Mumsnet Talk

I started taking sertraline 50mg just over a month ago for PMT, before that I was sleeping soundly but I got bad pmt and was anxious at times with some ocd traits so the tablets have helped me feel better but then just having a break over christmas could have helped too but the waking through the night is getting to me now, I went to the doctors last week and she said it was unusual to sleep less, normally people sleep better with the tablets, she changed the tablets to 20 mg of citrolpram (sp?) and I'm still not sleeping well but it could be too early days I've only been on them for 5 days.

So tired.......has anyone experienced this? What should I do?

Sleep problems are common when you start on an SSRI (like sertraline and citalopram, fluoxetine etc.), which are quite 'stimulating' as opposed to sedating, like the older tricyclics (amytriptilin, dopethein etc) which can help with sleep.
These usually settle down after about six weeks I think, and if you are normally a good sleeper then it shouldn't be a lasting problem once your body gets used to the drugs. YOu could also try taking them a different time of day?
Citalopram and sertraline are similar drugs (I have been on both, briefly) so have similar effects.
I would say stick with it for a couple more weeks and if no better then there are things you can do re. sleep (see the insomnia threads on here)- if you want specific tips ask me.
It always surprises me GPs don't seem to know about the sleep problem for some people with SSRIs.

When I took them, was also prescribed medication to counteract this effect for the first few weeks.

Thanks I will go back to the gp tomorrow, another thing that worries me is how long I'll be taking them for as my PMT will last at least another 20yrs I should think, maybe longer, also when the time comes to get off them what will happen?

What did they give you to help Goosey? Did they help and were there any side effects?

Actually sertraline is not stimulating, it's sedating hence your doctor saying it's unusual to sleep less on them.

Citalopram is slightly stimulating so not sure that change is going to help you much.

Well I rang my gp and that was no use to me tbh she said to carry on with the citalopram and to come backj if I'm still not sleeping properly in 6 weeks it's been 6 weeks now and I'm so so tired We are going on holiday in a few weeks to florida, it's costing a fortune and I'm worried about it now because it's supposed to be a tiring holiday but obviously when we booked it I had no idea this would be happening.

I took citalopram and was prescribed zopiclone for the first 2 week to help with sleep. My mum (a psychiatrist) said that was standard practise as it is known that citalopram can increase feelings of anxiety (inc sleeplessness) initially. I did find I no longer needed the zopiclone after a few weeks (maybe 4). I suggest, esp with holiday coming that you go back to your GP or see another one and ask them to prescribe you with some sleeping pills (I recommend the zopiclone) enough for a couple of weeks. You could try cutting the pills in half or quarters and just take small dose if you wake in night.

my doc gave me dosulepin,it is an anti depressant which they discovered made you sleepy so they use it as a combination thing.It is taken at night so you get the benefit of the sleeping part and worked a treat for me as waking halfway through the night was one of my problems,maybe you could suggest that to your G.P.

Thanks, I forgot to take my tablet on tuesday night so I took it yesterday morning instead and then didn't take one last night so I've changed to taking it in the mornings now and tbh last night I did get a better quality sleep, I've woken up today feeling reasonably normal!

I'll carry on and see if it continues to help before I go back to my GP.

Well that was another good night, only woke up once! I'm looking forward to a relaxing weekend I still don't feel as calm/ serene as I did on sertraline though, maybe it was because that was 50mg and the citalopram is only 20mg - anyone have an opinion on wether I should change back to it, if the gp will let me?

Hurray for sleep! Glad you have had 2 good nights!

Citalopram builds up gradually over about 6 weeks so it will take that long to feel the full effect of it. So, if you return to the other drug before then you won't know if it is going to work for you. If you feel you can hang on that long then I would give it the full 6 weeks before making a decision about which drug is right for you. I think it is a good idea to take the tablet in the mornings as you are.

I am currently taking dosulepin as recommended by lilyliz as insomnia was my issue and that is a good one for helping you sleep so if sleep continues to be a problem then you could suggest that to the GP?

Hi I hope you're still managing to sleep.

It is early days with the citalopram so you do need to give it the full 6 weeks.
If things don't improve though, don't be afraid to go back to your doctor.

I suffered with insomnia for a while before my depression was diagnosed. I was given citalopram but found it too stimulating and couldn't eat. Like Lilyliz and Solola, I am now taking dosulepin (not on commission honest). I have been on it for around two years now, and have found it brilliant in helping me sleep and treating my anxiety and depression.

Here's hoping for a good nights sleep tonight, I think I am going to go back to my gp on thursday and dh is going to come with me to say I really felt lots better of the other tablets, even with the lack of sleep I was a happier, more serene person and now I'm taking the tablets in the morning I hope sleeping will calm down but I don't see the point in settling for 6 weeks on citalopram when I don't think they have helped as much as sertraline, I will mention dosulepin incase gp thinks that will be a good idea though, what have been your side effects with those?

