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Mental Health Advise insomnia anxiety

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wolfe58

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A question to pick peoples brains

At night I suffer severe anxiety due to the fact that i worry about not getting enough sleep to be able to function adequate at work so sometime I go to work without any sleep or very little sleep. This has unfortunately lost me several jobs over the past 10 years.

I have now decided to take a proactive approach to the problem.
So with this in mind what meds would you recommend? The lowest effective dose.

GP has recommended Amitriptyline which requires me to take every day, but I would like to stress that I DO NOT SUFFER ANXIETY ON MY DAYS OFF AND CAN SLEEP AND MAINTAIN SLEEP.

I work 4/3 shifts a week so meds only needed on those days and not the other 3 when I do not have work.

My personal opinion (as a complete layman) would be a low dose of Zopiclone or would any of you guy and gals recommend an anti anxiety such as diazepam or xanax or any other med you have in mind?

This would be for long term use so dont be afraid to tell me the above cannot be used long term.

Any advice would be fab.

Thanks
 
Sorry for the late reply. Rather than any of those drugs, which can have quite harsh side-effects, I would suggest you look into propranolol as a first resort. It's a beta-blocker and well-known for reducing generalised anxiety and improving sleep in stressed individuals. It can be taken ad-hoc (ideal for your needs) without affecting its potency, has a short half-life (so should be gone in the morning), and kicks in within an hour.

There is also clonidine (an alpha-2 blocker) which can have a similar anxiolytic and somonolent effect if that doesn't work. Hopefully you can discuss this with an open minded GP.
 
I take trazodone, works good for me. I will sometimes take lorazepam subling if my traz isn't hacking it.
Remember, anytime you take a sleep aide you might experience a dependence to it. Even if it's nyquil.
Try exercise in the early part of the day. Not only will you do your body good, you'll be more tired come evening. Plus why take a med if you don't have, right?
 
I had to cease amitryptaline due to the 'hangovers'. It has a ridiculous half life. I'm on Trazodone now and it's an improvement.
 
Benzos for long term are really something you should not get into so I would not reccoment xanax or valium. You're going to inevitably keep needing larger and larger doses for your tolerance will grow. If your'e going to go down the benzo route i would only do that every so often/prn. some long term meds I know that are better for sleep maybe try Trazodone, low doses of serequil. but overall since your sleep deprivation seems to be from anxiety maybe for right now yes definitely medication will help but also try talking to a therapist so you in the long run won't have to rely on meds to sleep? just my humble opinion. hope it all works out!
 
OP,
CFC has some good advice with a beta-blocker or clonidine (which lowers blood pressure, btw).
Here are two more possibilities, depending on if you have problems falling asleep or staying asleep:

-Doxepin (Silenor)
It's NOT controlled and low-dose doxepin is for patients with sleep maintenance insomnia, which is waking up frequently or early in the morning and not falling back asleep.
It works for insomnia at doses in single-digit mg doses (3-6 mg). It does NOT work better if you take higher dosages.
http://www.mdedge.com/currentpsychia...xepin-insomnia

Ramelteon (Rozerem) is also not controlled and is indicated for late sleep onset. It basically gets you to sleep earlier.

Good luck!

Best, CD
 
EDIT: You know what, forget I forgot I posted, even though there was a lot of studies and meta studies behind what I did post.
 
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Zolpidem and the benzodiazepines aren't really high-quality medications for the application you're stating, according to my research. In fact, they really should be stayed away from if you use drugs recreationally or have only been sober a short amount of time.

I think cduggles is thinking around the right idea. Doxepin is used for insomnia, and it's not so hard to discontinue in the future, if that is the route you go, compared to zolpidem or related substances.
 
Trazodone kept me awake at night and gave me boners that wouldn't go away and I saw bright lights, doxepin made me hear noises that weren't there, amiltryptamine or whatever just wasn't good, ambien worked but I got addicted, temazepam was heavenly I didn't get addicted, but it was darn close, seroquel was my best experience with a sleep medication for the long term use. Knocks me out, makes me feel pretty good, even if minorly groggy in the morning. Honestly though I would avoid a sleep aid except for melatonin and just practice loading up on caffeine or some sort of legal upper/ Kratom or something, have a crutch ready for the morning. I used to worry like you and now that I have my morning crutches, I don't worry and need no help sleeping.
 
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