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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Persistent Anxiety And Insomnia Despite Taking Medication?

Hi I am currently on Escitalopram 20mg which I previously have responded to very well. My Gp recommended Mirtazipine which I tried but didnt help my sleep & couldn t tolerate the horrible side effects. I m back on Escitalopram but not really helping this time. My mood remain lowish with moderate anxiety & major insomnia. This is the worst I have felt & have been off work from May & it s now really getting to me. GPS understandably are reluctant to prescribe sleeping meds but seem to be only thing that works for me. I m constantly shattered. Really desperate now. See my Gp again on tues. Regards Jane
Fri, 12 Jul 2019
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General & Family Physician,  's  Response
Hello,

I would recommend you to have a TSH test to rule out thyroid problems as the cause of your anxiety and depression.
As for the treatment of anxiety and depression, sometimes a combination of pills is needed for better effect. For instance, escitalopram can be combined with venlafaxine.
Also combining medications with psychotherapy and healthy lifestyle increases the chance of symptoms control.

As for sleeping problems, you may try Zolpidem at night as this is not known to cause much dependence compared to other sleeping pills.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj, General & Family Physician
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What Causes Persistent Anxiety And Insomnia Despite Taking Medication?

Hello, I would recommend you to have a TSH test to rule out thyroid problems as the cause of your anxiety and depression. As for the treatment of anxiety and depression, sometimes a combination of pills is needed for better effect. For instance, escitalopram can be combined with venlafaxine. Also combining medications with psychotherapy and healthy lifestyle increases the chance of symptoms control. As for sleeping problems, you may try Zolpidem at night as this is not known to cause much dependence compared to other sleeping pills. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Antoneta Zotaj, General & Family Physician