Promethazine

[Catkins]

I've been taking promethazine for probably 10 weeks now to help me sleep. It did seem to work relatively well. I would still wake up bit I could drop back off to sleep quite easily. I was also prescribed it for during the day and sometimes take it in the morning if I'm feeling particularly anxious.

The last few nights it doesn't seem to have been working as well. Now it could be that because I have felt more anxious over the last few days, but I'm not sure. Could it have stopped working? In my prescription I can take 2 at night, wondering if I should try that?

I'm sure I did read somewhere that you can build up a tolerance to it. If so would upping the dose help?

[Catkins]

Well I rang the doctor - he said to carry on at the dose I'm on now but he's also prescribed propanolol.

Feeling a bit uncertain about what to do for the best.

[panic_down_under]

.I'm sure I did read somewhere that you can build up a tolerance to it. If so would upping the dose help?

Promethazine is an antihistamine with some antipsychotic properties. As with most antihistamines, tolerance can build though it is usually slow to do so. I can't say whether you're developing a tolerance to it, or are experiencing break-through anxiety. It might even be a combination of both. Increasing the dose may help for a while, especially if it is break-through anxiety.

Well I rang the doctor - he said to carry on at the dose I'm on now but he's also prescribed propanolol.

Feeling a bit uncertain about what to do for the best.

Propranolol can be sedating as it blocks adrenaline, aka epinephrine, so may help. It also diminishes the adrenaline fuelled symptoms of the 'flight-or-fight' response which can ease anxiety.

Personally, I would ask for immediate release trazodone to replace both promethazine and propranolol as it has a proven track record for easing SSRI/SNRI induced insomnia. It is mostly prescribed just for that these days despite being an effective AD.

[Catkins]

I didn't realise it could be SSRI induced insomnia. I just thought it was my usual insomnia which had started to improv a bit.

I'll see how I get on with the propanolol and promethazine to go to bed with tonight. If after a few days there isn't an improvement will ring and ask for trazodone.

[panic_down_under]

I didn't realise it could be SSRI induced insomnia. I just thought it was my usual insomnia which had started to improv a bit.

It may just be regular, garden variety insomnia, but if I remember right you began taking paroxetine not that long ago, hence my mentioning it. The treatment is the same either way.

[Catkins]

It was a dose increase from 40mg - 50mg. Would that still have the same effect?

[panic_down_under]

It was a dose increase from 40mg - 50mg. Would that still have the same effect?

Of the paroxetine? If so, then I wouldn't expect a 10mg increase to trigger significant insomnia, or other side-effects, nor for very long, but anything is possible with ADs, so... However, it does shorten the odds for it being just plain insomnia probably related to the heightened anxiety, imo. Is there a reason for the anxiety spike, or has it come out of the blue?

[Catkins]

We went to London to see our son at the weekend. I think the stress of it all was probably a bit too early on in my recovery.

I was pretty much on an even keel before then. Things were still tough going at times but I'd started to feel a lot more normal. Saturday night/Sunday morning things went a bit tits up because I got an upset stomach, possibly what I ate, pos IBS. Things took a nose dive from there really. Not quite back to square one, but not doing great just now.

[panic_down_under]

The stress of visiting London would likely have been enough to trigger a blip and the upset stomach wouldn't have helped. Anxiety and depression are arguably the manifestations of a type of auto-immune disorder and often worsen when the immune system is in overdrive as may have been the case with a stomach bug. All you can do is ride the storm until things right themselves again as they usually do. Even 'normies' have bad patches. All part of the rich tapestry of life.

[Catkins]

Well I took the propanolol last night before bed. I don't know if it made any difference. I slept a bit more, but did wake up every couple of hours. Will see how I feel this morning before taking another one.