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Schuyler - ANP
Schuyler - ANP, Nurse
Category: Mental Health
Satisfied Customers: 16185
Experience:  Adult Nurse Practitioner, MSN, private practice and hospitalist experience
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I have interstitial cystitis and chronic severe insomnia

Customer Question

I have interstitial cystitis and chronic severe insomnia with depression and anxiety. My doctor's PA prescribed Lexapro to go with Ambien. I began taking 1/2 a 10mg Lexapro last night. My doctor's PA said take 10mg of Ambien - actually zolpidem - at bedtime and then another 5 when you wake up. ( I have a very severe problem. ) This morning I had blurred vision and complete enervation. The blurred vision has just returned.I called my doctor and told him I thought I should discontinue the zolpidem and try eszopiclone again even though it is a suspect in the cause of the interstitial cystitis (combined with a long course of fluconazole). He said take the eszopiclone at bedtime and then zalaplon when you wake up. He told me to continue the Lexapro even with blurred vision because we have to treat my depression and anxiety. My gut is telling me not to take the Lexapro. My friends are telling me to consult a Psychiatrist because you know the drugs.
JA: How long have you been feeling this way? Have you reached out to anyone about this yet?
Customer: I have had a long succession of health problems since February and have been in treatment. The issue is getting a psychiatrist's opinion about my immediate situation. My doctor wants me to stop calling him with every little symptom. I am very distressed about his attitude.
JA: Anything else in your medical history you think the psychologist should know?
Customer: February: viral infection and bacterial infection treated with erythromycin. March severe bladder infection treated with 5 500mg Cipro. Result: a candida infection which would not go away, treated with fluconzole for two months (Monistat finally did the trick.) All this time eszopiclone for sleep.
Submitted: 3 months ago.
Category: Mental Health
Expert:  Schuyler - ANP replied 3 months ago.

Hello,

Welcome to Just Answer. My name is***** am reading your question and will be back with you ASAP.

Expert:  Schuyler - ANP replied 3 months ago.

I agree that you need a psychiatrist. Ambien should only be taken when you have 7-8 hours to sleep in bed. There is no protocol for taking it in the morning since it is a hypnotic that induces sleep. I don't doubt for a minute that you had blurred vision One of its side effects is increasing anxiety and depression in people who are suffering from those problems.

Lexapro is used for both depression and anxiety. You should be on something for those problems and Lexapro is a good one.

"....He said take the eszopiclone at bedtime and then zalaplon when you wake up. ..." I can't imagine why this was prescribed. Both eszoplicone (Lunesta) and zaleplon (Sonata) are sedatives. They aren't to be taken unless you can sleep.

Please consult a psychiatrist so you can get these problems straightened out. In addition, many studies have shown that a combination of cognitive behavioral therapy and medication works better for anxiety and depression than they do separately.

Kind regards,

NP Schuyler

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Customer: replied 3 months ago.
To clarify. I wake up after 2-3 hours after I have taken Ambien. I thought I should go back to eszopiclone because of the demising returns of the Ambien and its side effects, even though the eszopiclone may be causal in the bladder problem. So the doctor said take Sonata when I wake up in the middle of the night so that i can get little more sleep. Tonight is a test.
Customer: replied 3 months ago.
The eszopiclone did cause bladder pain. I guess I am stuck with the zolpidem and its side effects. Thank you for helping me.
Expert:  Schuyler - ANP replied 3 months ago.

You're so very welcome. There is a Ambien extended release formulation to help with waking up. Perhaps your provider could prescribe that.

Kind regards,

NP Schuyler

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