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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by 1980Monroe on May 6, 2004, at 23:31:11
I've heard the first time you take it, it produces a sedative effect, is this true?
Can you have a dosage where you only take it at night?
Is it the most sedating AD outthere? Please just give me some general info on how it works. THanks
Posted by chemist on May 7, 2004, at 2:33:46
In reply to How sedating is Trazadone, posted by 1980Monroe on May 6, 2004, at 23:31:11
> I've heard the first time you take it, it produces a sedative effect, is this true?
>
> Can you have a dosage where you only take it at night?
>
> Is it the most sedating AD outthere? Please just give me some general info on how it works. THanks
hello there, chemist here...in response to your question about how sedating is trazadone: very. strong affinity for histaminergic receptors, an old-school tricyclic that is associated with priapism (this means if you are male, you might have to go to the e.r.. to get a shot of a steroid in the family jewels, which translates to trazadone inducing a condition other than flaccid). predominantly used for sedating pre-op patients or for a sleep aid, you can count on trazadone being continually sedating. deep sleep and viagra-reduction are in your future, and you get the TCA side-effects as a bonus. i suggest ambien or sonata, the former if you have trouble falling/staying asleep, the latter if the difficulty lies in simply falling asleep...all the best, chemist
Posted by spoc on May 7, 2004, at 8:11:58
In reply to How sedating is Trazadone, posted by 1980Monroe on May 6, 2004, at 23:31:11
> I've heard the first time you take it, it produces a sedative effect, is this true?
>
> Can you have a dosage where you only take it at night?
>
> Is it the most sedating AD outthere? Please just give me some general info on how it works. THanks----
Hi, I am guessing that you are taking it (or considering taking it) as an AD, *not* a sleep aid? And want to *avoid* any drowsiness properties? In that case, while drowsiness is very common and also not just an initial effect of this drug, it's important to remember that everything works differently for everyone and not get discouraged until you try it yourself. Although (especially with the advent of newer types of ADs) it may not be all that popular anymore, there are indeed some who have come to it for various reasons and found it to be the most effective for them.I think that most who take therapeutic doses of trazodone as an AD do take most of it at night, to help minimize this s/e. And if you look into it, I think from what I've read myself, you may see that the incidence of other 'strange' s/e is in reality minute.
Btw, I take traz occasionally *for* the purpose of sleep, at 25 to 50 mgs, but have a bad habit of waiting too late to decide that I need it, which will exacerbate any sleepiness the next day. I am also kind of a light weight and can't take it as a sleep aid for many days in a row (or, you could say that after a few days I get a "bonus" night of sleep without it). But a lot of that may be due to how late I wait to take it when I do.
But I do like it; and think I would like it even more if I were also taking something else by day, perhaps one of the many psy drugs that tend to make sleep difficult. Then it would be offset, and vice versa. Anyway, in the event that sleep is your objective, traz is a very common and popular thing to be tried early on, although of course it won't fill the bill for everyone. It's also very cheap, no harm done to try.
But, back to usage as an AD -- I don't have any chemical expertise, but I wanted to mention another thing that maybe you could look into. I don't know the "specs" on this myself. I believe there is a drug called something like nefazodone, which is pretty much traz with a lot of the sleepiness properties "removed..." I don't know whether it is a "favored" medication... Or maybe you could talk to your doc about combining traz with something else? Good luck!
Posted by King Vultan on May 7, 2004, at 8:22:32
In reply to How sedating is Trazadone, posted by 1980Monroe on May 6, 2004, at 23:31:11
> I've heard the first time you take it, it produces a sedative effect, is this true?
>
> Can you have a dosage where you only take it at night?
>
> Is it the most sedating AD outthere? Please just give me some general info on how it works. THanks
Trazodone is classified as tricyclic-like, but it actually has a very different structure from a true tricyclic like amitriptyline or desipramine. Its closest relative in terms of structure and pharmacological profile is Serzone (nefazodone), but trazodone is noticeably more sedating and is probably not as effective an antidepressant. The sedation was a major drawback in using trazodone as an antidepressant back in the 80's as an alternative to the tricyclics, and when Prozac came out, trazodone was one of the first ADs to be dropped in favor of it.It did find a niche as a sleeping aid, however, as it has a relatively short half and is considered to be very sedating. In "Psychotropic Drugs", it is one of four ADs listed as +++ for sedation, the maximum in their subjective rating scale. These four drugs and their half lives are
-------------Sedation----Half life (hr)
Trazodone......+++...........4-9
Amitripytline..+++.........31-46
Doxepin........+++..........8-24
Remeron........+++...........35Maprotiline (Ludiomil), imipramine, and nortriptyline are all listed as ++ for sedation.
