Insomnia, ambien, zoloft and ativan

[srw906]

I have posted here before but I am starting to get nervous.  Been on 12.5 mg zoloft for 2 weeks and 25 mg for 1 week. I am starting to feel better. I also take .25 mg of ativan as needed which lately is only once or twice a day.  I take the zoloft in morning and have insomnia since starting it. Been on 5 mg Ambien per psychiatrist during work week. I am worried about sleeping with the Ambien as also only 4-6 hours sleep and being addicted. I see my psychiatrist next week and I am going to voice my concerns. Also going to psychologist and doing some Cognitive Behavioral Therapy.

[Paxiled]

Yes, antidepressants can make anxiety worse before they make it better, or they can just make anxiety worse.  It takes about 6-8 weeks for them to fully kick in, but the side effects kick in right away -- ironic, eh?  But the true but unfortunate answer to your question is that antidepressants can be stimulating to a given person as they are truly developed as antidepressants, not as anti-anxiety meds.  They just happen to often work for that too but sometimes a particular med doesn't set well.  Keep an eye on it.

[srw906]

Could my Zoloft be causing my anxiety to be worse?? I haven't taken any ativan but my heart is racing and I am shaky. I am doing the breathing techniques which helps a little.  I just want to enjoy more things. I have a psychiatrist appt on Wednesday. I am still feeling very weird.  Just about a month on zoloft. 2 weeks 12.5 and 2 weeks 25 mg.

[nursegirl6572]

Great advice from Paxiled.

It's good that you're being proactive about these meds.  Certainly, they can be helpful when we need them, but we must be cautious, as tolerance and dependency are real issues.  I agree that with the Ativan, your goal should be to slowly decrease from regular daily use to just "as needed".  If you take it here and there, only when anxiety is bad, you can take it for the long haul like that with no issues.  The Ambien should be limited to very short term courses of treatment, as anything more than that will cause rebound insomnia that will make the original insomnia look like child's play.  Trying Melatonin is a great idea as well....if you can get some results with that, you won't even need the Ambien.

Also talk to your therapist about things you can do to cope, relaxation techniques, etc.  Let us know how the discussion with the doc goes.  Keep us informed on how you're doing!

[Paxiled]

By the way, have you ever tried melatonin for sleep?  If it works it's pretty harmless and you could do without the Ambien.  About 1mg is a good dose for most people.

[Paxiled]

The Ativan is much more addictive than the Ambien, and you're taking it daily.  Voice your concerns about this as well.  Do you really need it twice every day, or can you take it just when you absolutely need it?  Have you learned any relaxation techniques?  If not, a CBT therapist should be able to teach you some.