RYAN (RCA7591)

[Atilla]

After coming off Xanax for sleep and still having difficulty falling asleep, my doctor prescribed Antivan.  Yes it does help me sleep; but I realize it is just like taking Xanax which I really did not want to do,( another Benzo),  but I had to get some sleep.    I have a little depression, plus with my anxiety, I seem to hyperventilate alot of the time.  At one time much earlier  I was on Elavil for migraines, and at that time, I noticed that it helped with my hyperventilation.  I did not seem to feel it quite as much while on Elavil .  I was only on 5 mgs.  I didnot have to withdraw from it because of low dosage.   Would Elavil be a good choice to go back to; or would Trazadone be a much better choice  for me as I understand it helps with sleep.  I realize perhaps to help with depression the Elavil would probably have to be a little higher.   THANKS!

[RCA7591]

Benzodiazepines such as Ativan and Xanax are not indicated for insomnia, as they lose their efficacy rapidly. The same could be said for the modern hypnotics such as Ambien and Lunesta (which are comparable to Benzodiazepines).

Elavil (Amitriptyline) or Pamelor (Nortriptyline) are two fantastic choices. They are wonderful for addressing depression, and anxiety recurring secondary to depression. Given you positive response to Elavil, I would recommend Elavil, at a starting dosage of 10 mg, t.i.d. The sedative effect will be apparent before the antidepressant effect. If necessary, the dosage may be increased to 25 mg, t.i.d. I would not exceed 75 mg daily. You can speak to the doctor about Elavil.

Allow a period of one month for the full benefit to be obtained.

Trazodone is not a great antidepressant, but it is sedating. Elavil or Pamelor would be better options.

Ryan