Question:
I have had problems sleeping for years. I wouldnt beable to go to sleep due
to anxiety, I used to take ritalin (3 yrs ago).
I now take two different types of antidepressants. One a SSRI and the other
a maoi i believe. I take 40 mg of Prozac in the morning and then 100mg
Trazadone before bed to help me sleep. I have just recently started taking
theese two and have been on them for about 2 - 3 months. I have a real hard
time sleeping and get very little sleep. I usually end up falling asleep at
1 oclock in the morning and wake up at 4 - 530 in the morning. I feel droggy
when I wake up but I end up becoming wide awake. can someone help tell me
what this is.
Answer:
Trazadone is not an MAOI. When I last researched the subject of anti-
depressants, (in 1996) it was considered absolutely lethal to mix an
MAOI with an SSRI. MAOIs can have lots of serious (potentially lethal)
side effects if mixed with certain things, including some types of
over the counter cough medicines, other antidepressants, several
different types of foods, and especially demerol.
In 1996, psychopharamacologists were just beginning to experiment with
the combination of multiple types of antidepressants. If you are
currently being treated by a GP, I would suggest going to a
psychiatrist,
or a sleep specialist, (or both) beacause even the best educated GP
doesn't have the expertise to mix up and antidepressant cocktail. IMO.
Insomnia is a common symptom of depression, but you should be careful
to make sure that an underlying sleep disorder isn't blamed on
your depression. Depression makes a simple excuse for most types of
sleep disturbance, but often it can be a chicken-and-egg type problem.
Having a serious sleep disorder can result in an increased
vulnerability to depression. If your mood, appetite, and ambition
seem to be coming back, but your sleep is still disturbed, make
sure that you FORCE your doctors to take your sleep complaints
seriously. It might be difficult, but if you are persistent, and
you are willing to search for a sympathetic doctor, you should be
able to get the help you need.
I believe that was probably mentioned as a possible side effect of the
drug. While not explicitly stated, that's how I read it.
Much interest has been shown in the effect SSRIs (such as Prozac) have on
quality of sleep. Prozac (fluoxetine) appears to reduce the amount of REM sleep
which is the stage of sleep when more obstructive apneas occur. It also appears
to affect the muscles surrounding the airway whose relaxation leads to
obstructive apneas. Apparently there is evidence that it improves muscle tone.
Against this, Prozac has a stimulant effect that tends to have adverse effects
on sleep quality.
Given the interest in SSRIs, it is understandable that any new anti-depressants
(ADs) will be scrutinised to establish whether they have any effect on sleep
quality. It appears that Serzone (nefazodone hydrochloride), which is not an
SSRI, affects the stages of sleep less than any SSRI. Research shows that
Serzone is a mild sedative and can improve sleep quality. However Serzone does
not have a long track record. Research results should be treated with caution
as the majority of published research studies have been commissioned and paid
for by Serzone's sole manufacturer.
Nevertheless I believe Serzone may well become the AD of choice for people with
sleep disorders because of its mild sedative effect, its apparent benign effect
on sleep patterns, its reduced sleep-related side effects and its very short
half-life compared with fluoxetine.
Have you tried reading "Desperately Seeking Snoozin" by John Weidman? He
is an insomniac that has been cured and now has w ritten a book about what
he did to cure himself. I read the book and pretty much have cured my own
insomnia by following his suggestions. Since reading the book nearly a
year ago, I have had very few sleepless nights. Try it. After all, If you
are not sleeping, you might as well be doing something. Right?
