Trazodone

[teej]

Well as some of you might know I've bumped around pretty much most of the popular medications for anxiety now.

I had a horrendous paradoxical reaction to citalopram, escitalopram and sertraline to the point where I ended up being admitted to hospital as a lunatic alcoholic wreck (that isn't really me :blush: - probably my lowest point).

In hospital I was put on Mirtazapine which yes helps me sleep but I seem to be also developing a paradoxical reaction to that so I'm starting to taper off. Thankfully dropping the dose has provided some fairly immediate relief.

I've also tried Pregabalin and lasted 4 days on that before bailing due to the side effects (I couldn't breathe properly so fairly serious!).

I ventured across Trazodone the other day as it has a similar (from my uneducated viewpoint) pharmacological action as Mirtazapine. For two months the mirt has been my friend mostly as it's been fairly tolerable as an AD for me.

I mentioned to the duty doctor this morning (whilst asking to come off the mirt) about trying it and was put down because it was "very sedating and we only give it to old people". Now before I get my keyboard bent out of shape writing to the practice manager is this true?

Based on my spotty history with medication is it something worth pushing to try or should I just drop the issue with the doctors (I'm not substituting medical advice for advice from a forum but since my doctors seem to be just guessing now...)?

Your thoughts are most appreciated.

[bernie1977]

I was put on Trazodone as I can't tolerate SSRI/SNRI meds. I tried citalopram, venlafaxine and duloxetine. I was on mirtazapine for a while but I wasn't happy with the weight gain. I've been on Trazodone for a few years now and it's always been kind to me. It was a psychiatrist that prescribed it for me.

In higher doses it can leave you sluggish on a morning. For treatment of anxiety and depression I think 150mg is the normal dose. You take this medication on a night and I'm normally asleep within 15 minutes. You need about 9 hours sleep to take the worse of the grogginess away.

[pulisa]

I think you may find it difficult to be alert enough for work to begin with,teej as trazodone has a very sedating effect.

[teej]

Thank you all for your replies.

Perhaps this might be one worth giving a try when I have some time off from work. I checked yesterday and I need to take a month off between now and December so it's a possibility!

I normally am getting 12 - 9 hours sleep in a night since I'm quite a heavy exerciser (keeping the mirt weight gain vaguely acceptable).

Interesting... :scared15:

I'm seeing "vaguely competent" doctor in 9 days so I'll bring this up as a possibility.

[AnxiousBaker]

Trazadone for me has helped wonderfully. If you ask to start on a low dose, say 50mg, you shouldn't feel at all sluggish in the mornings with very very little, if any, side effects. It is similar to Mirtazapine but that one works a great deal on histamine receptors. It put me into a coma pretty much when i tried it. Yet traz is fantastic.

Give it a go!

[teej]

I'm seeing my regular Doctor next Monday so I'm going to mention this and push for a referral to psych as this has all gone on for so long now.

Clearly the duty doctor didn't know what he was talking about. :lac:

[SADnomore]

Hi, all,
Wondering: if Trazodone doesn't work on the histamine receptors, does anyone know what it does work on, and whether it would be compatible with venlaxafine concurrently?

Good luck, teej! xx
Marie

[AnxiousBaker]

I think both Traz and Mirt do work on the same receptors just in different ways. Traz has a sedating feeling for many which is just right whereas mirt can be very potent, due to the histamine receptors and certain 5-HT2 receptors it works on. Traz seems to hardly touch any receptors that play a part in making you hungry, unlike mirt. They are both antagonists and dont have any real re-uptake ability like SSRI`s do, hence the very small side effects list.

Then again some folk find mirt fine and traz terrible! How amazing the human brain can be!

[teej]

Well I'm seeing the Doctor next Monday so I'm definitely going to ask about this if she insists on me taking *something*. Thanks for your responses.

[Emphyrio]

I've not taken it myself so I can't comment on this drug personally, but Trazodone has an active metabolite, meta-Chlorophenylpiperazine (mCPP), which can be very 'activating' and thus worsen anxiety. What this means is that while Trazodone itself can put you to sleep, the following day you can feel on edge and agitated. Just something to think about.

Trazodone can interact with a lot of other drugs as well.

[teej]

I've not taken it myself so I can't comment on this drug personally, but Trazodone has an active metabolite, meta-Chlorophenylpiperazine (mCPP), which can be very 'activating' and thus worsen anxiety. What this means is that while Trazodone itself can put you to sleep, the following day you can feel on edge and agitated. Just something to think about.

Trazodone can interact with a lot of other drugs as well.

That's a bit disappointing. Well I'll give it a try and see. I think it's pretty much going to be the last thing I try before coming off everything. I feel on edge and agitated on the Mirtazapine at the moment anyway.

[SADnomore]

Good luck, Teej!
Did you get a scrip from the gp, or are you waiting for referral?
Marie

[teej]

My doctor prescribed them to me. I'm still having a very hard time coming off the mirt and she seemed to think a cross taper onto this would make things a bit easier.

No referral yet until she feels she has exhausted all her options so :shrug:.

[AnxiousBaker]

I hope trazadone works for you, it really does have its benefits over some other meds.

[pulisa]

I suffer from "agitated" depression and got prescribed trazodone after exhausting every other possibility. I have to say that it did nothing for me but I reckon that dealing with the agitated form of the condition can be the most tricky in terms of meds. For me the lowest possible dose of escitalopram (5mg) has kept things relatively stable whereas high doses of other SSRI/SNRI/moclobemide have been either ineffective of have hospitalised me with absolutely unbearable agitation.

I do hope that the trazodone helps you deal with getting through the day/night. It's certainly worth trying.

[teej]

Well as Emphyrio suggested the trazodone metabolizing down into meta-Chlorophenylpiperazine absolutely messed me up yesterday in a big way. Thank goodness I recognized quickly. Such a shame because initially the sedative effects worked very well, but within 6 hours I was beginning to exhibit behaviours I had previously associated with taking sertraline and within 14 hours I was having a full blown SSRI level panic attack / anxiety.

Clearly the agonising of my serotonin receptors is not something I can cope with!

I took 15mg of Mirtazapine again last night on its own to start reversing the process so I'm pretty much back where I started. Oh well. Live and learn!

Not sure what the future holds now. Hopefully I can push for a referral and tell someone who understands all this what's happened.