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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by partlycloudy on December 24, 2004, at 10:03:30
I took one 50mg pill last night and I am a happy zombie today. Just need a couple of bolts in my neck and I'll be Mrs Frankenstein. I've been clobbered!! No anxiety, though. Heck, I don't even want any eggnog.
What a weird feeling, thank goodness I didn't have to work today. Don't think I could follow a spoken conversation at all.
Posted by Dan Perkins on December 24, 2004, at 10:27:56
In reply to Trazodone 50mg, OMG, posted by partlycloudy on December 24, 2004, at 10:03:30
I used to take Trazodone to put me to sleep when I was taking Parnate. It really does knock you out, but I never experienced any effect on my mood like you seem to be experiencing. Trazodone seems to work well for insomnia, but the major problem I had with it was severe dry mouth that would wake me up in the middle of the night dying for water.
> I took one 50mg pill last night and I am a happy zombie today. Just need a couple of bolts in my neck and I'll be Mrs Frankenstein. I've been clobbered!! No anxiety, though. Heck, I don't even want any eggnog.
> What a weird feeling, thank goodness I didn't have to work today. Don't think I could follow a spoken conversation at all.
>
Posted by jujube on December 24, 2004, at 10:44:27
In reply to Trazodone 50mg, OMG, posted by partlycloudy on December 24, 2004, at 10:03:30
Trazadone yuck! It affected me the exact same way. The first night I took 50 mg, and, the next morning I was in a sleepy almost depressed fog until about noon. The next night I only took 25 mg, and woke up in a fog and feeling really down again. I stopped taking it. It really affected me badly, and just wasn't for me, no matter how well it helped me sleep.
Tamara
> I took one 50mg pill last night and I am a happy zombie today. Just need a couple of bolts in my neck and I'll be Mrs Frankenstein. I've been clobbered!! No anxiety, though. Heck, I don't even want any eggnog.
> What a weird feeling, thank goodness I didn't have to work today. Don't think I could follow a spoken conversation at all.
>
Posted by HappyGirl on December 24, 2004, at 10:56:22
In reply to Trazodone 50mg, OMG, posted by partlycloudy on December 24, 2004, at 10:03:30
Hi:
I started taking the Trazodone 300 mg. this Monday due to some irritability along with depressive moods at work and home. Started from the 50 mg. around early Summer, this year, I'm quite happy its positive effect from taking Trazodone. However in my personal knowledge, ... Traz. makes some of folks quite 'zombi' along with other annoying S.E.s., such as Dry mouth, stomach upset and etc.I might be just one of those who can say 'good/positve' side of Trazodone, OPENLY and positively. However, ... I recall, ... in the first few wks on the Traz., I almost quit taking this A.D. due to 'sleepiness' which went throughout the days. I mentioned this to my pdoc., however he didn't offer a good alternative A.D., then I had no choice but stuck with the Traz.
BTW, I, too easily get those 'zombi' feeling from some of meds., but those S.E.s gradually go away with time. Zyprexa, Depakote and Traz., all of them made me 'zombi' at the beginning, but went away with time, between one month and three months' period.
In my suggestion, keep taking the Trazodone 50 mg., even the 25 mg. as long as you feel some 'relief/result' from taking the Trazodone.
H.G.
Posted by partlycloudy on December 24, 2004, at 12:16:42
In reply to Re: Trazodone 50mg, OMG, posted by HappyGirl on December 24, 2004, at 10:56:22
I think I will try 25mg. the relief from anxiety is so-o-o-o welcome.
(I am trying this as an alternative to ambien and xanax.)
Posted by Cairo on December 24, 2004, at 14:10:52
In reply to Trazodone 50mg, OMG, posted by partlycloudy on December 24, 2004, at 10:03:30
You'll become accustemed to the dose as 50mg is low. I take it trazodone 50mg for sleep and remember having vertigo when I first started it. Over time I've had to adjust the dose upwards to get a full night's sleep. When I've added other medications, I'm able to cut the dose, probably due to CytP enzyme induction.
My suggestion is to cut it back to 25mg (or lower - you can cut it into 1/8ths as I've done it), and see how you do. After a week or two, try increasing slowly until you get a good night's rest.
