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Does depression cause sleeplessness?

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Posted on Mon, 18 May 2015
Question: Hello - My father has not been sleeping for the past three months, awakens every 2 hours and cannot get back to sleep. He lacks desire to do anything he previously enjoyed, and does not want to leave the house. Its an effort for him to go to work every morning. He has been married for 35 years and has two grown children. His 15 year old dog died three months ago. He took the dog everywhere. He smokes 1/2 pack of cigarettes a day and doesnt drink alcohol. Do you think he is suffering from depression? What pharmacological recommendations would be appropriate considering his past medical history and current condition?
doctor
Answered by Dr. Seikhoo Bishnoi (2 hours later)
Brief Answer:
His symptoms suggest depressive disorder though need evaluation

Detailed Answer:
Hello thanks for asking from HCM for your health related queries

I can understand your concern. One aggravating factor for his symptoms is death of his dog which resulted in significant trauma. His symptoms like poor sleep, non-refreshing sleep, lack of desire of anything and lack of pleasure in anything or anhedonia etc are classical symptoms of depression. Considering his age he need proper treatment for his symptoms.

For depression commonly used antidepressants are SSRIs as Fluoxetine, Paroxetine, Sertraline etc or other drugs as Mirtazapine, Amitryptiline. As his main issue is poor non refreshing sleep so as per my opinion Mirtazapine would be appropriate treatment for him. The drug not only help in depression but also helps in good sleep. The drug is a non-benzodiazepine drug and this drug is safe to use for his age. This drug has no significant interactions with his drug HCTZ 50.

If his sleep problems persist even with treatment of Mirtazapine then in such case for some time low dose benzodiazepines can be used in treatment. These drugs will also relieve his anxiety and his sleep should improve.

Please visit a psychiatrist for the evaluation of his symptoms and prescription. Provide his proper support and nutrition and his symptoms would improve.

Thanks, I hope this helps you. Please feel free to ask again if you have more doubts.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Seikhoo Bishnoi (13 hours later)
Thank you for your reply!

With his cholesterol, does he need to be medicated? If so, what would you suggest. Are his lab levels in normal range besides the cholesterol?

I appreciate your feedback and know it is for informational purposes.
doctor
Answered by Dr. Seikhoo Bishnoi (8 minutes later)
Brief Answer:
Please upload the reports or mention them in question

Detailed Answer:
Hello again and thanks for a follow up

I am sorry but I am not able to see attached report on my dashboard. If possible upload his reports or you can mention the reports in question itself. You can also send the reports at YYYY@YYYY and address it to my name: Dr Seikhoo Bishnoi.

If his cholesterol is high but not in very high range then there is no need to give him any medicines, dietary adjustments would do the work. He should avoid taking foods rich in fats and refined carbs and should take food rich in proteins and complex carbs. This will help him in improving his cholesterol levels.

Thanks, Take care
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Seikhoo Bishnoi (24 minutes later)
These are his lab values:
BP 158/92, HR 76, Weight 230 lbs, TSH 3.4, PSA 0.6, TC 280 mg/dL, LDL 160 mg/dL, and HDL 40 mg/dL. He also smokes 1/2 pack of cigarettes a day.

What are your recommendations?
doctor
Answered by Dr. Seikhoo Bishnoi (35 minutes later)
Brief Answer:
The lab levels are in normal range

Detailed Answer:
Hello thanks for providing details

His BP and heart rate are in normal range.

His TSH and PSA are also normal

Total cholesterol is increased moderately while LDL is in high normal range. HDL is perfectly normal. So as per my opinion no need for medicines as of now. Dietary adjustments would help in correcting this. He should stop smoking and this will make the levels to come normal.

Thanks, Take care. I hope this helps you.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Seikhoo Bishnoi (12 minutes later)
Okay, great! One last question, do you think he needs a sleep aid such as sonata? WHich one would be best if so?
doctor
Answered by Dr. Seikhoo Bishnoi (12 minutes later)
Brief Answer:
Sonata can be given for short term for insomnia

Detailed Answer:
Hello thanks for asking again

Sonata is Zaleplon and the drug belongs to Z-drugs. It is usually not advisable to take the drug regularly for long term basis because of risk of dependence and abuse potential. He is showing depressive symptoms also and has also somatic complaints like poor sleep. As per my opinion for his symptoms medicines like Mirtazapine or Trazodon or Amitryptiline etc would be good and safe. For some time even Sonata can work for sleep. Visit a doctor for prescription of these drugs.

Thanks, Take care. Still have more doubts left please ask again.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Seikhoo Bishnoi (20 minutes later)
Thank you for all your help. Its appreciated and He is scheduled to see his primary care doctor for further recommendations this week.
doctor
Answered by Dr. Seikhoo Bishnoi (5 minutes later)
Brief Answer:
Thanks and take care

Detailed Answer:
Thanks for your appreciation

I hope my answers help you and your dad. Wish you and your dad a good health.

Thanks.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5187 Questions

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Does depression cause sleeplessness?

Brief Answer: His symptoms suggest depressive disorder though need evaluation Detailed Answer: Hello thanks for asking from HCM for your health related queries I can understand your concern. One aggravating factor for his symptoms is death of his dog which resulted in significant trauma. His symptoms like poor sleep, non-refreshing sleep, lack of desire of anything and lack of pleasure in anything or anhedonia etc are classical symptoms of depression. Considering his age he need proper treatment for his symptoms. For depression commonly used antidepressants are SSRIs as Fluoxetine, Paroxetine, Sertraline etc or other drugs as Mirtazapine, Amitryptiline. As his main issue is poor non refreshing sleep so as per my opinion Mirtazapine would be appropriate treatment for him. The drug not only help in depression but also helps in good sleep. The drug is a non-benzodiazepine drug and this drug is safe to use for his age. This drug has no significant interactions with his drug HCTZ 50. If his sleep problems persist even with treatment of Mirtazapine then in such case for some time low dose benzodiazepines can be used in treatment. These drugs will also relieve his anxiety and his sleep should improve. Please visit a psychiatrist for the evaluation of his symptoms and prescription. Provide his proper support and nutrition and his symptoms would improve. Thanks, I hope this helps you. Please feel free to ask again if you have more doubts.