Trazodone 50mg - how drowsy?

[Sparkling_Fairy]

Hey guys,

I'm wondering if anyone has experience with 50mg Trazodone as a sleep aid, and how drowsy it makes you?
Sertraline didn't agree with me at all, so my GP wants me to try Trazodone instead. Not particularly for anxiety. I take Propranolol which has greatly reduced my physical symptoms, and now after a few months my anxiety about my symptoms is finally starting to subside. He prescribed it as a sleep aid, because I'm not sleeping well at all.
He prescribed it a month ago, and I've been too afraid to take it. Which annoys me, because I was equally afraid of the Propranolol and now I'm so happy I took it, because I feel so much better on it!
But my fear with the Trazodone is that it will make me feel really drowsy, still not be able to sleep, and then I have to hold onto the walls if I need to go to the bathroom or something.

I'm just wondering how drowsy it makes you. I know that's different for all people, but in general what people's experiences are with it?

Thanks in advance!

[panic_down_under]

Trazodone is unlikely to poleaxe you the way you fear, but why not ask your GP if you can cut the dose in half to see what effect it has on you (I'm assuming you've been prescribed an immediate-release formulation). The reason it is the med of choice for SSRI induced insomnia in the U.S. is that it has a very short half-life, about 9 hours, so its effect doesn't usually carry over into the next day the way other meds prescribed for insomnia often do.

BTW - trazodone is a pretty good antidepressant which usually produces fewer side-effects than SSRIs and other ADs. Its main issue has been the sedation, but slow-release formulations have lessened this by better maintaining plasma levels above the sedation threshold. The usual antidepressant dose is in the 200-400mg range, up to 600mg for hospital inpatients.

You might find this useful: Stahl - Mechanism of Action of Trazodone: a Multifunctional Drug (PDF (http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.605.7477&rep=rep1&type=pdf))

[Sparkling_Fairy]

Thank you! I can’t cut it in half because it’s a capsule.

Guess I’ll just have to brave it. I feel really sleepy all the time anyway because I’m not sleeping.

[panic_down_under]

You could open the capsule to remove some of the contents, or mix the contents in a measured quantity of water and drinking only half immediately and discarding the other half - WARNING: it has a bitter taste. See: Trazodone, appropriate formulation choice and use guide (https://mypsych.nhsggc.org.uk/media/1553/trazodone-appropriate-formulation-choice-and-use-guide-clinical-guideline-final-draft-171220fdocx.pdf) (PDF).

But you should discuss that with your GP first.