QUESTION:
Dear Dr. Heller,
I have Mitral Valve Prolapse Dysautonomia. My symptoms are fairly severe. I also have sleep apnea and hypoglycemia. My understanding is that these are all related to the autonomic nervous system disorder in which there is a miscommunication between the brain and the heart. Apparently there are many forms this disorder can take. My major problem is sleeping and fatigue. I need to sleep 10-11 hours of sound sleep each night to feel rested and to function. I sleep with a CPAP machine and that helps some, but does not solve the problem. I have taken a variety of herbs and homeopathics and those help but I still not getting quality. The problem is that I'm taking 10 mg of Prozac for depression, also part of the syndrome, and the Prozac affects my sleep. I've tried the other SSRI's as well as other antidepressants but Prozac works best. Do you have any suggestions?
ANSWER:
I will virtually guarantee that you have at least one anxiety disorder. The generalized
anxiety disorder is a high 5HT-1 receptor activity, which is aggravated by SSRI's
like Prozac. BuSpar can make a huge difference here. Do NOT take grapefruit juice with
BuSpar because it will dramatically raise blood levels of BuSpar.
Post traumatic stress disorder likely enhances 5HT-2 receptor activity, which is
aggravated by SSRI's and BuSpar. Remeron works great here. Combinations of
medications are important.
Every anxiety disorder must be effectively treated. Your brain is treating life as if
you're alone in a cave and a hungry bear came in and saw you - your anxiety is too
high to let you sleep.
