I was recently switched from Paroxetine to Fluoxetine. It was one of the best decisions I have ever made. When on Paroxetine and I was tired ALL the time. I was literally falling asleep at my desk. It was hard to stay awake. I do have obstructive sleep apnea however I use a CPAP every night. According to the readout on the machine I usually stay between 2 and 4 events an hour. My problem is, since I switched to Fluoxetine I had been having difficult falling asleep at night, one extreme to another lol. Clearly I have some mental health issues, hence the Fluoxetine but I also take Duloxetine for pain/anxiety. This combo seems to work great. My head is clear and I have energy I haven't had in years. I wouldn't want to stop either medication but I NEED to be able to sleep at night. I've tried everything. Ambien doesn't work. Trazodone doesn't work. Hydroxyzine and diphenhydramine doesn't work. Doxylamine doesn't work. I've even taken some of my Oxycodone (for my chronic pain) at night and that doesn't work. I've gone natural and tried lemon balm, chammomile and valerian with no luck. I've been doing some research and found out that the FDA has approved low doses of Doxepin for use in insomnia. My father used Doxepin years ago and it greatly helped him with sleep. In my research I also see that taking it with anything that inhibits liver enzyme CYP2D6 (which both Fluoxetine and Duloxetine do) can cause the levels of the medication to build up in the body essentially behaving like you have taken more than you have. My question is, would it be safe to add a very tiny dose, say, 3 mg as a sleep aid to my medications. If it builds up enough to mimic say 6 mg or 10 mg that wouldn't be too bad. I am just really desperate right now and I need to know how safe this would be so I can bring it up with my doctor. Sorry for the long winded and confusing post and thanks to anyone who can help me.
My current medications/supplements:
Fluoxetine 20 mg
Duloxetine 60 mg
Lamotrigine 200 mg
Modafinil 200 mg
Lansoprazole 15 mg delayed release
Oxycodone 15 mg once a day (will be tapering off in the next few weeks)
Omega-3 3000 mg
Vitamin D3 5000 IU
Whole Food Multivitamin
Methylcobalamin
Probiotic
Magnesium 300 mg