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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 DKScully on January 14, 2007, at 15:36:50
OK, so I've been on Ambien, Lunesta, Amptryptiline, and Klonopin for sleep, and I went to my first psychiatrist appointment yesterday and was given Trazodone. I have a few questions:
1. I was told to take 25 mg for a couple nights and 50 mg if that doesn't work. What dosage are you on for sleep, if you take this drug? This seems like a low dose, from what I've read.
2. How long does it take to kick in? How long before I want to sleep should I take it?
3. It says on the instructions to take with food. Is that really necessary, for sleep? I don't usually eat before bed, but I guess I should, in this case?
4. What kind of success have you had with this med, for sleep?
5. What kind of side effects have you experienced?
Last night, my first night on Trazodone, was ROUGH. About an hour and a half after I took it, I was feeling so tired that I couldn't stay up any longer. Thought that was a good sign! But I didn't fall asleep. I spent the night lying there, sleeping in spurts with lots of odd dreams. This morning, I felt shaky, tired, and anxious (though the anxiety is probably me, not the meds).
Granted, I have been taking 3 mg of Lunesta, 1 mg of Lorazepan, and two Tylenol PMs to sleep on a regular basis, so the weirdness I am feeling and difficulty sleeping is probably more a result of withdrawal from those than it is a result of the Trazodone. I think.
Not sure if I should try 50 mg tonight. I am very anxious about this because I don't function well if I don't get enough sleep, and I don't want to have problems at work as a result of this... ugh!
I finally took 1 mg Lorazepan to alleviate the weirdness I felt this morning, and it helped immensely.
So, anyone have any ideas what's going on with me? I also take Lexapro, by the way.
Thanks so much, in advance, for your thoughts!
Posted by Buckeye Maniac on January 14, 2007, at 16:07:12
In reply to Trazodone for Insomnia--Seeking advice!, posted by DKScully on January 14, 2007, at 15:36:50
I have been on Trazodone for 5 days...and it helps me FINALLY sleep through the night. (100mgs)
(But I am 6'1 AND 235 Pounds)So far no adverse effects.
I am also on 200mgs Zoloft.
BM
Posted by DKScully on January 14, 2007, at 16:16:43
In reply to Re: Trazodone for Insomnia--Seeking advice!, posted by Buckeye Maniac on January 14, 2007, at 16:07:12
> I have been on Trazodone for 5 days...and it helps me FINALLY sleep through the night. (100mgs)
> (But I am 6'1 AND 235 Pounds)
>
> So far no adverse effects.
>
> I am also on 200mgs Zoloft.
>
> BMThanks for sharing, BM! I am 5'8", 135 lbs (female), so I guess the doses would differ in that respect!
Have you tried other sleep meds before this? How long does it take you to fall asleep after you take it? Did it work for you the first night?
Thanks so much for your help!
Posted by Phillipa on January 14, 2007, at 17:50:05
In reply to Re: Trazodone for Insomnia--Seeking advice! » Buckeye Maniac, posted by DKScully on January 14, 2007, at 16:16:43
Want to know too as it was suggested for me. I am currently on lunesta and valium. Love Phillipa
Posted by Buckeye Maniac on January 14, 2007, at 18:01:04
In reply to Re: Trazodone for Insomnia--Seeking advice!, posted by Phillipa on January 14, 2007, at 17:50:05
Well..Ive used xanax,Ambien combined with Benedryl, alcohol, Department Store "sleep aids" ( weak) Vicoden, and Niquil ( 3 tims the adult dose)
Trazone worked the second night...and has gotten better each night.
So I am a fan so far...I will let you know of any side-effects or if it stops working.
BM
Posted by fca on January 14, 2007, at 18:07:14
In reply to Re: Trazodone for Insomnia--Seeking advice!, posted by Buckeye Maniac on January 14, 2007, at 18:01:04
I am a big fan of trazodone--used it on a regular basis (3-4 times a week--25/50 mg)for 6-7 years with only a slight problem. If I used it nightly for several weeks I was more likely to have extra heart beats during and immediately after my morning run. This only happened when I was also taking SSRIs Good Luck and sound sleep
Posted by DKScully on January 14, 2007, at 18:11:26
In reply to Re: Trazodone for Insomnia--Seeking advice!, posted by fca on January 14, 2007, at 18:07:14
> I am a big fan of trazodone--used it on a regular basis (3-4 times a week--25/50 mg)for 6-7 years with only a slight problem. If I used it nightly for several weeks I was more likely to have extra heart beats during and immediately after my morning run. This only happened when I was also taking SSRIs Good Luck and sound sleep
Glad hear from a big fan of Trazodone, fca! How did you determine whether or not to take 25 or 50 mg of it on a given day? And how long did it take to "kick in" and help you fall asleep after you took it at night? Thanks!
