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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by anne on March 1, 1999, at 16:57:10
I am 39 years old with multifocal dystonia duration 10 months. Previously I had a focal dystonia (writer's cramp) x1 year. I thought I was coping pretty well with the progressing disability and pain and made a decision not to treat the dystonia agressively but to try and just live with the symptoms as best I can due to the cognitive side effects of the drugs. In December, the symptoms worsened and I started Klonopin 0.5 at bedtime to take the edge off the muscle cramps and aching in order to sleep. I was also taking Elavil 10 mg for sleep. Two weeks into Klonopin I became *depressed*. I didn't feel like myself anymore, no motivation, difficulty thinking (bad when you are a grad student) and no interest in food. My neurologist had previously tried me on Zoloft last summer (he thought I looked depressed)but it was very agitating (1/2 of a 25 mg tab)and increased my finger movements tremendously and I had facial movements for the first time. I was afraid to try another SSRI but my internist convinced me to try Paxil. It is impossible to know if it was a coincidence but my symptoms seemed worse again and I found Paxil to make me want to lay on the couch all day at 20 mg. Third try, Effexor XR. Makes me feel better than anything so far but had to cut the dose back to 37.5 due to severe insomnia (no Elavil x 1month). Also my neck hurts tremendously. While I appreciate my internist trying to help me cognitively, I'm really going downhill physically pain and movement-wise. The internist wants to add trazadone now for sleep then increase the effexor again. I'm afraid of more drugs by now, nothing seems to work right. All my docs say it's just trial and error, even the neuro's and I'm tired of all these experiments. I don't know where to turn.
Posted by dave on March 2, 1999, at 0:49:40
In reply to Need AD that doesn't increase dystonia, posted by anne on March 1, 1999, at 16:57:10
> I am 39 years old with multifocal dystonia duration 10 months. Previously I had a focal dystonia (writer's cramp) x1 year. I thought I was coping pretty well with the progressing disability and pain and made a decision not to treat the dystonia agressively but to try and just live with the symptoms as best I can due to the cognitive side effects of the drugs. In December, the symptoms worsened and I started Klonopin 0.5 at bedtime to take the edge off the muscle cramps and aching in order to sleep. I was also taking Elavil 10 mg for sleep. Two weeks into Klonopin I became *depressed*. I didn't feel like myself anymore, no motivation, difficulty thinking (bad when you are a grad student) and no interest in food. My neurologist had previously tried me on Zoloft last summer (he thought I looked depressed)but it was very agitating (1/2 of a 25 mg tab)and increased my finger movements tremendously and I had facial movements for the first time. I was afraid to try another SSRI but my internist convinced me to try Paxil. It is impossible to know if it was a coincidence but my symptoms seemed worse again and I found Paxil to make me want to lay on the couch all day at 20 mg. Third try, Effexor XR. Makes me feel better than anything so far but had to cut the dose back to 37.5 due to severe insomnia (no Elavil x 1month). Also my neck hurts tremendously. While I appreciate my internist trying to help me cognitively, I'm really going downhill physically pain and movement-wise. The internist wants to add trazadone now for sleep then increase the effexor again. I'm afraid of more drugs by now, nothing seems to work right. All my docs say it's just trial and error, even the neuro's and I'm tired of all these experiments. I don't know where to turn.
Anne, I know what you mean, I did know i need and AD
but my doc thought so. at the time i was on roughlt
1/2 of risperdal and 1/2mg of klonopin. we tried
zoloft, then wellbutrin, then celexa; all seemed
to work but i couldnt handle the side effects.
After being off all ADs for a few weeks now I
wonder if i need any, I know my doc will try to
talk me into trying more though. It is bad when
people dont even know if they really need it.
What if I have been depressed somewhat all my
life and that forms some of my personality?
What if being not depressed and on AD's makes
me in effect, a different person. I am like
you I really dont know what to do so dont feel
alone. I would imagine many here agree. Best of
luck to you Anne.
Sincerely
dave
Posted by Matt on March 6, 1999, at 18:09:38
In reply to Need AD that doesn't increase dystonia, posted by anne on March 1, 1999, at 16:57:10
Have you tried adding an ACA sort of drug like Benadryl?
