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Patient's Query
Hello doctor,
I weaned off of 40 mg of Paroxetine very slowly but my sleep was impacted and as of two months, I have been suffering from extreme insomnia. I have gone back to medication and I am currently on 20 mg of Paroxetine and 10 mg of Fluoxetine, but my insomnia has continued. I was prescribed Ativan (0.5 mg) for sleep, and it sometimes helps, but not always. Even if I take a bit more (I have taken up to .75 total), it does not always help me sleep. My psychiatrist prescribed Trazodone (she suggested I start at 25 mg and if I feel no effect, to take another 25 mg/ go up to 50 mg in one night (but I am concerned about serotonin syndrome from taking another medication that messes with Serotonin). Can you advise if I should be concerned about serotonin syndrome if I take the 25 (or 50) mg of Trazodone? Additionally, should I be concerned about anything else in terms of taking these three medications together?
Hello,
Welcome to icliniq.com.
Serotonin syndrome is an acute emergency case, rarely seen in common practice. At least not when you have already been taking 40 mg of Paroxetine for years. Also, Trazodone is a safer and better sleep-inducing agent when it comes to being used for sleep. As per my knowledge, in fact, these two drugs are given together in depression/ anxiety with insomnia. Yes, Fluoxetine is an SSRI (selective serotonin reuptake inhibitor) known to cause sleep disturbances. So, be careful with it and avoid taking it in the evening or at night at all. Let me know if I can help you more. Thank you.
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