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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Chronic Insomnia Be Treated?

I suffer with poor sleep, last week I got approximately 7 hours and since Satuday I have had even less. I have a darkened room, sleep pillow, fan, tried reading, low music, exercise and get no benefits. I am absolutely shattered, work 11 hr days and getting extremely irritable. I am getting tearful due to exhaustion. I have suffered with insomnia since around 12 years old (puberty), I am now 54 and it is getting worse. Went to drs yesterday and was told to read a book! I have previously been prescribed Zitalopran but have been told yesterday I cannot have sleeping tablets as they can cause early dementia. I am at a loss as to what to do.
posted on Mon, 6 Feb 2017
Twitter Sat, 23 Jun 2018 Answered on
Twitter Tue, 26 Jun 2018 Last reviewed on
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Neurologist,  's  Response
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.

Citalopram you were prescribed before is not the most suitable antidepressant for insomnia. If an antidepressant is to be used a more sedative one like Amitriptyline, Doxepine or Mirtazapine is preferable. They are preferable if insomnia is also associated with chronic anxiety disorder as they are also first line treatment for anxiety. Another option would be Suvorexant (belsombra) a recently introduced medication for insomnia acting directly in the sleep centers in the brain. These drugs are not associated with dementia, I imagine the doctors who told you that referred to Benzodiazepines which long term use may affect cognitive functions. So you should discuss their prescription with your doctors.

Hope I have answered your query.
Let me know if I can assist you further.

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How Can Chronic Insomnia Be Treated?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Citalopram you were prescribed before is not the most suitable antidepressant for insomnia. If an antidepressant is to be used a more sedative one like Amitriptyline, Doxepine or Mirtazapine is preferable. They are preferable if insomnia is also associated with chronic anxiety disorder as they are also first line treatment for anxiety. Another option would be Suvorexant (belsombra) a recently introduced medication for insomnia acting directly in the sleep centers in the brain. These drugs are not associated with dementia, I imagine the doctors who told you that referred to Benzodiazepines which long term use may affect cognitive functions. So you should discuss their prescription with your doctors. Hope I have answered your query. Let me know if I can assist you further.