Posted by DKScully on January 14, 2007, at 18:14:30
In reply to Re: Trazodone for Insomnia--Seeking advice!, posted by Buckeye Maniac on January 14, 2007, at 18:01:04
> Well..Ive used xanax,Ambien combined with Benedryl, alcohol, Department Store "sleep aids" ( weak) Vicoden, and Niquil ( 3 tims the adult dose)
>
> Trazone worked the second night...and has gotten better each night.
>
> So I am a fan so far...I will let you know of any side-effects or if it stops working.
>
> BMThanks, BM, I appreciate that! Your plethora of sleep drugs (prior to Trazodone) sounds so familiar to me. What time do you take it, relative to when you want to go to sleep? And do you take it with food?
Thanks so much!
Posted by fca on January 14, 2007, at 20:13:21
In reply to Re: Trazodone for Insomnia--Seeking advice! » fca, posted by DKScully on January 14, 2007, at 18:11:26
Nothing scientific in dosage--based on how I felt and if had slept well the night before--takes 40-60 minutes to begin working. Maybe a touch of morning grogginess but certainly no where as bad as having a difficult night
Posted by cgd092 on January 14, 2007, at 23:17:52
In reply to Trazodone for Insomnia--Seeking advice!, posted by DKScully on January 14, 2007, at 15:36:50
>
> 3. It says on the instructions to take with food. Is that really necessary,I never found Trazadone to upset my stomach.
> Last night, my first night on Trazodone, was ROUGH. About an hour and a half after I took it, I was feeling so tired that I couldn't stay up any longer. Thought that was a good sign! But I didn't fall asleep. I spent the night lying there, sleeping in spurts with lots of odd dreams. This morning, I felt shaky, tired, and anxious (though the anxiety is probably me, not the meds).
Since you've taken or are taking an SSRI antidepressant already, you shouldn't notice much anxiety from Trazodone. Also, if you cut out all your other sleep meds and switched straight to Traz, then perhaps that's why you didn't sleep so well.
But it did give me weird dreams. And a headache every morning after I take it.
Posted by UgottaHaveHope on January 14, 2007, at 23:28:34
In reply to Trazodone for Insomnia--Seeking advice!, posted by DKScully on January 14, 2007, at 15:36:50
Taking Seroquel is like being shot by an elephant dart. I would ask your pdoc for a sample of the 25 mg pack. Take it about 30 minutes before you plan to sleep. Providing you are not taking any other meds that cause the opposite effect (and I have no ideas what those meds would be, if they even exist), you will be knocked out. You will be groggy the next day, a side effect, but there is always a tradeoff with any med.
Posted by yxibow on January 15, 2007, at 1:44:55
In reply to Trazodone for Insomnia--Seeking advice!, posted by DKScully on January 14, 2007, at 15:36:50
As a female, you don't have the worry of what is not as uncommon as is listed -- priapisms, with trazodone.
You're probably right that you're going through cross-withdrawals from previous agents. It does sound like you suffer from chronic insomnia, I can sympathize.
I'm not a great fan of trazodone (Desyrel), but then I am a male and while young (I dont think its a good agent for older males -- priapism is probably harder to manage), I still have experienced priapisms at least twice, fortunately mild. I generally don't like the off use of non-sleep agents for their sedation. However if you've been through the laundry list of hypnotics (have you ever tried Rozerem ?), then maybe its worth a trial.
It can cause orthostatic hypotension (low blood pressure) and make you feel dizzy if you dont get into bed on time.
It can also idiopathically cause a high pulse rate for no known reason, although this is fairly rare.
It is an antidepressant dating from around the 70s that a full adult dose would put someone to sleep, I guess thus eliminating depression. Its cousin nefazodone (Serzone) is still used in depression as a generic but cautiously because it has some liver function problems for some individuals. If you have any psychosis, which I don't believe you have, it is not a good agent, as one of its main metabolites, mCPP can aggravate such disorders.
You may after a while become used to the effects of a 25, 50mg dose of trazodone and creep up into the serotonergic range of 100 or 150mg. This doesn't always happen but one has to backtrack to a lower dose and rinse and repeat, especially since you're combining it with another serotonergic agent.
