3 weeks on trazodone, feeling worried

Started trazodone 100mg per night on Friday 11th of June.
Today is the 3rd week on it.

My observations so far

• First 2 weeks - feeling very happy and no anxiety
• This week - feeling very anxious out in public places such as shops, getting bouts of dizziness at random times (felt like everything slowed down, thought I was going to blackout)

My question really is, are these just start up affects? Will it eventually get better in another say 2 weeks?
I have my GP review coming up in 2 weeks time so I can see what I am like then maybe...

I hope these are just start up affects cause the first week/second week was amazing!

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Originally Posted by irishman7

I hope these are just start up affects cause the first week/second week was amazing!

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Trazodone is still a potent sedative at 100mg and this can have a significant positive impact on anxiety hence the 2 good weeks, but this seems to be wearing off. The dizziness and derealization are most likely symptoms of the heightened anxiety rather than a direct med effect.

100mg is a low start dose. Antidepressive activity typically only begins at around 200mg and most take 225-300mg/day for good results. The maximum recommended dose is 400mg, 600mg in inpatient settings.

im moving up to 200mg tonight, will this help with my current chronic heightant anxiety im currently experiencing at 100mg :(

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Originally Posted by irishman7

im moving up to 200mg tonight, will this help with my current chronic heightant anxiety im currently experiencing at 100mg :(

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Probably not, unfortunately. The higher the dose the lower the sedation. On a more positive note, 200mg is about when trazodone starts acting as an antidepressant and begins initiating the brain changes which create the therapeutic response. If the anxiety gets unbearable talk to your GP asap as suffering is counterproductive.

How are you taking the 200mg, split dosing of immediate-release, or are you on a slow-release formulation?

Your right about the therapeutic response today was a lot better than the last few days/week. Maybe the 200mg will do the world of good, ill keep a close eye on it over the next few days. I have a phone appointment with the local GP next Monday. Im not sure about the type of trazodone, how do I find out if its immediate or slow release? maybe I ask the chemist, I take the 200 all in one go at night time

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Originally Posted by irishman7

Your right about the therapeutic response today was a lot better than the last few days/week.

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The therapeutic response doesn't kick-in after a single dose, I'm afraid. ADs work by stimulating the growth of new brain cells in the hippocampal regions of the brain. They provide the response, not ADs directly in say the way aspirin has an almost immediate effect on a headache. Unfortunately, brain cells don't grow overnight. It takes about *7 weeks for brain cells to grow, mature and form connections with other neurons across brain regions which is what seems to lower anxiety and/or depression, although some improvement can occur earlier.

*Yau SY, 2011; Kempermann G, 2015

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Im not sure about the type of trazodone, how do I find out if its immediate or slow release? maybe I ask the chemist, I take the 200 all in one go at night time

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Taking it only once a day suggests you are on slow-release tablets as immediate-release should to be taken in 2-3 split doses because of trazodone's short half-life. Slow-release meds usually have CR, SR, XL, XR in the name. Your chemist should know which variety you're on.

Sorry for the late reply its been a very busy week with work and local sport.

I was on the phone to the GP today and he said to continue with 200mg for a month and see how I'm doing, if I need to go up to 300mg he is happy to do it.

Im on the 200mg a week and 2days and I'm a lot more settled in myself im not high with anxiety which is brilliant!

I am going to the chemist tomorrow I will find out if I am taking immediate or slow release meds

I must say a lot of my anxiety is gone not 100% but im still hoping things will all fall into place :)

That's very good news. Sounds like you're on the right track :)

Hi Irishman,

I've just started trazodone. 50mg not sedating me at all. Im also withdrawing from Clomipramine 120mg went down to 90 for 3 days now on 60mg.

It'd be great to hear how you're doing now.

Take care,
Paul

HI Irish man itd be really great to find out how you're getting on