Anxiety Insomnia Medication
I have insomnia. What medication can I be prescribed to help me stay alert and awake during the day?
I need to take some kind of pills to sleep, but when I wake up I’m either not refreshed or the pills make me drowsy. This is especially true of benzodiazepines.
I desperately need something to help me stay awake and focused while at school or my job. I can’t even drive because of this. I just feel so tired and I can’t focus. Caffeine doesn’t work, it just makes me jittery and anxious, because I also have social anxiety. Vitamins and other OTC junk does absolutely nothing.
I know some people take amphetamines like Adderall or Vyvance to stay alert, but I wonder if I can take those with a benzo for my anxiety, because I think that since they’re stimulants they’ll make my anxiety worse.
Is there something I can take to help me stay awake but not make my anxiety worse? Or is there a safe combination of a stimulant and something to reduce my anxiety? Again, over the counter stuff for both these problems do not work, I’ve tried them all.
If you are taking a hypnotic at night then why don’t you consider stopping it. Clearly it is not helping you and if it is causing a “hangover” effect then it is just making things worse. Are you taking benzodiazepines during the day?
There are also certain hypnotics that are better than others. Long-acting drugs like Dalmane (flurazepam), for example, are not a good choice for some because it commonly causes daytime sleepiness.
What type of insomnia do you have? Sleep onset (hard time falling asleep), sleep maintenance (hard time staying asleep), or both? Also some hypnotics will cause significant changes in sleep architecture (brain waves when sleeping) typically reducing delta-wave (deep) sleep and increasing sleep latency to REM. It is also important that you take an approved hypnotic, many drugs used for sleep like Valium (diazepam) or Xanax (alprazolam) are NOT approved for insomnia and should be avoided.
The best medications for sleep onset insomnia include:
Ambien (zolpidem)*, Sonata (zaleplon)*, and Halcion (triazolam)
The best medications for sleep maintenance include:
Serax (oxazepam)
The best medications for sleep onset insomnia and sleep maintenance include:
Ambien CR (zolpidem extended-release)*, Imovane (zopiclone)*, Lunesta (eszopiclone)*, ProSom (estazolam), Restoril (temazepam), Doral (quazepam), Mogadon (nitrazepam), and Somnote (chloral hydrate)*.
* indicates the drug is NOT a benzodiazepine
The biggest problem in your situation is that you are complaining of excessive daytime sleepiness (EDS) however you are taking sedating drugs. Ideally it is best to change medications so you are not taking as much sedating medication. Have you tried antidepressants like Zoloft (sertraline), Paxil (paroxetine), or Effexor XR (venlafaxine extended-release)? Typically these drugs are used if a person has chronic anxiety. Benzodiazepines are best used short term however in some cases long-term use is perfectly fine.
There is a myriad of drugs that can help you stay awake but it is a terrible habit to take a pill to sleep and another pill to wake up.
Best thing to do is see your doctor (ideally a psychiatrist) and try to control your insomnia and anxiety. Also if you take a sleeping pill and you stay asleep but you wake up feeling unrefreshed then that is not a good medication for you. If you started to take a hypnotic that helped you sleep and you woke feeling refreshed your EDS may go away.
People can and do take stimulants with benzodiazepines and related drugs, some people have terrible anxiety from stimulants, particularly amphetamines (Adderall, Dexedrine) and methylphenidate (Ritalin, Concerta). There are two drugs that are “wake promoting agents,” Provigil (modafinil) and Nuvigil (armodafanil) that are often very helpful and they don’t cause a lot of the effects amphetamines and methylphenidate cause but some people do experience anxiety.
But again unless it is not possible it is best to try to eliminate the cause of the EDS rather than just treat it. Also none of the stimulants drugs are approved or commonly used to help people stay awake unless they have a medical problem. Legitimate use of stimulants for people with EDS is when they have a sleep disorder.
Jackson’s Insomnia Drugs
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