Hopefully to a good nights sleep-- Jay
Posted by ronaldo on January 15, 2007, at 5:11:23
In reply to Seroquel is a miracle for sleep, posted by UgottaHaveHope on January 14, 2007, at 23:28:34
Hi UgottaHaveHope
I tried Seroquel for rebound insomnia from Zyprexa withdrawal. It wouldn't work. I tried everything from 6.25 mg to 100 mg and nothing worked. The closest I got was with 6.25 mg. I think the rebound insomnia was too strong for it. Perhaps I should have tried 3 mg.
ronaldo
> Taking Seroquel is like being shot by an elephant dart. I would ask your pdoc for a sample of the 25 mg pack. Take it about 30 minutes before you plan to sleep. Providing you are not taking any other meds that cause the opposite effect (and I have no ideas what those meds would be, if they even exist), you will be knocked out. You will be groggy the next day, a side effect, but there is always a tradeoff with any med.
Posted by UgottaHaveHope on January 15, 2007, at 10:54:10
In reply to Re: Seroquel is a miracle for sleep » UgottaHaveHope, posted by ronaldo on January 15, 2007, at 5:11:23
Ronaldo: Hmmm, that's interesting. Where you taking any other meds at the time? If so, it may have caused the opposite effect. I would give Seroquel another try when you get the chance. You can take anywhere from 6.5 to 400mg for anxiety/sleep. To me, the smaller doses have just as much as an effect as the larger doses. Wishing you well, Michael
Posted by DKScully on January 15, 2007, at 11:26:03
In reply to Trazodone for Insomnia--Seeking advice!, posted by DKScully on January 14, 2007, at 15:36:50
Thanks for your feedback, everyone!
To update:
I had a SLIGHTLY less bad night on Trazodone last night. I feel very sleepy, but it just doesn't seem to make me fall asleep or stay asleep. It's obviously better than I would be taking nothing....
Do you think I should try 50 mg? My psychiatrist said I could, if 25 mg didn't do the trick. Do you think two nights is giving it a sufficient chance? Is there any possibility that I would sleep WORSE on 50 mg?
Thanks again for your feedback, everyone. This site is wonderful!
Posted by yxibow on January 15, 2007, at 13:57:07
In reply to Re: Trazodone for Insomnia--Seeking advice!, posted by DKScully on January 15, 2007, at 11:26:03
> Thanks for your feedback, everyone!
>
> To update:
>
> I had a SLIGHTLY less bad night on Trazodone last night. I feel very sleepy, but it just doesn't seem to make me fall asleep or stay asleep. It's obviously better than I would be taking nothing....
>
> Do you think I should try 50 mg? My psychiatrist said I could, if 25 mg didn't do the trick. Do you think two nights is giving it a sufficient chance? Is there any possibility that I would sleep WORSE on 50 mg?
>
> Thanks again for your feedback, everyone. This site is wonderful!
Two nights is a chance if one has life threatening effects to anything. But a few weeks at least is generally more realistic for any agent, I would think
Posted by blueberry1 on January 15, 2007, at 15:31:44
In reply to Re: Seroquel is a miracle for sleep » UgottaHaveHope, posted by ronaldo on January 15, 2007, at 5:11:23
When I was withdrawing from zyprexa I tried seroquel. It put me to sleep but only for about 3 hours. It just wouldn't work. Tried 25mg to 100mg. I think zyprexa is deceivingly powerful.
> Hi UgottaHaveHope
>
> I tried Seroquel for rebound insomnia from Zyprexa withdrawal. It wouldn't work. I tried everything from 6.25 mg to 100 mg and nothing worked. The closest I got was with 6.25 mg. I think the rebound insomnia was too strong for it. Perhaps I should have tried 3 mg.
>
> ronaldo
>
> > Taking Seroquel is like being shot by an elephant dart. I would ask your pdoc for a sample of the 25 mg pack. Take it about 30 minutes before you plan to sleep. Providing you are not taking any other meds that cause the opposite effect (and I have no ideas what those meds would be, if they even exist), you will be knocked out. You will be groggy the next day, a side effect, but there is always a tradeoff with any med.
>
>
Posted by Buckeye Maniac on January 15, 2007, at 19:17:37
In reply to Re: Trazodone for Insomnia--Seeking advice! » DKScully, posted by yxibow on January 15, 2007, at 13:57:07
> > Thanks for your feedback, everyone!
> >
> > To update:
> >
> > I had a SLIGHTLY less bad night on Trazodone last night. I feel very sleepy, but it just doesn't seem to make me fall asleep or stay asleep. It's obviously better than I would be taking nothing....