The only thing I'll caution you about is that while trazodone keeps me asleep all night, I've questioned the quality of sleep. A sleep study showed that I don't get stage 4 on trazodone, so we've added amitriptyline 10mg to the mix (the choice of amitriptypline due to pain control). See how you do on the trazodone, but be aware of whether you feel tired the next morning even though you've slept through the night without awakening.
Good luck.
Cairo
> I took one 50mg pill last night and I am a happy zombie today. Just need a couple of bolts in my neck and I'll be Mrs Frankenstein. I've been clobbered!! No anxiety, though. Heck, I don't even want any eggnog.
> What a weird feeling, thank goodness I didn't have to work today. Don't think I could follow a spoken conversation at all.
>
Posted by sdb on December 24, 2004, at 19:25:52
In reply to Re: Trazodone 50mg, OMG » HappyGirl, posted by partlycloudy on December 24, 2004, at 12:16:42
Hi partlycloudy,
I would be very interested how you will do with the 25mg dosage of trazodone. Could you communicate your experience trough this forum?
And second question: From which anxiety gave the trazodone some relief (it seems that it helped immediately)?
Thank you very much!
> I think I will try 25mg. the relief from anxiety is so-o-o-o welcome.
> (I am trying this as an alternative to ambien and xanax.)
Posted by Colleen D. on December 24, 2004, at 22:15:49
In reply to Trazodone 50mg, OMG, posted by partlycloudy on December 24, 2004, at 10:03:30
I guess it just wasn't for me for insomnia. Plus I wanted to eat like crazy the following day. Yuk! Hope you're well.
Colleen
Posted by KaraS on December 24, 2004, at 23:47:49
In reply to Re: Trazodone 50mg, OMG, posted by sdb on December 24, 2004, at 19:25:52
I took it for at least a couple of months. It made me feel sick - the nausea never went away. It's great if you can tolerate it because it can help you sleep without making you gain a ton of weight.
I just went to look up the dosages on RxList.com. I couldn't believe what I was reading:
"An initial dose of 150 mg/day in divided doses is suggested. The dose may be increased by 50 mg/day every three to four days."
http://www.rxlist.com/cgi/generic/traz_ids.htm
Unbelievable! I can't even begin to imagine starting on 150 mg./day.
K
Posted by ed_uk on December 25, 2004, at 7:57:07
In reply to Re: Trazodone 50mg, OMG, posted by KaraS on December 24, 2004, at 23:47:49
.......hmm! Try amitriptyline for a totally 'zonked out' feeling. I once took 50mg of ami and nearly lost consciousness!
Ed.
Posted by Cairo on December 25, 2004, at 8:10:41
In reply to Re: Trazodone 50mg, OMG, posted by ed_uk on December 25, 2004, at 7:57:07
I was on amitriptyline 50mg years ago for sleep and I did not have the morning hangover, though I usually am extremely sensitive to meds and doses. I have now added 10mg amitriptyline to 50mg of Desyrel, and do need to take it a little earlier in the evening so I don't get the morning drunkenness, though if I cut back the Desyrel to 25mg, I wake up during the night.
Everyone needs to find the right combo, dose and make sure to avoid caffeine for a good night's rest. Also, I've tried walking for 45 minutes in the early evening, then taking a warm bath to boost serotonin levels during the night (at the suggestion of my Rheumatologist) and it seems to help. Avoiding caffeine and chocolate are biggies for me. Even a cup of decaf will sometimes make me shake because of the tiny amount of caffeine in it. A cup of regular in the morning will definitely make me wake up at 2am and stay awake. One drink of beer or alcohol sometimes knocks me out and sometimes wakes me up early in the morning. Try avoiding all these.
The larger doses of Desyrel listed in the package insert are for depression. The lower dose are for sleep, though I repeat that Desyrel may not put you into stage 3 deep sleep. If you continue to have restless nights, consider having a sleep study as sleep apnea may be an issue.
Cairo
> .......hmm! Try amitriptyline for a totally 'zonked out' feeling. I once took 50mg of ami and nearly lost consciousness!
>
> Ed.
