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What Causes Sleeplessness While Treating Anxiety?
Question: hi doctor - i am on the following medicines:
imipramine 50, tynept od 37.5, librium 10 in the morning
quetiapine 150, lurasid 60, librium 10, tynept 12.5 in the night
with these medicines, my anxiety is slightly better but sleep is a problem, i go to sleep at 11pm and wake up by 2-3 am and then find it difficult to go to sleep, what would your advise be to better my sleep?
imipramine 50, tynept od 37.5, librium 10 in the morning
quetiapine 150, lurasid 60, librium 10, tynept 12.5 in the night
with these medicines, my anxiety is slightly better but sleep is a problem, i go to sleep at 11pm and wake up by 2-3 am and then find it difficult to go to sleep, what would your advise be to better my sleep?
Brief Answer:
You can take 15-20 mg Librium.
Detailed Answer:
Hello thanks for asking again
If your anxiety is good then that is a nice thing. You are taking Quetiapine and this should be helping in sleep. But if you are not finding refreshing sleep then you can take one and half tablet of Librium that is 15 mg and this can be increased to 20 mg for some days.
This will not cause much problems.
Thanks.
You can take 15-20 mg Librium.
Detailed Answer:
Hello thanks for asking again
If your anxiety is good then that is a nice thing. You are taking Quetiapine and this should be helping in sleep. But if you are not finding refreshing sleep then you can take one and half tablet of Librium that is 15 mg and this can be increased to 20 mg for some days.
This will not cause much problems.
Thanks.
Above answer was peer-reviewed by :
Dr. Raju A.T
Dear doctor - I get a lot of weird dreams. I am taking tynept 12.5 in the night along with quetiapine 150, librium 10 and lurasidone 60. Was reading on the net that tynept can cause nightmares, do you think tynept is the reason for my dreams. Will stopping it help? I take tynept od 37.5 in the morning also. Do you think stopping night dose will cause any problem? Should I stop night dose or make it half for some days and then stop. If not tynept, what can be other reason for my dreams?
Brief Answer:
You can stop the drug's evening dose without any worries.
Detailed Answer:
Hello again
I am not very sure about nightmares with 12.5 mg of Tyneptine but this might lead to insomnia and disturbed sleep. This could be the reason for weird dream like symptoms you are having.
Yes stopping the evening dose will help in improving the sleep. You can take it in afternoon after or with lunch.
No stopping night dose will not cause problems. You can stop 12.5 mg dose without any reduction of dose or worries.
Thanks. Take care
You can stop the drug's evening dose without any worries.
Detailed Answer:
Hello again
I am not very sure about nightmares with 12.5 mg of Tyneptine but this might lead to insomnia and disturbed sleep. This could be the reason for weird dream like symptoms you are having.
Yes stopping the evening dose will help in improving the sleep. You can take it in afternoon after or with lunch.
No stopping night dose will not cause problems. You can stop 12.5 mg dose without any reduction of dose or worries.
Thanks. Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
should I switch tynept 12.5 from night to afternoon or should I stop it totally? will stopping it totally bring my anxiety back? also what is the therapeutic dosage of imipramine, I am on 50 mg in the morning, should I make it 75 or keep it at 50 only?
Brief Answer:
You can switch to afternoon doses.
Detailed Answer:
Hello again
No both options are safe. Switching the Tynept from night to afternoon would not cause much problems and will not disturb the sleep.
Even stopping the drug will not bring anxiety back because you are also taking Tynept OD which provides almost full day drug levels.
You can increase the dose to 100 mg without any worries. Dryness of mouth, sleepiness etc side effects could be seen.
Thanks
You can switch to afternoon doses.
Detailed Answer:
Hello again
No both options are safe. Switching the Tynept from night to afternoon would not cause much problems and will not disturb the sleep.
Even stopping the drug will not bring anxiety back because you are also taking Tynept OD which provides almost full day drug levels.
You can increase the dose to 100 mg without any worries. Dryness of mouth, sleepiness etc side effects could be seen.