> >
> > Do you think I should try 50 mg? My psychiatrist said I could, if 25 mg didn't do the trick. Do you think two nights is giving it a sufficient chance? Is there any possibility that I would sleep WORSE on 50 mg?
> >
> > Thanks again for your feedback, everyone. This site is wonderful!
>
>
> Two nights is a chance if one has life threatening effects to anything. But a few weeks at least is generally more realistic for any agent, I would thinkTwo nights is not enough of a fair trial for Trazodone. The label even says it may take up to 2 weeks to reach it full theraputic effect.
This is not uncommon...as most of us know that few drugs work immediately..especially an anti-depressant like Trazodone.
I am about 5 nights in..and I am getting better
results already.Give it a couple weeks.
BM
Posted by DKScully on January 15, 2007, at 19:48:31
In reply to Re: Trazodone for Insomnia--Seeking advice!, posted by Buckeye Maniac on January 15, 2007, at 19:17:37
> Two nights is not enough of a fair trial for Trazodone. The label even says it may take up to 2 weeks to reach it full theraputic effect.
>
> This is not uncommon...as most of us know that few drugs work immediately..especially an anti-depressant like Trazodone.
>
> I am about 5 nights in..and I am getting better
> results already.
>
> Give it a couple weeks.
>
> BM
>Yeah, I suppose you're right, I just feel like 25 mg is a really low dose and as someone who generally has a high tolerance for sleep meds, my suspicion is that I'll need 50 mg...
I understand that anti-depressants typically take time to work, but I guess I didn't expect this to take a while, since it's being taken for its sedative effects, which you'd think would occur immediately (as they do with other sleep medications)? I guess that's why I get discouraged, but yeah, I'll give it time, I just might try the higher dose and see how I do...
Thanks so much for your insight, it is greatly appreciated!
Posted by blueberry1 on January 16, 2007, at 5:40:19
In reply to Re: Trazodone for Insomnia--Seeking advice!, posted by Buckeye Maniac on January 15, 2007, at 19:17:37
I don't know. That sounds strange to me. A drug is either sedating or it isn't. Sure if it is being taken at a therapeutic dose for depression, which these low trazodone doses are not, then yeah it takes a few weeks for any possible antidepressant effect to kick in. But for the side effect of sedation, that should happen immediately on the first dose. Maybe sleep does tend to improve with time on traz, don't know. I kind of got the feeling that the time needed for antidepressant effect and the time needed for sedation side effect were getting mixed up here. Maybe I'm wrong.
>
> Two nights is not enough of a fair trial for Trazodone. The label even says it may take up to 2 weeks to reach it full theraputic effect.
>
> This is not uncommon...as most of us know that few drugs work immediately..especially an anti-depressant like Trazodone.
>
Posted by DKScully on January 16, 2007, at 7:12:49
In reply to Re: Trazodone for Insomnia--Seeking advice!, posted by blueberry1 on January 16, 2007, at 5:40:19
> I don't know. That sounds strange to me. A drug is either sedating or it isn't. Sure if it is being taken at a therapeutic dose for depression, which these low trazodone doses are not, then yeah it takes a few weeks for any possible antidepressant effect to kick in. But for the side effect of sedation, that should happen immediately on the first dose. Maybe sleep does tend to improve with time on traz, don't know. I kind of got the feeling that the time needed for antidepressant effect and the time needed for sedation side effect were getting mixed up here. Maybe I'm wrong.
>Yeah, that was what I was thinking... However, since I am probably experiencing withdrawal symptoms from the other stuff I was taking for sleep (Lunesta, Lorazepam, and Tylenol PM), I probably should give those symptoms time to go away.
To update you all again, last night (Night 3 on Trazodone), I took 50 mg, and I think it was better than the 25, but still not a great night's sleep. I actually feel better in the morning than I did with the 25 mg, for some reason. A little groggy, but not horribly so, and much less anxious (which may mean the withdrawal from the other meds is improving).
Posted by fca on January 16, 2007, at 11:42:42
In reply to Re: Trazodone for Insomnia--Seeking advice!, posted by DKScully on January 16, 2007, at 7:12:49
blueberry is right--one does not need to build up a blood level--it is intrinsically sedating--I can not imagine 50 or even 75 mg would be problematic--having never taken any other soporific I can only compare it with unmedicated restful sleep--with trazodone I never experienced the deep sleep and energy on waking that I did unmedicated but it was much, much better than the fitful agitated sleep I was having. Take Care
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