Matt
Posted by Matt on March 6, 1999, at 18:12:15
In reply to Re: Need AD that doesn't increase dystonia, posted by dave on March 2, 1999, at 0:49:40
Btw, a) klonopin has been known to cause depression and b) I know how difficult it is being a grad student and dealing with this stuff. I'm in the midst of my dissertation right now, and all the mental illness issues on top of that is not easy to deal with.
Hang in there!
Matt
Posted by anne on March 6, 1999, at 22:32:14
In reply to Re: Need AD that doesn't increase dystonia, posted by Matt on March 6, 1999, at 18:12:15
Thanks for your words of encouragement! Afraid to try another *new* drug (Trazadone)right now, so I started taking Elavil 10mg again along with the Effexor. Sleeping again is bliss but the price is rather high; it does affect short term memory, especially in the am. In a way it seems wasteful to use an expensive new drug, then add another one which adds back the side effects the new ones don't have. Go figure.
Posted by anonymous on March 7, 1999, at 21:10:47
In reply to Does anybody use Trazadone?, posted by anne on March 6, 1999, at 22:32:14
> Thanks for your words of encouragement! Afraid to try another *new* drug (Trazadone)right now, so I started taking Elavil 10mg again along with the Effexor. Sleeping again is bliss but the price is rather high; it does affect short term memory, especially in the am. In a way it seems wasteful to use an expensive new drug, then add another one which adds back the side effects the new ones don't have. Go figure.
Try the trazadone. Many people use it successfully for sleep. Desyrel is the brand name, which some say works better.
Posted by Terry on March 7, 1999, at 21:14:35
In reply to Does anybody use Trazadone?, posted by anne on March 6, 1999, at 22:32:14
Anne -- I tried trazodone, but it made me groggy in the mornings. I also had bad dreams while taking it. I use clonidine now (Catapres), a mild antihypertensive drug, and it works well to help me sleep. I take Serzone for depression. Terry
> Thanks for your words of encouragement! Afraid to try another *new* drug (Trazadone)right now, so I started taking Elavil 10mg again along with the Effexor. Sleeping again is bliss but the price is rather high; it does affect short term memory, especially in the am. In a way it seems wasteful to use an expensive new drug, then add another one which adds back the side effects the new ones don't have. Go figure.
Posted by Elizabeth on March 9, 1999, at 22:00:37
In reply to Re: Does anybody use Trazadone?, posted by Terry on March 7, 1999, at 21:14:35
I have tried trazodone a few times, as it tends to be a first-choice drug for insomnia. However, when it did work, it would stop working after a couple of days (I had to keep increaing the dose).
Recently I've been using it as an alternative to a non-drowsy antihistamine (my doctor finally called in a sciprt for Claritin), which should tell you how well it works as a sedative-hypnotic!
However, most people's experiences are the opposite: trazodone helps them sleep and continues working over long periods of time.
Terry: clonidine can have some other effects on mood and anxiety if you take a half dose during the day - it's used a lot for kids with ADD, as it's supposed to help them with frustration tolerance.
-elizsbeth
Posted by Amy on February 10, 2000, at 14:50:38
In reply to Re: Does anybody use Trazadone?, posted by anonymous on March 7, 1999, at 21:10:47
> > Thanks for your words of encouragement! Afraid to try another *new* drug (Trazadone)right now, so I started taking Elavil 10mg again along with the Effexor. Sleeping again is bliss but the price is rather high; it does affect short term memory, especially in the am. In a way it seems wasteful to use an expensive new drug, then add another one which adds back the side effects the new ones don't have. Go figure.
