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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I am a 58 yr old femalel. I have chronic depression, PTSP,

Customer Question

I am a 58 yr old femalel. I have chronic depression, PTSP, anxiety, complicated grief, suicide ideation and severe insomnia (I can fall asleep but can't stay asleep. I take lexapro,prazosin and ambien 12.5. My biggest complaint is insomnia, it barely works anymore . My psychiatrist tried low dose serequel. I had horrible violent nightmares. My pgyschiatrist won,t let me try anything else because he told me we're running out of options and I have too many side effects. I have been seeing him for over 20 year since before my huband's suicide.i don't want to go to anyone else because he's been with through so much. He seems to have given up on me. My insomnia is what I really need hep for. What should I do?
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr. Z replied 2 years ago.
This website DOES NOT constitute treatment and only provides information and advice. For treatment (therapy and/or medications) you must go to a licensed professional in your area. Please note that anything said here is not private or confidential, as this is a public forum.
Hello, I am so sorry that your insomnia is this bad, I can understand how distressing this can be for you. So there are a couple options that you have to help lessen this insomnia
1. Switching from Ambien to Lunesta may be effective as Lunesta lasts longer throughout the night and has been shown to be more effective in keeping people asleep than Ambien. Ambien works faster than Lunesta though, but washes out of your system within 2-3 hours while Lunesta's half-life is usually twice as long. So either switching to Lunesta or possibly adding it to your sleep aid regimen may be helpful for you.
2. For many people, insomnia can be caused by stress/anxiety, so instead of relying on a specific sleep aid medication, switching or adding a benzodiazepine to your night time regimen may be effective for you. Benzoadiazepine lessen anxiety significantly and have a strong sedative effect to help you relax and fall (and stay asleep) as well. Some effective benzodiazepine that are fast acting would be Klonopin, Xanax, or Ativam.
3. Lastly while the Seroquel may not have been effective for you, there is another off-label sleep aid medication known as Trazodone, which is an older TCA antidepressant, that may be effective in lessening this insomnia. This medication has a strong sedative effect and is routinely used as am off-label sleep aid medication.
I hope this answers your questions and gives you some guidance on this issue. I truly hope that these options help to lessen your overall insomnia very soon. Please let me know if you have any questions or concerns as I am happy to assist and support you regarding this issue.
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