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Author Topic: trazodone for insomnia and zoloft for a 2nd time  (Read 444 times)

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Offline mom2boys

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trazodone for insomnia and zoloft for a 2nd time
« on: February 27, 2014, 09:30:58 AM »
I have been suffering with insomnia for a week now. I weaned off of Zoloft this past summer. My anxiety started about 10 years ago as insomnia so, with Dr. approval I am slowly starting Zoloft again. I have a Xanax script "as needed". He said it was fine to use that until the Zoloft started working again. But it only helped me sleep like the first night... I continued to take it, adding a half dose in the middle of the night after several hours of not sleeping. Eventually I usually fall asleep around 3 or so. Up again at 6.
I have never wanted to use Xanax on a daily basis. And using it for sleep was something that really worried me. I feared it would stop working which is exactly what happen. Although I think not so much a dependence already but more my mind worried about it not working...
When I had my first bought of insomnia years ago. I was put on Lexapro and trazodone. The trazodone put me to sleep the first night and continued to help me until I was able to wean off the meds eventually. I asked for trazodone again this time. Tried it last night and it did not work.....I felt sleepy and relaxed at first then it went away and back to nothing.... Now I'm not sure if I should continue or not? Does trazodone take awhile to start working for sleep too?  My Dr, said I could also continue with the Xanax. Of course all of this is very overwhelming. How I can go from NO MEDS to Zoloft, trazodone and Xanax and getting no SLEEP.
I don't know what to do next. I am also worried about Zoloft not helping this time. Or my insomnia not being anxiety at all but something more serious :fragend005:
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Hyperchondria(health anxiety), panic disorder,social anxiety, GAD, recently insomnia
Meds tried Lexapro,(twice) Trazodone, Cymbalta, Buspar,xanax, zoloft, back on zoloft for a 2nd time

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Re: trazodone for insomnia and zoloft for a 2nd time
« Reply #1 on: February 27, 2014, 04:07:19 PM »
And using it for sleep was something that really worried me. I feared it would stop working which is exactly what happen.

Benzodiazepines are not good sleeping pills as tolerance to the sedation develops quickly, often within a couple of weeks, sometimes even more quickly. Fortunately, the anti anxiety effect is mediated through a different receptor system which is much more resistant to tolerance developing.

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I asked for trazodone again this time. Tried it last night and it did not work.....I felt sleepy and relaxed at first then it went away and back to nothing.

You may just need a higher dose than last time. How much did you take last night?

Ian

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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline mom2boys

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Re: trazodone for insomnia and zoloft for a 2nd time
« Reply #2 on: February 27, 2014, 04:49:52 PM »
The trazodone is 50mg.
Xanax is only supposed to be until the zoloft starts kicking in.
I called again this morning but my Dr is out of town. I got a confused secretary,  who seemed to need my entire life history in order to ask another Dr. (My Dr.s normal secretary is off too)
She called back and said I could take the xanax and trazodone together before bed. My question about trazodone taking a few days to work was not answered. She said my Dr would be back Mon to give it through the weekend. I think those were her words not the dr she spoke to. I think she only asked him if I could take the 2 at the same time.
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Hyperchondria(health anxiety), panic disorder,social anxiety, GAD, recently insomnia
Meds tried Lexapro,(twice) Trazodone, Cymbalta, Buspar,xanax, zoloft, back on zoloft for a 2nd time

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Re: trazodone for insomnia and zoloft for a 2nd time
« Reply #3 on: February 27, 2014, 07:05:32 PM »
The trazodone is 50mg.

You could up the trazodone dose to 75-100mg, but it probably won't be 50-100% more effective. The amount of sedation per milligram diminishes as the dose increases. You should also first run the dose increase past your doctor.

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My question about trazodone taking a few days to work was not answered.

It is usually effective from the first dose, but there can be some improvement on subsequent days.

Ian


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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline mom2boys

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Re: trazodone for insomnia and zoloft for a 2nd time
« Reply #4 on: February 28, 2014, 10:46:31 AM »
Thank you. There was some improvement last night. I feared once again it wasn't working but I did fall asleep. Hopefully I will improve from there and get my mind straight. I have such an INTENSE fear of going to bed now. I was trembling last night before taking the meds. I did not even feel "real" anymore. I'm depressed that I am going down this path once again.

I do remember trazodone working for me the very first night years ago when this first happen to me. My sleep was disturbed longer this time though. I honestly did not think sleep would be an issue for me again. It was such a distance memory. I made it through some very stressful life situations  between then and now and nothing kept me up all night for days. I just don't get it. I was on no meds and dealing with things. It's as if my mind said "I KNOW you can't deal with insomnia so I'm going to hit you with that" If that makes sense. Irrational, I know.
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Hyperchondria(health anxiety), panic disorder,social anxiety, GAD, recently insomnia
Meds tried Lexapro,(twice) Trazodone, Cymbalta, Buspar,xanax, zoloft, back on zoloft for a 2nd time

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Re: trazodone for insomnia and zoloft for a 2nd time
« Reply #5 on: February 28, 2014, 04:25:35 PM »
It's as if my mind said "I KNOW you can't deal with insomnia so I'm going to hit you with that" If that makes sense. Irrational, I know.

