Over the years I've taken Trazodone for sleep off and on. Trazodone is an antidepressant, but it's used for insomnia in low doses. It's not a simple fix, though. Trazodone is supposed to be taken on an empty stomach -- but then I have that whole night eating problem, so that usually wouldn't happen, which might have interfered with its effectiveness. Whatever the reason, I could not get a consistent result with it. I experimented with the dosage but still couldn't figure it out. Sometimes it would not seem to do anything on a full dose, and other times even a half dose would quickly sedate me and last through the next morning.
Timing was another issue. Taking the medication too late at night would ensure morning grogginess, so it needed to be taken at least nine hours before I needed to wake up in the morning. But Trazodone would make me groggier if I took it too many days in a row, so I tried to take it only when needed, and by the time I couldn't sleep, it was already too late to take the drug. Also, there was only a short -- maybe 15 minute -- window in which it would make me sleepy, so if I missed it, I was out of luck. I ended up saving the pills until after a severe episode of sleep-deprivation for a bit of respite, which was hardly a solution.
I tried Ambien for awhile and it was effective for onset insomnia, but I would wake up at 4:00 a.m. every morning. Also, I understand it's not a great long-term solution since it's addictive and the sleep is less natural than one you would get from an antidepressant.
Now that I know there is a very real and valid reason for the chronic insomnia, I am on a mission to find a medication that will work for me even if it has to be long-term. Recently I began taking another antidepressant for sleep called Mirtazapine. Unlike Trazodone, it's meant to be taken every day, not just at times of sleeplessness. One of the side effects is increased appetite, which for me is a good thing. My doctor told me to give it a week because there may be some morning grogginess initially. I took it for seven days and had no problems getting to sleep, but I felt extremely sedated every morning. After that I tried taking half doses. I still felt way too sleepy in the morning, even after it made me sleep ten hours. Then I tried cutting it down even more, but I felt strangely restless at night.
Then my doctor prescribed Nortriptyline, another antidepressant at a low dose, and I couldn't tell that it did anything at all. Doubling the dose gave me that strange restless feeling. Theoretically I could have kept trying different things until I found something that worked better, but in real life I was barely functioning and couldn't risk going on like that. So I went back to the Mirtazapine. I figured feeling tired all day long was better than feeling tired all day long and tossing and turning all night.
What this means for my life is no more alcohol and I'm done for the night at 9pm. It's a trade I will gladly make if it means sleeping regularly (and I already hardly drank for sleep hygiene reasons). Thankfully I don't feel so sedated during the day this time, so maybe my body is adjusting to it or maybe I was just super tired before.
In conclusion: Medication is not a quick or simple or airtight fix.