Trazodone is a generic med that is relatively cheap and one that I've tried for my MAOI insomnia. While it did induce sleep for me at the 25-50 mg/night I tried it at (my doctor said I could go up to 100--I've heard of an upper limit for sleep of perhaps 150-200), the stuff did not agree with me and made me feel sluggish, out of sorts, and mildly depressed the next day. Apparently, I am in a minority, though, and most people have better success with it.
Todd
Posted by fayeroe on May 7, 2004, at 10:32:09
In reply to Re: How sedating is Trazadone » 1980Monroe, posted by chemist on May 7, 2004, at 2:33:46
Why are you suggesting prescription drugs to posters? What is your background in prescribing/suggesting meds?
Posted by Xanablu on May 7, 2004, at 12:07:12
In reply to How sedating is Trazadone, posted by 1980Monroe on May 6, 2004, at 23:31:11
> I've heard the first time you take it, it produces a sedative effect, is this true?
>
> Can you have a dosage where you only take it at night?
>
> Is it the most sedating AD outthere? Please just give me some general info on how it works. THanksReal SEDATING. My (after sev'l yrs. I have realized) not so psychiatrically bright gp rx'd 50-100, I started at 25 mgs at bedtime (it was for sleep) cuz I was caring for invalid mom & did not want to just 'go comatose', but I certainly did. & had a real groggy next a.m. These days, I will take(approx.) 12 mgs if needed and the job gets done fine. But I must be sure to take before 12 midnight and be guaranteed access to at least 7-8 hrs. uninterrupted sleep.
My very best, most restorative sleep was on, I think, 30mgs. Remeron. Slept good, was up and clear-headed in less than 30" and it nipped an anxiety disorder I didn't even know I had (just thought life was scripted mighty hellish) in the bud!
However, I grazed like Elsie the Cow from daylight to retiring and I cannot live in my thin family and be the 'fatty'. Way too upsetting. Not to mention time-consuming & unhealthy.Have finally found a couple of real therapists since then (4 1/2 yrs. later) and got a dx. which is much closer to the real me-undiagnosed AD(H)D, which offshot, or, strengthened formation of life-long anxiety disorder and dysthymia ,with intermittent bouts of clinical dep. on top, oh, say 'bout once a year from age 15. Started that in puberty, finally had an undeniable breakdown 2 1/2 yrs. ago. which in turn, finally, after yrs. of drug trials and telling docs I was not 'classically' depressed, I got the guys I needed. In 3 weeks I was on a stim, ssri, klonopin, inderal and had access to pain meds (for 3 herniated discs) when and if I needed them.
It took 30 years of hunting and pecking and dragging my a** thru this dark life to finally see some light at the end of the tunnel.
I am an artist, but no AD, or any other drug can open the doors in my brain and let the juices flow unless I have a healthy dose of a dexedrine booster. And I sleep just fine these days-still struggling towards the light, but at least the playing field is much more level now. God, what a long, looooong trip it's been. God blessed me w/a surprise baby girl when I was 40 (I had avoided kids cuz' I knew I was intermittently unstable), she is now 7 and I can actually embrace our future together, I feel (emotionally) like I'm 25 again. Just hope I can keep the banner high for both of us-it will certainly be worth the 30 year wait for med'l and family support & understanding & the freedom to be the real me.
Sorry for the speech. Just feel so thankful for a REAL 2nd chance. It CAN happen. But ya gotta work at it and be informed and be very pro-active.
Most of what I've learned about psych stuff either came from this site (thank you dr. bob) or from sources I gleaned from this site, then the web and bookstores and so on and so on. This site allowed me to educate myself to speak more confidently with docs and I certainly learned well enuf that I had to keep plodding on until I stumbled upon some gifted p-doc soul who wd. see me for what I was and have mercy on me. Thank god! it finally happened, cuz I was getting worse and worse-too many illnesses, deaths, divorces, etc, heaped upon my head in too little time.
But, time IS healing those losses, those wounds, and I am grateful to be here, broke, but stronger, smarter and more free than ever in my adulthood.
I'd best quit expansifying, before lightening blows me off my tattered throne.
Best of luck. Hope all goes well.Anyone reading this, send me some strong prayers and meditations, as I know I will need as much help as I can get, but, the future finally, is not taunting me, with ALL my petty faults and flaws, as it always has. Now I hope those taunting mental monsters eat my humble dust!
blue skies, nothin' but blue skies...
