.
There has to be some link between between the use of SSRIs and sleep cycle disruption.
I think that the anti-depressant keeps one stimulated and awake.. while it strips one off proper sound sleep especially the much-needed rem-sleep. (though I have read about mild-depression alleviation through REM-sleep supression)Lack of REM-sleep OR lack of quality sleep caused by SSRI (and the over-prescribed 'z'-class sleeping pills to offset SSRI induced insomnia) could explain the fatigue and general malaise. could also be attributed to feelings of depresonalization, increased stress levels (high cortisol), dissociation, being in a daze, feeling drugged and a general impairment of cognitive functions like memory, diminishing effect on imagination and creativity, lack of introspective thinking, perhaps even hallucinations, psychotic symptoms - mostly symptoms closely associated with sleep-deprivation.
High stress hormone levels and lack of REM-sleep would also make one feel very irritated, agitated, dysphoric and impair one's judgement making suicidal thoughts more dangerous.
I have been having dissociative symptoms and a general feeling of being in a daze constantly, which my Psych. calls 'depressive symptoms' and his fierce loyalty to mind-altering chemicals prohibits him from being honest about the effect of the anti-dep meds he prescribes.
As far as my depression is concerned - much of the torture is caused by the mental-effects of my meds rather than the emotional aspect (which has been effectively flattened to zero).
Venlafaxine seems to be even worse compared to the escitalopram I have been taking for over 4 months.
Is it time for me to kick the pdoc? or should I just kick the meds (albeit slowly as have the former-ssri users urged with much caution and love)?
Posted by Pheepho on April 24, 2010, at 9:57:42
In reply to SSRI-induced-Sleep-Disorder induced dissociation, posted by vic80 on April 23, 2010, at 13:47:05
Hi there,
I have suffered chronically from insomnia on AD's. I am currently weaning slowly off my AD because of this. I realized the insomnia was far worse than the depression. I am on seroquel to help me sleep, which is ridiculous.
I think healthy sleep is really important. I hope if the depression returns after the withdrawal, I'll be able to cope better, because my life is really better now. My pdoc doesn't know about it yet, but I find her useless and ignorant when it comes to withdrawal, so I feel safer when I'm in control.
I'm weaning it really slow, as you said, and I don't expect my sleep to improve right away, since insomnia is a withdrawal symptom! But I'm optimistic.
Another side-effect I've had on AD's along with insomnia is psychotic symptoms. My pdoc calls it psychotic depression, but I've had depression on and off all my life, never been psychotic while not on meds...
I've been on AD's for 10 years, when my depression was basically around crisis in my life, so looking back it seems absurd...expecting to spend the next few years weaning down and dealing with withdrawal...sucks...thanks for your post.
Posted by Pheepho on April 24, 2010, at 10:00:24
In reply to SSRI-induced-Sleep-Disorder induced dissociation, posted by vic80 on April 23, 2010, at 13:47:05
PS would be interested in any links or sources you have found helpful on this topic, if you don't mind posting them...
Posted by ed_uk2010 on April 24, 2010, at 10:22:04
In reply to Re: SSRI-induced-Sleep-Disorder induced dissociation, posted by Pheepho on April 24, 2010, at 9:57:42
>I have suffered chronically from insomnia on AD's. I am currently weaning slowly off my AD because of this. I realized the insomnia was far worse than the depression. I am on seroquel to help me sleep, which is ridiculous.
I hope you stay well once you're off antidepressants. If you do have to go back on an antidepressant, you should probably try one of the antidepressants which also helps sleep eg. amitriptyline.
Posted by Pheepho on April 24, 2010, at 10:53:45
In reply to Re: SSRI-induced-Sleep-Disorder induced dissociation » Pheepho, posted by ed_uk2010 on April 24, 2010, at 10:22:04
Thanks for the tip, that's a tricyclic, right? I think of them as pretty old-fashioned, why are they less used now?
Posted by Phillipa on April 24, 2010, at 10:55:12
In reply to Re: SSRI-induced-Sleep-Disorder induced dissociation » Pheepho, posted by ed_uk2010 on April 24, 2010, at 10:22:04
That's why I stay on the starter dose of luvox as the docs all think the ad's eliminate anxiety. I had horrible side effects on ad's years ago and usually discontinued in a week or two and felt much better on just benzos. I also googled last night and found no risk of cancers or long term memory issue on them if taken correctly and not escalated to high doses. So now that fear is gone. And antipsychotics cause so much weight gain and diabetes etc. And some have lawsuits. No I will stick to low dose luvox and the low dose benzos. Good luck to you. Phillipa
Posted by ed_uk2010 on April 24, 2010, at 11:12:44
In reply to Re: SSRI-induced-Sleep-Disorder induced dissociation, posted by Pheepho on April 24, 2010, at 10:53:45
>Thanks for the tip, that's a tricyclic, right? I think of them as pretty old-fashioned, why are they less used now?
Yes, amitriptyline is a tricyclic antidepressant. It is normally given as a single dose at night because it's quite sedating, at least to begin with. Tricyclics are effective for severe depression but they are dangerous in overdose and doctors often fear that patients may use them for suicide. Dry mouth, drowsiness and constipation are common side effects.
There are a variety of sedating antidepressants, not just amitriptyline. I thought it was worth mentioning since you do not appear to have had a good experience of newer antidepressants - especially due to the insomnia.
Mirtazapine (Remeron) is a newer antidepressant which is normally very effective for improving sleep. It generally causes fewer side effects than amitriptyline but it can cause a lot of weight gain.
Posted by linkadge on April 27, 2010, at 19:52:57
In reply to SSRI-induced-Sleep-Disorder induced dissociation, posted by vic80 on April 23, 2010, at 13:47:05
>loyalty to mind-altering chemicals prohibits him >from being honest about the effect of the anti->dep meds he prescribes.
This post was very well written.
Linkadge
Posted by linkadge on April 27, 2010, at 19:56:13
In reply to Re: SSRI-induced-Sleep-Disorder induced dissociation, posted by Pheepho on April 24, 2010, at 9:57:42
I've often thought this is actually the mechanism by which SSRI's work. They kind of f your brain up enough that it forgets about the problems it was having and get it thinking more about suvival and restoration of basic neuronal functioning. I.e. a shock therapy of sorts.
Sometimes when the dust settles, things happen to be a little better, but more often than not, the chronic sleep disturbance actually inhibits recovery. In addition, the initial adaptive surviaval response peters out as resources become limited.
This is the end of the thread.
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