Side effects - Fluoxetine and Insomnia

[el burgo]

Swims pet possum has been prescribed fluoxetine and has been on 20mg daily for 4 aprox 4 months; as time progressed swims pet possum found sleeping increasingly difficult (restlessness/mild muscle spasms). Swims pet possum has been prescribed a course of temazepam 10mg tabs and has yet to find a significant improvement.

Swims pet possum has read insomnia is a common side effect of fluoxetine.

Advice would be appreciated (experiences etc).

[Boca Bitch]

It is a significant side-effect, but I'm surprised to see a hypnotic benzodiazepine prescribed adjunct to an SSRI (as they can reduce effectiveness, depending on the 'why' the SSRI was prescribed). Has SWIY's doctor tried adrenergic agents first? Alpha agonists are often very effective at reducing stimulant-induced insomnia, without the dependence forming side-effects of long-term benzodiazepine use.

Tell whoever it is that SWIY sees that the 10mgs. temazepam is not effective at decreasing insomnia. And I would reccomend discussing the posibility of being prescribed an adrenergic agent, instead of a benzodiazepine, so that discontinuation could be immediate instead of drawn-out. Clonidine is fantastic, SWIM has found. He was prescribed it adjuct to both fluvoxamine and sertraline, it KNOCKED him out.. and SWIM is one hell of an insomniac anyway. The only undesirable side-effect is that there is a tad of a hangover, in that it can be difficult to wake.

[chibi curmudgeon]

Originally Posted by Boca Bitch

Has SWIY's doctor tried adrenergic agents first? Alpha agonists are often very effective at reducing stimulant-induced insomnia, without the dependence forming side-effects of long-term benzodiazepine use.

Alpha agonists?! Blech!

The "increasingly difficult" part is confusing, and leads me to believe maybe it's not a side effect of the fluoxetine at all. If it were a side effect, the insomnia would be more likely to show up right away--even before actual antidepressant effects.

Is the possum experiencing a sort of twitchiness, like electric shocks? That would definitely be an SSRI thing.

(I'm also assuming the fluoxetine is being taken in the morning, yes?)