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Taking Doxepin, Temazepam And Ambien. Having Depression After Taking Lexapro. Gained Weight. Suggest?

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Posted on Mon, 11 Nov 2013
Question: have been taking 150mg doxepin,30mg temazepam (restoril) and 20 mg ambien for past 2-3 years. Slept very well for 6-7 hours and had no hangover effects in the morning. I also took 40 mg Lexapro as I've had severe depression forever (a DNA test showed I had one of the four genes for depression). I have gained 25# in the last few years - I now weigh 25 more pounds than when I delivered my last baby. I had to change doctors and am seeing a P.A.. She is with a nerologist's office. She took me off all ambien and is weaning me off temazapam - 7.6mg a night with the doxepin.
I am not sleeping. I took the 7.5 and dox. at 9:00pm. Within an hour my legs were shooting with pain - something that usually woke me up in the mornings.(My primary is doing tests to find the reasons my legs hurt only when I'm lying down) Last night I was still awakeat 1:00am. At 2:00 I tookmobic for the pain and another 7.5 temazapam, plus0.5 of klonopin which I havn't been taking in the last week or so. At 3:00 I last looked at the clock and finally fell which was hellasleep. I got up at 8:00 this morning. What am I going to do?
In the past I went thru a period,of insomnia that lasted a week - I saw and heard things that were not real.
Then 30 years ago I drank beer at night for about 5 years-that just about killed me and did damage to my childen I'm certain. AA got me out of that mess. I've tried melatonin,trytophane. and handfuls of antihistamines (which on ly dried out my eyes and mouth). When the children started coming I was prescribed doridon which was hell.
I'm 68 years old' graduated magna cum laude in l990. Oh- I've had 2 sleep studies done. I was wide awake for the first one which infuriated the doctor because I was "not cooperating." The last was done 2 years ago. I was allowed to take 20mg. of ambien. I fell asleep within aa minute but woke up about 150 times and they said I had sleep apnea when on my back. I now use O2 when I go to bed. This new PA wants to schedule another sleep study - this time with no meds. I'm game for that ifmit will help find out what in the world this life long insomnia is and what to do.I understand this has been very long to read but I am desparate. I hope you can give some suggesstions.
Thank you very,very much. XXXXXX
doctor
Answered by Dr. Preeti Parakh (5 hours later)
Brief Answer:
Restless Legs Syndrome is a possibility.

Detailed Answer:
Hi XXXXXXX

Welcome to Healthcare Magic!

One possibility that struck me immediately on reading your query is that of restless legs syndrome. It is often misdiagnosed, with people being unsuccessfully treated for insomnia with sleep medicines when the cause is something else.

tingling, numbness, or other unpleasant or unusual sensations. The sensations are unusual and unlike other common sensations. People with RLS describe them using words like: uncomfortable, painful, creeping, itching, pulling, crawling, tingling and numbness. It is sometimes described as an exaggerated sense of positional awareness of the affected area.
2) Symptoms worsen in the evening or night. Patients with mild or moderate RLS show a clear circadian rhythm to their symptoms, with an increase in sensory symptoms and restlessness in the evening and into the night.
3) Symptoms worsen with rest, like lying down or sitting for a long period of time.
4) Symptoms improve with activity. Many patients find relief when moving and the relief continues while they are moving.

RLS can occur in young age but in some people it has a late onset which is often associated with use of medicines like antihistaminics, antidepressants (including both TCAs like doxepin and SSRIs like Lexapro) etc. Depression and being overweight are also associated with RLS, though it is not clear whether these cause RLS or RLS causes these.

RLS can be treated with gabapentin or dopamine agonists like pramipexole, ropinirole etc. Iron deficiency anemia, varicose veins, and thyroid disorders are also common in people with RLS and need to be evaluated and treated. Massaging the legs before sleep helps. Avoiding caffeine, alcohol, and tobacco, exercising every day and avoiding heavy meals before bed also benefits people with RLS.

I cannot say for sure that you have RLS but I do feel that you and your doctor should give it a serious thought.

Hope this helps you. Please feel free to ask if you need any clarifications.

Best wishes.

Dr Preeti Parakh
MD Psychiatry
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Preeti Parakh

Addiction Medicine Specialist

Practicing since :2002

Answered : 1486 Questions

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Taking Doxepin, Temazepam And Ambien. Having Depression After Taking Lexapro. Gained Weight. Suggest?

Brief Answer:
Restless Legs Syndrome is a possibility.

Detailed Answer:
Hi XXXXXXX

Welcome to Healthcare Magic!

One possibility that struck me immediately on reading your query is that of restless legs syndrome. It is often misdiagnosed, with people being unsuccessfully treated for insomnia with sleep medicines when the cause is something else.

tingling, numbness, or other unpleasant or unusual sensations. The sensations are unusual and unlike other common sensations. People with RLS describe them using words like: uncomfortable, painful, creeping, itching, pulling, crawling, tingling and numbness. It is sometimes described as an exaggerated sense of positional awareness of the affected area.
2) Symptoms worsen in the evening or night. Patients with mild or moderate RLS show a clear circadian rhythm to their symptoms, with an increase in sensory symptoms and restlessness in the evening and into the night.
3) Symptoms worsen with rest, like lying down or sitting for a long period of time.
4) Symptoms improve with activity. Many patients find relief when moving and the relief continues while they are moving.

RLS can occur in young age but in some people it has a late onset which is often associated with use of medicines like antihistaminics, antidepressants (including both TCAs like doxepin and SSRIs like Lexapro) etc. Depression and being overweight are also associated with RLS, though it is not clear whether these cause RLS or RLS causes these.

RLS can be treated with gabapentin or dopamine agonists like pramipexole, ropinirole etc. Iron deficiency anemia, varicose veins, and thyroid disorders are also common in people with RLS and need to be evaluated and treated. Massaging the legs before sleep helps. Avoiding caffeine, alcohol, and tobacco, exercising every day and avoiding heavy meals before bed also benefits people with RLS.

I cannot say for sure that you have RLS but I do feel that you and your doctor should give it a serious thought.

Hope this helps you. Please feel free to ask if you need any clarifications.

Best wishes.

Dr Preeti Parakh
MD Psychiatry