Psycho-Babble Medication Thread 64412

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Trazadone and Effexor XR..safe combo??????

Posted by DebbieLynn on May 27, 2001, at 10:33:13

My Pdoc just started me on Trazadone. (I currently take 225 mg of Effexor XR a day, 150mg in the morning and 75 mg at dinner time (about 6pm)) I take the Trazadone at night to help me sleep and stay asleep. He prescribed me 100mg pills, but told me to break them in half and start with 50mg at first. He said I could take up to 300 mgs, if it is necessary, but would probably feel hungover the next day. I have only taken 50mg, but I was reading a drug monograph, and it said they should be taken with caution, because of the risk of developing serotonin syndrome. I am really worried...but I do trust my pdoc...Does anyone have any input??? Any opinions or info is appreciated

 

Re: Trazadone and Effexor XR..safe combo?????? » DebbieLynn

Posted by Cam W. on May 27, 2001, at 11:32:29

In reply to Trazadone and Effexor XR..safe combo??????, posted by DebbieLynn on May 27, 2001, at 10:33:13

Debbie - There is usually no problem taking a serotonergic antidepressant like Effexor XR™ (venlafaxine) with a low dose of trazodone (Desyrel™). The problem of serotonin syndrome can occur (and then, not always) when you increase the trazodone to a dose where it's antidepressant activity kicks in (ie. 450mg to 600mg). Trazodone is not used much as an antidepressant anymore because it is far too sedating. The serotonin syndrome is definitely dose related. I have seen a mild case of serotonin syndrome in someone who was taking Paxil™ (paroxetine) at a 10mg daily dose and 100mg of trazodone at bedtime. When we lowered the trazodone to 25mg, the symptoms of serotonin syndrome went away.

Trazodone, in doses of 50mg to 100mg at bedtimes, are common used as a hypnotic in people taking SSRIs and other serotonergic antidepressants (except classical MAOIs, where the risk of serotonin syndrome is much greater). Trazodone is one of the safest sleeping pills for seniors, as well. I would try to avoid taking the 300mg dose very often, as it will affect your daytime performance because of the hangover effect your doc mentioned.

I hope that this is of some help. - Cam

 

Re: Trazadone and Effexor XR..safe combo??????

Posted by DebbieLynn on May 27, 2001, at 19:04:14

In reply to Re: Trazadone and Effexor XR..safe combo?????? » DebbieLynn, posted by Cam W. on May 27, 2001, at 11:32:29

> Debbie - There is usually no problem taking a serotonergic antidepressant like Effexor XR™ (venlafaxine) with a low dose of trazodone (Desyrel™). The problem of serotonin syndrome can occur (and then, not always) when you increase the trazodone to a dose where it's antidepressant activity kicks in (ie. 450mg to 600mg). Trazodone is not used much as an antidepressant anymore because it is far too sedating. The serotonin syndrome is definitely dose related. I have seen a mild case of serotonin syndrome in someone who was taking Paxil™ (paroxetine) at a 10mg daily dose and 100mg of trazodone at bedtime. When we lowered the trazodone to 25mg, the symptoms of serotonin syndrome went away.
>
> Trazodone, in doses of 50mg to 100mg at bedtimes, are common used as a hypnotic in people taking SSRIs and other serotonergic antidepressants (except classical MAOIs, where the risk of serotonin syndrome is much greater). Trazodone is one of the safest sleeping pills for seniors, as well. I would try to avoid taking the 300mg dose very often, as it will affect your daytime performance because of the hangover effect your doc mentioned.
>
> I hope that this is of some help. - Cam

Thank you so much for the info. I tried to look up information on the web, but you know how that goes. This post is great. It offers a lot of valuable information. When I decide to "wean" from the Effexor, do you have any suggestions??
I feel bad for questioning my pdoc's advise...but you never know because everybody is different.

Thanks again!!
Debbie

 

Re: Trazadone and Effexor XR..safe combo?????? » DebbieLynn

Posted by Cam W. on May 27, 2001, at 19:47:23

In reply to Re: Trazadone and Effexor XR..safe combo??????, posted by DebbieLynn on May 27, 2001, at 19:04:14

Debbie - You need to wean slowly from the Effexor XR. Ask your doc, but you will probably need to wean down 75mg every two weeks and then go to the 37.5mg capsules near the end. Some people need to increase the dose again if the withdrawl side effects appear.

If you type "Effexor Withdrawl" into the search function you will see some different withdrawl strategies, as well as what can happen if you don't wean from the drug slowly.

- Cam

 

Re: Trazadone and Effexor XR..safe combo??????

Posted by AmyL on May 28, 2001, at 15:59:24

In reply to Trazadone and Effexor XR..safe combo??????, posted by DebbieLynn on May 27, 2001, at 10:33:13

Hi,
I take 300 mg of Effexor in the am and 50-75 mg of trazadone in the evening. I've had no problems at all.
Good Luck!
Amy

 

Re: Trazadone and Effexor XR..safe combo??????

Posted by DebbieLynn on May 28, 2001, at 17:17:58

In reply to Re: Trazadone and Effexor XR..safe combo??????, posted by AmyL on May 28, 2001, at 15:59:24

> Hi,
> I take 300 mg of Effexor in the am and 50-75 mg of trazadone in the evening. I've had no problems at all.
> Good Luck!
> Amy


Really? How are doing on 300mg of Effexor? How long have you been on it? Are you on the XR too? Sorry for all the questions, but just today, I have notice that I have overflowing energy. Almost like I have taken "speed". Its weird. I am a little jittery too. I have been on 225 mg of Effexor XR for about 5-6 weeks. I normally take 50 mg of trazadone, but increased it to 75 mgs last night. Do you think that is why I feel this way today. I love the energy, but I not sure what is going on.

Thanks...Any info is greatly appreciated!!!!!
Debbie

 

Re: Trazadone and Effexor XR..safe combo??????

Posted by AmyL on May 29, 2001, at 8:46:34

In reply to Re: Trazadone and Effexor XR..safe combo??????, posted by DebbieLynn on May 28, 2001, at 17:17:58

Hi Debbie,
I've been on Effexor XR 300 mg for about 2 1/2 months now. The Effexor didn't kick in until about 4-5 weeks and then--boy what a difference. I'm back to the normal Amy!! No more depression or anxiety!! Yeah!

Regarding side effects--nothing really serious. The Effexor makes me burp a lot, the Trazadone at 75 mg makes me have some funky and sometimes scary dreams. I'm starting a full time job soon, so I'm having some problems sleeping, which is why I'm up to 75 mg. I usually take 50 mg with no wierd dreams, but as soon as I up it to 75, the bad dreams start.

Please feel free to ask any other questions!
Amy :)


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