> Try the trazadone. Many people use it successfully for sleep. Desyrel is the brand name, which some say works better.I am 29 and I started taking trazadone (50 mg @bedtime) for my insomnia/depression which has lasted for about 6 years now. I have tried serzone, paxil and celexa but I have a problem tolerating the ssri's and they seem to make my insomnia worse. Trazadone was the only medication that has relieved the "sinking" feeling of the depression. But, because of nausea I stopped taking it after 3 weeks of treatment and the depression is back. I have tried to restart the trazodone (and tried to increase the dosage) but it is not nearly as helpful as it was the first time. I am wondering if there is anyone out there who trazadone has helped in the past and if you have since found anything that has helped you as much? Please help...I am desperate! Amy
Posted by Amy on February 11, 2000, at 8:27:58
In reply to Re: Does anybody use Trazadone?, posted by Amy on February 10, 2000, at 14:50:38
I am 29 and I started taking trazadone (50 mg @bedtime) for my insomnia/depression which has lasted for about 6 years now. I have tried serzone, paxil and celexa but I have a problem tolerating the ssri's and they seem to make my insomnia worse. Trazadone was the only medication that has relieved the "sinking" feeling of the depression. But, because of nausea I stopped taking it after 3 weeks of treatment and the depression is back. I have tried to restart the trazodone (and tried to increase the dosage) but it is not nearly as helpful as it was the first time. I am wondering if there is anyone out there who trazadone has helped in the past and if you have since found anything that has helped you as much? Please help...I am desperate! Amy
Posted by CG on February 11, 2000, at 9:44:01
In reply to Has trazadone helped you?, posted by Amy on February 11, 2000, at 8:27:58
I used trazadone for about 4 years, along with Paxil. I could not sleep with Paxil alone. The Trazadone kicked in quickly and really helped me sleep. I was on 30 mgs Paxil and 100 mgs Trazadone at bedtime. I slept like a rock but did have a hard time getting up before 9 a.m. Then a year ago I went on a long trip and forgot to take the Trazadone! Two weeks without sleep and then the cussed withdrawl symptoms too. I was in Hawaii where just seeing a doctor would have been $120.00. I didn't think I would make it back, but somehow arrived home in one piece. Then the Trazadone never worked again, but I was still taking it. I didn't realize what was going on. It wasn't helping anymore, but I though I was just crazier than usual. When you are in the middle of all this madness it is so difficult to understand it. Six months later I decided something had to get better. I went back to the Doctor who put me on Serzone. It has many less side effects...no sweating, no itching, more normal sleep when the dose is high enough... other things that were good for me...but it is terribly short acting. If I take a morning dose and then wait 12 hours for the evening dose, I turn into a stark raving witch. I wish I could slap everyone I run into and myself included. So I began taking the doses in halves and dosing 4 times a day instead of 2. That helps a lot, but it is still easy to forget to take something 4 times a day. Also, unless the dose is high enough it is usless to begin with. Low doses were BAD news. So then I get into the anger, hostility thing. I vote for good mental health whenever possible!! Damn the Damn meds!
Posted by Amy on February 11, 2000, at 15:44:51
In reply to Re: Has trazadone helped you? and more Serzone , posted by CG on February 11, 2000, at 9:44:01
> I used trazadone for about 4 years, along with Paxil. I could not sleep with Paxil alone. The Trazadone kicked in quickly and really helped me sleep. I was on 30 mgs Paxil and 100 mgs Trazadone at bedtime. I slept like a rock but did have a hard time getting up before 9 a.m. Then a year ago I went on a long trip and forgot to take the Trazadone! Two weeks without sleep and then the cussed withdrawl symptoms too. I was in Hawaii where just seeing a doctor would have been $120.00. I didn't think I would make it back, but somehow arrived home in one piece. Then the Trazadone never worked again, but I was still taking it. I didn't realize what was going on. It wasn't helping anymore, but I though I was just crazier than usual. When you are in the middle of all this madness it is so difficult to understand it. Six months later I decided something had to get better. I went back to the Doctor who put me on Serzone. It has many less side effects...no sweating, no itching, more normal sleep when the dose is high enough... other things that were good for me...but it is terribly short acting. If I take a morning dose and then wait 12 hours for the evening dose, I turn into a stark raving witch. I wish I could slap everyone I run into and myself included. So I began taking the doses in halves and dosing 4 times a day instead of 2. That helps a lot, but it is still easy to forget to take something 4 times a day. Also, unless the dose is high enough it is usless to begin with. Low doses were BAD news. So then I get into the anger, hostility thing. I vote for good mental health whenever possible!! Damn the Damn meds!
