Best antidepressant for sleep?

[WillowJ]

Elizabeth Milo possibly this might help: http://www.cfstreatmentguide.com/1/...nd-cfs-99-of-patients-not-getting-better.html

everyone is very individual. unfortunately I agree that you might have to try a few things before finding something that works. If you have a really smart doctor or pharmacist, they might be able to suggest something based on your case history (e.g. specific symptoms and what medications you have not tolerated in the past). I have this one doc who is a genius like that.

 

[EMilo]

Elizabeth Milo possibly this might help: http://www.cfstreatmentguide.com/1/...nd-cfs-99-of-patients-not-getting-better.html

everyone is very individual. unfortunately I agree that you might have to try a few things before finding something that works. If you have a really smart doctor or pharmacist, they might be able to suggest something based on your case history (e.g. specific symptoms and what medications you have not tolerated in the past). I have this one doc who is a genius like that.

Thanks, WillowJ. I don't suppose your genius doctor is in Seattle, is he/she?

 

[WillowJ]

Thanks, WillowJ. I don't suppose your genius doctor is in Seattle, is he/she?

sadly, not near Seattle, and a pulmonologist (so kind of limited application anyway)

 

[Scott White]

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.

 

[EMilo]

Elizabeth, I take surmontil, an old AD, which is, I understand, the most sedating of them all. I do find though that it is not sufficient on its own (I have 'weapon-grade insomnia) and use other meds as well.

I hope you manage to find something to help you as the insomnia is misery.

Best wishes,

C.G.

I've never heard of that AD. I would consider my insomnia weapons-grade, also. Thanks for the support.

 

[EMilo]

Desyrel works great for me, 25mg. You would not "kill 2 birds with 1 stone" with this small dosage though, it would just put you to sleep.

Take with food. The absorption of the drug may be up to 20% higher when it is taken with food rather than on an empty stomach.

My doc just gave me an Rx for trazodone. I haven't got the nerve to try it yet. Do you know if you can only take it sporadically? I would love to just take something every few days. I am also taking gabapentin for sleep ~any idea if the two can be taken together? Thank you!!

 

[EMilo]

I take remeron 7.5 mg (recently reduced from 15mg after being on deplin for a couple of months) and 400 mcg of melatonin. That combination seems to work well for me. Btw, it is called remeron because it induces r.e.m. sleep. If you decide to go this route, be careful. Take your first dose on a Friday night, because it will knock your socks off. Your mind is starved for sleep and you will dream like crazy and be very groggy half of the next day. Titrate up slowly to find the right dose. If you go up too quickly like me, it gets to be too drying and you could run into problems. Eventually you will find a dose that works good and doesn't leave you hung over the next day. Good luck.

I've never heard of remeron, either! Thanks for the tip.

 

[EMilo]

I'm guessing you've tried 5htp?

I have not tried 5HTP. Do you recommend that before something like trazodone? I have tried melatonin, valerian, benadryl, unisom, tizanidine, valerian, PS, magnesium... I just need something to keep me asleep. It's the constant waking that might kill me.

 

[EMilo]

Elizabeth, My experience with Amitriptyline was a disaster. Not only did it not help with sleep but it left me feeling poisoned and like a zombie. The effects got worse rather then better over time. The effects on my gut was so severe that it has never gone away.

When I need help to sleep I try different things and change every few days. Baclofen (which was prescribed for restless legs), Benadryl and many allergy or antihistamines make me sleepy, some OTC painkiller drugs as well. I do appreciate that you have probably tried all of this.

Some people with CFS are reported as having high serotonin so it's controversial even taking an AD drug. I'm not depressed and the AD's I tried were purely for sleep and pain. They didn't work for me for either.

I'm sensitive to drugs and all the AD's I tried were a disaster. It may be trial and error for a while to find something from any group that will work for you. Hope you are lucky though.

I'm sensitive to drugs, too, and not depressed. Amitriptyline was top of my list and I'm really glad I asked because I have horrific IBS-C already and don't need any more gut trouble.

