Hello Doctor,
I have slept very little lately, often not at all. I take 30 mg mirtazapine and 7.5 mg zopiclone for anxiety and mild depression. My cognitive function and memory have declined. After being prescribed 25 mg of quetiapine and 75 mg of pregabalin for insomnia caused by somniphobia and racing thoughts, the issue persisted. Quetiapine was increased to 75 mg, and I added hydroxyzine. I've heard about sleep deprivation psychosis, which should be resolved by sleeping, not antipsychotics. Should I increase my quetiapine dose if I've slept very little? Also, one doctor suggested taking pregabalin in the morning for anxiety, while another said it’s unnecessary if I'm focusing only on insomnia. Which option should I follow?
Hello,
Thank you for reaching out to Dr. Galen. Please find the below response to your query.
It’s essential to understand that your experiences are part of a broader mental health issue that needs to be addressed comprehensively. From your description, it seems that your current treatment approach is focused primarily on symptom relief, which may not be effective in managing the underlying condition.
Your symptoms, including sleep disturbances and cognitive decline, suggest that you might be dealing with a mood disorder, such as Bipolar Affective Disorder. This could explain the wide range of symptoms you’re experiencing, including insomnia and anxiety.
Regarding your medication regimen, increasing your quetiapine dosage may help manage your symptoms temporarily, but it’s crucial to remember that relying solely on medication without addressing the root causes may lead to further deterioration of your mental health. I recommend seeking a psychiatrist who can provide a more thorough evaluation and develop a tailored treatment plan that targets the underlying issues.
Additionally, taking pregabalin in the morning may be beneficial for managing anxiety throughout the day, especially if you find that it helps you feel more balanced. However, if your primary goal is to address insomnia, focusing on nighttime medication might be more appropriate.
Ultimately, working with a healthcare professional who can assess your individual situation is vital for your recovery. I sincerely wish you the best on your path to regaining control of your life and health.
Thanks
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