Best antidepressant for sleep?

[Living Dead]

I cannot imagine why you would take an antidepressant for sleep. They are stimulating, and even if they also have sedative effects, the sleep quality isn't very good. Amitriptyline caused me damage. The first choice is always an antihistamine or a natural remedy such as valeriana. If that doesn't work I can recommend baclofen, codeine or neurontin. All of these can be combined with an antihistamine.

 

[Mij]

I cannot imagine why you would take an antidepressant for sleep. They are stimulating, and even if they also have sedative effects, the sleep quality isn't very good. Amitriptyline caused me damage. The first choice is always an antihistamine or a natural remedy such as valeriana. If that doesn't work I can recommend baclofen, codeine or neurontin. All of these can be combined with an antihistamine.

Some antidepressants are excellent for sleep. Trazodone in small doses does give you deep stage sleep, it's a older medication and is used mostly for sleep instead of depression because it works so well. Some can't tolerate it but others can, we all react differently A lot of ME and CFS doctors rec Trazodone to their patients.

 

[EMilo]

Believe it or not I’m thinking about trying Advil PM and/or Unisom Sleep Gels next. The most effective for me thus far is Amitriptyline 25mg and Temazepam 30mg for the last 7 years. However, it’s has lost its luster of late…I usual try to go solo with the Temazepam only because of the hangover effect with Amitriptyline. If I use Amitriptyline/Temazepam together I do sleep through the night. I have tried other prescription sleep aids and get NO effect, especially with popular Ambien. I can take three Ambien 10mg and be up all night. Trazodone keeps we awake all night too.

I do have some Unisom at home. Maybe I'll try that tonight in conjunction with gabapentin. I honestly wish somebody would just induce a coma for a month and let me catch up on rest.

 

[EMilo]

I'm another who could not tolerate amitriptyline. (the low dose, normally used for bed-wetting in 7-year olds).
It put me on a different planet (my feet seemed to be miles away if I tried to look down at them) my guts went crazy, I got non-stop cystitis and I kept passing out. It took a long time for these effects to wear off after I stopped taking it - several weeks/months.
I didn't mind the side-effects too much when I was cheerful, (it was a bit like being drunk), but when I was in a bad mood or upset, it was unbearable.

But I do know of others (with ME) who swear by it.

How are you with alcohol? I know a lot of PWME can't drink; (I've been sober for 22 years and ain't about to start that again) but maybe a "nightcap" might help you?

I sometimes use a mix of valerian, passion flower, hops and lettuce extract, an OTC preparation that sometimes helps a bit.

Nothing much does help though. When I'm going through a really bad patch of insommnia, I find the only way to cope with it is to at least rest all night - to try not to let my brain get out-of-control fretting about not sleeping.

I do try a bit of self-hypnosis too.
Concentrate on breathing slowly and deeply in to a count of 10, hold it for a count of 10, then slowly breathe out to a countdown from10.
Do this 10 times, while staring at a point high up on the wall/ceiling, and DO NOT allow yourself to blink.

On the last breath out, you are allowed to shut your eyes when you get to the end, allow all your muscles to relax with the last breath out.

If it doesn't help, you can start at the beginning again. Or do it 100 times.
All the concentrating and counting helps to stop your brain racing.

Another thing I use to stop my brain racing is to go through the alphabet, listing 3 vegetables for every letter, or 5 boys' names or 5 girls' names, or 3, or 5, or even 10 of whatever takes your fancy.

Much sympathy. The worst of it is actually having to consciously exist while feeling utterly vile for up to 22 hours out of every 24. Sleep is such a joyous escape from it!

Peggy-sue, last night I tried the alphabet backwards, thinking of drug names! My rules were it could not be a supplement, herb or vitamin, it had to be a RX or OTC drug, preferably something I have taken. It was way too easy and I got to "A" pretty quickly, but then doubled back to "Q". I fell asleep still trying to think of a Q drug!
Unfortunately, I was awake again half hour later and half hour later and half hour later... Until I got up after 5 crappy hours, but that was a good idea, thank you!

I quit drinking about 10 years before I got sick, but don't think I'm not thinking about night-caps every night!!

 

[EMilo]

Absolutely for sleep you can take as needed. The best part is that when you no longer need it for sleep you can just stop with no withdrawal type symptoms.

The best person to ask as far as taking gabapentin together with Trazodone is a pharmacist.

You are kidding! I thought you pretty much had to get on all ADs and stay on them (I've never been on any long-term meds). If I can try trazodone for a few nights that lessens the fear of addiction, brain zaps, withdrawal blah blah. Maybe I'll finally take it out of my "drugs I don't take drawer" and put it on the "drugs I'm fearfully considering shelf"!