 

[EMilo]

I think it would help to figure out why you aren't sleeping first. Do you have trouble falling asleep? Do you wake up and can't fall asleep again? Is there any pain or tenseness when you can't sleep? Is your body exhausted but your mind running around in circles?

I take hydroxyB12 for the pain, and NAC - N-acytlcysteine for my mind not shutting down properly ("wired but tired"). And 3 grams of fish oil daily to shut down the otherwise constant headache.

Did I never answer this? Sorry! Ok, my biggest problem is constant waking. And god forbid I have to get out of bed for any reason, I will NOT go back to sleep no matter what time it is. EVERYTHING wakes me. We have gone to great lengths to noise- and sound-proof my room. If anything wakes me, I'm awake. If nothing wakes me, I still spend most of the night in awake brain activity (according to the sleep study and my Zeo headband).

I have pain issues, too, and some trouble falling asleep and my mind definitely races, but none of that is a major concern. I do take 2 grams of fish oil. I'll look into NAC. Thanks for the help!

 

[EMilo]

Elizabeth, have you ever been tested for bartonella? Bartonella causes horrible insomnia...
Lithium Orotate can help with sleep, though it is OTC med.
Mirtazapine (Remeron) caused me severe worsening of neurological symptoms and brought me a range of new symptoms as well. I would be careful.

I don't think I have been tested for bartonella!Thank you!

 

[EMilo]

Elizabeth, I completely feel for you. When I first got sick all I wanted to do was sleep, but that switched over into pure no sleep insomnia. It was an awful time and I went nuts. I had to go on an antidepressant. I completely understand your plight. None of us are experts and we are so different in what works for us. A sleep study can be very difficult and I have yet to do one because I don't want to! I want to be in my bed.

I went on Tofranil, an old antidepressant in the beginning. It helped me for sleep. Trazadone is one of the more tiring antidepressants, otherwise known at Desyrel. Problem with that for me, it made me sick to my stomach. See why I am saying none of us are experts? It works differently for everyone.

I went on Sinequan at one point and Remeron. Both of them put 20 pounds on me and I was rolly polly. It took me forever to get the weight off and Remeron..I still have the 13 pounds extra it put on me!

5HTP gave me nightmares...bloody, killing nightmares.

SSRI's make me vomit. They give me horrible reflux and gerd.

See? We are all so different.

You need to try them out and find out for yourself. I hate telling you that. I would, if you can find a good psychiatrist, go to a good psychiatrist. I am not a fan of shrinks, but I will say this; they know their meds for the most part if you get to a good one and they can really help you. Some psychiatrists, all they do is prescribe meds. They are experts at it and they don't do therapy or talking. You are in and out.

I completely understand how daunting this is.

After you get a medicine that works and get some sleep, try to really help the CFS. It wasn't until I got sleep that I could think about methylation protocols and treatments for this thing, because I was just too strung out and needed SLEEP.

WOW. SO sorry you experienced all this. I truly don't think I can have a marginally happy life until I get the sleep under control. It rules my life and dictates how bad my symptoms will be. Everything would change if I could sleep. Maybe I'd be able to leave the house again!

 

[peggy-sue]

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!

 

[Abha]

Hi Elizabeth et al,

I'm on amitriptyline at present.I take 10 mgs and it puts me to sleep.I was supposed to increase it to two tabs per night but as 1 tablet is working ok I'll continue with this dose in the meantime.I'm an OP(malathion)affected patient and Dr Myhill uses it with such patients(according to her website).Over the past 40+years I have had various sleeping tablets.Some work for a very short period and then seem to make things worse.I used lithium orotate too and it seemed to work for a while.I never feel refreshed when I waken up....and it takes me ages to get going.I see others have had mixed experiences but then no drug is perfect.I'd prefer to do without but at present this is what I have to do.

