
Suggest Treatment For Insomnia While Having Anxiety



Anxiety/insomnia
Detailed Answer:
Hello XXXXXXX
I'm sorry you are having trouble sleeping. If it is just for a short time (couple weeks) you can take a benzodiazepine such as alprazolam (Xanax) or lorazepam (Ativan).
But if this is an ongoing problem, treating anxiety throughout the day will help with sleeping at night. An SSRi medication such as Lexapro (escitalopram) can help decrease your overall anxiety without sedation, and by addressing that, you may be able to sleep better. Escitalopram is an SSRI with one of the best side effect profiles, and quickest onset of action, so it may take a few weeks to start to see the benefits. In the meantime, you can also take the benzodiazepine.
Another option is a sedating, older antidepressant medication called trazadone. This can help with sleep and anxiety but may cause some daytime sedation, particularly at first.
Seeing a therapist to discuss the issues that give you anxiety, and for learning coping skills can help. So can mindfulness practices, yoga, and exercise during the day.
If you have ongoing anxiety, it is also a good idea to have a thyroid function blood panel done as thyroid abnormalities can increase anxiety too.
I hope this information helps. Please let me know if I can provide further information.


Thoughts on this
Detailed Answer:
A thyroid panel is a blood test of thyroid function that includes a measure of Thyroid Stimulating Hormone (TSH) and thyroxine level. Sometimes when people have unexplained anxiety it can be from thyroid dysfunction. This isn't as common of a cause of anxiety as how we think about things, but it is worth looking into.
Lexapro may still help you, but I would start with 5 mg tablets (a pediatric dose) and cut that in half (so only 2.5 mg) and not go up to 5 mg for 2 weeks. You can then make similar slow increases every couple of weeks until 10 mg. This gradual increase will result in it taking longer to see it's maximal therapeutic effects, but you may bypass the side effects this way. SSRIs are more likely to help with thought rumination problems.
Buspar (buspirone) is another anti anxiety medication but it is not sedating and it is not an antidepressant.
Mindfulness meditation can help some people with controlling thought rumination. There are youtube videos, or you can take a course, possibly at a nearby hospital/clinics or community college.

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