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Suggest Treatment For Altered Sleep Pattern While Suffering From Depression
Question: Sir,
I was detected with major depression, OCD, anxiety.The then psychiatrist prescribed me fluoxetine(prodep) 20 then 40 then 60 all for 7 months till date.I have had 4 sessions as of now with the doc. Depression and OCD seems to have reduced with occasional anxiety 'rush' in between only when i feel i'm losing my mind.Sleep and eating was ok. For the last 1 month my sleeping pattern is disturbed, vivid dreams, dizziness, fatigue, agitated, weight gain, a constant 'dreamy state of mind'and dark circled-puffy eyes are common.I also receive that constant stare from the people when i go out in public may be due to changes in physical features of my face and subsequently get panicky!. The doc recently told me, it's not a big deal and regular exercise will help but i tried in vain. This is making me embarrassed to go to work or even outside. i'm a 28 M factory manager , work in rotation shifts. no alcohol but chew and smoke tobbacco moderately. Need urgent help. from-India
I was detected with major depression, OCD, anxiety.The then psychiatrist prescribed me fluoxetine(prodep) 20 then 40 then 60 all for 7 months till date.I have had 4 sessions as of now with the doc. Depression and OCD seems to have reduced with occasional anxiety 'rush' in between only when i feel i'm losing my mind.Sleep and eating was ok. For the last 1 month my sleeping pattern is disturbed, vivid dreams, dizziness, fatigue, agitated, weight gain, a constant 'dreamy state of mind'and dark circled-puffy eyes are common.I also receive that constant stare from the people when i go out in public may be due to changes in physical features of my face and subsequently get panicky!. The doc recently told me, it's not a big deal and regular exercise will help but i tried in vain. This is making me embarrassed to go to work or even outside. i'm a 28 M factory manager , work in rotation shifts. no alcohol but chew and smoke tobbacco moderately. Need urgent help. from-India
Brief Answer:
Changed sleep architecture is most probable reason for your symptoms.
Detailed Answer:
Hello thanks for asking from HCM for your health related queries
I can understand your concern. Fluoxetine is a SSRI drug and you are on right doses and drug for OCD, depression and anxiety. The symptoms like disturbed sleep pattern, vivid dreams etc are probably occurring due to change in sleep pattern. You are on rotation shifts which is also an aggravating factor. These symptoms are resulting in chronically disturbed sleep and thus resulting in dizziness, fatigue, agitation, dreamy state of mind or brain fog like symptoms. The feeling of panic when people look at you are occurring most probably due to anxiety. Anxiety results in feelings as if people are staring on you. This results in constant state of awareness that people are looking on you. All these are occurring due to persistent anxiety and depression.
For vivid dreams and disturbed sleep medicines like Ramelteon or Melatonin can help. These medicines will help to correct the sleep architecture and thus will provide refreshing, sound sleep. This will help to improve the symptoms like fatigue, tiredness, dizziness, agitation etc. For the feeling of panic when people look on you relaxation exercises can help. Even increasing the dose of Fluoxetine to 80 mg per day will also help to control these symptoms. Medicines like Propranolol can help to reduce the anxiety especially in social situations. You can consult your doctor for re-evaluation and for prescription of these medicines. This will surely help you in coming out of your symptoms.
Please try to reduce the tobacco intake and if possible avoid using it prior to sleep.
Thanks, Hope this helps you. Please don't hesitate to ask again for more doubts.
Take care
Changed sleep architecture is most probable reason for your symptoms.
Detailed Answer:
Hello thanks for asking from HCM for your health related queries
I can understand your concern. Fluoxetine is a SSRI drug and you are on right doses and drug for OCD, depression and anxiety. The symptoms like disturbed sleep pattern, vivid dreams etc are probably occurring due to change in sleep pattern. You are on rotation shifts which is also an aggravating factor. These symptoms are resulting in chronically disturbed sleep and thus resulting in dizziness, fatigue, agitation, dreamy state of mind or brain fog like symptoms. The feeling of panic when people look at you are occurring most probably due to anxiety. Anxiety results in feelings as if people are staring on you. This results in constant state of awareness that people are looking on you. All these are occurring due to persistent anxiety and depression.
For vivid dreams and disturbed sleep medicines like Ramelteon or Melatonin can help. These medicines will help to correct the sleep architecture and thus will provide refreshing, sound sleep. This will help to improve the symptoms like fatigue, tiredness, dizziness, agitation etc. For the feeling of panic when people look on you relaxation exercises can help. Even increasing the dose of Fluoxetine to 80 mg per day will also help to control these symptoms. Medicines like Propranolol can help to reduce the anxiety especially in social situations. You can consult your doctor for re-evaluation and for prescription of these medicines. This will surely help you in coming out of your symptoms.
Please try to reduce the tobacco intake and if possible avoid using it prior to sleep.
Thanks, Hope this helps you. Please don't hesitate to ask again for more doubts.
Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
To check that whether lack of sleep or sleep timing was the factor,i took leave for 3-4 days and slept well at night but still that foggy state of mind existed. For e.g when i was travelling i stared outside the bus window lost in my own thoughts like it was difficult to comprehend the surroundings unknowingly, this was/is unnatural for me somewhat like 'close to hallucination' ( i know the feeling of taking marijuana). Also my libido has decreased and i'll will be getting married after a couple of months.ALL these things is convincing me to stop the medications for it's sideeffects outweigh the advantages. PLZ enlighten me.
Brief Answer:
Sexual side effects are reversible
Detailed Answer:
Hello again and thanks for asking a follow up
The symptoms like getting lost in thoughts are occurring due to anxiety only. In OCD and depression individuals develop lack of focus and they sometimes get lost in their thoughts. A lot of patients develop repetitive thoughts that they are not concentrating and this awareness results in the symptoms you are showing. Continue to take medicines and you will come out of these symptoms.
Fluoxetine is known to cause delayed ejaculation and in some individuals reduced libido. But these side effects are reversible and reduce on stopping the drug. At this time in my opinion you should continue to take medicines and for reduced libido you can consult your doctor. Medicines like Sildenafil or Tadalafil can help to reverse these side effects. No need to worry.
Thanks, still have doubts please ask again.
Take care
Sexual side effects are reversible
Detailed Answer:
Hello again and thanks for asking a follow up
The symptoms like getting lost in thoughts are occurring due to anxiety only. In OCD and depression individuals develop lack of focus and they sometimes get lost in their thoughts. A lot of patients develop repetitive thoughts that they are not concentrating and this awareness results in the symptoms you are showing. Continue to take medicines and you will come out of these symptoms.
Fluoxetine is known to cause delayed ejaculation and in some individuals reduced libido. But these side effects are reversible and reduce on stopping the drug. At this time in my opinion you should continue to take medicines and for reduced libido you can consult your doctor. Medicines like Sildenafil or Tadalafil can help to reverse these side effects. No need to worry.
Thanks, still have doubts please ask again.
Take care
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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