system
Suggest an antidepressant that help to treat anxiety and sleeplessness
human
Hello. I have problems with depression, anxiety, and trouble staying asleep. I go to sleep right away but wake after 5-6 hours. If I don t get 7-8 hours sleep I feel exhausted and depressed the next day. I have tried Zoloft and Paxil for the depression and neither worked for me. My anxiety seemed worse with these meds. Can you recommend an antidepressant that will help with my anxiety and sleep?
gpt
hi Sir/madamI have gone through your question and understand your concernsAccording to the history provided by you, I came to a conclusion that,  your suffering from stress related disorder which includes both depression and anxiety disorders.Sleep disturbance is one of the main symptom of the above mentioned problem.Regarding treatment: if I were your treating psychiatist, I would choose other drugs in the antidepressant group leaving paxil and Zoloft. it includes 1)SSRI like escitalopram2) mirtazepine3) SNRIs like desvenlafaxine 4) NDRIs like bupropionFor aborting acute attack, you can use benzodiazepines like clonazepamRegarding sleep disturbances, I prefer benzodiazepines for short duration of time (or) mirtazepine itself gives sleep without any addon drugs.I also recommend you to add cognitive behavioural therapy as an add on present treatmentIf all individual drugs fail, adjuvants can be included to present drug like thyroxin or lithiumI would also recommend you get investigated for thyroid abnormalities with serum T3,t4,TSH levelslast but not the least, as your problem is related to stress, practice stress relieving techniques like relaxation and breathing exercises, mindfulness, regular physical activity, following sleep hygiene techniques which all acts as stress reducers.