 

[EMilo]

I have used sedating antidepressants sporadically and this helps them to keep working by reducing tolerance. Regular use is needed if one is using them for depression or pain?

Best news ever. I can handle my depression and pain. I CANNOT handle my lack of sleep (which is really the cause of most epression and pain).

 

[EMilo]

I have used both with no issues. Both work on different receptors probably increase sedation. Always check with your doctor.

My doctor would prefer I increase the gabapentin dose rather than add a new drug, but I can tell you right now, gabapentin is not strong enough to get me to sleep and, the last time I took gabapentin, I quit at 300mgs because of side effects, so I really want to stay as low as possible. I'm happy to hear you have no issues. Thanks!

 

[Mij]

You are kidding! I thought you pretty much had to get on all ADs and stay on them (I've never been on any long-term meds). If I can try trazodone for a few nights that lessens the fear of addiction, brain zaps, withdrawal blah blah. Maybe I'll finally take it out of my "drugs I don't take drawer" and put it on the "drugs I'm fearfully considering shelf"!

If you are using an AD such as trazodone for sleep then you can use as needed. I got 5-5/12 hrs of deep stage sleep on only 25mgs. My natural sleep eventually came back but every once in a while I need to take it.

What dosage did your doctor recommend?

 

[EMilo]

If you are using an AD such as trazodone for sleep then you can use as needed. I got 5-5/12 hrs of deep stage sleep on only 25mgs. My natural sleep eventually came back but every once in a while I need to take it.

What dosage did your doctor recommend?

My doctor has actually held off for a year before giving me this Rx. She didn't want to give me an AD at all. I finally suggested trazodone for my sleep after reading an article on PR and she agreed that I could give it a try... but starting as low as possible. I will probably try 1/8 of a pill to see if I have an allergic reaction, then 1/4, then 1/2. I don't think I'd go higher than a half.

 

[Mij]

My doctor has actually held off for a year before giving me this Rx. She didn't want to give me an AD at all. I finally suggested trazodone for my sleep after reading an article on PR and she agreed that I could give it a try... but starting as low as possible. I will probably try 1/8 of a pill to see if I have an allergic reaction, then 1/4, then 1/2. I don't think I'd go higher than a half.

I'm glad you were able to get your doctor to prescribe this for you. There are times when I feel sleepy and I just need a little something so I'll take 13.5mg which isn't really considered a dose and I can get back into my sleep.

Some people take 50-100mg for deep stage sleep but I hope you can get away with less. I took 50mg once and I was very dizzy the next day.

 

[heapsreal]

My doctor would prefer I increase the gabapentin dose rather than add a new drug, but I can tell you right now, gabapentin is not strong enough to get me to sleep and, the last time I took gabapentin, I quit at 300mgs because of side effects, so I really want to stay as low as possible. I'm happy to hear you have no issues. Thanks!

I dont find neurontin sedating but for pain. Treating pain can improve sleep quality but yes something abit stronger like a sedating antidepressant can do the job. The same antidepressant can have different effects in different people. I remember reading about sermontil being very sedating. It did nothing for me but then others experiences have been the opposite. Trial and is only way to know if it's going to help.

 

[magicskyjuice]

What non-medicinal steps have you tried, if I may ask?

All the meds in the world won't do any good if you're not practicing good sleep hygiene (pitch black bedroom, gentle music, no caffeine after 4pm, etc etc)

Have you tried melatonin? it's OTC and has very few side effects if it works for you.

Mirtazapine/Remeron has pretty strong sedating properties for an AD, but you will crave sugar and food. weight gain is almost a certainty.

 

[helen1]

It's a drag to have to use meds but all the sleep hygiene in the world won't help your sleep if your biochemistry is unbalanced whether it's hormones, neurotransmitters, or whatever. After years of insomnia, I'm finding no protein or other sources of glutamate in the evening is helping me sleep better. And meanwhile working on getting the glutamate converted.

 

[redviper]

Have been taking amitriptyline for the past few weeks, it has been completely useless for me.

 

[EMilo]

Have been taking amitriptyline for the past few weeks, it has been completely useless for me.

So sorry

 

[Lou]

Red LED intranasal light has shown some pretty amazing results. I don't think there is a best anti-depressant, unless you're the 'miracle' girl that doesn't get any of the long term negative side effects.

 

[minkeygirl]

After taking Trazodone for years for sleep, 2 weeks ago I woke up totally drugged out til late in the afternoon and it continues. I can't fall asleep and can't stay asleep. Trazodone put me to sleep and Suntheanine kept me sleeping.

