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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Anxiety And Insomnia

my name is Nilanthi. After going through high doses of citalopram for moderate anxiety, I developed extreme anxiety and insomnia, 3 years ago. with much difficulty I m now out of extreme anxiety, but insomnia is still there. I tried virtually everything, but couldn t get out of it. I think remaining anxiety although it is not unbearable, is making me an insomniac. Please give advice, I m in Sri Lanka.
Thu, 13 Nov 2014
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Psychiatrist,  's  Response
Hello

Thanks for asking

High doses of citalopram may result in severe toxic symptoms and rebound increase in anxiety. You had problems of depression, anxiety and insomnia. Insomnia is still persisting. Citalopram is SSRI drug of antidepressant action. The drug is prescribed in morning times as it causes insomnia. Though your anxiety is now under control still for insomnia I would advise you to consult your psychiatrist again and to start some other drug of same class or other antidepressant class.

Medicines like Paroxetine have almost same efficacy but cause sedation which can be used in your problem of insomnia. Other drugs like Mirtazepine can be used as the drug have good role in sleep in 7.5 mg doses. Trazodon is also used for problems of insomnias. All these medicines don't carry abuse potential and are free of serious side effects. Consult your psychiatrist for these drugs.

Apart from that improve your sleep hygiene.

- Fix your time to go to bed
- You can take warm water bath in evening which will help in sleep
- Taking warm milk in evening will also help
- Use your bed only for sleep and don't watch TV or read anything on bed.
- Avoid alcohol, caffeine, tea or any carbonated drinks in evening.
- Try relaxation exercises and yoga for best results.

Hope this helps you

Thanks.
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Suggest Treatment For Anxiety And Insomnia

Hello Thanks for asking High doses of citalopram may result in severe toxic symptoms and rebound increase in anxiety. You had problems of depression, anxiety and insomnia. Insomnia is still persisting. Citalopram is SSRI drug of antidepressant action. The drug is prescribed in morning times as it causes insomnia. Though your anxiety is now under control still for insomnia I would advise you to consult your psychiatrist again and to start some other drug of same class or other antidepressant class. Medicines like Paroxetine have almost same efficacy but cause sedation which can be used in your problem of insomnia. Other drugs like Mirtazepine can be used as the drug have good role in sleep in 7.5 mg doses. Trazodon is also used for problems of insomnias. All these medicines don t carry abuse potential and are free of serious side effects. Consult your psychiatrist for these drugs. Apart from that improve your sleep hygiene. - Fix your time to go to bed - You can take warm water bath in evening which will help in sleep - Taking warm milk in evening will also help - Use your bed only for sleep and don t watch TV or read anything on bed. - Avoid alcohol, caffeine, tea or any carbonated drinks in evening. - Try relaxation exercises and yoga for best results. Hope this helps you Thanks.