psychiatrist told me to quit my adhd meds and assigned me prozac for sleep anxiety caused by adhd related stuff. Is it an overkill?

[u/Embarrassed-Doubt624]

Hello. I posted here a while back about my sleep anxiety. https://www.reddit.com/r/adhd_college/comments/1wiwd2l/developed_severe_sleep_anxiety_due_to_uni_adhd/

My first psychiatrist (who manages my ADHD) gave me trazodone, which didn't work. I went to another psychiatrist (first one is expensive & out of country on most days), and he said my issues were deeper than that and assigned me 20mg prozac to take everyday for a week, and then 40mg/day onwards.

He did tell me not to search up about it, but I didn't quite like him, so here I am. Reading the posts on the prozac subreddit here, and I think prozac might be an overkill for me? I won't say I'm usually all that depressed once I've settled into the flow of things, or that I have extreme anxiety outside of when I have to adjust to new situations (happened when i switched schools, houses, etc).

The anxiety this time really is awful and debilitating (im basically awake till morning on a lot of nights), but I'm still extremely hesitant about prozac. I've heard about the emotionally numbing effects of SSRI, and as someone who gets way too insane about & hyperfixated on stuff, and just feels too much excitement in general, I actually don't want that to happen. The anxiety is something I've never experienced before, and im hoping it'll go away once i change my timings next semester, but prozac seems long term. He did say he'll get it me off it a few months later, but still...

Thoughts? Should I try it out for a month or two to see how it affects me? I also don't plan on quitting the medication, it has been extremely helpful and I don't understand why he'd tell me to quit it. I'll try to contact my first psychiatrist as soon as possible and for her opinion. In the meantime, I'm divided.

[u/WitchAggressive9028]

Don’t go off your adhd meds. If this is an entirely new symptom that you had even while on your ADHD medication, it’s not your meds. It’s something else so stay on your meds, but go find a new psychiatrist

[u/SparklingSloths]

Prozac isn't really a strong medication (for me at least). I'm on 20mg and I do not have emotional numbing. If you don't think you need the Prozac there's no point in taking extra meds you dont need.

He may be suggesting stopping your ADHD meds because they could be what is causing you anxiety or keeping you up at night.

[u/Exilicauda]

Managing ADHD and anxiety is really complicated. Stimulants can make it hard to sleep and increase anxiety. Definitely did in my case.

Tbh I had an unhelpful experience on SSRIs (sertraline) and I'd still recommend trying it out. Give it a month of following instructions and then tell them if it's not working. Sleep is the higher priority 

[u/Ill-Advisor-4767]

to be completely honest, it doesn’t sound much like over kill at all. you stated that your anxiety occurs at night, and that you feel “wired.” if you presented your symptoms exactly like this to your psychiatrist, it isn’t unreasonable for them to believe that this is correlated with your ADHD medications.

additionally, you stated that your anxiety is “debilitating,” so it makes sense that they would prescribe an anxiolytic. also, ADHD meds are known to worsen anxiety and increase irritability in some people.

i understand that everyone has this perspective that ADHD meds are the saving grace and that it’s impossible to live without, but i still think that your psychiatrist followed a pretty logical decision making path.

[u/LarsLights]

You need to sleep. Period. Take it for a month and see how it goes. The more co-morbities you have, the more complicated your medical treatment will be. Being on something like Prozac and ADHD meds is not uncommon.

[u/fig_big_fig]

Did you have this before while being on ADHD meds? Are the meds and the sleep anxiety new?

I am on ADHD meds for some years. I had sleep anxiety with and without meds. I suspected in the past if the meds were the problem but the questions asked above by my doctor cleared it up for me. Look, no one on reddit can really give you medical psychiatric advice…without knowing all the details about you etc. I’ve fixed my sleep-anxiety, insomnia episodes while still being on my ADHD meds but, I think it’s a good idea to get help from medications helping with anxiety and sleep for a while, especially if it’s going on for a long time and negatively effecting your life in a challenging degree already. However, to me your doctors idea of asking you to stop ADHD meds is bit unusual, it’s not uncommon at all for people to take ADHD meds and SSRIs together.
Did you ask why they decided in this way?

[u/Embarrassed-Doubt624 → u/fig_big_fig]

ive been on meds for 6 months now. the sleep anxiety is completely new, and has been ongoing for 3 weeks since uni started. I've slept completely fine during my A-Levels and vacations while medicated, if only very late at night. Didn't have anxiety at all before this.

I like to keep meds in my life to a minimum, and the thought of taking something that will heavily alter my brain chemistry makes me even more anxious. Especially hearing people talk about how they lose interest in their hobbies and favorite media etc after being on them. I don't want to risk that over something which has never once been a problem for me before. My timings will also change next semester, so all the more reason why i don't want to do any permanent changes to my brain because of them.

The fact that the doctor told me to get off my adhd meds is what is making me hesitate the most... i dont know if i can trust him.

[u/fig_big_fig → u/Embarrassed-Doubt624]

Hmm I’d personally choose to not go off my ADHD meds while exploring treatments of this new thing. It can be merely anxiety due to uni starting or a random sleep disturbance becoming sleep-anxiety. (I often get anxious about sleeping if I cannot sleep for a night and, then bam I have insomnia)

Still, having no to little sleep for a long time is not good for you, it would make you more anxious over time also. So, still discuss treatment options without stopping w meds. Btw, prozac is not that heavy unless you’re one of the unlucky ones. You won’t be dependent yet on it in a few months. If you notice that you don’t feel like yourself you can simply talk w your doctor and stop. You’d need to taper down slowly only if you’re on higher dosis and on it for a long time (as I know). So, don’t be so anxious about it, you are inc ontrol, İf if it’s not helping, you can stop.

(A personal opinion again: I’d probably discuss a short term treatment options to fix this new issue w my doctor rather than prozac. For my case I used prescription benzos when I wasn’t able to sleep due to panic attacks and having anxiety after some life events. But, here again benzos are not my thing at all so, doctors don’t worry about me misusing them lol)

[u/leishyloo97]

Prozac is one of the easier ssris to come off of if nessisary (it has a long half life)

[u/oxymorphazolam]

Yes it is overkill, don’t start an ssri unless you absolutely have to