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Dr. Phil, MD
Dr. Phil, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56566
Experience:  GP in the United States
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I am a lady with mild/moderate spastic diplegia, which also

Customer Question

Hi I am a lady with mild/moderate spastic diplegia, which also makes me clench my jaw at night. I also have anxiety and depression and have been prescribed 10mg of escitalopram, which I have been on for 4 weeks. However the medication is making me have lots of very vivid dreams, where it feels like I am living another life at night. This is making me exhausted during the day and suffer from severe brain fog and lack of concentration. It is also making me clench my teeth even more than usual and I have been bedridden with the severe headaches, jaw, neck, shoulder pain. The tightness in these areas also cause me to feel very nauseous and off balance. The tiredness and bruxism symptoms is severely debilitating.
Is there another drug that would help my anxiety and depression, but not affect my sleep structure so much? Due to my limited mobility I would also not want to go on a drug that caused weight gain.
I have previously tried Veneflaxine 75mg, which caused the same side effects as above and recently Moclobemide, which did nothing for my anxiety and depression symptoms. Any advice would be really helpful.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Phil, MD replied 1 year ago.
any other medical issues?
Customer: replied 1 year ago.
No other medical issues apart from the spastic diplegia cerebral palsy, which I have already mentioned.
Expert:  Dr. Phil, MD replied 1 year ago.
what other meds do you take right now if any?
Customer: replied 1 year ago.
6mg diazepam at night for 4-5 days at a time when the night time Bruxism is really bad.
Expert:  Dr. Phil, MD replied 1 year ago.
Okay. I would advise trying amitryptiline or trazodone at night.This would have a better anti bruxism effect
Dr. Phil, MD and 3 other Medical Specialists are ready to help you
Customer: replied 1 year ago.
Is it ok to take the 10mg of escitalopram as well as trazodone at night?
I couldn't tolerate amitryptiline, as it gave my very bad nightmares which involved guns and blood.
How much trazodone should I take at night?
Would there be a better antidepressant other than escitalopram, that dosen't affect my sleep structure so much?
i.e the many vivid dreams I have on this medication, leaves me exhausted during the day, with severe brain fog. Also because I am having many vivid dreams, this is then making my bruxism more intense, which leaves me with severe morning headaches, jaw, neck, shoulder pain and nausea.
Expert:  Dr. Phil, MD replied 1 year ago.
Yes, you could do low doses together. It is a potential interaction but okay if your doctor monitors itI would do 50 mg of trazodone max