Q. I am doing good with anti-anxiety medicines, except sleepiness. What to do?

Answered by Dr. Manjunadh M Nair and medically reviewed by iCliniq medical review team.

 

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Hi doctor,

I am a 47 year old male suffering from anxiety disorder and being treated for OCD specifically. A year ago, I was prescribed Zoloft 100 mg (Sertraline). But after three months I have transferred to Prozac 40 mg (Fluoxetine) together with Risperdal 0.5 mg (Risperidone). This has been going for the last nine months. I also take Micardis 80 mg (Telmisartan) and Lipitor 10 mg (Atorvastatin). I am less anxious, but I lately started sleeping too much and losing concentration and focus. It is affecting my studies a lot. I came back to university after 20 years. When I am awake, I will come up with any excuse to procrastinate my studies, and usually, end up spending hours on my OCD-related day dreaming and rituals.

A friend, who is a health professional, recommended Adderall to help me concentrate and fight the obsessive thoughts. I halved my Prozac dose to sleep less than my regular 9 to 10 hours hopefully. I took an appointment with my psychiatrist two weeks from now, but I have midterms next week.My GP trusts my judgment. I could probably see her sooner than my psychiatrist. Should I ask her about Adderall?


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Dr. Manjunadh M Nair
DM GERIATRIC PSYCHIATRY., MD PSYCHIATRY., MBBS
Psychiatry, Psychologist/ Counsellor, Psychotherapy, Sexology

Hi,

Welcome to icliniq.com.

Since your Obsessive-compulsive disorder or OCD symptoms are under control using a combination of Risperidone and Fluoxetine, it is not an excellent choice to change it.

Fluoxetine usually causes insomnia rather than sleepiness, and it is often taken as a morning or afternoon dosage to prevent insomnia.

Risperidone can cause sedation, but you are using only a small dosage, and it is in the night I believe.

Here, using Amphetamine to counteract sleepiness is not recommended instead you can try using a drug called as Modafinil, which is available at a dose of 100 mg. Try it in the morning to prevent sleepiness and to concentrate better.

If you are experiencing worsening of OCD symptoms after reducing Fluoxetine to half, then it is advisable to bring it to therapeutic dosage range in OCD, which is 60 to 80 mg. Consult your treating doctor, discuss my opinion with him or her and take treatment with consent.

For further information consult a psychiatrist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist

 
 
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