Antidepressants (SSRIs, SNRIs, MAOs, TCAs, TeCAs)

I am currently taking Trazadone and have been getting good sleep with 50 m an hour before bedtime. I have been taking them for 2 weeks. I am a little groggy when I wake up, but it passes after a couple hours. I am starting to feel nausea in the early evenings. Have you had any side effects with Trazadone and do the side effects abate with time? Thanks for your response.

 

The trick to finding the 'right' sleeping medicaton is to try different things until you find the one that works consistently for you. This may be an old-fashioned benzodiazepine (temazepam, oxazepam), a sedating antidepressant (amitriptyline, trazodone), a new-generation sleeping pill (zopiclone, zolpidem) or some combination - I tend to favor lorazepam 1mg + melatonin 5mg + Benadryl 50mg. In the end it doesn't really matter. You find something that works and does not prodice much of a 'hangover' in the morning. Discuss this with your family physician and commit to finding what will work for you.

 

@Dr. Ancill, my ENT prescribed me Lorazepam Normon 1 mg ( Spanish) are they safe? and are they ototoxic?

 

Hi yes trazadone 5omg has helped me a lot sorted me out and apart from a few night sweats I was feelin the best I have felt in years !! A few months roll on and I've had a blip just at a review with doc so I'm now on 100mg trazadone and the doc has halved my citalopram as to me sleep is my biggest hurdle ! 2 weeks into this and I'm doing ok I wake up sometimes but I don't panic and I go back to sleep so it's just a tweak in the meds to help ya cope with ups n downs ! I'm having major work challenges and need my sleep ! Cher xx

 

Thanks for your response Cher69. Did it take some time getting used to and did you have any hangover effect the next day? I might have to try something else as the 50 m Trazadone makes me feel kind of loopy all day, even though I sleep better. When I half it it's not enough sleep, and 3/4 is enough to make me sleep, but I still feel loopy all day. I will try taking the 3/4 a little earlier and see if it helps. Otherwise I may have to stop taking it. I also take 1/2 an Ambien. Ambien, I find, only gives me 4 hours sleep.

 

Thanks Dr. Ancill for your response. I will continue to look for the right combination. Lorazepam and Xanex was mentioned to me by my family doctor when I told him the Ambien only gave me 4 hours sleep. I thought I would try an anti-depressant first along with the Ambien before trying the lorazepam. If I do decide on trying lorazepam, I first will stop the trazadone, but I should wean off the Ambien first, correct?

 

I can feel a bit groggy at first but I soon shrug that off with an hours blast in the gym on my way to work ! X

 

quick update. I've been talking amitriptyline for 18 days. I also started taking chelated magnesium, and my T is definitely reduced. Still there, but probably down 1/3 or so. As long as I'm doing something, in school or in a conversation, I barely notice it. I do still strongly notice it at night, but when I'm listening to white noise it's almost completely gone. It hasn't helped my anxiety, but I do feel a bit more at peace and a bit less pessimistic.
Cons- Doesn't help me fall asleep much faster, but I want to sleep in the next day and getting up sucks. I've also had an increased appetite and gained a couple lbs, but my weight fluctuates all the time, not sure if it's the medicine.

 

I took amitriptylline for months it worked great in the beginning but I started getting
Loud spikes at night from it so I stopped it. I started on 10mg and went upto 50mg
During the course.

 

Cher, how many hours of sleep do you get with the 50 m Trazadone, and do you only take the one med? I am getting more used to it, but still experiencing nausea. I might have to try something else.

nightman, I was wondering about the amitriptyline. What dose do you take and how good is the sleep you get from it? Thanks. I am having trouble with Trazadone and might have to try something else.

 

@patty I usually get off to sleep no problems - if I wake up - I often do its about 1-30 ish and I hopefully get back off to sleep wihtin 30 mins or so - I then sleep to 5.30am - I haven't slept 6am for over a year and Im coping with this routine now - I get up an get on with the day - its amazing what you can do in the firt 1 hour of the day.

Trazadone has given me night sweats - but not all the time and that's manageable - Im now on 100mg though and the doc reduced my citalopram

Cher x

 

Hey @Cher, just wanted to say it is nice to see you back on the board! Hope all is well with you and your family, and that spring is coming soon to York. Sorry about your work challenges. Having a few of my own right now...

Trazadone works well for a lot of people. Unfortunately, anti-Ds in general seem to be a problem for me and trazadone left me feeling completely wacky the next day. Right now, I am taking Rozerem (a newer drug, made primarily with the active ingredient with melatonin) plus a very small amount (.5mg) of the anxiety benzo alprazolam (Xanax). I get off to sleep, but usually am awake about four-five hours later. Usually can fall back for another couple hours, but not always. My doc and I are continuing to work on the right combo. Like @Dr. Ancill said, its trial and error.

Oddly enough, while my daytime anxiety is doing pretty well, I still struggle with night-time anxiety. I sometimes wake up in the middle of the night feeling panicky and anxious. When I do, I take another .25 mg alprazolam.