Thanks
Above answer was peer-reviewed by :
Dr. Prasad
Also, I am on librium 10 mor/eve, how do I taped it off so as to avoid withdrawal symptoms. I think imipramine is taking care of my anxiety, was wondering if it's a good idea to continue with librium, what would your advise be?
Brief Answer:
You can skip morning doses.
Detailed Answer:
Hello again,
Librium 10 mg is a very low dose and even if you skip morning dose that would not cause much withdrawal symptoms. You can start skipping morning doses and take this drug on SOS basis in morning hours. Once you become stable without Librium morning dose then evening dose can be targeted.
But even if you continue to take Librium that will not result in dependence.
THANKS.
You can skip morning doses.
Detailed Answer:
Hello again,
Librium 10 mg is a very low dose and even if you skip morning dose that would not cause much withdrawal symptoms. You can start skipping morning doses and take this drug on SOS basis in morning hours. Once you become stable without Librium morning dose then evening dose can be targeted.
But even if you continue to take Librium that will not result in dependence.
THANKS.
Above answer was peer-reviewed by :
Dr. Yogesh D
Dear doctor - i am on the following medication:
quetiapine 175mg, lurasid 60, etilam 0.5 (doctor switched me from librium 10 to etilam during my last visit)
tynept od 37.5, librium 10, imipramine 50 in the morning
The change in librium in the night to etilam was made for my better sleep. my doctor told me if etilam does not help, i can try doxepin 25. I was reading on the net that doxepin is good for insomina at dosage of 1, 3 and 6 mg and not 25, is it true? since my sleep is not good ( i wake up early and find it difficult to go to sleep), i was thinking of taking doxepin today, should i take 25 or 5 mg (1/2 of 10mg), what is the right dosage of doxepin for maintenance of sleep? also
i have been taking imipramine 50 mg in the morning for little for than 2 weeks, can i now increase it to 75 or wait for some more time, my doctor feels that i should wait for one month before increasing the dose? i think i need higher dose of impiramine for my anxiety, can i make it 75 from today? should i take 75 in the morning or divide it between morning and evening? my doctor feels that divided dosage works better, is it true? pls advise
quetiapine 175mg, lurasid 60, etilam 0.5 (doctor switched me from librium 10 to etilam during my last visit)
tynept od 37.5, librium 10, imipramine 50 in the morning
The change in librium in the night to etilam was made for my better sleep. my doctor told me if etilam does not help, i can try doxepin 25. I was reading on the net that doxepin is good for insomina at dosage of 1, 3 and 6 mg and not 25, is it true? since my sleep is not good ( i wake up early and find it difficult to go to sleep), i was thinking of taking doxepin today, should i take 25 or 5 mg (1/2 of 10mg), what is the right dosage of doxepin for maintenance of sleep? also
i have been taking imipramine 50 mg in the morning for little for than 2 weeks, can i now increase it to 75 or wait for some more time, my doctor feels that i should wait for one month before increasing the dose? i think i need higher dose of impiramine for my anxiety, can i make it 75 from today? should i take 75 in the morning or divide it between morning and evening? my doctor feels that divided dosage works better, is it true? pls advise
Brief Answer:
You can take 10 mg Doxepin
Detailed Answer:
Hello again
Low dose Doxepin has been studied for management of insomnia but I don't think taking 3-5 mg will help you much. If you don't want to give 25 mg a try then you can take 10 mg today and see the results.
Imipramine dose can be increased to 75 after 2 weeks of use. But since your doctor advised to remain on 50 for four weeks then better to not to increase the dose.
Take
You can take 10 mg Doxepin
Detailed Answer:
Hello again
Low dose Doxepin has been studied for management of insomnia but I don't think taking 3-5 mg will help you much. If you don't want to give 25 mg a try then you can take 10 mg today and see the results.
Imipramine dose can be increased to 75 after 2 weeks of use. But since your doctor advised to remain on 50 for four weeks then better to not to increase the dose.
Take
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Imipramine works better as a single dose in the morning or in divided doses more/eve, if I have to make it 75, should I take it in the morning or 50 in the morning and 25 in the night? My doctor feels divided doses work better. I am keen to take 75 in the morning as I feel evening dose interferes with my sleep. What would your advise be?
