Aid in sleeping

I have had tremendous difficulty in the past year getting a good night's sleep.  The antidepressants I have tried don't seem to work for long.  Currently I am taking 450 mg. of serzone and 225 mg. Effexor XR.  The Effexor XR worked to give me 6.5 to 7 hours of sleep for about 2.5 months. I am in therapy.  I have no difficulty in falling asleep, I can't sleep more than 4.5 to 5 hours/night.  I have considered electric shock but my therapist doesn't think I need it.  I know that many people can function on this amount of sleep, but I can not.  By 1:00 or 2:00 in the afternoon, I am exhausted and depleted.  My therapist doesn't know what else to prescribe other than sleeping pills, such as Oxazepam and Sonata.  What would you suggest that might induce a longer sleep period?  Thanks for your suggestion.

[HFHS MD - RG]

Different psychiatrists have different strategies in treating insomnia.
An improvement in your sleep hygiene may help your sleep problems. Discontinuing daytime naps and avoiding caffeine (ie coffee, soda, chocolates)at or near bedtime may help.
Taking Effexor during the day and increasing the dose of Serzone to be taken at night may also help.
Sonata and Oxazepam are short acting medications and would not last long in your system to help your sleep through the night.
I would not recommend long term use of sleep medications. However, for short term use, long acting benzodiazepines like Restoril or Ativan may help.
I would recommend consulting your psychiatrist to discuss other strategies to help you sleep at night.
ECT is not used for insomnia alone but ECT is done if you suffer sleep difficulties along with the other symptoms of depression that is not adequately treated from medications.

[To cutter]

Have you tried adding Trazedone?  It was almost a miracle for me. I used Trazedone at night in addition to my regular dose of Zolfot and I cannot tell you the difference it made!   It's an anti-depressant that has a side effect of causing drowsines so there's no addiction problem and it's fairly innocuous.  The fist few weeks I was on it I was a little groggy until mid-morning the next day but that went away and I felt fantastic. I am very sleep dependent and was really having a hard time with going to sleep but waking up at 5:00 a.m. and not being able to go back to sleep.  I don't think Trazedone is contraindicated with the meds you're on, so you should be able to add it to your regimen and see if it helps.  Another possibility is that your current meds just need to be increased because the effectiveness is lessened.  Good luck.