Posted by partlycloudy on December 25, 2004, at 10:19:23
In reply to Re: Trazodone 50mg, OMG, posted by sdb on December 24, 2004, at 19:25:52
I didn't take it last night at all, to see just how disrupted my sleep would be without any chemical aid: I woke up every hour or so for the entire night. (I would have tried the 25mg except the pill isn't scored for breaking and I was too darn lazy to go ALL the way downstairs to the kitchen to do it.)
So, this morning I was not groggy, but extremely anxious (and no, it wasn't 'cause of Santa Claus!!). I have generalized anxiety disorder and it is not always situational; I just have a bad day and if I don't treat the anxiety, I'll just sit curled up with my head behind my hands and try to hide like a turtle. It's worst in the morning, so trying the trazodone sounds like it would help.I'll let you know how things go.
Posted by ed_uk on December 25, 2004, at 10:43:13
In reply to Re: Trazodone 50mg, OMG » sdb, posted by partlycloudy on December 25, 2004, at 10:19:23
Hi!
Some people do really well on amitriptyline.... I was just joking because of what happened to me when I took it!
Ed.
Posted by KaraS on December 25, 2004, at 15:13:03
In reply to Re: Trazodone 50mg, OMG, posted by ed_uk on December 25, 2004, at 7:57:07
> .......hmm! Try amitriptyline for a totally 'zonked out' feeling. I once took 50mg of ami and nearly lost consciousness!
>
> Ed.
My first psychotropic med was amitriptyline. The doctor gave me a sample of 75 mg. pills. Also, I'm petite (less than 5'3"). Can you imagine? I was literally out for 2+ days. It was horrible.K
Posted by HappyGirl on December 25, 2004, at 15:55:51
In reply to Re: Trazodone 50mg, OMG » sdb, posted by partlycloudy on December 25, 2004, at 10:19:23
Hi:
You may switch/take the Nefadozone if the Trazodone giving you so much 'zombi,' ... probably around the 100 mg., even starting from the 50 mg., if you're more prone to get 'zombi' feeling during the day.Before the Trazodone, I was the Serzone(now, Nefadozone/generic form). In my personal view/experience, Serzone and Trazodone is quite similar in regrad to the effectiveness. The reason why I switched to Serzone/Nefadozone was the effectivenss started to wear-off, even I upped to the 600mg.(Maximum dosage)Nefadozone. Then, in my suggestion, if you would feel unfuctionable and other 'serious' problems due to the Traz., you could switch to the Nefadozone. Because, in my personal experience on those two A.D.s, the Trazodone is MUCH stronger than the Serzone/Nefadozone, in regard to the 'effectivenss' along with 'S.E.'s, particularly 'zombi/sleepiness.' I rarely felt 'zombi' even on the 600 mg. Serzone/Nefadozone. However, on the 300 mg. Trazodone, I feel mid-range 'sleepiness,' then for the past two nights/days, I cut it back to 250mg. which seems to control the depressive side of my Bp II fairly well.
However, you need to speak to your pdoc. before considering the Nefadozone due to 'liver' issue. In my case, I NEVER had any problems when I was on Max. Serzone/Nefadozone during the four to five years' period along with other 'liver' issue, 'Lithium.'
H.G.
Posted by zeugma on December 26, 2004, at 11:37:27
In reply to Re: To Cairo, posted by ed_uk on December 25, 2004, at 10:43:13
I found this article on tolerance to amitriptyline side effects, at doses therapeutic for depression. I personally think pharmacogenetics is the way to go with these disorders, since theoretically there are enough medications out by now, and AMI has been out so long that it's already showed us its nasty surprises (that it and clompiramine consistently rank as the most efficacious of all AD's is also no small consideration):
Clin Chem. 2004 Dec 8; [Epub ahead of print] Related Articles, Links
Amitriptyline or Not, That Is the Question: Pharmacogenetic Testing of CYP2D6 and CYP2C19 Identifies Patients with Low or High Risk for Side Effects in Amitriptyline Therapy.Steimer W, Zopf K, von Amelunxen S, Pfeiffer H, Bachofer J, Popp J, Messner B, Kissling W, Leucht S.