Brief Answer:
You can continue to take single dose
Detailed Answer:
Hello again
In my opinion effectiveness of single dose will be equal to two divided dosing because half life of drug is long.
If you are feeling better and have no sleep issues then you can take 75 mg in morning hours without any worries.
Thanks
You can continue to take single dose
Detailed Answer:
Hello again
In my opinion effectiveness of single dose will be equal to two divided dosing because half life of drug is long.
If you are feeling better and have no sleep issues then you can take 75 mg in morning hours without any worries.
Thanks
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear doctor - have been getting tingling sensation on my tongue as if my mouth is burning. I am on the following medication:
Quetiapine 150, lurasidone 60, doxepin 10 in the night
Imipramine 50, tynept od37.5 in the morning.
I was taking librium 10 mor/eve, which was replaced by etilam in the night, since I was not getting proper sleep, doctor replaced etilam with doxepin. Have been getting tingling sensation for the last 2-3 days, can't figure out why I getting it. Only change I have done is stopping librium in the night. Today I didn't take morning librium as well. What do you think is causing it? Is it the withdrawal symptom of librium? What should I do to overcome it? Pls advise.
Quetiapine 150, lurasidone 60, doxepin 10 in the night
Imipramine 50, tynept od37.5 in the morning.
I was taking librium 10 mor/eve, which was replaced by etilam in the night, since I was not getting proper sleep, doctor replaced etilam with doxepin. Have been getting tingling sensation for the last 2-3 days, can't figure out why I getting it. Only change I have done is stopping librium in the night. Today I didn't take morning librium as well. What do you think is causing it? Is it the withdrawal symptom of librium? What should I do to overcome it? Pls advise.
Brief Answer:
This could be milder withdrawal.
Detailed Answer:
Hello again
Librium has been replaced by Etizolam and I don't think this tingling is occurring due to withdrawal of Librium, but even if benzodiazepines are replaced in equivalent doses even then mild withdrawal symptoms or worsening of anxiety could be seen. So this might be slight worsening of anxiety on chaining Librium to Etilaam. But that would reduce by own in coming days.
Thanks.
This could be milder withdrawal.
Detailed Answer:
Hello again
Librium has been replaced by Etizolam and I don't think this tingling is occurring due to withdrawal of Librium, but even if benzodiazepines are replaced in equivalent doses even then mild withdrawal symptoms or worsening of anxiety could be seen. So this might be slight worsening of anxiety on chaining Librium to Etilaam. But that would reduce by own in coming days.
Thanks.
Above answer was peer-reviewed by :
Dr. Yogesh D
dear doctor - have not been sleeping well. some nights I don't sleep at all. apart from the medicines mentioned above, what else can I take?
My doctor stopped Librium 10 in the night and started me on etilam 0.5, took etilam for 2-3 days without any respite from sleep problem. then he put me on doxepin 25 mg, I started with doxepin 10 in the night even that does not seem to work. with 10 mg I am getting constipation and acidity in the middle of the night, not keen to make it 25. what change according to you will help me with my sleep problem without much of side effects?
My doctor stopped Librium 10 in the night and started me on etilam 0.5, took etilam for 2-3 days without any respite from sleep problem. then he put me on doxepin 25 mg, I started with doxepin 10 in the night even that does not seem to work. with 10 mg I am getting constipation and acidity in the middle of the night, not keen to make it 25. what change according to you will help me with my sleep problem without much of side effects?
Brief Answer:
Zolpidem can be kept as option.
Detailed Answer:
Hello again
Most of drugs are not working because of insufficient doses and high anxiety you are having. Higher doses are resulting in side effects and you are not tolerating. For sleep onset in my opinion if Etizolam or any other benzodiazepine are not working then we can think of Z-drugs. Zolpidem ER tablet can be given a try. The drug in dose of 12.5 mg after dinner should help in sleep onset and will also help in maintaining of sleep. You can think of taking this drug and talk with your doctor for that.
Thanks.
Zolpidem can be kept as option.
