Survivor1

Survivor1: Sleeping after trazodone (and benzo)

251 posts in this topic

The melatonin really seems to help me get back into a rhythm of sleep. If I have 3 nights in a row where I take too long to sleep I will take melatonin for 3 - 5 days and my sleeps seems to re-set itself. I have read that the effect can wear off that is why I only use it for 3 - 5 days and then stop until I hit a rough patch again. If you read the thread though you will see you need to be careful not to take too much as it can have the opposite effect and make you feel depressed in the morning. If you can find 1 mg pills, then cut them in quarters. I can only find 2 mg pills so I cut them in 1/8ths. That is closer to the amount your body naturally makes. Here they recommend taking it at night fall. I take it about an hour before I want to sleep and that seems to work. Best of luck to you getting some more zzzzz's.

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I have read the Sleeping tips several times - no luck yet.  Herewego, I have tried melatonin, but even that does not work.  Thanks for responding, I'm glad it is working for you.

 

 

Any responses to the question I posted on Oct 3?

 

 

Thanks again all.

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SW answered that question already.

What is it you would like to read??

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To keep things clear, I've quoted your Oct. 3 post and added dates [in square brackets and brown text] related to your experience with trazodone:

I am beginning to suspect that I am getting tolerant of Trazodone.  

  • Before the rapid taper , I was on 75 mg and initially [Oct 2015] was getting about 7 hrs of sleep.  
     
  • It [sleep] slowly deceased to 5.5. [by April 2016] This decrease was what prompted me to get off it (too quickly of course).  
     
  • [tapered 75 mg to 0 mg over two months, ending in June 2016]
     
  • After I reinstated [July 25, 2016] and got up to 50, I slept well for 6-7 hours for about a month, then I noticed the decrease beginning.  
     
  • By the second month [September 2016], I was sleeping for 4 broken hours a night.  

I have seen a decrease in most of my symptoms, but  if Traz has fizzled out and there is no more sleep improvement, would it be better to start reducing slowly?

...

I would like to know what you all recommend when holding does not lead to more improvements, even though a few symptoms are intolerable right now.

 

Seroquel usage from your signature:

 

May - June 2016: Used on alternate nights for 6 weeks during last weeks of rapid taper and a few weeks following (up to 25mg).

Use as a rescue med, 10 mg, when sleep is poor (used for 7 nights between Sept 1-12; dc Sept 12)

 

It definitely reads as if you are not reacting to trazodone as you once did.  I'm going to ask other moderators to review your situation and to suggest a possible next step.

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Thanks very much!

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Update ...

 

Last night was the fourth night on 62.  Worked first night 6 hrs sleep.  Last three nights only 3-4 hrs.  Since on it for only 4 nights, should I kick it back down to 50?

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Survivor1, at some point you will probably need to ride through a wave of reduced or little sleep to get off psychotropic medications and retrain your sleep process. Otherwise you'll be either

  • adjusting dose up and down -- for a long time -- to get the sleep you're expecting and wanting,
    --- or ---
  • taking another prescription medication to induce sleep.

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Scallywag,

 

As hard as it is, I agree with you.  Is there anyone out there who went on 3 or less hrs sleep for over a year of tapering?  How do you manage?  I am scared witless of this; I have a job and two kids!  Just looking for some support.

 

I know that I cannot updose anymore as Traz seem to be ineffective.  And I'd be lying if I said I haven't thought of adding a third med.  In a moment of insanity I even considered a benzo!!

 

I am not hopeful that I will see any sleep improvement no matter how long I hold

 

1) Should I consider tapering? If so, at the usual 10%/mo?

 

2) Is it possible to see any sleep improvement while I am on this med (tapering), or do I have to be completely off to see any sleep improvement?

 

Thank you for your help.

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I think Scallywag put it as well as it could be put.

 

Seems your system accommodates to trazodone after a while.

 

Many people here have gotten through phases of poor sleep. It's very common in withdrawal.

 

What are you taking for your hypothyroidism? Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html
and copy and paste the results in this topic.
 

Is it possible your thyroid meds need adjustment?

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Altostrata, fortunately, my thyroid level is OK.  Was checked only two weeks ago.

