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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Severe Insomnia While Taking Nortriptyline For Depression?

Have been taking 25mg of Nortriptyline at night for anxiety/depression, but have severe insomnia . Went up to 37.5mg and insomnia got worse and also got nauseous. Sleep for maybe 2 hours and then doze on and off for the rest of the night. No other side effects at 25mg dose. SSRIs give me severe nausea. If I take this in the morning instead of night time will I still have the sleep problem?
Tue, 9 Jun 2015
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Psychiatrist,  's  Response
Hello thanks for asking from HCM for your health related queries

I can understand your concern. In most of individuals Nortriptyline causes sedation and help in sleep but even with increasing the doses your symptoms of insomnia are worsening. In such case I'd advise you to consult your psychiatrist again for reevaluation. Medicines like SSRIs failed to work because of nausea as side effect. But some other medicines like Trazodone or Mirtazapine etc can be utilised. These medicines are antidepressants and help in good sleep without increasing the risk of abuse. If even after changing the medicines symptoms persist then benzodiazepines can be tried. These medicines will help in good sleep. Please use these drugs on SOS basis only. You can also change the dosing of Nortriptyline to morning time and see if this helps. If change in time results in improvement then there is no need to change the medicines. Visit your psychiatrist if symptoms persist.

Thanks, Hope this helps you. Take care

Dr. Seikhoo Bishnoi,
Psychiatrist.
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What Causes Severe Insomnia While Taking Nortriptyline For Depression?

Hello thanks for asking from HCM for your health related queries I can understand your concern. In most of individuals Nortriptyline causes sedation and help in sleep but even with increasing the doses your symptoms of insomnia are worsening. In such case I d advise you to consult your psychiatrist again for reevaluation. Medicines like SSRIs failed to work because of nausea as side effect. But some other medicines like Trazodone or Mirtazapine etc can be utilised. These medicines are antidepressants and help in good sleep without increasing the risk of abuse. If even after changing the medicines symptoms persist then benzodiazepines can be tried. These medicines will help in good sleep. Please use these drugs on SOS basis only. You can also change the dosing of Nortriptyline to morning time and see if this helps. If change in time results in improvement then there is no need to change the medicines. Visit your psychiatrist if symptoms persist. Thanks, Hope this helps you. Take care Dr. Seikhoo Bishnoi, Psychiatrist.