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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by TheTaoOfPhil on March 6, 2008, at 13:23:37
Hi,
I am very med-sensitive and so my pdoc started me off @ 2.5 mg of Celexa. The treatment is primarily for anxiety: I have PTSD and since working through my history in therapy my anxiety has gotten a lot more difficult. My pdoc has successfully treated anxiety with a low dose (5mg Lexapro/10mg Celexa). So my target is 10mg. (My insurance won't cover lexapro :-(
The good news is that I already (after five days) feel less anxious even on this low dose. The other good news is that it is sedating enough when I take it that I take it at night to help me get to sleep, but the sedating effects that I had felt during the day appear to be diminishing.
The bad news is that I _think_ it may be causing me to wake up in the middle of the night. The problem here is that I was _already_ waking up in the middle of the night around 3:30 a.m., which is the same time I am still waking up. The difference may be that when I wake up I am a bit _more_ awake than I usually am. I am able to get back to sleep by taking a Chinese herbal supplement that I have, but waking up like that every night is starting to take it's toll. I feel generally better but also sleep-deprived.
I have read posts from the archive where people have reported this problem (not being sure how much it's the medication causing the waking), but those were from several years ago.
So, I'm wondering, if I increase the dose the next step, to 5mg, might it make this problem better? In other words, if it's the anxiety that's waking me up, as opposed to the med, then maybe taking more will cause me to sleep through the night. But if it's the med, then it might get worse?
Alternatively, has anyone had success combining Celexa with something else (something _non_ benzo) to help with sleep?
If I report this problem to my pdoc, who is extremely conservative about side-effects, she'll yank me off it and get me to try something else. But I _so_ want this to work. Trying this medication has been a really huge deal for me because I am so averse to medication that I have been doing everything to cope with my PTSD symptoms (yoga, meditation, other forms of exercise, acupuncture, Chinese herbs, western supplements, etc., etc. ) to avoid it. I have sporadically tried other medications (Neurontin, Buspar), but this is the one that otherwise has the least side-effects. Now that I am seeing what it's like to be less anxious with this medication, I really _don't_ want to try something else.
Thanks for your help.
Posted by Zyprexa on March 6, 2008, at 17:37:30
In reply to Interrupted sleep with Celexa: me or the drug?, posted by TheTaoOfPhil on March 6, 2008, at 13:23:37
You could take an additional med with the celexa. Like an anti-psychotic that helps sleep. Anti-psychotics are realy good for PTSD. the celexa helps depression but does not much with sleep. I did not find that it helped with anxiety, like the antipsychotics do.
Posted by elanor roosevelt on March 6, 2008, at 18:47:42
In reply to Re: Interrupted sleep with Celexa: me or the drug?, posted by Zyprexa on March 6, 2008, at 17:37:30
why don't you try taking the celexa in the morning?
i'm amazed when i hear of people taking it at night
i wouldn't be able to sleep on iti had early morning waking on both celexa and lexapro but woke up in a good state of mind
as far as your insurance goes--samples of lexapro are still fairly ample in the doctors' offices
ask your pdoc and your md
good luck
Posted by 4WD on March 6, 2008, at 20:44:36
In reply to Interrupted sleep with Celexa: me or the drug?, posted by TheTaoOfPhil on March 6, 2008, at 13:23:37
> Hi,
I have been on Celexa for a couple of years now and never had any trouble with it waking me in the middle of the night. I did have trouble starting a few months ago waking up way to early (after 6 hours sleep or so) and so my pdoc put me on Trazadone. That took care of the problem. It also kept me from waking up in fear. The fear used to be what woke me up in the morning but now I dont get scared till after I've been up a few minutes.
You might try asking your pdoc for a Trazadone prescription. I only take 100 mg and it really works. The especial beauty of it is that it is non narcotic and non habit forming so doctors are pretty willing to prescribe it.
I am glad the Celexa is helping with your anxiety. It never did a thing for me anxiety wise. But then none of the SSRIs did.
Marsha
>
Posted by Phillipa on March 6, 2008, at 22:03:25
In reply to Re: Interrupted sleep with Celexa: me or the drug? » TheTaoOfPhil, posted by 4WD on March 6, 2008, at 20:44:36
Unfortunately they don't seem to for everyone me included will be a benzo for lifer I guess. Lunesta is pretty good think you could try that? Phillipa
Posted by Molybdenum on March 7, 2008, at 3:19:08
In reply to Interrupted sleep with Celexa: me or the drug?, posted by TheTaoOfPhil on March 6, 2008, at 13:23:37
Hi,
Citalopram worked for me for a couple of years. We kept upping the dose about 20mg at a time every 6 mths until I was on 80mg. But by that stage it wasn't working any more and I foolishly persevered thinking I just needed a higher dose. I didn't know that they could just poop out on you.
When I switched to venlafaxine & mirtazapine, I got to feel what citalopram "used" to be like for me and thankfully this combo still works for me now - another 2 years later.
Anyway, re your post & sleep. I used to get very vivid dreams on citalopram. http://www.dr-bob.org/babble/neuro/20080114/msgs/810021.html
if you're interested.Something non-benzo to help you sleep would be melatonin. If you have trouble waking in the middle of the night then get the slow release ones. It's very cheap too. I get mine from http://www.melatonin.com/. I was suspicious using my credit card over the net for pills (!) but I have ordered from them about 10 times now & never had a problem.
