HEALTH LINE

Questions and Answers

I have been taking Nardil for a year (60 mg) and Rivotril (2 mg) to help me sleep. The Rivotril no longer helps me sleep, and the 25mg of trazadone I take to sleep only puts me out for about 2 hours. I have recently started taking a small amount of Xanax, which neither puts me to sleep nor keeps me asleep. The result is I am addicted to both Rivotril and Xanax (with no benefit) and I cannot sleep more than 3 hours a night. I am exhausted from sleep deprivation. And I have experienced a tremendous weight gain. I have read both that Nardil makes you gain weight, and is used to stop bulemics from binging.

Hi Michael ... sorry to hear about your problems.

Let's have a look at your drug treatment.

1. Nardil (phenelzine) with a usual daily dose range of 15-30 mg. is a mono-amine-oxidase inhibitor widely used in the treatment of major depression.
2. Rivotril ( clonazepam) is a benzodiazepine anticonvulsant used to treat certain seizure disorders - a major side-effect which you are exploiting is drowsiness, tolerance to its action is common - physical and psychological dependance are a disadvantage.
3. Trazodone (Desyrel) is also an anti-depressant, atypical type, with a usual daily dosage range of 150-200 mg.
4. Xanax (alprazolam) also a benzodiazepine, is used in usual daily dose of 0.75-1.5 mg. for the treatment of anxiety and depression - see #2.

It's hard to see how you've ended up with such a drug cocktail. If you are being treated for depressive illness, your psychiatrist should rationalize both the type of drug and its dosage most likely to be effective (one drug only at a time) - the MAO-inhibitors are notorious for weight gain. Your dependance on clonezepam and alprazolsam, the two benzodiazepines can be countered by gradual dosage tapering until you're completely off them.

Drugs are no more than a temporary crutch in the management of insomnia - get a consult with someone specializing in this disorder.
Best wishes.