OT: Any sucess with Prozac or other SSRI?

[grumpygirl]

Hello All- I have just begun taking 10mg of Prozac for what I have been told is mild to moderate depression. I said I would give it a try although I truly think my major problem stems from non restorative sleep. I wake often and sometimes have trouble falling asleep. On the rare nights that I do get some uninterrupted sleep I generally feel much better the next day and do not feel depressed or overly tired (DUH!! ). I might get one night of such sleep every 4-6 weeks.
Anyway, my experience so far with Prozac is that it is NOT helping with my sleep. For example, last night I woke up at 3 a.m. and never went back to sleep. The alarm went off at 6 and I was up for the day. Needless to say I am dragging butt this morning. I had tried Melatonin for a few weeks and although I did fall asleep I didn't always stay asleep and I felt like I was in a fog all day long even on the low dose of 300mcg. The Prozac seems to help with the mild sadness but not with the sleep. Can I take Melatonin at night to sleep and the Prozac in the a.m. ??
So my question is this: has anyone else had this side effect from Prozac or any of the other SSRI's? I have tried Zoloft in the past ( maybe 8 yrs ago after a family crisis) but that had the same-if not worse-effect on my sleep. I truly felt awful on that stuff. Do you guys have any suggestions. I feel that I would be 1,000 % better if I could just get some consistent restorative sleep. Any thoughts???
BTW- I have been on the Prozac for about a week now. I have to keep the dose kinda low because I usually have such exaggerated side effects from almost any medicine I take-it's just the way my body is. Thanks for any and all suggestions-GG

[Tielman]

Hello All- I have just begun taking 10mg of Prozac for what I have been told is mild to moderate depression. I said I would give it a try although I truly think my major problem stems from non restorative sleep. I wake often and sometimes have trouble falling asleep. On the rare nights that I do get some uninterrupted sleep I generally feel much better the next day and do not feel depressed or overly tired (DUH!! ). I might get one night of such sleep every 4-6 weeks.
Anyway, my experience so far with Prozac is that it is NOT helping with my sleep. For example, last night I woke up at 3 a.m. and never went back to sleep. The alarm went off at 6 and I was up for the day. Needless to say I am dragging butt this morning. I had tried Melatonin for a few weeks and although I did fall asleep I didn't always stay asleep and I felt like I was in a fog all day long even on the low dose of 300mcg. The Prozac seems to help with the mild sadness but not with the sleep. Can I take Melatonin at night to sleep and the Prozac in the a.m. ??
So my question is this: has anyone else had this side effect from Prozac or any of the other SSRI's? I have tried Zoloft in the past ( maybe 8 yrs ago after a family crisis) but that had the same-if not worse-effect on my sleep. I truly felt awful on that stuff. Do you guys have any suggestions. I feel that I would be 1,000 % better if I could just get some consistent restorative sleep. Any thoughts???
BTW- I have been on the Prozac for about a week now. I have to keep the dose kinda low because I usually have such exaggerated side effects from almost any medicine I take-it's just the way my body is. Thanks for any and all suggestions-GG

I have been taking the SSRI Lexapro (10mg) for almost 2 years now, and havn't had any sleep related issues. I've recently been upped to 20mg for the last 3 months, and havn't had any sleep related issues.

The only sleep related issue that I have run across is that my CA (Central Apenas) have not been able to drop below 1-2 per night (on average). I have had the occasional ".09" AHI, and about once a week a 1.5-1.9 AHI.

Please remember that with ANY SSRI, it takes between 3 and 4 weeks to take effect, and some of them have withdrawal issues.

Hope you find an answer.

[roster]

None of the SSRIs work. It is a scam by the pharm companies and their cronies at the FDA.

A new study published today is sure to set off another storm in the ongoing debate about the widespread prescription of antidepressants. Professor Irving Kirsch at the University of Hull and colleagues in the US and Canada report that new generation 'SSRI' antidepressants like Prozac or Seroxat mostly fall, "below the recommended criteria for clinical significance" (Kirsch et al. 2008). In other words, the most modern drugs prescribed for depression generally don't work.

Full article: http://www.spring.org.uk/2008/02/new-st ... s-dont.php

[DoriC]

Don't know if you've discussed short-acting Ambien with your Dr for short term use? I used it for about 6 months on/off when my husband first started therapy and I was staying awake "on guard" all night. Talk about depression from lack of sleep! He also used it during the first few weeks of adjustment. I don't think it creates as much of a dependency as the SSRIs as I was able to gradually discontinue Ambien with no ill effects. My husband just stopped because he was only on them for a very short time.

[Tired Linda]

I have been on the Prozac for about a week now.

The Prozac seems to help with the mild sadness but not with the sleep.