It isn't at all irrational, this is the way the mind often works when anxiety takes control. It goes for the mental jugular hitting your where it knows you're most vulnerable. :(

The answer to your insomnia is the get the anxiety under control. Trazodone can set up the physical conditions for sleep, but if the anxious mind won't cooperate then it probably won't happen.

If you continue to have problems then you could replacing trazodone with Seroquel or Zyprexa. They improve mood as well as being sedating, and have some affect on anxiety too. The downside is they can have unpleasant side-effects when taken long-term.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline mom2boys

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Re: trazodone for insomnia and zoloft for a 2nd time
« Reply #6 on: March 01, 2014, 09:12:12 AM »
I will keep those in mind. The zoloft is what is supposed to eventually help the anxiety. And the xanax taken with the trazodone.
Last night felt like a relaxed haze all night. I was not up walking around, reaching for my phone to read etc. I just felt like I wasn't really asleep.
I will look up those meds and talk to my dr after the weekend. Still hoping what I am doing now just needs more time. I started the zoloft at a very low dose. 12.5 for several days. Have now been on 25 mg for 3 days. Working up th 50 possibly higher but 50 is what I was on before.
Thank you for your help.
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Hyperchondria(health anxiety), panic disorder,social anxiety, GAD, recently insomnia
Meds tried Lexapro,(twice) Trazodone, Cymbalta, Buspar,xanax, zoloft, back on zoloft for a 2nd time

Offline mom2boys

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Re: trazodone for insomnia and zoloft for a 2nd time
« Reply #7 on: March 19, 2014, 10:19:18 AM »
Well, there was improvement with the Xanax and trazodone together. But I was afraid of needing the Xanax every night when I've always only used it as needed, very seldom. Went back to my Dr. he said to take clonidine (a blood pressure med) with the trazodone in place of the Xanax. I was very reluctant to try the clonidine, he has attempted to prescribe this to me in the past for anxiety but I was too scared to try and ended up on Zoloft. The first night, no Xanax, clonidine and traz. together resulted in another sleepless night... I felt very strange, slow heart rate etc. Very calm and relaxed but no sleep. Called the next day, he said to up the Traz to 75 mg and continue with the clonidine. Saw some improvement the following nights, although still waking early and very weak, light headed etc during the day.
Up until last night, I couldn't fall asleep again.... I've been contemplating calling the dr again but am just so overwhelmed and exhausted.
I feel like trazodone just simply is not working for me this time and the clonidine relaxes my body, blood pressure and heart rate but does nothing for my mind and my ability to FALL ASLEEP. I know the Zoloft is what is supposed to be helping that . I've been up to the 50 mg dose for 2 weeks now. A month on Zoloft again all together after starting at 12.5 mg.... So tired of the back and forth. Thinking I'm getting better then having a bad night, which will spiral my worry out of control. That means Zoloft is not working. I am ok during the day (besides being weak and light headed) but VERY scared in the evenings leading up to bedtime and going to bed.
I mentioned Seroquel at my visit. He said he did  not want to go that route. He thinks it's anxiety and the Zoloft will help....
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Hyperchondria(health anxiety), panic disorder,social anxiety, GAD, recently insomnia
Meds tried Lexapro,(twice) Trazodone, Cymbalta, Buspar,xanax, zoloft, back on zoloft for a 2nd time

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Re: trazodone for insomnia and zoloft for a 2nd time
« Reply #8 on: March 19, 2014, 05:08:24 PM »
I was very reluctant to try the clonidine, he has attempted to prescribe this to me in the past for anxiety but I was too scared to try and ended up on Zoloft.

Clonidine is a blood pressure med that acts on adrenaline receptors and does have some anti anxiety and panic properties, but Zoloft is likely to be far more effective once you're on a high enough dose.

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I know the Zoloft is what is supposed to be helping that . I've been up to the 50 mg dose for 2 weeks now. A month on Zoloft again all together after starting at 12.5 mg.... So tired of the back and forth. Thinking I'm getting better then having a bad night, which will spiral my worry out of control. That means Zoloft is not working.

Zoloft is unlikely to be doing much given you've only been on the minimum therapeutic dose for 2 weeks. Antidepressants typically take 3-12 weeks to kick-in once you're at a therapeutic dose. You will also probably need to take 100-150/day, maybe more for good results. The maximum dose is 300mg, though some do well at 400mg.

Quote
I mentioned Seroquel at my visit. He said he did  not want to go that route. He thinks it's anxiety and the Zoloft will help.

Seroquel may well knock you out, but the anti psychotics can have unpleasant side-effects so, IMHO, should only be used once the more benign options are exhausted. If trazodone isn't working, then mirtazapine (Remeron) or doxepin (Sinequan) might.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

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