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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Anxiety And Depression

hi i was wondering if i should go the emergency room. It's Saturday. I have Depression and General Anxiety Disorder. I take Wellbutrin 200mg and Concerta 18mg in the morning. I haven't slept in five or six days straight i dont even know... it's all starting to run together now. i'm exhausted and i can feel my depression setting in and worsening because of it... i feel like I should be dying at least by then i'd get some sleep.. i've tried over five sleep medications. My doctor recently put me on xanax 1mg it doesn't do jack squat but slightly relax me, I have a high tolerance to things like that i've been on hydrocodone for five years for my back condition. I was supposed to take seroquil with it but insurance threw a fit about it so I have to wait for the weekday to come and will get it sometime next week. I want sleep so badly I just cry now... should I go to the ER or a after hours clinic? Please help me...
Thu, 23 Apr 2015
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Psychiatrist 's  Response
Hello thanks for asking from HCM for your health related queries

I can understand your concern. You are suffering from Depression and Generalised anxiety disorder and are on Wellbutrin (Bupropion) and Concerta (Amphetamine drug). You have problems in falling asleep and this is further potentiating your anxiety. Most of sleep medicines are not working. You have been taking Hydrocodone for back problems. As per my opinion many other medicines like Quetiapine or Olanzapine can help you in falling asleep. These medicines in low doses help individuals to sleep. Xanax or many other sleep medicines are not working properly so as per my opinion benzodiazepines conventional sleep medicines would not work. Other drugs like Mirtazapine, Trazodon which are anti-depressants and these drugs can help to sleep you better. Discuss with your psychiatrist to substitute Wellbutrin with either of these anti-depressants and you will see improvement.

You have taken hydrocodone also and this has caused dependence most probably. In such case medicines like Pregabalin, Gabapentin can also help. Both these medicines not only help to reduce the symptoms of mild withdrawal but also help in reducing anxiety and cause sleep. Please discuss with your psychiatrist for these drugs.

Thanks, Take care
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Suggest Treatment For Anxiety And Depression

Hello thanks for asking from HCM for your health related queries I can understand your concern. You are suffering from Depression and Generalised anxiety disorder and are on Wellbutrin (Bupropion) and Concerta (Amphetamine drug). You have problems in falling asleep and this is further potentiating your anxiety. Most of sleep medicines are not working. You have been taking Hydrocodone for back problems. As per my opinion many other medicines like Quetiapine or Olanzapine can help you in falling asleep. These medicines in low doses help individuals to sleep. Xanax or many other sleep medicines are not working properly so as per my opinion benzodiazepines conventional sleep medicines would not work. Other drugs like Mirtazapine, Trazodon which are anti-depressants and these drugs can help to sleep you better. Discuss with your psychiatrist to substitute Wellbutrin with either of these anti-depressants and you will see improvement. You have taken hydrocodone also and this has caused dependence most probably. In such case medicines like Pregabalin, Gabapentin can also help. Both these medicines not only help to reduce the symptoms of mild withdrawal but also help in reducing anxiety and cause sleep. Please discuss with your psychiatrist for these drugs. Thanks, Take care