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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2253
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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I have severe anxiety which henders my ability to sleep

Resolved Question:

I have severe anxiety which henders my ability to sleep well, Im a commercial contractor with very, little work, i lost my mother to suicide, and declared bankruptcy that about someup my situation. i need something, could you help point me in the right direction
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Vikas replied 5 years ago.

Since how long you are suffering from anxiety?

Could you please mention all of your symptoms?


Customer: replied 5 years ago.
I have been taking Ambien for 3 years, 1 at night for sleep. the anxiety has been progressing more in the last year since my mothers death and current poor unemployment status.
Expert:  Dr. Vikas replied 5 years ago.
Thanks for your reply. I am really sorry to hear about your mother's death.

Any type of stress may worsen or aggravate the anxiety symptoms and may be the same is happening with you also.

There are two possible treatment options in your case.

  • Medicines
  • Psychotherapy specially CBT
Medicines - Ambien is not indicated for treating anxiety symptoms. Medicines such as Benzodiazepins and antidepressant are the first line medicines for treating anxiety disorder. Since Benzodiazepines and medicines such as Ambien should not be taken for a long time because of the risk of dependence on them and tolerance to their effect, in your case a sedating antidepressant such as Mirtazapine (Remeron) to be taken at night could be very useful.
Mirtazapine is a sedating antidepressant which well help you in sleeping at night and will also control your anxiety symptoms effectively.

Additionally you can also ask your doctor to prescribe Clonazepam Orally Disintegrating Tablets in low dose such as .25 mg to be taken on as and when needed to control acute anxiety symptoms. This tablet can bring rapid relief within minutes to half an hour in most patients.

As I mentioned before, Ambien should not be used for long duration and you are taking it since last 3 years, therefore you should also ask your psychiatrist to taper this medicine slowly while continuing the Mirtazapine and Clonazepam tablet.

Besides medicines, psychotherapy specially CBT can also be a good option either with or without medicine.

What is Cognitive Behavioural Therapy?

Please discuss with your GP / Psychiatrist about all the options I have mentioned above and hopefully you will start noticing improvement in your symptoms within 10 -15 days after starting the treatment.

Best wishes,


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