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Can Anxiety Cause Insomnia?

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Posted on Wed, 28 Dec 2016
Question: I have an anxiety disorder and as a result, insomnia. I cannot take SSRIs or SNRIs so that leaves a lot of medications out. Right now, amitriptyline 50 mg has been added, which I feel helps, and I take 50 mg amitriptyline, 100 mg trazodone, and use Xanax for anxiety. I am wondering if adding Seroquel 20 mg will help with the amitriptyline. I'm still not where I should be. I still have good days and bad days of insomnia.. I have tried in the past Seroquel and trazodone, but for some reason that doesn't seem to work anymore. Would 20 mg of Seroquel and 50 mg of amitriptyline be a good combination? I also use Xanax occasionally and can use it for sleep, 50 mg. Please let me know Thanks.
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (58 minutes later)
Brief Answer:
It can be used but difficult to predict outcome

Detailed Answer:
Hello,
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

First of all I like to make it clear that amitryptiline can be used with seroquel without any serious side effect.

In addition there is practical benefit as low dose of seroquel can be used for anxiety. Although 25 mg too low but anti anxiety dose of seroquel is 50-200 mg per day. I mean to say that since you are not comfortable with current regimen of treatment why not to try slightly higher dose which could be effective for both sleep as well as anxiety. This will probably eliminate use of xanax.

Having said this I have one reservation. Although theoretically it is good option but no literature exists in favour of combination.

I hope this helps you.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (32 minutes later)
Should I try the slightly higher dose of Seroquel before bedtime then?
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (1 minute later)
Brief Answer:
Yes

Detailed Answer:
Hello,
Thanks for reverting back to me.

In my view you should target at least 50 mg of seroquel at bedtime.

Thanks again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (8 minutes later)
Should I keep the trazodone at 100 mg then also?
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (25 minutes later)
Brief Answer:
It can be continued

Detailed Answer:
Hello,
Thanks for reverting back to me.

For time being Trazodone can be kept and than it can be stopped gradually.

I hope this clarifies further.
Thanks and regards.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Ashok Kumar Choudhary

Psychiatrist

Practicing since :2000

Answered : 3355 Questions

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Can Anxiety Cause Insomnia?

Brief Answer: It can be used but difficult to predict outcome Detailed Answer: Hello, Thanks for using Healthcaremagic. I read your query and understand your concerns. First of all I like to make it clear that amitryptiline can be used with seroquel without any serious side effect. In addition there is practical benefit as low dose of seroquel can be used for anxiety. Although 25 mg too low but anti anxiety dose of seroquel is 50-200 mg per day. I mean to say that since you are not comfortable with current regimen of treatment why not to try slightly higher dose which could be effective for both sleep as well as anxiety. This will probably eliminate use of xanax. Having said this I have one reservation. Although theoretically it is good option but no literature exists in favour of combination. I hope this helps you. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for my future patients. In future if you wish to contact me directly, you can use the below mentioned link: http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386 Thanks and regards.