Prozac For Sleeping Problem?

[ThaiPauly]

For the last 2-3 weeks my wife has been having really bad trouble sleeping. She is getting 2-3 hours a night, once a week she maybe will get 4. She is 52 years old.

 

We have tried all the usual ways to solve this, melatonin tablets, meditation ( before going to bed) in a darkened room, keeping away from her mobile for 2-3 hours before bed, but nothing is working.

 

So I took her to see the local doctor on Tuesday and he prescribed Alprazolam (Xanex) 0.5mg 0.25mg (2 separate tablets of the same thing) and Prozac 20mg.

 

What I can't understand is why has he prescribed Prozac? One of the greatest side effects of this drug is to cause insomnia. He must be treating her for depression, I mean she looks depressed as anybody would who was getting that much sleep, but because the whole interview was carried out in English there was no mention of depression. She is also getting other side effects, sweaty hands and face, tiredness, she is unable to function normally.

 

If anyone has any ideas about this I sure would like to hear them, we were not due to go back to see him for another week but I have made sure she has another appointment to see him on Monday, then maybe we can get some answers

 

Thank you.

 

TP

[Sheryl]

Presumablyhe thinks she is depressed.

But it does not sound like he was a psychiatrist. Before taking this I suggest you have her evaluated by a psychiatrist.

Has she already had a sleep study?

Is there any possibility she is taking amphetamines (ya baa)?


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[ThaiPauly]

No she has not been for a sleep study yet, I want to see this doctor again tomorrow and question him about what exactly he is treating her for? Then discuss the sleep study with him, if he knows anything about it, another day is not going to make any difference right now and today is a Sunday so there is not much to be done.

 

As for the Yaba, she has never had a drug in her life.....(To my knowledge) and I think after 15 years I would know

[BB1958]

For somewhat of a balanced approach to the issue - this could prove usefull https://nutritionfacts.org/topics/insomnia/

 

Within there are many videos on topic - this is a FACT based site not anecdotal...

Good luck for both you and your wife 

[simple1]

I take prozac, two 20mg capsules in the morning for stress due to a chronic medical condition. My GP advised it would take approx 2 / 4 weeks before any discernible effect. For some it aids sleeping, for others it does not.

[Rally123]

Take her to your nearest Psychiatric hospital. Don't bother getting a referral letter from her doctor. Only costs 50 Baht to see the trick cyclist. Medications are as cheap as chips. Your wife maybe suffering 'Anxiety' problems. Probably not having had it before she will have no idea as to why she can't sleep. I suffer depression/anxiety and take Sertraline for the depression and Ativan for sleep problems. I've  had Prozac (the wonder drug) in the past. Didn't work for me. Depressants can take as long as 6 weeks to kick in so don't expect instant results. Good luck.

 

PS I believe Sertraline to be the most used antidepressant in Thailand. Prozac has to be one of the most expensive. 

Edited August 12, 2018 by Rally123

[Sheryl]

Prozac is a brand name import, there are inexpensove locally made generic equivalents. But I agree sertraline, which is same mode of action, is preferrable. Onset quicker as well. And sertraline also available in locally made generic.

 

Neither of these requires a script so do nOT buy from clinic/hospital.

 

Several  TV members have SPOKEN HIGHLY this western trained female pyschiatrist at CMU (Sripat): Professor Nahathai Wongpakaran

 

There is a also psych hospital in CM and also a privare psych clinic  that many have used:

 

Huai Kaeo Polyclinic -  8 Huaykaew Rd, Thesaban Nakhon Chiang Mai, Amphoe Mueang Chiang Mai, Chang Wat Chiang Mai 50300. Dr Pairat Pruksachatkun  5 pm to 8 pm every night

 

OP I cannot stress enough that you should not accept such meds and treatment from a non-psychiatrist. T

 

There is no need to go back and ask what she is being treated for, it is evident from the meds that it is a "shot gun" approach to cover both anxiety and depression. the anxiety med by the way is highly addictive.

 

 

 

[Led Lolly Yellow Lolly]

@ThaiPauIy I can offer you some insight on this. Without going into boring details I struggled with depression, anxiety/panic attacks since early childhood. As I became an adult insomnia set in. Fast forward to my 40s and these issues were always something I just dealt with, I was never a believer in popping pills to make problems go away. . .

