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Can't sleep worth a crap

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Hi Gang,

Happy New Year to all my crazy brothers and sisters here on CB. I have a big problem and I'm seeking advice or suggestions from the wonderful folks here. I sleep like crap. I basically have to stay up until I am so tired I can't see straight. Then and only then, can I get some sleep. I've discussed this with my PDOC and here's his latest suggestion.

He wants me to add 10mg of Doxepin to the 15 mg of Lexapro and 1mg of Clonazepam I take before bed. Additionally, I am on 40mg of Quinapril and 25 mg of Atenelol for high blood pressure.And lastly, Crestor, just 5mg for shitty cholesterol ratios. I also take a multi vitamin, omega 3 fish oil and co Q10 daily. He also suggested upping the Lexapro to 20 mg, which I have not tried yet. I saw him this past weekend for my latest every 3 month session.

I can't believe how many friggen drugs I am on. My depression is doing better, but I still have shitty days here and there. My anxiety at night is obviously out of whack.

So I have a few questions for you all.

Has anyone ever done the Lexapro, Clonazepam, and Doxepin (for sleep) combo?

Can the Doxepin at that small dosage crash and cause probelms with the Lexapro?

BTW, at first PDOC said let's try Restoril vs Clonazepam. I told him I liked my nightly clonazepam, because the drug stays in my system long and tames the daytime anxiety.

He agreed and suggested Trazadone next. Then he recalled I had bad sinus issues and nixxed it. Finally he came to the Doxepin conclusion. He would have rather gone with Restoril over the others, in an effort to keep the number of drugs I was on down.

I have yet to fill the script for Doxepin, and wanted some thoughts here before I porceeded. I like my PDOC, he's done good by me. I am however, apprehensive about introducing yet another chemical into my already nutty brain.

FWIW, my diagnosis is MDD and PTSD caused by a personal bankruptcy, sibbling death, and other stressful issues.

Any and all help or thoughts would be most appreciated.

Thanks all and again Happy New Year to everyone, stay strong, live long.


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I'm afraid that I don't have any experience with Doxepin myself...if you don't get any helpful responses on it in particular, you might want to start a thread w/ the drug name in the title, just b/c it might grab someone. Theoretically, it's a TCA, which means it might help w/ the depression and the sleep stuff in combo--which would be pretty good, yes? Your lexapro dose also has some room to spare, but that probably won't help w/ sleep.

anyway, not much help...I've been through the need help w/ sleep rollercoaster and it's not fun. good news is there's a lot of options, so you can keep trying things until you find something helpful. as a side note, a lot of people use melatonin, which is OTC. my pdoc said that probably 1/3 of his patients will succeed w/ it. if you haven't tried it, you might want to check with your doctor about whether to consider it.

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You mentioned sinus issues. Have you had a sleep study? I'm thinking you might have sleep apnea. Admittedly, since I have it myself, it may be a hammer that makes the whole world look like a nail. However, it's very common. If you have it, and you can stand to wear a mask while you sleep, you may be in for a treat. The better sleep may help you with some other issues too. If I'm not mistaken, apnea has been shown to raise blood pressure.

If your coverage is not so good, you could have someone listen to you while you sleep, or make a long duration tape recording, and see if you snore or stop breathing for a while. That's not the same as getting a sleep study, but it could prioritize things. Plus, it might be useful if you need to get a referral for a sleep study.

If you have sleep apnea, every time you wake up after not breathing, you're subjected to lots of stress. That can happen many times per night. I'm thinking that might mean that you find it very tough to go all the way asleep.

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