Posted by yxibow on December 31, 2005, at 23:34:16
In reply to Re: Cymbalta Insomnia- Trazedone?, posted by Dawnie on December 30, 2005, at 23:08:32
> > > I have been on 60mg Cymbalta for 7 weeks and have been experiencing insomnia for which I take 100mg Trazodone. I sleep very well on Traz getting quality REM sleep. However, I am male and also experience anorgasmia with Traz.
> >
> > I'm a natural insomniac so I can't say that Cymbalta has contributed significantly to it like Effexor did years ago when I tried it.
> >
> > >I tried taking Remeron which is also very sedating, but Remeron gives me quite an appetite and I pack on the pounds.
> >
> > Definately -- I'm just pushing off 40% of it in the gym.
> >
> > >I hope the sexual side effect of Trazodone will subside in time.
> >
> > It probably will -- but one thing, and I assume your doctor knows, is that Trazodone and Cymbalta are both metabolized by P450 CYP2D6, which means there is a slight potential for drug-drug interactions. The anorgasmia is probably more due to the Trazodone, but could also be due to the combination.
> >
> > Decreased libido was reported in 1.3% of the outpatient community in Trazodone tests. Of course then there is "the problem" with Trazodone to watch for in relation to this -- priapism. Occurs more often than not, not to scare you (I experienced it mildly mostly about once every few months but continued to take the drug for a while) -- although if you're younger, you're probably likely not to be in too much danger of such a situation.
> Are you aware othe dangers of men taking Trazedone. A new psychiatrist (one covered by our insurance) put my son on it a few years ago (along with a number of other med changes) and when he started getting extremely manic we went back to our old psychiatrist. He took him off the Trazedone immediately. Apparently a side affect in men is a painful erection that wont go away and often needs surgery. The late Freddie Prinze had this happen to him. I would ask your doc about this. Ask him about Ambien instead.
>
>There are several problems with Trazodone. Those who are borderline or have psychotic disorders generally should not take Trazodone as its metabolite mCPP is known to cause psychosis.
"The problem" is definately also a reason I wouldn't recommend it, especially for older men whose organs are, um.. more sensitive. I was much younger when I took it and I bounced back from the occasional problems in ways we won't discuss in polite company. :) But you're right, it is a serious problem with Trazodone with some and I believe it is a separate internal black box for Desyrel. My conjecture is that it is probably related to the changes in blood pressure that Trazodone causes.
It generally hits you over the head like a hammer, it causes orthostatic hypotension (low blood pressure), and if you can stand that and not sleep , you are probably emptying the refrigerator if you have enough to have a true psychiatric dose of the medication as it promotes hunger.
I would much rather people attempt to convince their doctors to take the relatively safe pseudobenzodiazepine related sleep agents such as (in order of general effectiveness), Ambien (esp above 10mg up to 20mg), Lunesta (esp at 3mg), and Sonata (although wierd visual sensations have been reported with Sonata).
poster:yxibow
thread:589545
URL: http://www.dr-bob.org/babble/20051231/msgs/593868.html