Zoloft PM and Insomnia


I like taking Zoloft PM Versus the morning but at bedtime it gives me insomnia sometimes with waking up in the night. In the morning it makes me feel drowsy all day and I prefer the bedtime dose even though it wakes me up at times. I am in 50 mg and take Hydroxyzine Paomate 100 mg at bedtime with Lorazepam/Clonazepam 0.5 mg as needed. I take up to 15 mg of melatonin lately but have had to go to 20 mg a night in the past. I cannot seem to stay asleep with Zoloft even at 50 mg at night but it seems to help somewhat when I do not take Ativan/Klonopin at bedtime. It's harder to initiate sleep without the Ativan/Klonopin (usually take one or the other) but it keeps me asleep throughout the night more. What can I do to help my sleep?

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Hi NBAdude,

Yours is a question that definitely needs to be asked of the doc who's prescribing all this. If you are not seeing an MD that specializes in sleep, that might be helpful.

Also in case you don't already know, there are non-pharmaceutical methods to improve sleep that are very effective. They are called CBT-I, for cognitive behavioral therapy specifically designed for insomnia.

These nondrug methods are typically what docs suggest first before drugs. You might ask your doc about that. If you are the self-help type, there's lots of good info online about CBT sleep training methods for adults.


Cognitive behavioral therapy doesn't work for me. It's a very poor form of therapy and is very ineffective. It's incredibly overrated and fails to help the majority that need it.


If your sleep habits are absolutely perfect, you have zero negative thoughts about sleep, if you have stress and anxiety completely under control, and you lead an active healthy lifestyle supportive of good sleep, then there's probably not a whole lot CBT sleep training methods can do for you.

But you are wrong about it being overrated. It helps most people who try it. That's what the stats show. That's why it's recommended by the AASM first, before drugs.

The real question you should be asking is what are the root causes for my insomnia? Get to those and your sleep should improve. You might not need drugs at all to do that.


How can I help if the CBT isn't that useful though? My doc is hesitant about prescribing pills for sleep. It's a lot due to probably being under treatment for ADHD from vyvanse. I don't know what is the best approach but insomnia is bad for me sometimes unless I exercise a lot and avoid caffeine, but let's be is a hard time to always exercise like if I get sick or have studying to do. What is the most realistic approach is what is making this so difficult. I take some "anxiolytic" things before bed, but it only mildly helps but I guess it's better than maybe "sleeping pills." I hate how there is no way to get to the root of this really...It's quite frustrating. Yeah CBT helps...but is it enough for someone in my specific situation? I don't really know... I will have to talk with my Dr. and see what he thinks.

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