Posted by saturn on March 1, 2007, at 22:12:33
In reply to Re: Trazadone fear » saturn, posted by yxibow on February 28, 2007, at 2:30:28
> > My doc has several times mentioned, and even once prescribed trazadone.
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> > I'm scared to death of priapism. I know it's something like 1 in 1000, but from experience with other psych meds I seem to be prone toward the more serious and rare complications.
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> I don't want to scare you any more but its more common than 1 in 1000. I don't know your age, but I believe priapisms are more dangerous in older individuals simply because of the age of the... organ. I had for quite some time doctors who believed that depressed people should receive Trazodone rather than true sleep drugs. I had at least 2 priapisms, maybe more, though I continued to use the drug. I solved them, um... yes, by standing on my head, so the blood drained away. And actually, it worked.
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> > My biggest fear is that I'd have priapism AND also be so sedated that I wouldn't be able to get the the hospital.
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> > Has anyone else dealt with this? And how helpful is Trazadone for sleep, especially in terms of long-term usefulness, tolerance and withdrawal?
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> Well there is a problem of escalation with Trazodone. One really shouldn't be taking more than 25-50mg or so for sleep. Eventually people (or at least myself) get used to it, and 50 becomes 75 and 150, and then you're into the adult dose range for Trazodone. At least the adult range that it was used for I guess in seriously depressed patients in the 70s because a dose of 300mg or so would put most people in a vegetative state I would think considering how much it hits one over the head like a brick. So you have to back off and restart again the Trazodone at a lower level.
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> I agree with the other poster, I don't think it should be used for sleep. There are other agents, if one must have to take an agent for a side effect, 7.5mg of Remeron (now don't go running to the fridge as it makes your appetite stronger) is a good and adequate dose for sleep. It also benefits because it can enhance REM sleep. You might have trippy dreams with it, at least at first.
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> If not Remeron, there is the third option of a very small dose of doxepin (Sinequan), which you have to give a weekend to get over with. I took it between these priapism episodes as a substitute and it knocked me out the whole weekend. You adjust to it though and the agent doesn't do that constantly. It is a tricyclic and an antihistamine (my mother takes it for angioedema because it blocks H1 and H2 and probably helps her insomnia) so it does carry some of the tendencies of TCAs though at sleep levels probably not that much.
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> But personally, I believe in the long term use of actual sleep agents [pseudo-benzodiazepine agents such as Ambien/AmbienCR, Lunesta (weaker, and oh so metally tasty), and Sonata (weakest)]. Yes, tolerance can build up with those, so again, one might have to back off and restart. I'm a terrible insomniac so I take Rozerem and Ambien.
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> Which brings me to Rozerem. That's another alternative and while some doctors might be scared that melatonin can lead to depression -- sensitive individuals might have a reaction, it is far more powerful than any OTC melatonin you can buy. This one has no dependence and if you havent had a bad reaction to melatonin I would seriously suggest it to your doctor.
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> -- tidings
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> Jay
Thanks Jay. Yeah, I think you're right, I should perhaps stick with Lunesta, which has on the whole served me well.I had also tried Rozerem for only about 5 days, perhaps I may give it another shot sometime. Thanks so much for the feedback. Regards...Saturn.
poster:saturn
thread:736939
URL: http://www.dr-bob.org/babble/20070224/msgs/737505.html