 

HOWEVER, a couple of years ago my panic attacks and insomnia started getting completely out of control, I'm not sure why, but my workload had gone through the roof. Simple things like getting my blood pressure checked became a trigger for a panic attack. Even though I have normal blood pressure I could never get anything below 190/100 in a BP test. Also, It was usually sunrise before I managed to get to sleep. It was crippling my work and family life so my wife and I agreed it was time for me to get help.

 

I was immediately referred to a psychiatrist, who immediately prescribed a low dose of Sertraline (antidepressant) and a low dose of Alprazolam. This combination has been HIGHLY effective for me and I have to admit it has really improved my quality of life. My family life has improved because I'm a nicer person to be around. I've been taking the Sertraline for a couple of years and I have agreed with my doctor that I should keep Alrazolam in my pocket for emergencies. I take 0.25 mg of Alprazolam if I can't sleep, maybe twice a week. It works. I haven't had a panic attack for 2 years.

 

It's worth noting that Alprazolam is a highly potent, fast acting benzodiazepine, the fastest acting of all the benzodiazepine family, why it is so useful for panic attacks. You start to feel the effects withing minutes, and you can take it sublingually for an even faster effect. It's is highly addictive and extremely dangerous if mixed with alcohol. Use wisely. 0.25 is a very low dose and won't be addictive if taken a few times a week for sleep. Alprazolam is not a sleeping pill, but it is useful in insomnia where it is caused by anxiety.

 

You may want to discuss Sertraline with the doctor, I personally think this would have been a better choice for your wife.

 

My shrink is a lovely woman, intelligent, understanding, overall good human being. She's moved on now and I believe she works somewhere in Chiang Mai. If that's where you are, I can find her and put you in touch.

 

Good luck with it all and I hope it all works out fine for you both. Feel free to PM me if there is something more private to talk about.

Edited August 12, 2018 by NilSS

[Sheryl]

P.S. i just reread your post and it seems this is not a long term problem but just the past couple of weeks -- and she is menopause age.

 

In that case this is either (1) worry/anxiety fairly recent in onset or (2) menopause.

 

If she is not worried or troubled anout something then menopause likely culprit. In which case psych meds ate NOT needed and she needs to see a Gyn specializing in menopause.

 

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[Led Lolly Yellow Lolly]

I wanted to say something similar because the OP troubles me. Depression doesn't just suddenly switch on. Antidepressants should NOT be prescribed without proper psychiatric evaluation. 

[ThaiPauly]

On 8/12/2018 at 9:38 PM, Sheryl said:

Prozac is a brand name import, there are inexpensove locally made generic equivalents. But I agree sertraline, which is same mode of action, is preferrable. Onset quicker as well. And sertraline also available in locally made generic.

 

Neither of these requires a script so do nOT buy from clinic/hospital.

 

Several  TV members have SPOKEN HIGHLY this western trained female pyschiatrist at CMU (Sripat): Professor Nahathai Wongpakaran

 

There is a also psych hospital in CM and also a privare psych clinic  that many have used:

 

Huai Kaeo Polyclinic -  8 Huaykaew Rd, Thesaban Nakhon Chiang Mai, Amphoe Mueang Chiang Mai, Chang Wat Chiang Mai 50300. Dr Pairat Pruksachatkun  5 pm to 8 pm every night

 

OP I cannot stress enough that you should not accept such meds and treatment from a non-psychiatrist. T

 

There is no need to go back and ask what she is being treated for, it is evident from the meds that it is a "shot gun" approach to cover both anxiety and depression. the anxiety med by the way is highly addictive.

 

 

 

 

Sheryl,

Do you happen to have the contact number for the clinic in Huaykaew Road ? Thanks

[Sheryl]

http://www.chiangmailocator.com/chiang-mai-hospitals-clinics-5127:huai-kaeo-polyclinic

 

But do nto overlook the menopause aspect. A psychiatrist will not help with that and taking a psychiatric approach to a hormonal issue will not be counterproductive. Unless you have other reasons for thinking she has a psychiatric problem (including symptoms that go bad more than just a few weeks) I would think twice about going down this road.

[ThaiPauly]

On 8/12/2018 at 9:38 PM, Sheryl said:

Prozac is a brand name import, there are inexpensove locally made generic equivalents. But I agree sertraline, which is same mode of action, is preferrable. Onset quicker as well. And sertraline also available in locally made generic.

 

Neither of these requires a script so do nOT buy from clinic/hospital.