About 6 months ago I tried some other TCA (forget what) and Rozerem in case and I was totally drugged or they didn't work.

I have probably tried 20+ things over the years to sleep and most either drugged me out or amped me up. The ones that did work now cause tachycardia (benedryl) or drug me.

OTC stuff doesn't even touch it although last night I took 20 mgs of melatonin (excess is not nearly enough) and I slept for about 3 hours. Woke up doubly drugged.

So now I have to find something else. The options are so limited and the side effects like weight gain concern me.

I might be able to get to sleep, but don't know what to do when I wake in the middle of the night. I have pretty serious sleep issues.

Thanks

Minks

 

[heapsreal]

After taking Trazodone for years for sleep, 2 weeks ago I woke up totally drugged out til late in the afternoon and it continues. I can't fall asleep and can't stay asleep. Trazodone put me to sleep and Suntheanine kept me sleeping.

About 6 months ago I tried some other TCA (forget what) and Rozerem in case and I was totally drugged or they didn't work.

I have probably tried 20+ things over the years to sleep and most either drugged me out or amped me up. The ones that did work now cause tachycardia (benedryl) or drug me.

OTC stuff doesn't even touch it although last night I took 20 mgs of melatonin (excess is not nearly enough) and I slept for about 3 hours. Woke up doubly drugged.

So now I have to find something else. The options are so limited and the side effects like weight gain concern me.

I might be able to get to sleep, but don't know what to do when I wake in the middle of the night. I have pretty serious sleep issues.

Thanks

Minks

combinations can work also and alternate them regularly.

Dont know if u have tried them but heres some suggestions, anticonvulsants like neurontin or lyrica. baclofen, tizanadine which are muscle relaxers, seroquel which is an antipsychotic but used in low doses for severe insomnia, periactin is an antihistamine suppose to increase deep sleep.

Also maybe look at something that workked for u in the past that stopped working, generally after a long break some of these things can help again??

good luck.

 

[minkeygirl]

Hi Heaps, after 18 years the only thing that worked was benedryl and trazodone. Benedryl now causes tachycardia.

Seroquel, LDN kept me awake and baclofen was like speed. Pretty much every other TCA drugged me out. Lyrica and most others in that entire class amps me and Neurontin didn't help me sleep but did help me gain 60 lbs!

I will look into periactin but as you can see, I'm kind of stuck.

I slept maybe 2 hours last night because I dind't take any trazodone. I was tired but my brain was wide awake. I'm still feeling like someone pumped my skull full of air but its' kind of hard to tell if I feel drugged since I'm so sleep deprived. I may have to take a tiny dose of the traz to avoid w/d and just wait til I eventually crash from only 2 hours of sleep a night in a few days. Then maybe then I'll be able to tell if it is the trazodone. And if it's not then WTF?

What do you tell a doc who doesn't get ME? Hey doc, if feels like my cranium has air in it? What do you think we should do?

Thanks for the suggestions. You'd think they'd figure this out by now.

Mew

 

[heapsreal]

Hi Heaps, after 18 years the only thing that worked was benedryl and trazodone. Benedryl now causes tachycardia.

Seroquel, LDN kept me awake and baclofen was like speed. Pretty much every other TCA drugged me out. Lyrica and most others in that entire class amps me and Neurontin didn't help me sleep but did help me gain 60 lbs!

I will look into periactin but as you can see, I'm kind of stuck.

I slept maybe 2 hours last night because I dind't take any trazodone. I was tired but my brain was wide awake. I'm still feeling like someone pumped my skull full of air but its' kind of hard to tell if I feel drugged since I'm so sleep deprived. I may have to take a tiny dose of the traz to avoid w/d and just wait til I eventually crash from only 2 hours of sleep a night in a few days. Then maybe then I'll be able to tell if it is the trazodone. And if it's not then WTF?

What do you tell a doc who doesn't get ME? Hey doc, if feels like my cranium has air in it? What do you think we should do?

Thanks for the suggestions. You'd think they'd figure this out by now.

Mew

i feel for you as i go through similar periods where nothing works. Hate making suggestions for someone experienced with all this stuff but have u had night time cortisol measured recently?? Maybe something like phosphatidylserine in doses of 500mg could help???
Maybe u just need speed which might act like a benzo?? no stupid joke?? its bad that many of those sedatives had a reverse effect on you, what do docs say about that?
Circadian rthym is often spoken about but cortisol rthym not so much but worth investigating. Some are using low doses of bromocriptine in the morning to reset body clocks etc cycloset is one of the drugs worth looking into for this??