Thanks for your response!!! I was beginning to feel like I was losing my mind having started the trazadone again to no avail. It really helped the first time I took it but all it does for me anymore is give me a stomach ache. I tried serzone 2 years ago and I was actually on it for about a year until I didn't THINK I needed it anymore. I stopped the serzone and had a relapse and....big surprise.....the serzone didn't work for me the second time around. That is why my doctor then put me on Trazadone because he said that it hits the same area of the brain as serzone and since the serzone once helped...the trazadone should help now since it's a different family of AD. And,it helped for a while...until I felt like I didn't need them anymore...Which brings me to where I am today. DO NOT STOP TAKING THE SERZONE IF IT IS HELPING YOU!!!
Have you ever tried any other antidepressants that have helped in the past? I too tried Paxil but the nausea was worse than the depression. Maybe I just don't give the drugs a long enough chance but it's just really frustrating, as I'm sure you're well aware. The depression and insomnia suck but then when I take the damn meds sometimes I have to ask myself which is worse. It's a double edged sword, you know?
I agree....DAMN THE MEDS!
Amy
Posted by Amy on February 11, 2000, at 15:51:24
In reply to Re: Has trazadone helped you? and more Serzone , posted by CG on February 11, 2000, at 9:44:01
> I used trazadone for about 4 years, along with Paxil. I could not sleep with Paxil alone. The Trazadone kicked in quickly and really helped me sleep. I was on 30 mgs Paxil and 100 mgs Trazadone at bedtime. I slept like a rock but did have a hard time getting up before 9 a.m. Then a year ago I went on a long trip and forgot to take the Trazadone! Two weeks without sleep and then the cussed withdrawl symptoms too. I was in Hawaii where just seeing a doctor would have been $120.00. I didn't think I would make it back, but somehow arrived home in one piece. Then the Trazadone never worked again, but I was still taking it. I didn't realize what was going on. It wasn't helping anymore, but I though I was just crazier than usual. When you are in the middle of all this madness it is so difficult to understand it. Six months later I decided something had to get better. I went back to the Doctor who put me on Serzone. It has many less side effects...no sweating, no itching, more normal sleep when the dose is high enough... other things that were good for me...but it is terribly short acting. If I take a morning dose and then wait 12 hours for the evening dose, I turn into a stark raving witch. I wish I could slap everyone I run into and myself included. So I began taking the doses in halves and dosing 4 times a day instead of 2. That helps a lot, but it is still easy to forget to take something 4 times a day. Also, unless the dose is high enough it is usless to begin with. Low doses were BAD news. So then I get into the anger, hostility thing. I vote for good mental health whenever possible!! Damn the Damn meds!
Oh, I forgot to ask you...What withdraw symptoms did you experience while getting off of the trazadone?
Posted by CG on February 12, 2000, at 9:40:29
In reply to Re: Has trazadone helped you? and more Serzone , posted by Amy on February 11, 2000, at 15:51:24
I couldn't even think enough to realize I was having withdrawl from Trazadone. I thought I was simply feeling very sick. Sweat was pouring from every pore most of the time. Even my legs and arms were sweating. My head was generally soaked all the time. I felt weak and nauseated and my blood pressure was up. Talking was an effort so I talked pretty quiet when I had to talk. I couldn't stand up very long. So, I thought I was just sicker than sick and didn't know what the heck was going on. I would jump awake from sleep, always thinking there was "sombody in the house!" (A mad killer???) Whew, it was pretty terrible. I thought trazadone was a fairly benign medication, but I don't any more. Withdrawl from the Paxil was nothing compared to the trazadone. BTW, the reason I am still on Serzone is because who knows what could be worse??? Good luck to you, Amy! As has been said before, most everybody gets a pretty individual reaction to the meds. CG
Posted by julepp on February 19, 2000, at 10:39:47
In reply to Getting Off Trazadone, posted by CG on February 12, 2000, at 9:40:29
WOW!!!and I thought the Paxil withdrawal I went through was bad!!
I tried trazadone 10 yrs ago, it was wonderful for sleep, I just couldn't breathe!
It would start out like a "stuffy" nose and continue from there. My doc said it was probably because I'm asthmatic and have multiple allergies.
Too bad, because I went to sleep quickly, just didn't stay that way, kept waking up due to the breathing.
