Jump to content

Choose locationChoose Location
  • Sign in or Enroll
    • Open I want to choose my medical group or hospital
    • Clear my location
Change Location
Sutter Health
  • Video Visits
  • Find Doctors
  • Find Locations
  • Treatments & Services
  • Locations
  • Sign in or Enroll
    • Video Visits
    • Find Doctors
    • Find Locations
    • Treatments & Services
    • COVID-19 Resources
    • Pay a Bill
    • Symptom Checker
    • Get Care Today
    • Health & Wellness
    • Classes & Events
    • Research & Clinical Trials
    • For Patients
    • About Sutter Health
    • Giving
    • Volunteering
    • Careers
    • News
    • For Medical Professionals
    • Other Business Services
Close Search
  • Home
  • Ask an Expert
  • Insomnia and SSRI Medications
Content

Ask An Expert

Insomnia and SSRI Medications

Daniel Becker

Daniel Becker, M.D.

Mills-Peninsula Medical Group

Mills-Peninsula Physician HMO Network

Question:

What can I do if my SSRI is causing me to have insomnia? I've been on Prozac for a year (and it's been a huge help with my OCD), but I can't seem to string together more than two hours of sleep at a time.

Answer:

There are many potential causes of insomnia. If you have not done so already, I would recommend that you speak with your physician in order to determine the most likely cause of your insomnia. If, in the opinion of your physician, other causes of insomnia seem unlikely - and if the onset of insomnia has been in relationship to your being placed on Prozac - then it may seem likely to you and to your doctor that Prozac is the primary cause of your problem.

All medications have the potential to cause side effects or adverse effects. Although the selective serotonin re-uptake inhibitors (SSRI) tend to have a relatively low incidence of such problems, side effects do sometimes occur when patients take Prozac or other SSRI medications.

I am assuming that, like most patients, you are taking Prozac in the morning. If you are taking it later in the day, you may wish to discuss with your physician the possibility of shifting the dose to the morning. Many individuals who have sleep disturbance in relation to SSRI medication find that the problem resolves when they take their medication in the morning. Also, side effects may diminish when the dose of a medication is lowered. Again, this possibility should be discussed in detail with your prescribing physician. Sometimes the dosage of a medication can be lowered to the extent that side effects resolve while maintaining the desired therapeutic effect.

When patients and their physicians wish to lower the dose of a medication, but find that doing so results in break-through of symptoms, they may choose to utilize adjunctive therapeutic approaches in order to maintain the therapeutic effects despite a lower dose of the primary medication. These adjunctive approaches often involve other medications, but an equally important option - especially for obsessive-compulsive disorder (OCD) - would be psychotherapy. If you are not already receiving some form of psychotherapy, this again would be an important topic to discuss with your physician. Cognitive behavioral therapy (CBT), in particular, has been shown to be effective with respect to OCD. Many patients receiving such therapy find that they need far less medication than they did before they began CBT.

Finally, if the approaches mentioned above are not sufficiently helpful, your physician may choose to try you on an alternate SSRI medication. As you may know, there are many medications in this class, and Prozac is only one of them. Each of these medications - in any given patient - will have a slightly different therapeutic effect, and also a slightly different side effect profile. It is more than likely that you and your physician could find a SSRI medication that would result in fewer problems with insomnia; the difficulty is that such an alternative medication may not produce as robust a therapeutic effect as you describe for Prozac. As a result, the decision to switch to an alternative medication is a complex one - and, of course, one that should be discussed in great detail with your physician.

Related Questions

Question
  • Opioid Pain Medication Dependence vs. Addiction
    I've been taking vicodin for a number of years because of chronic back pain. My concern is that I've become dependent on them. Is there a difference between physical dependence and addiction?
  • Emotional or Behavioral Problems in Adolescence
    I can't tell if my son (age 14) is just being a teenager or if his symptoms might be early signs of a mental health problem. He's not doing as well in school, is overly sensitive to comments, sleeping more, and binging on junk food.
  • "Broken Heart Syndrome" - Stress Cardiomyopathy
    I've been through some bad loses this year (relationship, foreclosure) and have had chest pain and shortness of breath. My doctor said I had stress cardiomyopathy (broken heart syndrome). What are the other symptoms, is it dangerous, will I get it again?
  • Depression and Stress
    I'm 33, with two wonderful kids, but my life is falling apart when it comes to my relationship with my husband. I don't want to be around him because he's so controlling. I cry a lot, my head pounds, I'm dizzy and I have body pain. Is this depression?
  • Nocturia: Frequent urination at night
    What can I do about frequent urination during the night? I wake up at least once or twice to urinate.

Back to Mental Health

The Sutter Health Network of Care
Expertise to fit your needs
Primary Care

Check-ups, screenings and sick visits for adults and children.

Specialty Care

Expertise and advanced technologies in all areas of medicine.

Emergency Care

For serious accidents, injuries and conditions that require immediate medical care.

Urgent Care

After-hours, weekend and holiday services.

Walk-In Care

Convenient walk-in care clinics for your non-urgent health needs.

About Sutter

  • About Our Network
  • Annual Report
  • Awards
  • Community Benefit
  • Contact Us
  • News
  • Giving
  • Find Care

  • Birth Centers
  • Care Centers
  • Emergency Rooms
  • Hospitals
  • Imaging
  • Labs
  • Surgery Centers
  • Urgent Care
  • Walk-In Care
  • View All >
  • Featured Services

  • Behavioral Health
  • Cancer Services
  • Family Medicine
  • Home Health and Hospice
  • Orthopedics
  • Pediatrics
  • Pregnancy
  • Primary Care
  • Women's Health
  • View All >
  • Patient Resources

  • Accepted Health Plans
  • Classes and Events
  • Estimate Costs
  • Health and Wellness
  • Medical Records
  • Medicare Advantage
  • My Health Online
  • Pay a Bill
  • Symptom Checker
  • Our Team

  • For Employees
  • Physician Careers
  • Recruiting Events
  • Residencies and Fellowships
  • Sutter Careers
  • Vendors
  • Volunteers
    • ADA Accessibility
    • Contact
    • Privacy
    • Do Not Sell My Personal Information

    • LinkedIn Opens new window
    • YouTube Opens new window
    • Facebook Opens new window
    • Twitter Opens new window
    • Glassdoor Opens new window
    • Instagram Opens new window

    Copyright © 2022 Sutter Health. All rights reserved. Sutter Health is a registered trademark of Sutter Health ®, Reg. U.S. Patent & Trademark office.

    Cookie Policy

    We use cookies to give you the best possible user experience. By continuing to use the site, you agree to the use of cookies. Privacy Policy Cookie Preferences

    Privacy Policy Cookie Preferences