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HELP: Pregnancy, Insomnia and Anxiety, and Medication ?

Question:
My sister is 8 weeks pregnant and having a crisis, and I was hoping someone could offer advice for her situation. She is having SEVERE anxiety and insomnia, and cannot sleep at all most nights without medication. Her OB/GYN suggested UNISOM (an over-the-counter sleep aid) only as an absolute last resort. She has taken it four nights in a row. She is in a state of panic and going downhill emotionally. Naturally, she is very worried that she is hurting her baby.


Answer:
This should help your sister. I have a very stressful job and had a lot of stress outside of work during the last 2 years. In the past when I am under stress for too long my body goes into this bio-chemical thing and I start having anxiety attacks. After a few attacks in less than a week it is called Panic Disorder. I've only had this twice in my life. Once about 7 years ago. (I am 28 now) And just recently. Fortunately, I went to the right doctor the first time who diagnosed it. Recently, it just started back up again. I knew what was happening and went right to the doctor and got the same prescription. It works! I was presribed Immipramine at 25 mgs for 10 days, then 50 mgs thereafter. You usually take this for about 4 months. In the begining the doctor also gave me Xanax .25 mgs (the lowest dose) two times a day for a few weeks. It takes a while for the Immipramine to build up in your system. I felt symtom free immediately. After the 4 months you go off the Immipramine and the anxiety is gone. For me it's been 7 years since the last time I has this problem. I just let too much stress into my life. I'm not sure if she can take this while she's pregnant. But, it may help her after she has the baby.

She should also do some form of exercise that makes her sweat. My wife is pregnant and is using a stair stepper. It's low impact and makes you really sweat if you set the resistance high. I lift weights and ride my bicycle. The exercise will help get rid of built up tension that your sister might be holding in. It has to be aggressive excercise though.

The active ingredient in unisom is doxylamine succinate, the same antihistimine that was used in the morning sickness drug Bendectin (Debenox in the UK). It has been used by millions of women and the only birth defect that has been substantiated is a slightly increased incidence of pyloric stenosis, which is not immediately life-threatening and can generally be corrected by surgery. And the increase in incidence is so slight that nobody noticed it until all the lawsuits over limb defects. Yes, parents won court cases, but the scientific evidence does not support their claims and several cases are still pending appeal.

I took it for three pregnancies, and would not hesitate to take it if needed. But it is not that great of a sleep aid, since all anti-histimines develop tolerance--it will stop working after a few weeks, and it *does* mess with the sleep cycles.

NO! It's an herb, but it's a potent drug. I ran a medline search last year and learned that while it is very effective, there are some problems with its effect on the circulatory system. I canot take it because of a natural proclivity toward low blood pressure, and considering the importance of circulation to the fetus--well, I personally consider the Unisom safer.

I also heard that they were going to be doing some research on the use of Melatonin during pregnancy, but it's a hormone, and I wouldn't recommend it to any pregnant women until some of the data is in.

There is a newish drug called Ambien (Zolpidem) that isn't even listed in the PDR yet, so I don't know its pregnancy classification. But ask the doctor.

I have an anxiety disorder as well as insomnia for over 10 years. I have tried Xanax for the anxiety with no help (made me severely depressed, etc). I am currently using Ambien for the insomia, unfortunately it isn't working for me. Even when I tried doubling the dose as per my M.D. Ambien is a relatively new drug, so I do not have access to the pharmacology. Therefore, I do not know if it is compatible with pregnancy. My advice would be to call your local pharmacist in the morning to find out about being pregnant while using it. If it's alright to use, GET it from your Dr. Sometimes Dr's aren't too helpful in prescribing the CORRECT medications for insomnia! I unfortunately, know that all too well!


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