Detailed Answer:
Hello again
Most of drugs are not working because of insufficient doses and high anxiety you are having. Higher doses are resulting in side effects and you are not tolerating. For sleep onset in my opinion if Etizolam or any other benzodiazepine are not working then we can think of Z-drugs. Zolpidem ER tablet can be given a try. The drug in dose of 12.5 mg after dinner should help in sleep onset and will also help in maintaining of sleep. You can think of taking this drug and talk with your doctor for that.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Along with quetiapine 150, my doc added sizopin 12.5 for sleep. Still could not sleep last night after taking sizopin. I personally feel lurasidone is interfering with my sleep. I have following questions:
Can lurasidone cause sleep problem?
Can I take it in the morning instead of night?
I am taking 60 mg in the night, can I make it 40 in the morning?Will making it 40 from 60 have any withdrawal effects?
I took 60 last night, should I skip it tonight and take it in the morning? Will it cause any problem?
Can lurasidone 60 be replaced with quetiapine 150 sr? Will it cause any problem? Pls advise.
Can lurasidone cause sleep problem?
Can I take it in the morning instead of night?
I am taking 60 mg in the night, can I make it 40 in the morning?Will making it 40 from 60 have any withdrawal effects?
I took 60 last night, should I skip it tonight and take it in the morning? Will it cause any problem?
Can lurasidone 60 be replaced with quetiapine 150 sr? Will it cause any problem? Pls advise.
Brief Answer:
Lurasidone dose can be reduced to 40 without worries.
Detailed Answer:
Hello again
I don't think Lurasidone is causing the sleep disturbance in your case.
But if you are thinking to take Lurasidone in morning hours then you can take it without worries. This would not affect its actions.
Reducing the dose from 60 to 40 would not cause any withdrawal symptoms. Lurasidone is safe to use and taper drug.
You can skip todays dose and take 40 mg in morning. This will not cause any problem.
Lurasidone can be replaced with Quetiapine but you are already taking Quetiapine. I don't think this will cause any problems if cross tapering is done properly.
Thanks.
Lurasidone dose can be reduced to 40 without worries.
Detailed Answer:
Hello again
I don't think Lurasidone is causing the sleep disturbance in your case.
But if you are thinking to take Lurasidone in morning hours then you can take it without worries. This would not affect its actions.
Reducing the dose from 60 to 40 would not cause any withdrawal symptoms. Lurasidone is safe to use and taper drug.
You can skip todays dose and take 40 mg in morning. This will not cause any problem.
Lurasidone can be replaced with Quetiapine but you are already taking Quetiapine. I don't think this will cause any problems if cross tapering is done properly.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have stopped taking librium 10 mor/eve, eve dose I stopped about a week back and morning dose I have stopped 2-3days ago. I have following questions:
I am experiencing anxiety, is it a withdrawal symptom of librium?
Does 10mg cause withdrawal symptoms? My doc says it is too small a dose to cause withdrawal? What's ur view?
How long do the withdrawals last?
I have not substituted it with any other benzo, do I need to do that? If yes, which one? My doc had earlier said etilam, now he says rivotril but I am not keen to take benzo.
What are the chances that I am experiencing withdrawal from librium 10, if yes, how long will it last?
I am experiencing anxiety, is it a withdrawal symptom of librium?
Does 10mg cause withdrawal symptoms? My doc says it is too small a dose to cause withdrawal? What's ur view?
How long do the withdrawals last?
I have not substituted it with any other benzo, do I need to do that? If yes, which one? My doc had earlier said etilam, now he says rivotril but I am not keen to take benzo.
What are the chances that I am experiencing withdrawal from librium 10, if yes, how long will it last?
Brief Answer:
This is not due to withdrawal.
Detailed Answer:
Hello again
- Yes 10 mg of Librium is a small dose and its very rare to see withdrawal at this dose. You are taking Etizolam too (evening dose ?) and in this case any chance of withdrawal is rare. I don't think the anxiety is due to withdrawal.
- Librium is also a benzodiazepine drug like Etizolam or Clonazepam. Etizolam is safest as it is very rarely associated with withdrawal.
