Insomnia & Sleepiness from SSRI?

[lallieth]

How the heck can an SSRI make you sleepy and give you insomnia all in the same day?

I know from experience that when the Celexa reaches a certain stage(generally at 5 weeks,and guess where I am now?) that it caused 3-4 days of insomnia.

I am tired during the day and avoid napping,but when it comes to bedtime I feel wide awake...UGH..I take my meds in the morning.

I was thinking of taking some ativan to help me sleep,because I know this stage wont last and dont want to get into sleep aids

Suggestions?

 

[Retired]

Selective Serotonin Reuptake Inhibitors (SSRI) are the most recent evolution in anti depressant / anti anxiety meds some of which have been later approved for treating other related disorders such as OCD.

They were developed in the early 90's when they were shown as effective as Trycyclics (the gold standard at that time) but with significantly fewer side effects.

The reason these medication usually have fewer adverse effects than their predecessors in treating depression / anxiety is because they are truly "designer drugs".

SSRI and SNRI were designed to work on a lock and key principle, the same pharmacological principle used by many of the very specific medication being introduced today.

The SSRI releases a compound, resembling a key that fits into a lock or receptor in the brain neurotransmitter system, to block re uptake of Serotonin being released from neurotransmitters as part of its regular functioning.

It is believed that this inhibition of reuptake of Serotonin has been shown to treat depression in patients based on extensive study.

By making the action very specific, the goal is to affect only one neurotransmitter..namely Serotonin.

In reality, science has not succeeded in developing a compound to be that specific, so other neurotransmitters are also affected; albeit to a much lesser degree that were affected by the previous classes of anti depressants such as the tri cyclics.

Therefore some SSRI's have a minimal effect on adrenergic, muscarinic, hystaminergic and dopaminergic receptors. Effects on these neurotransmitters are the cause of the common unwanted side offects of SSRI SNRI's.

All this to provide you with some background, but also to suggest the SSRI you are taking may be producing some adrenergic activity at bedtime.

This would explain remaining wide awake at night.

This type of adverse effect generally subsides with time, as the brain chemistry becomes acclimated to the new compound. Nevertheless it should be reported to the prescriber/doctor who may introduce an adjunctive treatment to overcome the insomnia.

OTOH of the adverse effect persists, your prescriber/doctor may chose a different compound which would not affect you this way.

Finding an SSRI /SNRI which is compatible with your particular brain chemistry while delivering the expected therapeutic effects may take a few trials until the right one is found.

If a change in compound is being made, be sure to ask the doctor how the switchover is to be made. Some meds need a special protocol to switch from one to the other.

Finally be sure your doctor and pharmacist have a complete list of all prescribed and over the counter preparations you use to avoid unwanted drug / drug interactions.

Finally ask about the potential for any drug / food interactions with the meds you will be taking.

 

[lallieth]

I wonder if taking the celexa at night would change anything..then perhaps I could take advantage of the sleepiness it causes..I will try that this coming weekend and see what happens.I did take a smidge of ativan last night and had a good sound sleep

 

[David Baxter PhD]

I was about to suggest that, lallieth. Switching to taking the Celexa at night should solve the problem.

 

[Retired]

I did take a smidge of ativan last night and had a good sound sleep

How many milligrams in a smidge?

 

[lallieth]

How many milligrams in a smidge?

Omg Steve,,my dr laughs when I tell him how much I take and wonders how I can possibly break down such a small tablet,but I do lol

He gave me 10 ativan back in Nov and I have 5 whole tablets left

 

[Retired]

No problem in scoring tablets and using only what you feel comfortable with. The effect of Ativan varies on many factors such as a persons body weight, age, liver function, and having had previous therapeutic exposure to benzodiazepines.

Ativan comes in 0.5, 1.0 and 2.0 mg scored tabs.

Yoour doctor would benefit from knowing what dosage gives you the relief you need, in order to plan your renewal prescription. You can ask for the medication to be dispensed at any of the above dosage strengths (on your doctor's prescription in Ontario) as each of those tabs is scored and you can customize your (PRN) as needed dosage.

The usual cautions about not using alcohol should be observed when using Ativan, but most drug interactions do not occur, because of the "clean" manner in which lorazepam (Ativan) is metabolozed.

 

[lallieth]

I have a new prescrip for .5mg but I would only use 1/4 of that.It's not alot,but its enough to bring relief for me

No problem in scoring tablets and using only what you feel comfortable with. The effect of Ativan varies on many factors such as a persons body weight, age, liver function, and having had previous therapeutic exposure to benzodiazepines.

Ativan comes in 0.5, 1.0 and 2.0 mg scored tabs.

Yoour doctor would benefit from knowing what dosage gives you the relief you need, in order to plan your renewal prescription. You can ask for the medication to be dispensed at any of the above dosage strengths (on your doctor's prescription in Ontario) as each of those tabs is scored and you can customize your (PRN) as needed dosage.

The usual cautions about not using alcohol should be observed when using Ativan, but most drug interactions do not occur, because of the "clean" manner in which lorazepam (Ativan) is metabolozed.