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Wednesday, July 20, 2011

Medications For Insomnia

So you're having trouble sleeping and you went to your psychiatric clinician for help. And somehow you left their office with a prescription for remeron (also called mirtazapine). And you're thinking that this remeron medicine is for insomnia, to help you sleep because that's what the clinician said right!? And why oh why wouldn't you believe what a licensed professional tells you!?

Well guess what...remeron is an antidepressant, not a sleep aide! So if you happen to suffer with insomnia AND you're depressed, remeron may be the right medication for you. But if your only issue is a sleep problem...don't you want a medication that's only job is to put you to sleep!? Of course!

First, some effort needs to be put into developing good sleep habits. Sure all the other psych websites give you long lists and long articles of how to magically turn yourself into sleeping beauty! But here's the low-stress version:

* standardize your wake time
* limit amount of time awake in bed
* limit napping
* remove the clock from your vision
* avoid caffeine after 12noon and avoid alcohol after 6pm
* avoid stressful activities in the evening

Second, find a clinician whose not afraid to give you a thorough evaluation and an appropriate sleep medication if your primary diagnosis turns out to be insomnia. Remember, sometimes a sleep problem is really a symptom of some other medical or psychiatric diagnosis. Make sure you ask exactly what kind of medication you are being prescribed. Too often clinicians are prescribing medications that have a side effect of sedation to treat insomnia. Like the remeron...which is an antidepressant with a side effect of sedation. Trazodone is often prescribed for insomnia but it is an antidepressant with a side effect of sedation.  And seroquel is an antipsychotic but sometimes prescribed for insomnia because its side effect is sedation! Don't expose your body to these medications just for insomnia.

As a Nurse Practitioner, I always ask myself..."Is this a medication I would prescribe for myself for this particular problem?" And guess what! I would NOT prescribe remeron or trazodone or seroquel for my own insomnia! I would prescribe ambien or restoril or lunesta. Take care of yourself. Don't accept second rate service. It's your body! And next time you see your clinician...ask them if the medication they are prescribing for you is something they would prescribe for themselves. http://www.eleventhhourllc.com/online-advice/default.aspx