Can you please help meno, I need something to help me sleep.

Hello Again,

I am sorry Trazadone did not work for your sleep. I will do my best to help.

You may want to consider Amitriptyline again, if your doctor agrees; depends on what side effects you were having. I am giving you some important information about Amitriptyline here. Please see www.mayoclinic.com for further information about Amitriptyline.

Amitriptyline (Oral Route)

Amitriptyline is used to treat symptoms of depression. It works on the central nervous system (CNS) to increase levels of certain chemicals in the brain. This medicine is a tricyclic antidepressant (TCA).

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

There may be some interactions with Trazadone.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Bipolar disorder (mood disorder with alternating episodes of mania and depression), or risk of or
• Heart attack, recent—Should not be used in patients with these conditions.

• Diabetes or
• Glaucoma or
• Heart disease or
• Overactive thyroid or
• Schizophrenia or
• Seizures, history of or
• Urinary retention (trouble urinating), history of—Use with caution. May make these conditions worse.
• Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

This medication can be used for depression in larger doses and in smaller doses for chronic pain issues.

Precautions

It is very important that your doctor check your progress at regular visits to allow for changes in your dose and to check for any unwanted effects.

Amitriptyline may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you or your caregiver notice any of these adverse effects, tell your doctor right away.

If you do not want to try Amitriptyline again, there are several other medications frequently ordered for sleep that your doctor may recommend for you to try.

I am also going to give you some relaxation Exercises that you may use before bed to calm down into a restful state and also a sleep hygiene program.

Relaxation Exercises

Breathing Exercise

Here are some relaxation exercises to help your anxiety that you could do at work or before sleep to relax. Here is a breathing exercise that can be done almost anywhere. Take the deepest breath you can with your mouth and hold it in for as long as you can. When you want to let it out, purse your lips and let is out very slowly through your lips and make sure all the air is out of your lungs. You may do this 2-4 times every hour or so. If you do it too many times in a row you may get dizzy so just 2-4 times each time you do it . This will help you relax.

Progressive Muscle Relaxation Exercises.

Lay flat on your back in the bed or on the floor. Starting with your feet, tense your muscles for 5 seconds, then relax for 5 seconds. You will go up your body with each muscle group in the same manner, 5 seconds tense then 5 seconds relax. This will tire your muscles and cause you to feel sleepy and relaxed. Exercise is also good, simply walking daily in a pleasant environment may help. Exercise produces endorphins in your brain which improve mood. Please, check with your doctor first, even though you sound in good health.

Mindfulness

Mindfulness is a type of meditation in which you focus on being intensely aware of what you're sensing and feeling in the moment, without interpretation or judgment. Practicing mindfulness involves breathing methods, guided imagery, and other practices to relax the body and mind and help reduce stress. Negative or random thoughts can be draining. It can also make you more likely to experience stress, anxiety and symptoms of depression. COVID has been causing much anxiety and depression across not only the USA but across the globe. These exercises may help significantly. There are many simple ways to practice mindfulness. Some examples include: Pay attention. Try to take the time to experience your environment with all of your senses — touch, sound, sight, smell and taste. For example when you go outside take notice of the sky, the grass, any flowers or smells. Focus in. Live in the moment. Try to be open to allow the things around you in. Find joy in simple pleasures. Accept yourself. Be able to accept all of yourself. Look at the positives, Be kind to yourself. Focus on your breathing. (Slow, deep breathes in through your mouth, hold them in for a few seconds, then blow them out through pursed lips - slowly and steadily.)

Sleep Hygiene

This includes things you do as you prepare for bedtime. Do not have any stimulating beverages or alcohol. Alcohol will actually keep you awake after the initial sleepiness. Do not exercise before going to bed. Do not eat after 7pm. About two hours before bedtime start relaxing. Do not watch scary or unnerving things on television or read any books that are similar. You may watch some relaxing, enjoyable TV show or read a book of the same, as well as relaxing music. Begin to turn down the lights as you get closer to bedtime. Stop using your phone or any electronic devices about one hour before bedtime. When you go to bed, get comfortable. If you are not asleep within ten minutes, get up and go in another room and relax in a chair. You may read, listen to music until you feel sleepy. Once you are sleepy, return to bed. Do this repeatedly until you actually go to bed and fall asleep. You must go to bed and get out of bed the same time daily, seven days per week. Never watch TV in your bedroom or use your electronics in bed. The bedroom is just for sleep and sexual relations, not watching TV or playing on your phone or tablet. It is a hard regimen to follow but testimonials say it works.

I hope something I have written here will help you.

Please free to ask more questions now.

If you would like to ask further questions later just contact Just Answer request me (@Brenda RN LCSW), or another Expert will be happy to help.

All the Best,

Brenda RN LCSW