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Almost all of us want and seek 100% accurate predictions about what is going to happen -- how long a symptom will last and how intense it will be. Nobody can offer us anywhere near that level of certainty. :(
 
There are people posting on this site who have gone for long periods of time, months and months, on very little sleep. None would recommend it to others, but they are surviving (working and having as much of a life as possible) and/or made it through.
 
If I were you, I'd consider the 10% taper. You may need to switch to a liquid to get the doses that are difficult to achieve with cutting a tablet. If you do switch to liquid, keep your dose the same and treat the switch as a dose reduction, i.e. hold at liquid dose for several weeks.
Making a liquid from a tablet or capsules

 

Traz is "sparingly soluble" in water, so it's more of a suspension than a solution. You'll need to shake the liquid before using a syringe to draw the dose from the center of the liquid.

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Altostrata, fortunately, my thyroid level is OK.  Was checked only two weeks ago.

 

So you're not taking thyroid hormone?

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Yes, I am. I added it to my signature.

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SW, sorry I missed your last reply.  A few developments:

 

I believe that I am having a "mini" seroquel w/d.  Looking back at my notes, I see a return of symptoms of w/d such as fatigue, night sweats, anxiety, when I discontinued Seroquel  on Sept 12 that had abated when I first updosed to 50.  I had not clued in that Seroquel could be the cause. 

 

On top of that, to get 62 mgs T, I halve a 100 mg tablet and quarter a 50 mg tablet.  One night I liquified the 50 mg tablet and took a quarter (along with the 50 mg half); the rest of the liquid I refrigerated.  Turns out that the refrigeration degraded the suspension and I was in effect using only 50 mg from the halved tablet for three nights.  Started having brain zaps, twitching, immediately.  Re-reinstated to 62.  (Confusing, I know!).  Brain zaps and twitching have reduced.

 

I am now having insane anxiety and depression issues.  The only upside is this past week I have been able to get 5 hours of broken sleep.  I am hoping this continues; if so, I will hold off tapering for another few weeks in the hope that the anx/depr diminishes.

 

I am not looking for an accurate prediction on what will happen, only some hope that sleep could improve while tapering, as I can't imagine functioning like this for 1-2 years of tapering.

 

Thank you so much for your advice and patience in reading my story.

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So the liquid you made degraded over 24 hours? Or was it 72 hours?

 

You should be able to stabilize after going back to 62.5mg Seroquel. It may take some time. Keep steady on this dose, take it at the same time each day.

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Hard to tell if it was 24 or 72 hrs. By the time I used it up three days later, I had developed the twitching, etc.  I have gone back up to 62 mg (Trazodone, not Seroquel), but am having a really difficult time with the sky high anxiety and depr  :(.  I will keep the dose for a while.

 

Thanks Altostrata

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Hello,

 

Updating my status ... most symptoms have improved, but jelly legs/disorientation, anxiety and depression remain fairy high.  And sleep has devolved to 4 hours broken  :( I am still holding but the sleep thing is adding to the anx and depr.

 

One burning question (pardon me if it has been answered before):  can sleep improve as doses get lower and lower (during tapering) since some receptors are freed up?

 

Thanks as always.

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Two days later and sleep is worse ... about 3hrs/night. But anx seems more improved since last post.  Tried a supplement called Somnapure that has melatonin and a few others like valerian root. Gave me nightmares.  Still feeling shaky ...

 

Was wondering if it's recommended to begin tapering since it's been a month from the last reinstatement, even though some wd symptoms are still present.  

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Sorry to hear that you had nightmares. That's rough when you're already dealing with not getting the sleep that you want and need. If you wanted to test that supplement, you could try taking a smaller amount, ¼ or ½  a capsule or tablet.

 

Which of the Tips to help sleep have you tried?

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Scallywag, thanks for the reply.

 

I actually took 1/3 of the tablet as the whole one has 3 mg melatonin.  Both mornings I took it, I was very groggy/shaky, and today woke up in a deep funk.  As I write this, the depr seems to have lifted somewhat.  Don't know whether this was due to the melatonin, or just the depr I had been having (had not been this bad though).   I am trying to limit this supplement has it has a lot of ingredients that affect GABA receptors, and since I am a recovering klonopin user, I don't think it would be good for me long-term.