At least it's pseudo-natural. Give it a try, my sleep specialist (I have central sleep apnoea) says some of his patients are very sensitive to it & only need 1mg to get a good night's sleep. I take 6mg.
At the price they sell it, it's worth a try.
Another good non-benzo I've been taking for years is zolpidem. See http://en.sanofi-aventis.com/group/products/p_group_products_nervous_stilnox.asp
I can honestly say that I've been taking one of the 12.5mg slow release tabs every night for years (even before they had the new 12.5mg SR ones, I used to take the 10mg ones) and I have never built up a tolerance. My sleep doctor says that's because it has such a short half-life. I dunno.
Anyway, of all the sleeping pills I've used over the years (and I think I've had them ALL - even chloral hydrate & flunitrazepam!), zolpidem has the least hangover-effect the next day. Highly recommended.
Good Luck ;)
Posted by rgb on March 7, 2008, at 6:21:13
In reply to Interrupted sleep with Celexa: me or the drug?, posted by TheTaoOfPhil on March 6, 2008, at 13:23:37
The side-effects are likely to change over the next few weeks, so I'd stick with it for now and see how it develops.
Do you really feel sleep-deprived or just /worry/ that you should be sleep-deprived because you sleep less hours than usual?
Btw, I sometimes get these awakenings from sertraline too, but my sleep schedule is odd anyway, and interrupted sleep gives me vivid dreams :)
Posted by TheTaoOfPhil on March 7, 2008, at 6:44:51
In reply to Re: Interrupted sleep with Celexa: me or the drug? » TheTaoOfPhil, posted by rgb on March 7, 2008, at 6:21:13
Hi Folks,
Thanks for the input and suggestions.
I think what may be happening is that the sedating effect of this med is wearing off: whereas it _had_ be knocking me out at bedtime, last night it took me a while to fall a sleep. _And_ I woke up again several times and then finally woke up at 4:30 a.m. The odd thing is that I feel pretty good at the moment. I think I'll try taking the next dose first thing in the morning. I suspect I'll find that it's not really so sedating in the morning any more. And if it is, maybe I'll just have a second cup of green tea :-)
As for zolpidem, I wonder if this isn't similar to Lunesta, which in turn is similar to ambien? The problem with Ambien (and this side effect is mentioned in the literature about Lunesta, too) is that it can cause people to effectively sleep walk for long periods of time and not remember a thing that they did in the episode, to include driving to bars and having sex with strangers. My pdoc, who as I mentioned is quite conservative about side-effects, won't prescribe ambien any more, unless the patient commits to handcuffing himself to the bed :-)
I've heard of trazadone and maybe will ask the pdoc about it again. The first time I mentioned it she said it can be helpful but of course warned me about the worst side effect which for men would be priapism. But I don't know how _likely_ that would be. . . .
I've used melatonin quite a bit and my experience has been that it helps me fall asleep but not stay asleep. But I haven't tried the extended release type. Here again, the other problem is that my pdoc gets nervous about melatonin (and 5-HTP) because there are no _studies_ about their interaction with other meds. I'm at the point where I'm almost more comforable with medications that are studied as opposed to things that are less certain.
All right, well, I'll just try not taking the Celexa this evening and see what happens when I take it in the morning.
Thanks all for sharing your experiences!
Posted by Justherself54 on March 7, 2008, at 7:14:18
In reply to Re: Interrupted sleep with Celexa: me or the drug?, posted by TheTaoOfPhil on March 7, 2008, at 6:44:51
I've used zopiclone for years and so has my mom and brother..we've had no incidents of sleepwalking..trazadone may work well for you, but was not for me..one dose..I didn't sleep and felt like I had a hangover the next day, minus the drinking the night before. I'd go with the zopiclone before I'd add something like seroquel, which works like a charm but made me crave sweets..and I'm already on a med that makes you crave them..
Posted by 49er on March 8, 2008, at 15:25:59
In reply to Interrupted sleep with Celexa: me or the drug?, posted by TheTaoOfPhil on March 6, 2008, at 13:23:37
Hi,
I found that 3/4 teaspoon of powered magnesium has kept my insomnia at a very low level in spite of tapering off of Remeron, which I take for sleep.
You also might want to google milk peptides which mothers in France use to calm their babies.
Personally, as one who ended up on 4 meds thanks to insomnia from the first two meds, before I make the decision to completely taper off of my meds, I don't think adding another med to solve a problem is a good idea. But obviously, you have to do what you think is best.
I do understand how you feel. When something is working well, you don't want to mess with success. But knowing what I now know, I would have done things so differently. I guess we all can say that about aspects of our lives.
Good luck.
49er
Posted by TheTaoOfPhil on March 10, 2008, at 10:32:37
In reply to Re: Interrupted sleep with Celexa: me or the drug?, posted by 49er on March 8, 2008, at 15:25:59
Hi 49er,
> Personally, as one who ended up on 4 meds thanks
> to insomnia from the first two meds, before I
> make the decision to completely taper off of my
> meds, I don't think adding another med to solve
> a problem is a good idea.<SNIP>
> knowing what I now know, I would have done
> things so differently.Can you elaborate on how you would have done things differently, and what the issues were/are? I'm at the point where I either need to add something to the mix to deal with the sleep issue or just try a different medication altogether, so it would be helpful to hear your thoughts.
Thanks!
This is the end of the thread.
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