Effexor & Insomnia

Hi everyone ... I'm new here. After many many different medication and/or combinations, I have finally hit on a combination that works well for me. Effexor has been the ONLY med that has lifted my depression. I have been on it for several months now and I feel great on it. The problem, though is that it causes pretty severe insomnia. When we've lowered the dose, I sleep, but the depression comes back. Has anyone had any success in dealing with a medication induced insomnia? I'll make suggestions to my psychiatrist. This is just so frustrating!

hi seesawgirl
can the dr. give you something to sleep? it is odd, cause effexor had me yawning so much that i had to stop taking it cause it made it dangerous to drive. funny how meds work so differently for different people. good luck. welcome to psych central. you will find we have several forums where you can post about your concerns and receive feedback from other members. you will get a lot of support here. again, welcome

I'm insomnia-prone and most antidepressants I've tried make it worse. I usually end up taking Ambien or low-dose mirtazipine for sleep. I just started taking mirtazipine, and half a 7.5 mg tablet is working great. Hard to believe such a low dose makes me sleep.

I also take Webber Super Sleep sometimes. It's a combination of 5-HTP, L-theanine, & melatonin. It usually works for me, too.

*Always consult you pdoc, doctor, and you're mental and general health team before adding, adjusting, or changing your meds and/or using supplements etc.

I would start and end with sleep hygiene:
Sleep Hygiene: Tips & Techniques - National Sleep Foundation
Twelve Simple Tips to Improve Your Sleep | Healthy Sleep

There are four levels of sleep with 3-4 being the ones that heal and benefit body, mind along with REM sleep.
Stages of Sleep

Sleep Meds:
Chart on most common sleep meds:
Sleeping Pill Brands and Tyeps: The Pros and Cons

The first med. that most docs and pdocs go to is Trazodone. It's effects on the brain and the side effects are preferable then Z-drugs.
They very down to earth, so to speak.There is a lot of information on this site but
Desyrel (trazodone): A Synopsis for the Educated Consumer | The Good, the Bad & the Funny of these Crazy Meds
Some anecdotal reports, as usual take people's reaction with a grain of salt but if you read enough of them. You can get a feel of the overall impression. It is important to look at how long they took the med:
TRAZODONE HCL: Side effects, ratings, and patient comments
Trazodone - Reviews, Ratings, Comments by Patients

*Now you are already on an anti-depressant. I believe it's Venlafaxine-Effexor. I need to look at the O.P. There can be a lot of problems when mixing two anti-depressants, even at low doses. You have to have a skilled pdoc to work with. It can be very dangerous

A research paper on antidepressants including tricyclic's help with insomnia:
It continues on, a very good paper with good references.
FPIN's Clinical Inquiries: Antidepressants for the Treatment of Insomnia in Patients with Depression - American Family Physician

Tricyclics is a class of older anti-depressants that can induce sleep:
Tricyclic antidepressants (TCAs) - Mayo Clinic

The problem with the Z-drugs on a regular basis is that tolerance will build up and can make sleep habits and the 4 stages of sleep disruptive. They basically act almost like benzodiazepines. They affect GABA receptor sites. Which, as an anoxylitic will be calming and will make you sleepy. The problem it down-regulates GABA receptor sites over time= tolerance and lack of effectiveness. If you use them. I would only use them PRN strictly, IMO.
There are also other drugs like low doses of some antipsychotics- Zyprexa
That are used with positive results, but there are also side effects that go with any typical or atypical meds. Though they can be dose related. Even on low doses there can be side effects. This first paper below is short and gets straight to the point. The second one, longer and more information:
Choosing Wisely | Treating sleep problems
Off-label use of atypical antipsychotics: Lack of evidence for their use in primary insomnia | Formulary Journal

There are also over the counter drugs like diphenhydramine and doxylamine. The issues with those are that they are antihistamines and anticholinergic drugs.
Here are some studies and articles on the above:
Sleep complaints: Whenever possible, avoid the use of sleeping pills. - PubMed - NCBI
I don't believe tolerance builds that quickly, as mentioned in reference 13. I do believe it does build. As as an anecdotal and aside, a friend of mine was taking diphenhydramine daily. He started going up in dose from 50mg-75-100mg over time.
I think the most bothersome side effect is the dry eyes, mouth, and throat from my own experience.
Diphenhydramine - Wikipedia, the free encyclopedia

Finally a gigantic meta-analysis of sleep and sleep disorders. This is if you really want to delve deep or look at certain parts:
https://books.google.com/books?hl=en...page&q&f=false