 

[Mij]

My doc just gave me an Rx for trazodone. I haven't got the nerve to try it yet. Do you know if you can only take it sporadically? I would love to just take something every few days. I am also taking gabapentin for sleep ~any idea if the two can be taken together? Thank you!!

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.

 

[Misfit Toy]

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.

Years ago, I used to just take an antidepressant here and there. Elavil helped with sleep so much, I would literally lick the pill and go to sleep. Trazadone too. My friend takes Trazadone as needed. Not every night. You should try it. Pharmacists know you can do this. The meds aren't issued out like that, but if it's for sleep only, I wouldn't worry about it too much.

Elizabeth Milo-SLEEP is the most important thing in my book, It helps me handle things and get out. However, there have been times I sleep great and still feel like dog. But still, not sleeping makes one nuts.

 

[heapsreal]

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?

 

[heapsreal]

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.

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

 

[WillowJ]

my biggest problem is constant waking. ... If nothing wakes me, I still spend most of the night in awake brain activity (according to the sleep study and my Zeo headband).

did they look at your respiratory activity in connection to your sleep? my sleep doc decided I could be starting to stop breathing and this could cause me to wake up to prevent this (even though by traditional assessment I have no apnea at all). Trial with a CPAP did find breath stoppage events to fix.

do you ever wake up breathless or with the sensation you've not been breathing recently?

 

[Firestormm]

... If nothing wakes me, I still spend most of the night in awake brain activity (according to the sleep study and my Zeo headband)...

I have the same problems Elizabeth. I do take several prescription drugs, none specifically for sleep however, but one is an anti-depressant. I hadn't realised Gabapentin can be prescribed for sleep - seems strange - but if it helps then cool as I'm on that one too but for pain. Similarly, as was mentioned, I hadn't realised Baclofen was another aide to sleep - another drug I take that helps take the edge off of the muscular aches and twitching. I guess the combination of several drugs will all serve to help the body and brain enter a relaxed state.

I do take Sominex in addition to my prescribed meds. Just half a pill each night, every night. I find that if I take it an hour before I would hope to retire, then it really does begin to send me under. You can of course 'push through' this should you wish - but I find it is enough to get me into sleep-mode.

I have altered by day-time routines in an attempt to improve my 'sleep-hygiene' and rarely now fall asleep during the day. My activity in the afternoon and evening is flat - other than cooking dinner - but I try and stay awake until about 10pm. I have found this means I fall asleep quicker and for longer - but still encounter many of the previous issues. Although it is easier now to get back to sleep. When I do wake, I get up and move environments, and if I know I won't return easily to sleep I might read in the lounge on the sofa for a bit. If sleep is obviously not going to return, then I will begin my day - whatever the time.

Other things I can now do, and try to do each day, include getting outside for some fresh air and gentle exercise and ensuring I have some fresh air in my room at night if I can. Also that the temperature is comfortable for me - I still sweat heavily at night. I purchased a good mattress some time ago and that changed things noticeably. Though I am sure you have done all that you can in this respect.

I am about to embrace a sleep study at hospital over 2 days (1 night), and wanted to ask if they specifically prescribed anything for you based on the observations they made? What were their conclusions?

Personally I was disappointed they will not be running my study over 3 nights at least - as my neurologist had said they really needed to do. I get these 'seizures' at night sporadically, though often a couple a week I suppose, and it was really those that they are trying to get a handle on. I think the chances of building up an accurate picture during one night are significantly reduced.

Thanks.

Edit:

I forgot to say, my Antidepressant - now Moclobemide - was not prescribed for sleep. Unless a doctor is associating anxiety as a possible cause of sleep-distress I suppose, which none of my own ever have; I can't see the association. I have been through double-digit prescriptions of different Antidepressants over the past 14 years. Each doctor I see has his own preference it would seem. This one though doesn't seem to disagree with me. And if you read the link - perhaps it helps explain why. I was told it was 'an old one' which I took to mean not one of these newer 'trendy' pills. But it works for the primary diagnosis which was associated depression of course.