 

Regarding the sleeping tips (note I couldn't access the link on the second page - the one with Altostrata's post), I have a white noise machine, blackout shades, practice proper sleep hygiene, use guided meditation, lavender oil on my pillow, and magnesium 250 at night.  I actually do feel sleepy 50% of the time, and head to bed right away, around 10 pm.  Most nights I fall asleep within an hour of taking trazodone, but the frequent wake ups have become debilitating and I have to wake up at 6:30 am like many people. 

 

Would you recommend beginning a (micro)taper now, or continue to hold to stabilize further?

 

Thank you for your support!

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How are your symptoms? What is the daily pattern if any?

 

Would you add the dates that you reinstated traz to your signature?  I think the timeline is something like this:

  • reinstated to 25 mg at the end of July
  • updosed to 50 mg in early August
  • updosed to 62 in early october

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Timeline is correct.

 

I have seen an improvement in most sxs, especially in the afternoons.   Biggest improvement in anxiety in the last two days.  Currently anxiety 3/10 (had been a 9), depr 4/10 (this morn 9), anhedonia 4/10, shakiness 3/10, jelly legs/disorientation 4/10, insomnia 7/10 (All but insomnia had improved but became worse after my accidental drop to 50 traz for 3 days in early Oct.)  Don't know what I'd do if insomnia got worse. All other sxs 1 or less.

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Please add the timeline to your signature. It's easier for us to get the full picture when the approximate dates are there.

 

Do your symptoms change intensity dramatically throughout the course of a day, or from day-to-day?

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Timeline added.  

 

Sxs usually do not change dramatically throughout the day, or from day to day. (Except for today's depr.)

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Hey survivor

 

I was just reading your post and happen to be in the same sleepless boat. it hard to believe how many many folks taking the insomnia train from these meds. I am 2 1/2 years out from cold turkeying Zoloft and zyprexa and the insomnia is still bad. Oddly enough, I was sober for 15 years previously and have started drinking again as a way of getting sleep. A little bit unorthodox, I know. I wish it didn't have to be this way and that my sleep rhythms would reestablish themselves, but for the past 5 months, 3 or so beers has been allowing me 5-6 hours of sleep a night and even occasionally a nap later in the day. I still have fatigue and cognitive problems from all the lousy sleep over the last 2+ years. I tried trazadone twice in wd and only got 3 1/2 to 4 hours of sleep and suffered all day dizziness the next day. I hope you the best with your sleep issues. I know how frustrating and maddening this all is.

 

Poetjester

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Hi Poet,

 

Thanks for your support.  I wish I could use alcohol, but since I dc'ed klonopin, I do not want anything that would compromise the GABA receptors, which alcohol binds to.  I'm glad you are finding some relief! Insomnia is a *****.

 

Best wishes to you!

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Hi Survivor. I think a good bet would be to hold at your current dose of Trazodone of .62 if you want your sleep to improve. You probably have some healing from the benzo leftover even though it's been a while. I know I did when I first started tapering Traz. That is why I went slow to give my symptoms a chance. When I held longer on the Traz (months) I got some days of really long restful sleep. I understand how you feel about getting off quickly. We all do but sometimes if we slow it down we really see progress. Good luck to you.

 

Marie

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Marie,   I will keep holding, thanks for the input. And good luck with remeron!

 

Scallywag, after what seems like improvements in most areas, I seem to have worsening of others: twitching, zaps, insomnia (last night 2 hours), disorientation.  It's hard to imagine that trazodone would conk out completely so I am wondering if I am in a wave from seroquel d/c.  Do you think I would benefit from a low dose reinstatement of it (maybe 1 or 2 mg)?  I am not able to manage on such little sleep, and while I do not know if this would resolve anything, maybe it is worth a try?

 

Thanks.

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It definitely sounds like a wave. It's hard to say what the source is though -- changes in traz doses or the absence of Seroquel.  Are you keeping notes on paper of your symptoms?

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Yes, I'm keeping notes.  I think if tonight I get 2 hours sleep, I'll have to think about reinstating a low dose of Seroquel.  Please let me know your thoughts.  Thanks.

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It's a complete roll of the dice or "craps shoot" about reinstating Seroquel would make a difference for you. It's really unclear what would help right now after last year's fast taper off trazodone and then this year's introduction of Seroquel and subsequent fast taper off it, followed by a reinstatement of trazodone with a few updoses.