 

Several  TV members have SPOKEN HIGHLY this western trained female pyschiatrist at CMU (Sripat): Professor Nahathai Wongpakaran

 

There is a also psych hospital in CM and also a privare psych clinic  that many have used:

 

Huai Kaeo Polyclinic -  8 Huaykaew Rd, Thesaban Nakhon Chiang Mai, Amphoe Mueang Chiang Mai, Chang Wat Chiang Mai 50300. Dr Pairat Pruksachatkun  5 pm to 8 pm every night

 

OP I cannot stress enough that you should not accept such meds and treatment from a non-psychiatrist. T

 

There is no need to go back and ask what she is being treated for, it is evident from the meds that it is a "shot gun" approach to cover both anxiety and depression. the anxiety med by the way is highly addictive.

 

 

 

 

 We are going to see a Doctor Pairat at the Huaykaew Clinic tomorrow evening the Doctor at Sripat is no longer there so they tell us

Edited August 15, 2018 by ThaiPauly

[Moonlover]

TP, you have, in my opinion, had some very good advise here and I totally agree with Sheryl's.

 

May I step in with one more suggestion. Might you consider the Traditional Chinese Medicine (TCM) approach?

 

Personally, and I'm speaking very much from experience, TCM's holistic approach to this kind of problem is, in many ways superior to the western medication stile, which, very often only tackles the symptoms, not the underlying cause.

 

I understand there are many TCM practitioners in Chiang Mai and would suggest that you and your wife explore this avenue.

 

Good luck to you both. I hope that you can resolve this issue.

 

ML

[vinegarbase]

1. Cut out any TV/computer/ or phone an hour before she wants to sleep.

2. One hour before she wants to sleep take 10mg melatonin and 400mg magnesium. With age the bodies natural melatonin production drop so supplementation is necessary at times, magnesium also can relax the body and most peoples diet today lacks in magnesium.

 

Give this a try.

[rumak]

On 8/14/2018 at 10:46 PM, Sheryl said:

http://www.chiangmailocator.com/chiang-mai-hospitals-clinics-5127:huai-kaeo-polyclinic

 

But do nto overlook the menopause aspect. A psychiatrist will not help with that and taking a psychiatric approach to a hormonal issue will not be counterproductive. Unless you have other reasons for thinking she has a psychiatric problem (including symptoms that go bad more than just a few weeks) I would think twice about going down this road.

I have yet to see if the OP's wife (or he) think there is a problem that is "psychiatric".  I realize they are not

experts but...my common sense tells me that a psychiatrist will almost always find something that they

believe is an issue.  In my case they would probably think i am a complete nut case.  How many times have we gone to any doctor without walking out with bags of medicines.  

As soon as one starts taking mind/body altering drugs the chances of finding the real cause are almost

non existent.  I am not going to offer specific suggestions as I will be just one of many here telling you

"what works for me"..   If your wife can hang on...do take Sheryl's advice,  and also give a little more time

trying to see if YOU can figure out what is causing this.   A smart person seeks advice, but ultimately

makes a decision that they feel is best.  I once tried antidepressants for just a month.  Didn't like the feeling, so stopped and had dizzy spells when lying down for 2 months !  Think 3 times before going down that road.

 

[Rally123]

8 minutes ago, rumak said:

my common sense tells me that a psychiatrist will almost always find something that they believe is an issue. 

I disagree. Due to the time scale before antidepressants kick in there really isn't harm being done to take them to see if they do help. You have to start somewhere. And that should be with professionals.

 

12 minutes ago, rumak said:

As soon as one starts taking mind/body altering drugs the chances of finding the real cause are almost

non existent.

 That is b******x. It's once you get to control one's depression/anxiety the doctor can then get a better understanding. When I first went into depression I never understood what was happening to me. I'd never experienced anything like it before. I'd constantly roll up in the fetal position     for hours crying for god knows what. Before a doctor could define what was causing my depression he had to medicate me. I got sectioned twice and I am not ashamed to admit it. Don't end up like I did. At the first chance of feeling 'not right' go see a professional. That's what they're there for.

[ThaiPauly]

3 hours ago, vinegarbase said:

1. Cut out any TV/computer/ or phone an hour before she wants to sleep.

2. One hour before she wants to sleep take 10mg melatonin and 400mg magnesium. With age the bodies natural melatonin production drop so supplementation is necessary at times, magnesium also can relax the body and most peoples diet today lacks in magnesium.

 

Give this a try.

