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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat Sleeplessness While Having Anxiety And Depression?

hi I am 42 I have bipolar and sever anxciety, depression and can not sleep I also have migraines and fibermalagea with the medication I am on I am currently takeing Prozac 80 mg abien 10 levothyroxine 112 topiramate 150 hydroxyzine 50 2 times a day gabapentin 400 clonazepam 1mg 3times a day flexereal
Thu, 17 Mar 2016
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Psychiatrist,  's  Response
Hello thanks for asking from HCM for your health related queries

I can understand your concern. You have severe anxiety, depressive disorder, migraine and fibromyalgia. The current issues are poor sleep and even with medicines you are not able to sleep properly.

If we consider the medicines then Prozac 80 mg (Fluoxetine) is for anxiety and depression. Ambien (Zolpidem) and Clonazepam are for sleep and anxiety also. Hydroxizine for anxiety, Topiramate is helping in mood stabilisation. The doses are high and should help in sleep. For poor response one option is to increase the dose of Zolpidem or to replace the Fluoxetine with some other SSRI like Paroxetine that can help in good sedation. Paroxetine has almost same efficacy and helps in sleep also. You can visit a psychiatrist for opinion regarding this drug. This will help you in sleep.

I'd also advise you to improve your sleep hygiene. Avoid excess tea, coffee, alcohol especially in evening hours. Fix your time to go to sleep and avoid watching TV or reading on bed. Take warm water bath in evening to improve your sleep. Light exercise in evening also aids in sleep. Please follow these steps and you will surely see improvement.

Thanks, Hope this clears your doubt. Take care

Dr. Seikhoo Bishnoi
(Consultant Psychiatrist)
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How To Treat Sleeplessness While Having Anxiety And Depression?

Hello thanks for asking from HCM for your health related queries I can understand your concern. You have severe anxiety, depressive disorder, migraine and fibromyalgia. The current issues are poor sleep and even with medicines you are not able to sleep properly. If we consider the medicines then Prozac 80 mg (Fluoxetine) is for anxiety and depression. Ambien (Zolpidem) and Clonazepam are for sleep and anxiety also. Hydroxizine for anxiety, Topiramate is helping in mood stabilisation. The doses are high and should help in sleep. For poor response one option is to increase the dose of Zolpidem or to replace the Fluoxetine with some other SSRI like Paroxetine that can help in good sedation. Paroxetine has almost same efficacy and helps in sleep also. You can visit a psychiatrist for opinion regarding this drug. This will help you in sleep. I d also advise you to improve your sleep hygiene. Avoid excess tea, coffee, alcohol especially in evening hours. Fix your time to go to sleep and avoid watching TV or reading on bed. Take warm water bath in evening to improve your sleep. Light exercise in evening also aids in sleep. Please follow these steps and you will surely see improvement. Thanks, Hope this clears your doubt. Take care Dr. Seikhoo Bishnoi (Consultant Psychiatrist)