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Hello from JustAnswer.
Are you asking for suggestions for other medicines to consider?
Is your Psychiatrist continuing to try medicines to help with this situation?
If so, what medicines have been most recently tried?
Have you been tried on any other antidepressants, particularly ones that work by a different mechanism than the trazodone?
Thank you for the additional information.
The usual next medicine that I would consider in someone that has been tried on the various medicines that you have used would be a different antidepressant that works by a different mechanism. And it would specifically be appropriate to consider an antidepressant that is more sedating, such as mirtazapine. There also are certain medicines that are used to augment antidepressants, that also work by a different mechanism that can be considered such as Seroquel or Abilify. These latter medicines are usually reserved for people with more severe symptoms because of possible side effects, but in someone with more severe and persistent symptoms, it may be an appropriate consideration.
Is there any further information that would be helpful?
Lexapro is an SSRI, just as the Prozac is an SSRI. Since you have already tried the Abilify, that is obviously not an option at this point. At this point, it would be reasonable to consider a different antidepressant, such as the mirtazapine noted above.
It certainly is one of the most sedating antidepressants and would work for most people. However, there is no medicine that works for 100% of people, and it is impossible to know ahead of time who will respond and who will not.
Is there any additional information that would be helpful?
Please let me know is I can provide any further assistance.
There are no other primary sleep medicines that would commonly be considered in this situation and that work by a different mechanism than the sleep medicines that you have already tried. You have already been tried on several different benzodiazepines, and there is no logic in trying another benzodiazepine. Older sleep medicines, such as the barbiturates and meprobamate, are generally avoided in people with depression.
There are other antidepressants beyond the mirtazapine that I noted above, but the mortazapine has the advantage of being the most sedating.