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I am psoriatic arthritis patient with back pain and si joint pains in addition to other joint pains. I use hcqs 200 mg for psa. Spine surgeon prescribed duloxetine 20 mg one in morning & one in the evening for my back pain. These tablets also reduce other joint pains and also helps in controlling my inflammation. But my problem is because of this duloxetine capsules my sleep has become very much disturbed and I am unable to fall asleep when I wake up in the night. I feel active all the time and suffering with racing thoughts/brain fogg. I am not able to calm my mind by all means. To counter this I added mythy cobalamin 750 mcg and 1/2 of clonotril - .25 mg. But still then I get up between 3 to 4 am and unable to fall asleep. Totally I am getting a sleep of about 4.5 hours to 5 hours a day. Increasing clonotril dose causing me irritation in the stiff muscles surrounding the joints. I tried magnesium supplement which worked nicely but it increased my scalp psoriasis rapidly. I tried all forms of magnesium but same results. Melatonin helped a bit but it causing tiredness during entire day. Could you please suggest any medicine to calm down my thoughts and to get a restful sleep? Thank you.

3 Doctors Answered
Perhaps meds may not be the answer for you some tips to get sleep +sleep at a fixed time so that it becomes a routine/habit. +early to bed and early to rise +two hours of sleep before midnight are more beneficial than four after +before going to bed have this. In a cup of hot milk add 1tsp turmeric +1tsp cinnamon+1tsp black pepper +meditate before you lie down +sleep is often elusive. Any attempt to force it only drives it further away. It is better to divert the mind with soft old music or light reading can also help +regular, active exercising during the day and mild exercise at bedtime enhances the quantity and the quality of sleep.
Start methotrexate if no relief then start biologicals along with medication do physiotherapy be active do lot of exercise life style modifications add yoga to calm down urself as stress will precipitate it more.
-if duloxetine is causing so many problems better to stop it - start on drugs methotrexate hope you should be recieving for your psoriasis the details of your psoriasis treatment is not available here - if you can upload the treatment details of psoriasis I can help you in better way.
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