GG,
I've been on a number of SSRIs over the years, and Prozac was one of them. The changes are very subtle and you have already noticed the sadness is better. Remember that it, in itself, is a good thing. It may take more time, I'd give it at least another week. Then call your doctor.

Zoloft was not good for me, either. (can also cause weight gain)

Melatonin worked for my daughter and got her over a hump, but that was all she took. I wouldn't mix anything with the Prozac without talking with my doctor.

I didn't have sleeping issues with Prozac though. I slept soundly. And it never failed that when I started having issues like restlessness, wakefulness, etc., my dosage needed to be tweaked...time to see the psych, and he usually raised a bit. Then I'd go back to sleeping like a rock.

You don't say who is prescribing your antidepressants, but I would hope it is a good psychiatrist experienced in depression issues. I have been extremely lucky over the years to have a few who were easy for me to talk to and were willing to listen. One could look at me walking into his office and know something was out of whack and he was 99% correct.

I currently take Wellbutrin and Lexapro, and my sleep doc is aware of that. He has told me SSRIs can sometimes cause a problem by delaying sleep because he noticed it took me longer than "normal" to fall asleep at my sleep study. (I'm surprised I slept at all). But he thought it was far more important to get me sleeping first, and then see if my meds needed to be adjusted.

Sleep and depression are a tangled up mess. If you want to chat more, PM me.
Linda

[grumpygirl]

Thanks Linda for the detailed information. I am thinking of taking the Prozac at night instead of in the morning to see if that might work better. I guess it is just trial and error at this point. No, I am not seeing a really good psychiatrist. Our small town only has two now(some major changes in our hospital system-lots of docs left the area) and they are reportedly not very good, so my GYNO prescribed the meds. I had taken Prozac several years ago during a time when I was very overwhelmed and at that time I was seeing a "shrink" however he was one of those docs that just signed the prescription and didn't do much talking. At that time I took Prozac for maybe 4 mos. and I do remember having trouble falling asleep and waking several times during the night. At that point I was up to 20 mg a day. I think I stopped because of the sleep issues-that was before cpap. After I started cpap I really felt I didn't need the meds anymore but the initial benefits of cpap didn't last very long as far as feeling rested and now I feel just as bad as before cpap. There has to be a solution!! BTW- I will have been on cpap 3 yrs. in Nov.(wow- I can't believe it's been that long).
So, I guess I am kinda on my own with this whole thing. I am going to try taking it at night tonight-I didn't take one this morning-but I am not sure I really want to continue with this if it is just going to add to my fatique. THat has been a major issue with me lately and I am afraid if I don't get some quality sleep that I am going to end up catching every "bug" in town this winter!! Thanks again for your time and advice- GG

[dtsm]

I have very limited knowledge and experience with SSRI but do know that what works for one might not work for another. You may have to try different SSRI?

I was diagnosed with Irritable bowel syndrome. I used lexapro 10 mg daily for almost one year and it was well tolerated, did not impact my sleep [or cpap therapy] and had no withdrawal symptons. The only downside was it took 4-6 wks before the medication kicked in, and during that first two month period, I also took a very small dose of clonizapem to help with sleep [2.5 to 5 mg daily]. Keep in mind clonizapem is a relaxant and usually not to be taken with cpap patients - but both my sleep doc and family doc signed off on it.

Keep in mind it's possible the two are not related [i.e. cpap and medication]. Have you consulted your doctor - either sleep doctor, family doctor or doctor who prescribed prozac? They should provide some guidance for you.

And good luck.

[M.D.Hosehead]

Grumpy, SSRI antidepressants seldom help sleep. In fact, as you have observed yourself, if they do anything to sleep, they interfere with it. You can be pretty there is a pill that will help you sleep, if you want to go with pharmacology. You may want to consider non-pharmacological app approach first:

http://www.sleepfoundation.org/article/ ... ep-hygiene

A balanced review of SSRI's can be found on Wikipedia:

http://en.wikipedia.org/wiki/SSRI


I don't think Rooster's cynical view

None of the SSRIs work. It is a scam by the pharm companies and their cronies at the FDA.

is consistent with the evidence, or even with the article he linked.

The general conclusions of big studies like the one quoted in Wikipedia ("The magnitude of benefit of antidepressant medication compared with placebo ... may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial.") may or may not apply in an individual case.

It's a pity you haven't had a consultation with a skilled psychopharmacologist. I know you live in a small town; a really good consultation is worth a trip to a bigger city. Maybe you could ask friends, family or acquaintances for a name.

[Breathe Jimbo]

All the SSRIs take significant time to kick in and give you the full benefit. Prozac is slower than most in this regard. You should take it the same time every day and try to live healthy in the meantime. The package insert may have recommendations on when to take it during the day.

