Anxiety and insomnia in PD

[FutureWell]

I write this to try to help the PD warriors and their carers. My husband was diagnosed with PD 3 years ago, and his 2 most disturbing symptoms have been anxiety and insomnia. After 7 months of experimentation with meds, his anxiety was relieved by Venlafaxine. However the insomnia was a constant battle. He was prescribed Zopiclone, then Zolpidem, with limited success, then he was prescribed Clonazepam because it was suspected he had REM Sleep behaviour disorder. However it totally wiped him out the next day. And I did not like how he seemed on that medication, totally not himself. So, as of 3 nights ago we seem to have hit upon the solution to the insomnia, with additional benefits of less tremor, and an extra improvement in anxiety levels, mood levels, and less apathy. All of the experimentation over the past 3 years has been with the full knowledge of his consultants. But I am putting this out here to try to help others, because I know how difficult life has been for my husband, and I have no other reasons for posting.

So during the day in addition to his levodopa 100/25, 3 times per day, he takes 40mg of propranolol which relieves tremor, and 150mg of Venlafaxine for anxiety twice per day.

So we now come to night time. 30 minutes before bed, he has 37.5 mg of Venlafaxine for anxiety, 10mg of Melatonin and 30mg of Mirtazepine for the insomnia, and 100/25 controlled release levodopa to help with jumping legs.

It is 100% the addition of the low dose mirtazepine added to the low dose Venlafaxine which has resolved the insomnia.

Through the night if he wakes to use the toilet, he takes another 37.5 mg of Venlafaxine and a second 100/25 of controlled release, and is asleep again within the hour.

The addition of mirtazepine to the venlafaxine has made an enormous difference to our lives in 3 nights, compared to the past 3 years.

I hope this helps whoever reads this.

[LAJ12345]

I have just managed to wean my husband off mirtazapine which I am convinced caused his Parkinson’s in the first place! 30 mg is quite a high dose. It made him sleep alright but left him zombie like with frozen face and severe apathy.

[Heldover101]

Propranolol actually helps reduce anxiety also.

[rebtar]

30 mg is not a low dose for Mirtazapine. 7.5-15 is what is usually prescribed for sleep. More than that can be activating. You might consult with his Dr. about trying to ease back down to 15 or 7.5, to see if it is equally helpful for sleep.

[Despe]

Did he ever try Magnesium and Melatonin? The combination of these two an hour before bed works well for my husband.

[ion_ion]

I'm in the 5th year and I have no more the sleeping issues I had during the 1st year; I used Lorazepam, melatonin , which turned me into a zombie. I switched to 1/2 onion before bed for few months and after I started HDT combined with 4 c/l pills a day I sleep very well and the REM is gone. But also I accepted the situation and avoid any stupid stress. I pretend I'm not sick and go to the bed between 10-11pm and wake up at 6am and go to work.

[Rhyothemis in reply to ion_ion]

How do you use the onion? Do you eat it raw or cooked? Or do you do the 'onion jar' thing (inhale the vapors)?

[ion_ion in reply to Rhyothemis]

Raw, like an apple. At this time I have no sleep issues so I'm no longer using it.