Rx for Sleep Related Stress Hormones?

I went to a new PCP yesterday and discussed my sleep maintenance insomnia with him. My sleep doctor had prescribed Doxepin 10 mg, which was mildly successful except for a 17 pound weight gain.

Anyway, my new doc suggested that my stress hormones are out of balance/used up, especially serotonin. He prescribed in place of the Doxepin a drug by the name of Brintellix. He said that it would help restore my stress hormones, thus allowing me to sleep better without the weight gain.

Has anyone used Brintellix and what has your experience with it been? Does the stress hormone theory sound plausible? If so, then it might be the source of trouble for many people, especially since apnea really stresses us out!

M'ohms wrote:I went to a new PCP yesterday and discussed my sleep maintenance insomnia with him. My sleep doctor had prescribed Doxepin 10 mg, which was mildly successful except for a 17 pound weight gain.

Anyway, my new doc suggested that my stress hormones are out of balance/used up, especially serotonin. He prescribed in place of the Doxepin a drug by the name of Brintellix. He said that it would help restore my stress hormones, thus allowing me to sleep better without the weight gain.

Has anyone used Brintellix and what has your experience with it been? Does the stress hormone theory sound plausible? If so, then it might be the source of trouble for many people, especially since apnea really stresses us out!

If you haven't already, I'd suggest doing Google searches on that stuff......particularly in Drugs.com.
Yes, Sleep Apnea messes with our hormones and things like that......leads to Diabetes, etc., etc.

Do your homework before taking medications. Most seem to have good and bad effects.


Den

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I went to Drugs.com as soon as I got home with the script. I am particularly cautious of drugs that interfere with my thyroid replacement since I had thyroid cancer. Nothing stood out as a red flag for any of my concerns.

I haven't had personal experience with that medication. It's an antidepressant introduced in the U.S. at the beginning of this year. Its target is serotonin. It's related to (but not identical to) the SSRI family of ADs which include Prozac, Zoloft, Lexapro, Celexa, and several others.

As far as dealing with stress hormones, I would personally want to look more closely at (and maybe target) cortisol before going after serotonin. My understanding is that elevated cortisol (as is usually the case with chronic stress) suppresses serotonin, so cortisol might be the more important causal variable to focus on.

Treating the underlying sleep disorder corrects for any hormone imbalances that may be occurring.

Neither of those two drugs would be an appropriate choice for what you described. This new doc of yours sounds like a total quack. I can't think a single legitimate medical practitioner that would make statements like those he made to you. Run, run far, far away and find a new doc.

Paralel wrote:Neither of those two drugs would be an appropriate choice for what you described

Silenor (doxepin) won FDA approval in 2010 for the treatment of sleep maintenance insomnia.
http://www.drugs.com/newdrugs/somaxon-a ... -2070.html

Jay Aitchsee wrote:

Paralel wrote:Neither of those two drugs would be an appropriate choice for what you described

Silenor (doxepin) won FDA approval in 2010 for the treatment of sleep maintenance insomnia.
http://www.drugs.com/newdrugs/somaxon-a ... -2070.html

Whereas this medication is being prescribed off label since SSRIs definitely are not sleep aids and in fact are known to disrupt sleep.

49er

PS - See this link in which it mentions SSRIs effecting sleep.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC181155/

49er is correct, SSRIs can disrupt sleep, while some can help, it seems to depend on the person and the drug in question. It's more art than science.

While Doxepin is approved by the FDA for sleep maintenance insomnia, it still wouldn't be my choice, given the common, significant weight gain adverse effect that eventually leads to discontinuation and/or non-compliance, leaving the patient right back where they were, and with the weight gained (assuming the person was not underweight to start with), the patient now has to deal with all the health consequences attached to that. I have yet to meet a patient that was on doxepin that didn't regret it after gaining 20, 25, 30+ lbs.

Many drugs are approved for many things, but it doesn't mean they are a good choice.

Thanks for the replies. I will definitely look into the cortisol aspect and have a new discussion with sleep doc! I am not in favor of continuing with the doxepin.

Thanks for the interesting read, 49er. Too bad it was written in 2001 which predate Brintellix. I'll investigate further...

M'ohms wrote:Thanks for the interesting read, 49er. Too bad it was written in 2001 which predate Brintellix. I'll investigate further...

You're very welcome

Good point which leads to something I forgot to mention. Obviously all SSRIs are different from each other but it does seem that generally, many of them disrupt sleep. Since Brentellix is also an SSRI, that is why I would be very leery of it even though there isn't specific research on it.

Best of luck.

49er

Absolutely! That's why I like to run these things by our wonderful forum members!

Do you have an endocrinologist? If so, I would discuss with him/her before taking. Since you've had thyroid cancer, you may also have other glandular problems which might lead to a stress hormone imbalance, but I'd want to know, such as by blood test results, that this was the type imbalance interfering with sleep. Since you just saw the PCP, I'm assuming he hasn't done any blood work of this nature yet? I have some hormonal imbalances, due to both thyroid & pituitary tumors, I'm lucky though, they don't affect my sleep.
I would think blood tests should be able to reveal the imbalance, I know they can reveal cortisol imbalances, so the 'stress hormones' he mentioned should also show up, either directly or indirectly on blood tests.

If you don't have an endocrinologist, PM me, I have a great one close to your area (I live in Jeff, he has an office in Clarksville), if you are interested.

I'm just kind of uneasy with brand new drugs, especially when used off-label, such as he is suggesting. Now it may have been his drug rep suggested this usage, but it still sounds a little off to me. I've taken several drugs off-label & before I will do that, I make the Dr. convince me why I should take something that way without FDA labeling. My neurologist knows I'm that careful, so if he plans to try something that way, he copies the JAMA article (or other publication) that shows findings of why a drug works this way, lets me read them & then call back & decide if I want to try the drug or not. Now I don't expect that from every Dr. but I've been thru a lot with my neurologist & he knows I won't go off-label without a very good reason.

I read the info on Brintellix & did see a note in the prescribing info that a side effect can be 'trouble sleeping' so that make me even more nervous of this off-label use. Just my thoughts.

Jen