That meta-analysis mentions the meds but also natural supplements:
First a caution- some supplements can have side effects with medications, some very serious
Some common supplements to promote sleep- melatonin, pwd magnesium(citrate or glycinate), l-Theanine, l-Tryptophan or 5-HTP- -Trytophan and 5-HTP should never be used with any serotonergic drugs, SSRI's, SNRI's. It can cause serotonin syndrome. Which is very serious
Serotonin syndrome - Mayo Clinic
Serotonin Syndrome: Causes, Symptoms, and Treatments

Valerian root, chamomile, lavender and more:
Natural Remedies That May Help You Sleep - Health.com

And finally:
Insomnia | University of Maryland Medical Center

*Always consult you pdoc, doctor, and you're mental and general health team before adding, adjusting, or changing your meds and/or using supplements or any of the above!


*Sorry about my misspellings, my spelling and spell checker need to be updated.
*Thaks for pointing out trazodone jo_throne I missed probably the most prescribed one.

Yep, looks like you should ask your p-doc before trying the Super Sleep since you are taking Dffexor/venlafaxine. I have taken it with Cymbalta and didn't have any problems, but venlafaxine has a much greater effect on serotonin receptors than Cymbalta, plus I don't take a high dose of Cymbalta. You don't want serotonin syndrome, for sure.

What I have read about Ambien/zolpidem says that it doesn't tend to disrupt sleep architecture (you'll get enough deep sleep). That's different from the info. in metamorphosis17's post.

I didn't ask if you tend to wake up in the middle of the night or if you tend to have trouble falling asleep in the first place. If you wake up in the middle of the night, the extended release pill, Ambien CR, will probably work better.

There are other "z" sleep meds like Lunesta and Sonata that are weaker than Ambien and there's trazodone, which doctors tend to like. None of those made me sleepy the least bit, but they might work for you.

I haven't tried Rozerem/ramelteon so I have no comments about it.

I have fibromyalgia as well as depression. I used to take 375 mg/day Effexor for fibromyalgia pain and depression before Cymbalta was available. It gave me extreme insomnia. I would stay awake until the sun started coming up much of the time unless I took Ambien. I didn't take it 100% of the time, but I probably took it about 90% of the time. Sometimes it would seem like I had developed a tolerance to the 10 mg dose of Ambien, so I would stop it for a month and then it would work again.

I never got any "withdrawal" type effects if I stopped Ambien. Some people say they do. I don't count insomnia as a rebound effect, since I wasn't sleeping before I started taking it.

I don't "casually" recommend that someone take prescription sleep meds regularly, but if you're taking 450 mg Effexor, your case of depression is not "casual" and if your doctor doesn't see any option other than for you to stay with that med, you need a way to get some sleep.

I hope you find something that works for you.

Good post, metamorphosis17. Thanks for the information. I read the "Stages of Sleep" one. I am bookmarking your post to make a note of the links.

It would be wonderful to have effective antidepressants that fix sleep problems too or at least don't cause worse ones.

You're welcome, I'm glad it helped!
I revised my post after reading the above post. Thanks, jo_throne, I had missed trazodone and the tricyclic's.
So, I added some extra information and studies on it. Often, they are used for both issues. Talk to your pdoc/health care prescriber about all of the information. The more you learn and share with your prescriber , hopefully, a pdoc. The better it will be for your treatment!

Yes I had sleep struggles while on an AD. I spoke with my pdoc and he prescribed for me, something to help me sleep through the night.

Welcome to PC

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Are you taking XR? I was on 450 of that and I couldn't even sleep 3 hours a night.. horrible experience.. I switched to plain instant release and had no problems at all after that.

I always found Benadryl to help my insomnia with effexor. I also took my effexor in the morning to energize me during the day. Here is a link to my post talking aaaaall about my effexor experience. Hope you can get to sleep.

That's a really common side effect with Effexor. Do you take it first thing in the morning? Avoid caffeine in the afternoon and all that stuff already? You might need an additional med to help you sleep. I'm on a med in the same class as Effexor and I've taken Effexor in the past and I've always needed augmentation with trazodone or remeron or Elavil or something to help me sleep.

I have the same issue with Effexor. It improves my mood but I can't sleep at all. I have to take Trazodone to sleep, which works pretty well for me.

Hi seesawgirl

I have been on Effexor for about seven years - it helps me and I have not noticed any effects regarding insomnia.

The links that metamorphosis12 provided above about sleep hygiene are well worth checking out. I used to find it hard to sleep but applying sleep hygiene methods has worked for me.