I had terrible insomnia with setraline. Only because the ad's stopped me worrying, I was tired but didn't Care,iyswim.
.
I'm now off them, sleeping better, but get much more worked up about a poor night than I would have when on the ad's.

I would stick with them if you can. But do go back to the doc if you aren't happy.

I've been back to the gp today and changed back to sertraline, I'm hoping that taking them early in the morning will help with sleep, I am now at the point of having dreams which I can't remember but I wake up feeling like I haven't slept and I'm still waking a few times in the night and I'm grinding my teeth in my sleep again

I have also cut down drinking, my new plan is to only drink a couple on fri and sat nights and tonight I have been swimming for an hour and 10 mins.

Drugs are not a long term solution.

If they stop you jumping off a bridge - fine. Long term use - No.

Research alternatives - there's tones of information out there on how to control mental distress with diet.

Reading Suggestions:

Doctoring The Mind, Richard Bentall
Potatoes Not Prozac, Kathleen Desmasons.

That's absolute rot,you're dangerous and misguided to advise someone to cease medication to peddle some hippy shit about potatoes. Would you advise a patient with cardiac problems to stop beta blockers and eat more potatoes?

No, some complex carbohydrate potato can't and won address a mental health issue adequately

If it wasn't so misguided and foolish I'd laugh. potatoes not prozac.
Christ you couldn't make that up

Op ignore advice to cease your medications it's unsafe advice
many people are adequately well maintained on meds long term,with minimal contraindications

Do maintain contact with GP
Get regular reviews
And take care

scottishmummy. Pills are not a long term solution. it is the title of a book not a dietary suggestion.

I get so fatigued with people who love pills - they wear their disease like a badge. 'oh i'm on these, my doc. prescribes these' etc. They've become group identity markers and its pathetic. people need to start taking responsibility for their own health as lord know no authority today is going to do it.

I don't blame people for developing mental health problems, I've been sectioned myself and spent over a month in a psychiatric hospital. I speak from personal experience when i say that people are drugged for no other reason than that doctors don't know what else to do. We live in a medical dark age.

yes, there has always been mental disorder of one form or another be that actual response to severe trauma, spiritual awakening or talking to God. The mental health problems we have today are unprecedented, whatever Socrates may have said (if indeed he even existed)..he would have described isolated incidences, quite different from the widespread melancholia and breakdown we see now. It follows industrialisation and the denaturing of foods.

Everyone will suffer from low periods, especially if they've been through real hardship - that is life and, thank god, doesn't happen all that often for most people. It is different from the imbalanced highs and lows of a people fuelled on stimulants like sugar, refined flour, coffee, sweets, biscuits and fizzy drinks.

If you genuinely, sincerely believe that all that shit we consume can have no affect on our minds and bodies then it is you that is dangerous. If you're so sure that these powerful drugs that line our supermarket shelves are so innocent then why not try feeding them, exclusively, to your children and then see how bright and even tempered they are.

Its been studied in schools and prisons - good, unrefined food balances the mind, improves criminal intention, improves learning, controls mood swings and hormonal fluctuations.

Clarry, if the op has been put on antidepressants by her gp, don't you think it's a bit silly to tell her not to take them?

You have never met her, I presume. Your "advice" isn't helpful.

We all know that a/d's should be taken with other things, such as research, CBT, counselling etc. But advising to do these instead of meds is at best misguided and at worst dangerous.

Lovemygirls, I have recently been put on a low dose, and I find that as long as I take them before 10am I sleep fine. Any later, and I find my sleep is very disturbed. It did take a few weeks to settle though.

I haven't told anybody to do anything.

No you haven't told anybody to do anything.

However you have said 'long term use no' when it comes to taking ADs. This is not the case. Many people owe their survival and quality of life to long term use of ADs. To suggest that they are not good to take long term is unproven and irresponsible.

I am looking at a few things not just the ad's, I have also started going to counselling sessions and I have cut right down on drinking alcohol as well as improving my diet as I wanted to lose half a stone anyway and I am getting more exercise after doing 60 lengths last night I managed my 1st undisturbed sleep in 2 months! I think part of that is because I was determined to only think positive thoughts during my swim and I came home feeling I had no fears or worries at all. I'm lucky that my issues are only that I have severe PMT and slight OCD and not depression as I had PND 10 yrs ago and it was incredibly hard to function but now I'm leading what I consider to be a successful life I just wanted to iron out the last few wrinkles in my life I have a lot of support and I am very lucky.

Love my girls I have been on sertraline on and off for 11 years, the last time I went back on it about six months ago I also has problems sleeping and like you was taking it in the evening as that was when I remembered to do so, when I spoke to my GP about this he advised me to take it in the morning as apparently it can effect your sleep if you take it at night.

Hope this helps.

Thank you

I've given in, I'm now having vivid dreams, I wake feeling like I've not slept and I'm exhausted so I'm taking some kalms sleep aid tablets tonight in a bid to try6 and get a good nights sleep.