Antidepressants or anxiolytics for sleep and pain management

Posted by mary4 @mary4, Feb 2 5:07am

I am in my 4 fourth year of PMR. On 3.mg pred and using the DSNS taper. Very slow. I suffer from insomnia. Was prescribed Zopiclone. Not a great drug for many reasons. Prided some relief for sleep and stiffness that keeps me up at night. I am vaguely aware that some members have been prescribed antidepressants for pain. I would like to explore a non addictive drug for nighttime pain and insomnia. Any experience with specific drugs used for sleep and pain? Thank you.

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

John, Volunteer Mentor | @johnbishop | Feb 2 8:07am

Hello @mary4, There are some discussions in other support groups on Connect for Doxepin (Sileonor) which is non-addictive for insomnia. Here is a link to the discussions found using the search function on Connect - https://connect.mayoclinic.org/search/discussions/?search=Doxepin.

Here's some information on the drug:
"Doxepin (Silenor) - This helps a person stay asleep. Unlike other sleep medicines, this drug is not addictive and does not cause dependence. It is available in capsule and liquid forms. The recommended doxepin dosage for adults is 6 milligrams (mg), taken once daily at least 30 minutes before bedtime."
--- Which medication is best for anxiety and insomnia?
https://www.medicalnewstoday.com/articles/best-medication-for-anxiety-and-insomnia.
The Sleep Foundation also has a comparison of options that might be helpful - https://www.sleepfoundation.org/sleep-aids/compare-sleep-medications

mary4 | @mary4 | Feb 2 10:22am

Many thanks John. I will discuss with my doctor. Prednisone reduces the natural melatonin we produce. I was thinking of melatonin but it has not been tested on people with autoimmune disease.

nancy53 | @nancy53 | Feb 2 11:28am

I'm taking 50mg before bedtime of Trazodone, an antidepressant. It works for insomnia. As far as drugs go, it's pretty safe.

When my PCP prescribed it, I said "but I'm not depressed" through tears! 🙂

Bless you suffering with PMR for 4 years. I'm going on 3 months and am hoping for remission soon.

mary4 | @mary4 | Feb 2 12:00pm

In reply to @nancy53 "I'm taking 50mg before bedtime of Trazodone, an antidepressant. It works for insomnia. As far as..." + (show)

Thanks so much Nancy53. Good luck.

joanierav | @joanierav | Feb 2 8:40pm

In reply to @mary4 "Thanks so much Nancy53. Good luck." + (show)

i take 2 mil of lorazapam works great but not for pain.

tootiredtoknit | @tootiredtoknit | Feb 3 11:09am

Duloxetine and Fetzima (SNRIs) are both approved for chronic pain but be careful about taking them with opioid drugs because they can synergististically cause Serotonin Syndrome (I found this out the hard way with Tramadol and Fetzima.) If you want to try it, make sure you get them both from the same subscriber or that the subscribers talk to each other about appropriate dosing. Another alternative would be a muscle relaxant like Flexoril which tends to make you sleepy but really relaxes your muscles so they aren't stiff. The pain will subside in a day or 2 of relaxation.