Thanks,

 

I take magnesium myself and have some at home so I will give her some to take tonight

[ThaiPauly]

47 minutes ago, rumak said:

I have yet to see if the OP's wife (or he) think there is a problem that is "psychiatric".  I realize they are not

experts but...my common sense tells me that a psychiatrist will almost always find something that they

believe is an issue.  In my case they would probably think i am a complete nut case.  How many times have we gone to any doctor without walking out with bags of medicines.  

As soon as one starts taking mind/body altering drugs the chances of finding the real cause are almost

non existent.  I am not going to offer specific suggestions as I will be just one of many here telling you

"what works for me"..   If your wife can hang on...do take Sheryl's advice,  and also give a little more time

trying to see if YOU can figure out what is causing this.   A smart person seeks advice, but ultimately

makes a decision that they feel is best.  I once tried antidepressants for just a month.  Didn't like the feeling, so stopped and had dizzy spells when lying down for 2 months !  Think 3 times before going down that road.

 

I understand where you are coming from and the only meds she is currently taking is Melatonin until we see the doctor later on today. We will take all the meds she has already been given but not taken to see what this doctor has to say about them. I don't want her on anti-depressants either, she has always been a very happy go lucky girl, it really pains me to see her in this situation, is it depression? I have no idea, she knows that the baht is not doing well against the pound as I am always moaning about it, but that's not it!! I wish it was, I would stop moaning.......anyway I will know more later, thanks for your comments, everyone's comments are very much appreciated

[rumak]

2 hours ago, ThaiPauly said:

I understand where you are coming from and the only meds she is currently taking is Melatonin until we see the doctor later on today. We will take all the meds she has already been given but not taken to see what this doctor has to say about them. I don't want her on anti-depressants either, she has always been a very happy go lucky girl, it really pains me to see her in this situation, is it depression? I have no idea, she knows that the baht is not doing well against the pound as I am always moaning about it, but that's not it!! I wish it was, I would stop moaning.......anyway I will know more later, thanks for your comments, everyone's comments are very much appreciated

If she has been happy go lucky...how can it be depression ???  well, there are chemical changes (for example during menapause) that  can cause one to have serious issues.   But to right off give someone anti-depressants without further thought is just stupid.  There are large numbers of chronicles by people who will tell of their horrible experiences with such.  (hate to say goooogle...but, you can google it)

The medical profession and of course some posters think that just because a "professional" prescribes something you should follow.  I am not in that camp.  People posting here about their experience with

depression, etc. are not relevant to this post.  Glad that whatever they take works for them, BUT really what you are trying to do is determine the cause in your wife's case.  Take your time, get opinions from recommended professionals, not just anyone.

 

[rumak]

3 hours ago, Rally123 said:

I disagree. Due to the time scale before antidepressants kick in there really isn't harm being done to take them to see if they do help. You have to start somewhere. And that should be with professionals.

 

 That is b******x. It's once you get to control one's depression/anxiety the doctor can then get a better understanding. When I first went into depression I never understood what was happening to me. I'd never experienced anything like it before. I'd constantly roll up in the fetal position     for hours crying for god knows what. Before a doctor could define what was causing my depression he had to medicate me. I got sectioned twice and I am not ashamed to admit it. Don't end up like I did. At the first chance of feeling 'not right' go see a professional. That's what they're there for.

I would prefer if you would call it kwai excrement.  i'm happy that you are happy now.  think i will pass on the " try it and see what happens" method though.  actually, i did try it, and did NOT like it one bit, especially when i stopped and had withdrawals.

Edited August 16, 2018 by rumak

[Rally123]

3 hours ago, ThaiPauly said:

I don't want her on anti-depressants either,

Why? It's not as if they will turn her into some kind of monster. What is it about antidepressants that you're scared of?

Edited August 16, 2018 by Rally123

[Rally123]

4 hours ago, ThaiPauly said:

I take magnesium myself and have some at home so I will give her some to take tonight

 

Don't try self medication. You may make things worse.

Quote

Any supplement is going to take a minimum of 2 to 4 weeks to begin to work before person feels them 'kick in.' If it's a mineral, you're looking at about 90 days before your deficiency is fully amended because you're asking your body to absorb a rock.

 

Edited August 16, 2018 by Rally123

[ThaiPauly]

The Specialist that we saw tonight at his clinic has put her on a two week course of Remeron which is also an anti-depressant. He is confident that it will work, but might take longer than 2 weeks.

 

The doctor seemed to know his stuff, he was one recommended by Sheryl, speaks good English and also works at Sripat hospital.