 

Hi my friend @LadyDi sleep is such an issue for us t people ! I'm happy if I get 5 or 6 hours if I get unbroken sleep I'm so happy and proud I've slept !!!! I usually wake 1am 2am ish I do tend to worry will I sleep again if my meds r working I don't panic and snuggle down to sleep but that can be 1 hour later ! When my meds r not working I can be tossing n turning and really not sure how much sleep I get.

I just wish I could accept sleep as normal why does sleep consume me ! We take it for granted when we sleep and worry when we don't!

I really wanted to be off the meds by now and sleep naturally will I ever do that I don't know ! The doc is happy to carry on with meds and I'm happy motivated busy active so a few tablets is small price to pay - but it's not normal is it ?

I've accepted I have T for life I hoped I would be off tablets and living life as before without meds - but for now I just think how far I have come how happy I am now I have energy and I sleep enough to cope - so meds / Anti D tablets are part of my life but gosh its amazing how many people need ths support . It a sign of the times I think - we have toooooo much pressure in life !

I hope you are well - UK is showing the signs of spring - bring on good weather - long walks with my boy Dylan and exciting times with family - much love - cher x

 

If you change from Ambien (zolpidem) to lorazepam, the lorazepam will cover any withdrawal effects but discuss this with your doctor.

 

There is no 'magic' answer to what to take for sleep - it is highly individualized. I start my patients on lorazepam 1mg to reduce their pre-sleep anxiety + melatonin 5-10mg to trigger sleep + diphenhydramine (Benedryl) 25-50mg to keep them asleep for about 6 hours. I adjust according to response.

 

Just one quick comment. I couldn't tolerate Remeron at all! Made me a complete zombie. If it works for you, it may well fix any insomnia issues you may have. In fact, all you may do is sleep. LOL. Really, I've read that it does work very well for some people. I left my doctor who I'd seen for many years because she absolutely wouldn't listen to me when I said that I couldn't get use to it or tolerate it despite my best efforts. Losing 2 weeks of my life was trial enough in my opinion. My issue at the time was insomnia. I had to move on and try something else. It turned out that HRT completely relieved that problem, at least until my tinnitus became a big issue again. Now I'm having my hormones checked to see if that is behind my recent surge in tinnitus. I went for a blood test yesterday and won't get the results for several more days. Haha, I guess that wasn't so quick a comment after all.

 

I couldn't tolerate Remeron either. Tried it for three weeks and made my tinnitus so much worse. I'm still in the process of recovering from it, 4 months later.

 

Why is lorazepam such a favorite in the medical community among benzodiazepines? I'm just curious. Is it because it is not metabolized in the liver?

I can understand a reluctance to use alprazolam, as it has such an incredibly short half life. Why not use a longer half life drug like clonazepam? Like I said, this is just my curiosity, and I would like a physicians opinion.

 

clonazepam has mostly anti-epileptic properties and not much hypnotic properties, nowadays Z-drugs should be prescribed instead of benzos but they are mostly very hard to get(at least where i live).

In thailand, getting flunitrazepam or any other hypnotic benzo ( estazolam, nitrazepam, temazepam, triazolam) out of a governement hostpital is an easy job but a no go with Z-drugs.

 

Thank you Dr. Ancill.

 

Do anyone of you know if taking amitriptyline will make things worse? Having both T & H I am nervous about medications. Though my ENT thinks it will help both T&H.

 

Hi Demi,
I never had this drug. But something to relax might help.
I took a small dose of Temesta for a few days, and it helped me to relax and sleep. I was very afraid
to take such medications, but if you try it out savely and with your ENT, it might help you.

I just found this:
http://www.ncbi.nlm.nih.gov/pubmed/11771024

Greets tomytl

 

Interesting study, however that dose is quite high. Usually they will start you at 10 and move up from there. What dose did doc prescribe Demi?

 

Demi .. You have to be very careful with Anti Depressants as some of them can increase tinnitus symptoms for a few weeks.. This happened to me with this drug ..no 2 people react the same and it may well be fine for you..but im just saying...

 

i take all sorts of meds, and i am not really happy with what i am taking, but i have no choice - otherwise i cannot sleep. This is due to the doctor who put me on elavil in the first place. My "treatment" for tinnitus was completely wrong, and now i am paying the price - severe unrelentless tinnitus and huge med intake.

 

Can I take Zanaflex (=Tizanidine, sirdalud?) or does it make tinnitus worse? I would like to have quick answers, thanks!

 

Just wanted to follow-up and let folks know that Trazadone definitely helps for sleeping. It takes a long time to get used to, and it took me over 3 weeks. I came very close to giving up on it. I now take 75 m Trazadone along with .5 m Ambien and sleep good most nights. I think I will try to slowly taper the Ambien, and see if I can get by with the Trazadone and some Melatonin. I suggest anyone wanting to try Trazadone start out small (25m and work your way up) so you can get used to it more easily.

 

@Street Spirit It is a very small dosage to start with, 10mg

 

Yes, that is what I was prescribed as well. I am still debating.