Published Jun 21, 2005
Husband was just dx with major depressive disorder, anxiety disorder and insomnia. Was started on Lexapro and then changed to Paxil and Ambien. The meds work great for the depression and anxiety, and have even increased his appetite, but he isn't able to fall asleep until about 0330 and then only sleeps for about 4-5 hours. Any suggestions?
I don't have any suggestions, but understand. My dh is going through the same thing. He just had his sleep study done and we are waiting for his results. He can't stay asleep. He will go to sleep about 11 pm on avg, but is up at 1a, and usually in 1/2 hr increments after that. He has to get up for work at 4:30a. The MD has prescribed Ambien, but it does not help him. I'm interested in what everyone has to say.
I have insomnia, but from what, we have no clue! It seems to be very common among cluster headache sufferers. I have quite a few friends from nursing and med school who suffer from insomnia...in fact, at one point we were going to name the 9th floor of our apartment building the "Insomnia Floor." I sleep best from 5am - noon...
I tried Ambien, but it did nothing. Ativan worked for a little while, but I was still able to stay up until around 3am without being tired. Then I took Klonopin. I could still stay up all night on Klonopin, but in addition I felt horribly tired during the day. I went off it last week. I had a sleep study in May, but all it basically showed was that I have problems sleeping! (Duh...I knew that already...hehe)
One thing that I know helps many who have insomnia are the tricyclic antidepressants. But part of the problem with the TCA's is that they can cause a person to sleep too much. I know I can't use them for insomnia (or for anything) because even on low doses I can still sleep about 20 hours a day or so.
The sleep psychiatrist wants to work with me on fixing my sleep schedule. I dunno about this....the cluster headaches are going to come, no matter how much I try to adjust my sleep schedule!
So...I'm sorry I don't have really any better answers. My psychiatrist and I were going to work on switching me from Klonopin back to Ativan or Xanax because they are not so long acting. I guess we'll see! Would love to know if any major insomniacs have found success with anything!
It is so specific to each person which drug or combinations of drugs will seem to work. I have not been a person who sleeps since I was born. At least that's what I hear from everyone who knew me when I was young and it has carried through my life except for maybe a few teenage years. The combination that seems to work best for me is Zoloft and Lunesta (eszopiclone). While taking ambien I experienced night time disorentation to the point of trying to get out of my room through the dresser, walking down the steps and not knowing how to get back up. My husband woke me many times until I finally stopped taking them. I have since heard of others who have similar episodes with ambien, so keep that in mind. Keep trying, It's an amazing thing to get sleep, when you are not used to it. It's like a gift to me when I truly sleep for a night.
Insomnia can be one of the side effects of Paxil. He may just need to adjust his dosage.
many antidepressants cause insomnia, like said above. Check dosages and times...may need adjustment. I know wellbutrin kept me up ALL NIGHT LONG.
Yes, the Lexapro and now Paxil have made his insomnia worse, the Ambien does nil. He's always been a night person, but this is getting out of control. Maybe I'm paranoid, but it doesn't seem right to get only 3-4 hours sleep night after night. He works in the yard doing landscaping, we've tried to establish some kind of a routine, but still looking. I think part of the problem is that he has a hard time recognizing when he's sleepy. Sometimes he'll fall asleep on the couch and he swears he didn't know he was going to go to sleep. Seems odd to me, cause I sure know when I'm about to fall asleep, but we're all so different.
Thanks for the info, and please keep them coming.
The falling asleep on the couch or in his recliner sure sounds familar!!!! My husband will do the same thing. He has fell asleep driving before also. Very scary to think about. I too find it hard to believe when he says I didnt mean to go to sleep. I get so frustrated with him sometimes, then feel bad, because I don't think he can help it. It's interesting to hear others views and suggestions.
zacarias, ASN, RN
Maybe I missed it but did you say whether he took the Paxil at night or in the morning? If it makes him stay awake, he should definitely take it in the morning and try to not nap at all during the day.
He doesn't take a nap during the day, is physically active, but just doesn't get sleepy. Thanks for posting suggestions and any insights. I can only imagine how frustrating it must be for people not to be able to go to sleep. My idea of heaven is that you get to sleep as long as you want....lol
If I have trouble sleeping I take Benadryl 50mg and then I sleep just fine. Good luck. :)
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