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    Suggest treatment for insomnia while having anxiety

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Posted on Thu, 1 Jun 2017 in Mental Health
Question: what can I take to help me sleep at night for aniexty?
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Answered by Dr. Bonnie Berger-Durnbaugh 1 hour later
Brief Answer:
Anxiety/insomnia

Detailed Answer:
Hello XXXXXXX

I'm sorry you are having trouble sleeping. If it is just for a short time (couple weeks) you can take a benzodiazepine such as alprazolam (Xanax) or lorazepam (Ativan).

But if this is an ongoing problem, treating anxiety throughout the day will help with sleeping at night. An SSRi medication such as Lexapro (escitalopram) can help decrease your overall anxiety without sedation, and by addressing that, you may be able to sleep better. Escitalopram is an SSRI with one of the best side effect profiles, and quickest onset of action, so it may take a few weeks to start to see the benefits. In the meantime, you can also take the benzodiazepine.

Another option is a sedating, older antidepressant medication called trazadone. This can help with sleep and anxiety but may cause some daytime sedation, particularly at first.

Seeing a therapist to discuss the issues that give you anxiety, and for learning coping skills can help. So can mindfulness practices, yoga, and exercise during the day.

If you have ongoing anxiety, it is also a good idea to have a thyroid function blood panel done as thyroid abnormalities can increase anxiety too.

I hope this information helps. Please let me know if I can provide further information.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 2 hours later
thank you!! what is a thyroid blood panel? I go to the Dr Thursday.. Some days I'm fine and others I'm not.. I use to be on lexapro and they started me off on 10's and I had all the side effects the third day and didn't like it.. so then they told me to break in half n take that and prescribed me klonopins .5 and I quit taking lexapro cause I felt like a zombie and made me more Moody.. And just took the klonopin as needed n that helped me more.. I try and stay busy most of the day and exercise and then come home with kids and get them situated n then I shower n relax some, then I got me a xanex to help relax. just hope my Dr will prescribe me something to help with anixety n to help me sleep.. I just think too much.. it hasn't been bad til the last month or so..
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Answered by Dr. Bonnie Berger-Durnbaugh 43 minutes later
Brief Answer:
Thoughts on this

Detailed Answer:
A thyroid panel is a blood test of thyroid function that includes a measure of Thyroid Stimulating Hormone (TSH) and thyroxine level. Sometimes when people have unexplained anxiety it can be from thyroid dysfunction. This isn't as common of a cause of anxiety as how we think about things, but it is worth looking into.

Lexapro may still help you, but I would start with 5 mg tablets (a pediatric dose) and cut that in half (so only 2.5 mg) and not go up to 5 mg for 2 weeks. You can then make similar slow increases every couple of weeks until 10 mg. This gradual increase will result in it taking longer to see it's maximal therapeutic effects, but you may bypass the side effects this way. SSRIs are more likely to help with thought rumination problems.

Buspar (buspirone) is another anti anxiety medication but it is not sedating and it is not an antidepressant.

Mindfulness meditation can help some people with controlling thought rumination. There are youtube videos, or you can take a course, possibly at a nearby hospital/clinics or community college.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3138 Questions

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