Hi doctor,
I am a 26 year old male, and I am a doctor. From the past year, I have been suffering from delayed onset sleep disorder, I sleep at 4 AM and wake up after noon. I saw a psychiatrist, and he put me on Melatonin, Modafinil, and Zolfresh. But I am still unable to sleep at the desired time, and pressure of studies has put me into depression. I was unusually weepy, and it was difficult to concentrate. I saw a doctor again, and he put me on Sertraline, explaining that the symptoms were actually due to depression. I was prescribed Paroxetine 25 mg CR by another psychiatrist. I did not take them and suffered from depression for six months. I was finally convinced by a counselor to take the drug. I started with Pexep CR 25 mg every night, and I took it for two months regularly. My depressive symptoms were greatly resolved, but my sleep cycle was not helped at all. A few day before, I read about chronotherapy for delayed phase sleep disorder and wanted to give it a try. I practiced the schedule for seven days and was sleeping fine but, I stopped taking Paroxetine after taking half tablets for seven days. From past 4 to 5 days, I have been experiencing vivid dreams with awakenings. While awake, my head seems to spin every 10 to 15 minutes for 4 to 5 seconds, which is disturbing. I am unable to concentrate on studies, which is putting me through anxiety and weepy phases. I know these are withdrawal symptoms of Paroxetine, but I do not want to go back to that drug. I am fine, and the only issue I have is delayed sleep phase onset insomnia. Please help me with withdrawal symptoms and treatment for delayed sleep phase onset insomnia. Thank you.
Hi,
Welcome to icliniq.com.
Thanks for this query.
- I can understand your concern regarding your delayed onset insomnia. Sleep is very important for a good mental health. Sleep disturbances can cause depression and vice versa
- I have read your history carefully. You are suffering from insomnia, which is causing depression. After correction of your insomnia, your depression will improve. Presently, you are suffering from Paroxetine withdrawal. Sudden stopping of this medicine is the reason.
- SSRI (selective serotonin reuptake inhibitor) should be tapered slowly. I suggest you try some mouth dissolving Benzodiazepines like Clonazepam, whenever needed, to reduce the withdrawal symptoms.
- For your insomnia, I will suggest you go for polysomnography to rule out other possibilities. If you want to attain proper circadian rhythm, I will suggest you maintain proper sleep hygiene. Do morning exercises. Do not take coffee in the evening. Your bed should be used for sleep only. Avoid using the internet before sleep. Drink plenty of water. And do not take naps in the morning.
Hope my answer helped you. Regards.
For more information consult a psychiatrist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist
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