Re: Heightened anxiety/agitation/jumpiness day after taking sleep meds
Originally Posted by
bg222
I've been taking Trazodone 100mg nightly for a little over a month for insomnia.
Was 100mg the starting dose, or did you start on less and it was subsequently increased?
Last week my doctor also added in Lunesta 3mg because the Trazodone was not effective on its own many nights. I'm able to sleep with this combo but shortly after waking up in the morning and throughout the day I feel SO jumpy and agitated. It's as if I drank 5 cups of coffee. I feel like I'm going to jump out of my skin and I feel really anxious.
Both trazodone and eszopiclone (Lunestra) have very short half-lives, around 10-12 hours for trazodone (I'm assuming you're on immediate-release tablets) and 6 hours for eszopiclone so I would expect the symptoms to be worse just after you wake up and easing through the day. I'm wondering if the drop in plasma levels of one or both is triggering these symptoms.
My doctor has written this off as "just anxiety" and wants me to try more meds to manage the anxiety.
He could be right. It's hard to tell. An anxious mind is very capable of generating our worst nightmares if given half a chance.
In the past I had awful experiences trying low doses of Zoloft (only took 3 days and stopped due to extreme panic attacks, appetite loss, diarrhea, etc.)
How low a starting dose?
and later Mirtazapine (took 4 days and despite sleeping ok was agitated/shaking so badly the next morning and day that I couldn't even type on the computer and was knocking things over). When I stopped both of these meds the side effects greatly lessened or stopped completely.
They may have lessened/stopped because you discontinued the mirtazapine, but it could equally be that stopping caused your mind to stop generating the symptoms. Despite what it says on the packaging, mirtazapine is really only an antihistamine, not AD, which mostly eases anxiety by sedation, not by tackling the underlying biological cause.
Because I had these horrific side effects with Zoloft and Mirtazapine I'm wondering if the Trazodone could be causing the agitation and anxiety I'm experiencing now.
The only way to know is by stopping trazodone. Talk to your doctor first though.
Maybe I am extremely sensitive to serotonin-targeted drugs?
Sertraline (Zoloft) is the only serotonergic med of the four. Neither trazodone, mirtazapine, or eszopiclone have much effect on brain serotonin pathways.
Or if it could be related to the Lunesta?
The usual eszopiclone start dose is 1mg. Did you start at 1mg, or go straight to 3mg?
Can anyone offer help for tapering off these meds for sleep? I've read about taking sleep meds every other night instead of every night as an initial way to cut dependence.
I doubt you have become dependent on either med after being on them such a short time. Their short half-lives further mitigates the risk.
Or I was thinking of reducing the Trazodone to 50mg to see if there's any effect from that.
That might be a good idea as trazodone is usually at its most sedating at the lower end of the dose range becoming less so as it increases with sedation being only a minor issue at the *doses at which it acts as an antidepressant, especially when taking slow-release formulations which are better at keeping plasma levels above the sedative threshold. However, you should get your doctor's okay on this first.
* 150-400mg/day for immediate-release tablets, 150-375mg slow/extended-release and up to 600mg for severely depressed hospital inpatients
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The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.