 

In your first post you report having started taking klonopin as a result of hypothyroid-induced insomnia. Have you had your thyroid levels assessed recently? If yes, what did the lab tests show?

 

edited to add: Do you see a pattern in your symptoms? Please post the last few days notes of symptoms and doses here in your intro thread.

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Thyroid levels are OK  (TSH 1.5, range 0.45-4.5;  Free T4 0.99, range 0.82-1.77; T3 90 range 71-180).  Tests done 9/30/16.

 

There does not seem to be a pattern to my symptoms.  In the last week, overall anxiety and depression decreased, but I had a few random spikes.  Today anx is there but different - not the stomach churning kind like I had been having but from worry - that I will not be able sustain any decent sleep over the two years+ that it will take for me to taper Traz., and how to manage my job and kids on 2 hours sleep.

 

Other persistent symptoms are shakiness, weak legs/disorientation, inability to enjoy things, faint brain zaps, mildish body twitches/alerting sensations, sensation of freezing skin, but there has been some improvement in most. And of course, insomnia, which is unrelenting.  I feel I can manage with the symptoms except the sleeplessness.

 

Last night I added 0.5 melatonin, 500 mg lemon balm, and 200 l-theanine, and got 6 hours broken sleep! The alerting was less, but I still woke up three times.  I am excited about this but I know amino acids are not long term solutions, so my anx is what to do when this effect conks out - I know I need to take this day-by-day but I can't help the ruminations especially with the last week of bad sleep. I am super groggy this morning from this cocktail, but will take the sleep anytime.

 

By the way, I spoke to my doctor about the situation, and while she sympathizes, she advocates adding a med for sleep like doxepin, or klonopin  :(

 

Thanks very much.

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Good to read that you got a decent night's sleep last night.  Fingers crossed for it to happen again tonight.

 

A few years ago I was prescribed lorazepam to help with sleep. My psychiatrist told me to be very, very careful because it wouldn't take much to cause worse problems than I was having.  Based on that advice I made a rule for myself, that I would only take a half-dose after 2 nights of no-sleep. 

 

If your newfound combination helps for a few days, you could try tapering it down bit by bit and then use my "only if I really, really need it" rule.

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SW ...

 

Well, after the second night on this, I had 5 hrs broken sleep.  However, both mornings I felt extremely anxious and depressed and overall not well at all - worse than when I did not take it despite the sleep.  I do not think I should take this cocktail for more than 1 night.

 

At this point, I am extremely scared.  I toy with going back on seroquel, but am afraid that it may poop-out like trazodone.  If I do not add anything to traz, I am relegated to 2 hrs sleep per night.  I feel that all my other symptoms are very manageable.  But how to deal with this insomnia without getting on another drug?

 

Since traz is not working, I would like to start tapering.  Please let me know what you think.  Could sleep possibly improve as the taper progresses?

 

As always, I appreciate your advice.

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Survivor,  I'm sorry the promise of the new herbal combo didn't work out.

 

Given what I've seen with other people, I would hold at 62 mg until the insomnia lessens and you know what your withdrawal normal looks like. Both increasing and decreasing dose pose risks. When experiencing withdrawal symptoms, stability is almost always better than making a change.

 

In the last 15 months you've gone through

- a fast taper off a benzo a year ago,

- a fast taper off trazodone this year

- starting and stopping seroquel, June - Sept.

 

That is a lot for a person to cope with neurologically. Another change is unlikely to help.

 

It's possible that you will be dealing with sleep issues for an extended but finite period.  For public consumption, I'll only say that it's awful and rotten that you are facing this, although there are numerous vile and vulgar words and expressions far more appropriate to describe the situation. I wish I could be more helpful.

 

 

In my fatigue and mild fog, I couldn't recollect your situation and had trouble discerning it from your signature and therefore spent a bit of time reading several posts to get the picture. If you feel like updating your signature to make the details easier for foggy-minded moderator moments, feel free to use the modifed version below:

 

Current medications: 62 mg trazodone; NatureThroid 65mcg

 

Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25 25 mg; 08/03 50mg;  10/01 62mg.

Supplements: Multivitamin; Magnesium 250 mg; PhosphatydylSerine 300 mg on and off, not sure if it works, but does not hurt. Currently trying lemon balm oil and l-theanine (200mg), no opinion yet

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