Thanks.
This is not due to withdrawal.
Detailed Answer:
Hello again
- Yes 10 mg of Librium is a small dose and its very rare to see withdrawal at this dose. You are taking Etizolam too (evening dose ?) and in this case any chance of withdrawal is rare. I don't think the anxiety is due to withdrawal.
- Librium is also a benzodiazepine drug like Etizolam or Clonazepam. Etizolam is safest as it is very rarely associated with withdrawal.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Am not taking etizola, no benzo am taking. Since I am not taking any benzo after stopping librium, can librium cause withdrawal since I have not replaced it with any other benzo?
Or should I start night librium again......Or zapiz or etilam? Out of three, you think I should stick to night librium to avoid any withdrawal?
Or should I start night librium again......Or zapiz or etilam? Out of three, you think I should stick to night librium to avoid any withdrawal?
Brief Answer:
You can take 10 mg Librium for some days.
Detailed Answer:
Hello again
Librium 10 is a very low dose and I don't think this is resulting in withdrawal. But since you are sensitive to changes in medicines this could be mild withdrawal. You can take Librium 10 in evening for a couple of weeks and then can reduce the dose of 5 for next one week. After that you can stop the drug completely.
This will prevent even mild withdrawal symptoms.
Thanks.
You can take 10 mg Librium for some days.
Detailed Answer:
Hello again
Librium 10 is a very low dose and I don't think this is resulting in withdrawal. But since you are sensitive to changes in medicines this could be mild withdrawal. You can take Librium 10 in evening for a couple of weeks and then can reduce the dose of 5 for next one week. After that you can stop the drug completely.
This will prevent even mild withdrawal symptoms.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
have not been sleeping for the last 3-4 days, went to my doctor and he has put me on haliperidol dt 10 and phernargan 25 along with other medication, he feels these medicines will help me to sleep better. do you think he has made the right choice? what is your view on adding these medicines? i am worried about the side effects, does haliperiodol have more side effects than oleanz or sizodon? is weight gain more with haliperiodol than oleanz or sizodon?does it give tremors? does phernagan help with tremors and other side effects of haliperidol?pls advise
Brief Answer:
Haloperidol should be avoided in my opinion.
Detailed Answer:
Hello again
Haloperidol is a first generation antipsychotic drug. The drug is associated with a lot of side effects and is commonly used for psychotic cases or in cases of manic agitation only. Your main symptoms are anxiety and depressive symptoms and I'd have not prescribed you haloperidol.
But you are not tolerating other medicines and you are not able to sleep then you can give Haloperidol a try and see if symptoms and sleep improve.
I can't comment if this is right choice. I'd have advised you to take Olanzapine or Sizodone or any other second generation antipsychotic. Chlorpromazine can be utilised in your case as your main issue at present is non refreshing sleep.
Weight gain is seen commonly with Sizodone or Oleanz and the risk is less with Haloperidol. Haloperidol is associated with side effects like Extrapyramidal side effects. Trembling is one of common side effect.
Phenargan will help in sleep and will also help to prevent dystonia or other EPS associated with haloperidol.
Thanks. Take care
Haloperidol should be avoided in my opinion.
Detailed Answer:
Hello again
Haloperidol is a first generation antipsychotic drug. The drug is associated with a lot of side effects and is commonly used for psychotic cases or in cases of manic agitation only. Your main symptoms are anxiety and depressive symptoms and I'd have not prescribed you haloperidol.
But you are not tolerating other medicines and you are not able to sleep then you can give Haloperidol a try and see if symptoms and sleep improve.
I can't comment if this is right choice. I'd have advised you to take Olanzapine or Sizodone or any other second generation antipsychotic. Chlorpromazine can be utilised in your case as your main issue at present is non refreshing sleep.
Weight gain is seen commonly with Sizodone or Oleanz and the risk is less with Haloperidol. Haloperidol is associated with side effects like Extrapyramidal side effects. Trembling is one of common side effect.
Phenargan will help in sleep and will also help to prevent dystonia or other EPS associated with haloperidol.
Thanks. Take care
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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