[SleepingUgly]

I didn't take one this morning-but I am not sure I really want to continue with this if it is just going to add to my fatique.

Do not go off SSRIs except under your (incompetent? disinterested?) doctor's supervision.

If your sleepiness is due to depression, it may take longer for the Prozac to help you in this regard. I don't know much about the effects of antidepressants on sleep, except that SSRIs can exacerbate (cause?) leg movements, whereas Wellbutrin is less likely to do so.

I don't know if this site is reliable, but it seems to indicate there are some newer antidepressants that may help with sleep:

http://ndri.com/article/effect_of_antid ... p-131.html

Is your CPAP working well for you so that you've ruled out residual respiratory events as a cause of your nighttime problems? And have you addressed sleep hygiene issues (eg, not staying in bed if you're not sleeping, up at the same time every day, etc.)?

[davecpap]

I was put on Celexa 20mg (the lowest, starter dose) back in April for Anxiety/Depression issues.

Anyways, the Celexa they said would take 4-6 weeks to take effect....3 months later, still having daily anxiety/depression symptoms. At that point I sought out a psychologist instead of the psychiatrist I was seeing. The psychologist started teaching me about cognitive behavioral therapy, had me read David Burns' Book Feeling Good: http://www.amazon.com/Feeling-Good-Ther ... 140&sr=8-1 in between sessions.

Also, he showed me several articles/studies showing exercise to be as or more affective as SSRIs, and that they start to work faster. He encouraged me to start exercising, which was really tough, but it made a big difference. I think the combo therapy/exercise did a lot more than the Celexa (which I'm still taking). I'm not sure the celexa is doing anything - good or bad. I'm considering stopping taking it, but I'm going to wait a little while longer until I make sure this bout of anxiety/depression is behind me. Good luck!

[Prevail]

I have lots of experience taking SSRI's in the past so I can chime in here.

Prozac is usually the best SSRI for depression and had the least amount of side effects. When I took it, I had severe depression and could not sleep more than 3 hours, like you. After taking it, my sleep became normalized within a couple weeks. Generally, Prozac will take 4 weeks to come into full effect, so I wouldn't count it out until you've given it a couple weeks.

Changing the time of day that you take it may also help. One side effect that people experience is sleepiness, so taking it at night would be a better idea.

Prevail

[brain_cloud]

I didn't take one this morning-but I am not sure I really want to continue with this if it is just going to add to my fatique.

Do not go off SSRIs except under your (incompetent? disinterested?) doctor's supervision.

If your sleepiness is due to depression, it may take longer for the Prozac to help you in this regard. I don't know much about the effects of antidepressants on sleep, except that SSRIs can exacerbate (cause?) leg movements, whereas Wellbutrin is less likely to do so.

I don't know if this site is reliable, but it seems to indicate there are some newer antidepressants that may help with sleep:

Older ones, too, can have a substantial hypnotic effect; many of the tri-cyclics, for example, and trazodone. The first few days on an SSRI is likely to cause sleep disturbances. Therapeutic effect, if it happens, is coincident with the down-regulation of the serotonin receptors, which is a matter of weeks.

It's also the case that any of the anti-depressants are more likely to be efficacious in seriously ill patients, and less likely in mild to moderately ill ones.

[M.D.Hosehead]

BrainCloud is right about the sedeative/hypnotic effectes of may antidepresantsa. If all you are seeking is a pill to put someone to sleep, there are scores of those.

This statement:

It's also the case that any of the anti-depressants are more likely to be efficacious in seriously ill patients, and less likely in mild to moderately ill ones.

is also correct, but deserves comment IMO.

Severely depressed people are unlikely to respond to placebos, so a drug effect is easily detected in that group. Mildly-moderately depressed people have a high placebo response rate, perhaps 50%, which makes a valid drug effect hard to detect in a placebo-controlled study. Even though it can't be demonstrated statistically, there are moderately depressed individuals who have a positive response to antidepressants. One hope is that biological markers may be discovered--perhaps in DNA--that will identify probable responders.

Errors arise when the results of statistical analysis are applied to individual cases. And that's a big risk as insurance companies (and government agencies) increasingly try to use "outcome research" to determine what medical care will be covered.

Individual variability is also the reason I hope Grumpy can find her way to someone good.

[Jaylee]

Older ones, too, can have a substantial hypnotic effect; many of the tri-cyclics, for example, and trazodone. The first few days on an SSRI is likely to cause sleep disturbances. Therapeutic effect, if it happens, is coincident with the down-regulation of the serotonin receptors, which is a matter of weeks.

It's also the case that any of the anti-depressants are more likely to be efficacious in seriously ill patients, and less likely in mild to moderately ill ones.

Dr. Cloudy.