Some anxiety and maybe a bit of depression and SLEEP
Question:
I have had problems sleeping for 5.5 years now. 3.5 years ago I saw an doctor for the first time about it. This is the storry so far: – 3.5 to 1.0 year ago: 50mg Vallergan (antihistamine) – 1.0 to 0.8 year ago: 40mg Surmontil (Trimipramine) and 30mg Vallergan – 0.8 to 0.5 year ago: 30mg Vallergan – 0.5 to 0.1 year ago: 20mg Prozac and 20mg Vallergan – 0.1 till now: 150mg Dothiepin (tricyclic with anti-anxiety properties) Without medication I have problems both getting to sleep and maintaining sleep. With medication I usually only have problems with too early awakening, without being able to get back to sleep. I guess I average about 5 hours sleep a night with medication, with about one really bad night a week. The Vallergan has allways worked in a way, but it’s not the "ultimate solution" of course. I used Surmontil for 3 months. The only thing it gave me, was irregular heart-rhythms. The only thing Prozac gave me, was decreased libido. 3 weeks ago I had a long talk with my doctor, and she "decided" anxiety is the most probable cause for my insomnia. I was then given Dothiepin, a tricyclic with anti-anxiety properties used widely in UK, and I finally ditched the Vallergan. I didn’t notice any sedation at all from the initial 75mg dose, so after a week it was upped to 150mg. The first 5 days on 150mg I slept better than I have done for ages. The week after that (till today) I haven’t slept good at all, though. I can still feel the sedation coming on, but I wake up way too early. If I wake up after 4 hours of sleep, or 5 hours after I took the 150mg of Dothiepin, I don’t feel sedated. So, it seems the sedation isn’t lasting long enough. 150mg is the maximum dose of Dothiepin outside hospital, so it can’t be upped. I’m a 183cm/100kg "Tyson-built" male. In 2 weeks time I will go on a holiday-trip. The last 5 years all my holiday-trips have largely been spoilt by insomnia, and now it seems like this one too will be of the half man-half zombie variety. What can I do? The Dothiepin was prescribed because it should help both insomnia and anxiety. Now, it doesn’t seem to help me much regarding insomnia, and it’s probably too early to tell what effects it will have on my anxiety. 3 weeks isn’t enough for most people? I have read, mostly on newsgroups, that Trazodone is by far the most sedating antidepressant. I have also read that the anti-anxiety effects of Dothiepin is very small/weak compared to Paxil, Xanax and more "specialized" stuff like that. So, I’m thinking that I should have Trazodone in the evening and fx. Paxil in the morning. What do you think? This would be bad because it means quitting Dothiepin before it has even got the chance to show what good it can do. I’m also going to counseling (for the first time) in a few days. I don’t think it will be in time to "save" my holiday, though.
Response:
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