Institut fur Klinische Chemie und Pathobiochemie.
BACKGROUND: Amitriptyline has been replaced in many countries by alternative and more expensive drugs based on claims of improved tolerability and toxicity and despite slightly reduced efficacy. Preliminary studies indicate that adverse effects could be linked to polymorphisms of drug-metabolizing enzymes, but information on their clinical impact remains scanty and includes mainly case reports. We conducted a prospective blinded two-center study seeking correlations between CYP2C19 and CYP2D6 genotypes, drug concentrations, adverse events, and therapy response. METHODS: Fifty Caucasian inpatients with at least medium-grade depressive disorder received amitriptyline at a fixed dose of 75 mg twice a day. Blood samples for concentration monitoring of amitriptyline and nortriptyline were taken weekly until discharge along with evaluations of depression (Hamilton Depression Scale and Clinical Global Impression Scale) and side effect (Dosage Record and Treatment Emergent Symptoms Scale) scores. RESULTS: In a ROC analysis, nortriptyline but not amitriptyline concentrations correlated with side effects (DOTES sum score >/=5; area under the curve, 0.733; P = 0.008). Carriers of two functional CYP2D6 alleles had a significantly lower risk of side effects than carriers of only one functional allele (12.1% vs 76.5%; P = 0.00001). The lowest risk was observed for carriers of two functional CYP2D6 alleles combined with only one functional CYP2C19 allele [0 of 13 (0%) vs 9 of 11 (81.8%) for the high-risk group; P = 0.00004]. We found no correlations between drug concentrations or genotypes and therapeutic response. CONCLUSIONS: Combined pharmacogenetic testing for CYP2D6 and CYP2C19 identifies patients with low risk for side effects in amitriptyline therapy and could possibly be used to individualize antidepressive regimens and reduce treatment cost. Identification of genotypes associated with slightly reduced intermediate metabolism may be more important than currently anticipated. It could also be the key to demonstrating cost-effectiveness for CYP2D6 genotyping in critical dose drugs.
Of course, taking 75 mg amitriptyline as a starting dose is likely to wipe anyone out. Years ago when I had 75 mg nortriptyline capsules, I would go off the medicine for a while, then decide I was better off on it. But the 75 mg nortrip (and I believe nortriptyline is about one-sixth as sedating as amitriptyline) would wipe me out the next day. If I had had any sense, I would have gone to a public clinic and gotten 25 mg caps prescribed so I could have titrated up.
notable, too, is that the subjects in the study were 'inpatients.' It seems that moderate to severe depression responds much better to amitriptyline and other TCA's than other meds.
Posted by ghost on December 26, 2004, at 12:19:40
In reply to amitriptyline, posted by zeugma on December 26, 2004, at 11:37:27
havent slept well in... well, over a year. waking up every hour or so (if i was lucky enough to sleep).
FINALLY got trazadone, and i SLEPT. lil groggy for a few hrs in the morning, but i SLEPT!
plus i just plain felt better. i think the antidepressive qualities helped, too.
i dont take it every night, it seems like getting a few good nights sleep gives me another few good unmedicated nights. gets me into a schedule again. i'm sure i'll take it tonight for my return to work in the AM. blecch. :)
ghost
Posted by partlycloudy on December 26, 2004, at 12:50:04
In reply to i LOVE trazodone, posted by ghost on December 26, 2004, at 12:19:40
I took a third of a 50mg pill of trazodone last night - slept very well and had the benefits of no anxiety until around noon. It's good enough for me!
Posted by sdb on December 27, 2004, at 16:45:55
In reply to Trazodone 50mg, OMG, posted by partlycloudy on December 24, 2004, at 10:03:30
The reaction on trazodone seem to differ frequently. Some people have tiredness others have agitation. The trazodone blocks (downregulate) alpha receptors and this can cause relaxation of smooth muscle (for example bladder muscle, benefit for people with paruresis) and more pounding heart.
