Depression

Tom replied to me that he also has had trouble sleeping, and this is what I wrote him back. Anybody else have advice for agitated insomnia? Tom, Here's what you have to do. Call your doctor today, right now if you can, and ask him to prescribe Elavil, relatively low dose (50 mg), for sleep. The stuff is now available as a generic, and it costs about the same as aspirin. When I need this, I actually use a pill cutter and take a 12.5 to 25 mg dosage (though this kind of thing is very individual, and when I was extremely depressed, I sometimes was taking two x 50 mg a night). Start off low--no more than 50 mg--or you may really zonk out. Note: remember this is an adjunct to, not a substitute for, the Celexa. On the plus side, if you're anything like me, you will sleep unbelievably well thanks to Elavil, almost from the first night you try this. In fact, make sure you're at home when you take it, because you will get so sleepy it will be hard to stay awake. Avoid the alcohol while on it, because the two compound each other's effects. Also, you may wake up at night, but you can easily fall back. Also on the plus side, some research indicates that the older tricyclic antidepressants (elavil was one of the first) may be more effective even than the SSRI's, especially for men. They've fallen into disfavor because of their side effects. See next item: On the negative side, there are some noticeable side effects. The ones I noticed were: 1) dry mouth--all in all, not that bad, you can suck on some hard candy if you want or just drink some water every once in a while. A trifling concern. 2) sleepiness--if you're suffering extreme insomnia, this is actually kind of a godsend, but prepare yourself for some grogginess during the day. As the depression starts to lift, you might want to wean off the elavil to give yourself more energy during the day. But for now, sleep at night is definitely more important, in my view. And being a little groggy during the day is also kind of nice, particularly if you, like me, suffer a kind of agitated depression while awake (grogginess takes the edge off this.) Remember, unlike old sleeping pills, elavil is an antidepressant, non-habit forming, and it won't hurt your sleep long term. If anything, you'll need less of it as you start feeling better. 3) difficulty urinating --not tremendously so, but it takes a little longer to get that urine stream started; if you have bashful bladder problems, this compounds them a bit. Again, pretty much of a trifling concern. 4) a bit of a body buzz. actually, this was a side effect i personally rather enjoyed, but not everybody does. Take it with a grain of salt. 5) a slight elevation of resting heart rate -- again, no big deal. All these things are reversible when you go off it. As an athlete, you might pride yourself on have a low, low hr; this will kick it up a few beats, but it's not a problem, believe me. I first learned about elavil in the 70s when I had my first bout of depression, horrible insomnia, etc. A friend of my father's told me about it and said that as soon as he took it, he started to be able to sleep at night, and this was the first domino in turning his whole situation around. Definitely keep me posted on this. If your doctor is at all hesitant to prescribe elavil (generic name amitryptiline), though I see no reason why he or she would be, explain your extreme sleep problem and ask to do elavil on just a trial basis. The doctor may suggest alternative drugs--Trazadone (another antidepressant) or even Ambien (a new sleeping pill)--but I personally would insist on the elavil trial first. This stuff does have some side effects as indicated above, but believe me, it's the closest thing to the Sand Man I've ever found. Good luck and see if you can try it out tonight. If you get a week or two of decent sleep, you will definitely find it a blessing--and you'll have some heavy duty escape from ceiling-staring misery. Think of it this way--if you can sleep 8 hours a night, as opposed to 4, your depression will be 33 percent cured! Congratulations on your distance swimming. You will indubitably set more records in the future, too. Jim

Tom replied to me that he also has had trouble sleeping, and this is what I wrote him back. Anybody else have advice for agitated insomnia? Tom, Here's what you have to do. Call your doctor today, right now if you can, and ask him to prescribe Elavil, relatively low dose (50 mg), for sleep. The stuff is now available as a generic, and it costs about the same as aspirin. When I need this, I actually use a pill cutter and take a 12.5 to 25 mg dosage (though this kind of thing is very individual, and when I was extremely depressed, I sometimes was taking two x 50 mg a night). Start off low--no more than 50 mg--or you may really zonk out. Note: remember this is an adjunct to, not a substitute for, the Celexa. On the plus side, if you're anything like me, you will sleep unbelievably well thanks to Elavil, almost from the first night you try this. In fact, make sure you're at home when you take it, because you will get so sleepy it will be hard to stay awake. Avoid the alcohol while on it, because the two compound each other's effects. Also, you may wake up at night, but you can easily fall back. Also on the plus side, some research indicates that the older tricyclic antidepressants (elavil was one of the first) may be more effective even than the SSRI's, especially for men. They've fallen into disfavor because of their side effects. See next item: On the negative side, there are some noticeable side effects. The ones I noticed were: 1) dry mouth--all in all, not that bad, you can suck on some hard candy if you want or just drink some water every once in a while. A trifling concern. 2) sleepiness--if you're suffering extreme insomnia, this is actually kind of a godsend, but prepare yourself for some grogginess during the day. As the depression starts to lift, you might want to wean off the elavil to give yourself more energy during the day. But for now, sleep at night is definitely more important, in my view. And being a little groggy during the day is also kind of nice, particularly if you, like me, suffer a kind of agitated depression while awake (grogginess takes the edge off this.) Remember, unlike old sleeping pills, elavil is an antidepressant, non-habit forming, and it won't hurt your sleep long term. If anything, you'll need less of it as you start feeling better. 3) difficulty urinating --not tremendously so, but it takes a little longer to get that urine stream started; if you have bashful bladder problems, this compounds them a bit. Again, pretty much of a trifling concern. 4) a bit of a body buzz. actually, this was a side effect i personally rather enjoyed, but not everybody does. Take it with a grain of salt. 5) a slight elevation of resting heart rate -- again, no big deal. All these things are reversible when you go off it. As an athlete, you might pride yourself on have a low, low hr; this will kick it up a few beats, but it's not a problem, believe me. I first learned about elavil in the 70s when I had my first bout of depression, horrible insomnia, etc. A friend of my father's told me about it and said that as soon as he took it, he started to be able to sleep at night, and this was the first domino in turning his whole situation around. Definitely keep me posted on this. If your doctor is at all hesitant to prescribe elavil (generic name amitryptiline), though I see no reason why he or she would be, explain your extreme sleep problem and ask to do elavil on just a trial basis. The doctor may suggest alternative drugs--Trazadone (another antidepressant) or even Ambien (a new sleeping pill)--but I personally would insist on the elavil trial first. This stuff does have some side effects as indicated above, but believe me, it's the closest thing to the Sand Man I've ever found. Good luck and see if you can try it out tonight. If you get a week or two of decent sleep, you will definitely find it a blessing--and you'll have some heavy duty escape from ceiling-staring misery. Think of it this way--if you can sleep 8 hours a night, as opposed to 4, your depression will be 33 percent cured! Congratulations on your distance swimming. You will indubitably set more records in the future, too. Jim