Posted by mattw84 on April 29, 2005, at 21:41:55
In reply to Re: Trazadone, Hangover and Feel Awful » Phillipa, posted by Wildflower on April 29, 2005, at 11:54:05
To all,
Trazodone is an effective *short* term treatment for insomnia. As many of you have pointed out, you have experienced the hangover thereof -- which is pretty much universal... Anyone who uses Trazodone for sleep is bound to have a hangover. Regardless, it is has amongst the safest dose vs. side-effect profile compared to other sleep aids. I currently am an MS2 med student and see this frequently prescribed simply based on the fact that:
A) It *ALWAYS* works
B) Is not a drug used recreationally (A basis for many prescribing physicians regardless of a patient's known history. No physician wants their liability insurance to eat up any more of their income than it already does...)
C) Out of 200+ patients I have seen this prescribed to - not one has had the so affectionately coined "boner" side-effect. Priapism and Trazodone, though medically documented, is regarded as nearly a "medicinal urban legend." (Either way viagra, or the "blue-pill," is only 20 times the cost... So I guess as a doc you just can't ever satisfy everyone.)
Also mentioned, the atypical antipsychotic class is often utilized for reasons A/B listed above. Olanzapine (Zyprexa) is very effective, as well as a few others...
True sedative/hypnotics are difficult to get prescribed by at a clinic/hospital simply because they are easily misused(date rape...) or abused by a patient. (Which polypharmically can be fatal in some cases.)
However, if you see an interest or psychiatrist, your options expand greatly but not implied that this is for the better. It only means that your physician has been paid to go on vacation and attend an 'educational seminar' or symposium for the latest and greatest treatment for insomnia. (Most recent is Lunesta I believe? Either way we have a lot of residents in/on their way to a Long Beach symposium... ahh the rough life...)
Ambien, Sonata, and a few benzos pretty much reign over what I personally consider to be the ideal treatments. Most residents just tell me to shut up and let them write the rx's though - so what is my advice worth. Oh wait...
In my personal experience (!) the "z" class and benzos create an undo and rather rapid tolerance/dependence upon themselves. (Not to imply that such an effect is not beneficial to the *poor* pharmaceutical industry.)
I am currently withdrawing from 6 milligrams of daily treatment with Xanax. I am officially down to 5.75mg per day and as per experience would recommend that this group of drugs be avoided. Of course the first symptom of withdrawal is insomnia. Firstly I tried Trazodone -- which like others, left me hung over on an extremely crucial day so I refuted taking anymore. Next came Ambien, which just so happens to have a high affinity for GABA(alpha) receptors, just like Xanax! Does it allow me to sleep - yes, but does it further my ability to withdraw from Xanax - NO! "It is not a benzo so what are you worried about," quoth the attending on Wednesday. How some people get their license to practice is beyond me...
So I spoke with resident psychiatrist (for whom I have little respect for -- or for the profession) and asked her what sedative/hypnotics were available. She was unable to think of any off-hand!! (Even though a second year med student, myself, can think of 6.) So I made a few suggestions and came to an agreement to "trial" a long-standing, as in having been in practice since 1832, insomnia treatment. (Yes -- 1832)
Since having initiated my adjuvent treatment with this drug I have had no ill side-effect and will undoubtedly be able to taper much more quickly had I not ever encountered this pharma.
You all are probably wondering what this 'miracle' insomnia cure is -- well it's not for everyone. Yet is have a *DEEP* respect for medications it may just be the answer to your prayers. The drug is coined "Somnote" but is perhaps better known as the "Mickey Finn" or "Knockout Drops." Generic name: Chloral Hydrate. The utmost effective and alike side-effect lacking treatment for insomnia I have yet to encounter.
Now, if you go to your doctor requesting chloral hydrate you will likely be instantly flagged as a drug abuser - it ranks up their with asking for morphine or quaaludes. Refer to http://www.somnote.com for further information. I hope this help all my fellow insomniacs out there, and maybe even save you all a few bucks.
Best of luck to all -- Regards,
M.W.
* I apologize to all for having not posted recently, life has been hectic and I can't seem to find the balance! All are welcome to Babble-Mail me their questions if you want my input any more quickly!
poster:mattw84
thread:491216
URL: http://www.dr-bob.org/babble/20050428/msgs/491705.html