 

Lets hope for the best.

 

 

[Sheryl]

Please do not overlook the menopause aspect. Hormone replacement therapy might do more good than pysch meds and a psychiatrist will nto pick up on that or be able to advise.

 

Does she also have any of the following:

 

hot flashes or intolerance to heat (more than before) (with or withotu sweating)

Mental fogginess at times

muscle aches and pains

Mood swings/irritability

 

?

 

Those are all signs of menopausal effects

 

[rumak]

13 hours ago, Rally123 said:

Why? It's not as if they will turn her into some kind of monster. What is it about antidepressants that you're scared of?

I know that this is just one article......and the medical profession has many more on their side.  But

this is my answer to your question,  and i hope some readers will think about it

www.nytimes.com/2018/04/17/health/antidepressants-withdrawal-readers.html

[Rally123]

2 hours ago, rumak said:

i hope some readers will think about it

I didn't gain any help from your link Rumak. It's just a compilation of individuals who experienced withdrawal symptoms when coming off of antidepressants. The writer Benedict Carey is a journalist. Not a psychiatrist. Any medication that has been taken for a period of time needs to be reduced slowly.   

Quote

Antidepressants are not addictive or habit-forming. Unlike drug withdrawal, antidepressant discontinuation effects are not related to addiction but can reflect physiological consequences of stopping a drug, just as when someone with diabetes stops insulin.

 

Edited August 17, 2018 by Rally123

[rumak]

3 hours ago, Rally123 said:

I didn't gain any help from your link Rumak. It's just a compilation of individuals who experienced withdrawal symptoms when coming off of antidepressants. The writer Benedict Carey is a journalist. Not a psychiatrist. Any medication that has been taken for a period of time needs to be reduced slowly.   

 

I don't trust anyone who wears a suit.   Or anyone that quotes in REALLY BIG LETTERS

[ThaiPauly]

On 8/16/2018 at 9:11 PM, Sheryl said:

Please do not overlook the menopause aspect. Hormone replacement therapy might do more good than pysch meds and a psychiatrist will nto pick up on that or be able to advise.

 

Does she also have any of the following:

 

hot flashes or intolerance to heat (more than before) (with or withotu sweating)

Mental fogginess at times

muscle aches and pains

Mood swings/irritability

 

?

 

Those are all signs of menopausal effects

 

She has been having terrible back and shoulder pain lately Sheryl, she is seeing another doctor for this, she has therapy every week, I know that it's a bit better as she is not talking about it . She gets clammy hands sometimes, her mood is quite stable considering what she is going through. Someone mentioned to me that maybe she should have Estrogen injections??? I have no idea who she should go and see if she requires hormone replacement therapy and how do I find out if that's what is needed?  I thought she had been through the menopause 3 years ago, she had similar symptoms, could not sleep, but it only lasted a few days, ( a week at most according to my diary)but we thought that was it. Her periods also stopped at this time. She did not see a doctor regarding her sleeping then, she just started again, She was advised to visit a physichatrist,  by our local doctor (Dr.Morgan) she went once but did not feel any benefit and was better before she was supposed to go again.     Today after taking the medication from the Doctor she slept like a baby but is suffering a really bad hangover so they must be quite strong, as has been said it is difficult to get to the bottom of this problem if she is constantly doped up. What to do?

[Sheryl]

Estrogen is not given as an injection. Tablet or cream or patch and unless she has had a hysterectomy she also needs progesterone. A gynecologist specialiving in menopause is who qould provide this.

Menopausal symptoms last from months to years, not a few days.

That said they would usually start before or soon after periods stop, not 3 years later. So if her periods completely stopped (as opposed to becoming infrequent/irregular) a full 3 years ago and no problem until now menopause is unlikely to be the culprit.

I am having some trouble figuring out just how long this insomnia has been for and how severe it is. From what you now say it seems like it may be off and on.

Intermittent on and off bouts of insomnia do not usually need any treatment. Even a week or 2 week straight bout of insomnia, often best just toughed out.

If the medication she was given leaves her hung over obviously she should go back to the prescribing doctor and tell him so. It aounds like she was supposed to have already gone back but did not.

Basically ahe needs to either weather this on her own or, if she feels it is intolerable, then fully comply with scheduled visits etc. Going once, skipping next appointment because the felt better, then taking the prescribed drug and complaining about its after effects but not returning to the doctor to tell him, etc is not the way to proceed.

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