Posted by HappyGirl on December 27, 2004, at 19:06:41
In reply to Re: Trazodone 50mg, OMG, posted by sdb on December 27, 2004, at 16:45:55
Hi sdb:
I now got a good answer to my 'puzzle' after having read the following:--- The trazodone blocks (downregulate) alpha receptors and this can cause relaxation of smooth muscle (for example bladder muscle, benefit for people with paruresis) and more pounding heart. ----
Before the Trazodone, I needed to make several trips to the bathroom during 8-10 hours' sleep because of the Lithium which makes me drink a lot of liquid throughout the day. Even the Serzone/nefadozone didn't help a bit on this regard, ... however thanks to 'Trazodone,' this problem/nocturia seems finally came to the end.
Besides this, if you don't mind, ... could I ask a question, ....
After I took the 300 mg. Trazodone for three days/nights, my depression seems MUCH better. Do you think this, 'temp. dosage' made some 'jump'(like 'jump-start' on car?) on my depression?
Thanks for your 'educational' information on Trazodone.
H.G.
Posted by sdb on December 27, 2004, at 20:18:38
In reply to Re: Trazodone 50mg, OMG//sdb, posted by HappyGirl on December 27, 2004, at 19:06:41
Hi HappyGirl,
300mg of trazodone is higher starting dose.
Trazodone and Nefazodone have a similar chemical structure. Nefazodone
differs in the Pharmacokinetics, side effects and the transformation of the
liver. The two substances have a unique system to increase extracellular
serotonin levels. Trazodone increases the 5-HT extracellular level through a
double mechanism in which the 5-HT transporter and 5-HT 2A/C receptors are
involved and it has influence of GABA transmission. In the majority of cases
the antidepressive effect of serotonin inhibitors (ssris) start in about 30
days. Trazodone is said to work in seven or less days. The unique
pharmacological profile and the high starting dose could have triggered the
"jump-start". I suggest you to find a maintenance dosage by go down
gradually from the 300mg dosage.kind regards
sdb
Posted by HappyGirl on December 28, 2004, at 0:17:24
In reply to Re: Trazodone 50mg, OMG//to HappyGirl, posted by sdb on December 27, 2004, at 20:18:38
Hi sdb:
Thanks for your VERY informative resoponse since I have NO idea how the Trazodone working on my system. Having dxed with Bp II with ultra rapid cycler in 1998, I have been taking four different meds., Zyprexa 5 mg., Lithium 900 mg., Wellbutrin SR(generic form) 300 mg. and Trazodone 250 mg.Since early this year, 2004, ... more exactly after the Trazodone, I am moderately/fairly stable with less depressive moods and NO-manic episodes. Also, there is no 'anxiety' to worry about.
In the past, both Lithium and WB sr. made me several 'muscular' problems, ... such as 'tremors' on my hands, 'jaw' popping-up(not often) during meals, general 'muscle' aches and etc. After the Trazodone which I started from the 50 mg. early Summer, this year, those S.E.s started to subside one by one, although I have 'slight' tremors and muscular ache once awhile. At first, I thought I got used to both meds, particularly the Lithium. However, having read your response along with the above post, I truly believe the Trazodone is a 'key' for alleviating most of S.E.s I got from both WB sr and Lithium.
Thanks again for your valuable information on Trazodone along with Serzone/Nefadozone.
H.G.
Posted by partlycloudy on December 28, 2004, at 7:45:25
In reply to Re: Trazodone 50mg, OMG, posted by sdb on December 27, 2004, at 16:45:55
> The reaction on trazodone seem to differ frequently. Some people have tiredness others have agitation. The trazodone blocks (downregulate) alpha receptors and this can cause relaxation of smooth muscle (for example bladder muscle, benefit for people with paruresis) and more pounding heart.
I wondered why my blood was pounding in my ears and my blood pressure has been normal!
Thanks for the info. I continue to do well with about 25mg of trazodone, and I bought a pill splitter so I don't have to chase the little buggers around the counter...
Posted by AuntieMel on December 28, 2004, at 14:15:19
In reply to Re: Trazodone 50mg, OMG » sdb, posted by partlycloudy on December 28, 2004, at 7:45:25
without it i rarely got more than a few hours sleep - and they weren't continuous. i started out with 50mg, and recently went to 100mg. if i'm tired at all, i'll still take just 50, but if i'm wired i take 100. it's a lifesaver
This is the end of the thread.
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