Posted by Mick on March 21, 2000, at 7:42:06
In reply to Re: Does anybody use Trazadone?, posted by anonymous on March 7, 1999, at 21:10:47
>My pharmacist warned me not to take Trazadone
plus Effexor because of the possiblity of the
'serotinin syndrome' / hypersotonergic effect
of too much serotonin in the system.
My doctor prescribed 75 mg. Effexor after over
a year of 40 mg. Paxil + 50 mg. Trazadone + therapy.
Does anyone have any experience with these meds?
Posted by Noa on March 21, 2000, at 12:27:02
In reply to Re: Trazadone + Effexor danger?, posted by Mick on March 21, 2000, at 7:42:06
I have taken larger doses of effexor (300 or so) along with 25 to 50 mg trazodone, which helped me sleep. I hadn't heard any warnings about it being dangerous.
Posted by JohnL on March 22, 2000, at 0:55:36
In reply to Re: Trazadone + Effexor danger?, posted by Mick on March 21, 2000, at 7:42:06
It sounds like the pharmacist is being cautious. But if your doctor prescribed, it's probably best to follow his/her instructions. I've heard of people taking larger doses of Traz with Effexor, and also larger doses of Serzone (a close cousin of Traz) with Effexor.
Serotonin syndrome is always a risk when we mix multiple serotonin medications. Infrequently it's even a risk on just one drug. As with any other approach, it might be a good idea to start low and go slow until you have a better feel for how you will respond to these meds.
Posted by Cam W. on March 22, 2000, at 6:46:30
In reply to Re: Trazadone + Effexor danger?, posted by JohnL on March 22, 2000, at 0:55:36
Mick - Most pharmacists are incredibly anal and do err on the side of caution, as many of them have seen severe serotonin syndrome and its not pretty. You can monitor this yourself. The doses you are taking are low, so, ordinarily you would not expect a problem. What you can watch for are increased body temperature, sweating, and a kind of vibrating feeling. If you do get these and they are not too annoying they will probably disappear within the first week or two as your body adjust to the drugs. If they are annoying call your doctor. You should inform your doctor anyway if they do occur, just to keep him/her up to speed on your progress. - Cam W.
Posted by Scott L. Schofield on March 22, 2000, at 9:44:49
In reply to Re: Trazadone + Effexor danger?, posted by Cam W. on March 22, 2000, at 6:46:30
It sounds like the pharmacist is being cautious. But if your doctor prescribed, it's probably best to follow his/her instructions. I've heard of people taking larger doses of Traz with Effexor, and also larger doses of Serzone (a close cousin of Traz) with Effexor.
>
> Serotonin syndrome is always a risk when we mix multiple serotonin medications. Infrequently it's even a risk on just one drug. As with any other approach, it might be a good idea to start low and go slow until you have a better feel for how you will respond to these meds.
I have even seen quite a few reports of serotonin syndrome occurring as the result of combining lithium with an SSRI. Lithium has been purported to enhance serotonergic neurotransmission via postsynaptic second messenger systems. Many investigations have demonstrated this using various methods.
- Scott
Posted by Morgianna on April 6, 2000, at 20:48:16
In reply to Re: Does anybody use Trazadone?, posted by anonymous on March 7, 1999, at 21:10:47
Trazadone is great; a high dose will leave your with some memory loss and hung over in the morning. BUT...... it doesn't cause the tremendous appetite increase that Elavil caused me. Also, trazadone doesn't leave me with the dry mouth problem like Elavil.
Posted by afatchic on May 1, 2000, at 23:30:08
In reply to Re: successful us of Trazadone?, posted by Morgianna on April 6, 2000, at 20:48:16
I took Trazadone for several years and I loved it! I found that all I needed was 50mg at bedtime as a maintenance dose. When I first started Trazadone, I was so zoned-out and hung over that I literally walked into walls! The only reason I'm not taking Trazadone now is the weight gain side effect (I put on 40 pounds). I'm on Wellbutrin now and I'm still waiting for it to "kick-in" and releive my depression symptoms. Meanwhile, I've developed insomnia. It seems the trick to finding the right AD is finding the side effects that annoy you the least.
> Trazadone is great; a high dose will leave your with some memory loss and hung over in the morning. BUT...... it doesn't cause the tremendous appetite increase that Elavil caused me. Also, trazadone doesn't leave me with the dry mouth problem like Elavil.
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