Xana
Posted by chemist on May 7, 2004, at 12:11:32
In reply to Re: How sedating is Trazadone » chemist, posted by fayeroe on May 7, 2004, at 10:32:09
> Why are you suggesting prescription drugs to posters?
i hope you have asked the same question of several other posters. my answer is: because they have asked for advice about a medication. in a case like this - when a poster writes something along the lines of ``i'm considering taking drug A but heard that there are some unfavorable side effects and i'd like some information about drug A and what doses people have found effective'' - it seems appropriate to (1) provide information about drug A to the best of my knowledge; and (2) suggest another medication that might be better tolerated, produce the same effect as drug A, and provide some information on that drug. these posts contain *my opinions*, and the person on the other side is free to take any of the information or none of it and hopefully make an informed choice along with their doctor.
>What is your background in prescribing/suggesting meds?see my reply to AMD under the thread Lamictal insanity, entitled ``okay, i'll tell you.'' that's my scientific background. but the real issue is exactly what you wrote in your post: i am making *suggestions*, not writing prescriptions, or coercing people in any way. i make *suggestions* based on experiences i have had with a medication (and i mean having taken it), what is in the literature, and a distillation of the shared experiences of others.
all the best, chemist
Posted by spoc on May 7, 2004, at 12:49:55
In reply to Re: How sedating is Trazadone » 1980Monroe, posted by chemist on May 7, 2004, at 2:33:46
>.... deep sleep and viagra-reduction are in your future, and you get the TCA side-effects as a bonus.... <
I think maybe this just sounded stronger than one person's opinion, but more like a guarantee. I don't read much of the med board since I am not currently on or close to being on anything (unfortunately), but from the little I have seen I had thought you normally supported the position that people shouldn't alarm others based on their own experiences. I think the priapism thing is actually pretty rare, isn't it?
Of course, it's understandable that it sticks out in people's minds to a greater extent than is based in statistics, due to the chilling image it conjures! I think you've defended Effexor users from those that would discourage them, and wouldn't bring up the rare side effect that a permanent change in the brain can take place, in which the person will always feel crummy without Effexor, even if feeling crummy *on* it was why they went off it. An incidence of priapism surely pales in comparison, but neither are probably reasons why someone shouldn't try them.
But no matter probably -- I think the poster may actually be asking about traz as an AD, not a sleep aid, going on the fact that he/she mentioned being under the impression that "initial sedation" could occur.
But in a meds discussion is admittedly not somewhere I belong, for long anyway. Happy Friday, all the best to you too!
Posted by noa on May 7, 2004, at 20:44:05
In reply to How sedating is Trazadone, posted by 1980Monroe on May 6, 2004, at 23:31:11
I don't know if it is the *most* sedating AD or not, but fwiw, my experience taking it is that it's very sedating. BUT, I am also very sensitive to the sedative effects of meds (benzos knock me out even at very small doses).
Posted by afatchic on May 7, 2004, at 22:03:08
In reply to How sedating is Trazadone, posted by 1980Monroe on May 6, 2004, at 23:31:11
Yes, traz is VERY sedating. I took it for about 4 years as an AD in the late 80s. My experience was quite positive. I only took it at bedtime and found that the groggy, hang-over effect in the morning only happened in the first few weeks.
I always read that people don't think traz is a good AD, that's it's only useful for sleep, but that wasn't my experience. For me, it was wonderful, like having someone turn on a light switch after I'd been sitting in the dark for years.
Atleast you won't lose all desire for sex, like with SSRIs. Yes, priapism is a rare SE, but that can only if your a man.
> I've heard the first time you take it, it produces a sedative effect, is this true?
>
> Can you have a dosage where you only take it at night?
>
> Is it the most sedating AD outthere? Please just give me some general info on how it works. THanks
Posted by joebob on May 8, 2004, at 9:29:49
In reply to How sedating is Trazadone, posted by 1980Monroe on May 6, 2004, at 23:31:11
before sleep...
16 months now, no adverse effects for me
fall asleep, stay asleep
Posted by joebob on May 8, 2004, at 9:31:26
In reply to Re: How sedating is Trazadone » fayeroe, posted by chemist on May 7, 2004, at 12:11:32
Posted by chemist on May 8, 2004, at 13:00:52
In reply to i find your posts very helpful and informative (nm) » chemist, posted by joebob on May 8, 2004, at 9:31:26
thanks!!!! ll the best, chemist
Posted by Questionmark on May 8, 2004, at 22:44:38
In reply to Re: How sedating is Trazadone » chemist, posted by fayeroe on May 7, 2004, at 10:32:09
> Why are you suggesting prescription drugs to posters?
Because this is a psychiatric prescription drugs message board, and that's what people do here. They/we ask questions and different people offer suggestions to their questions. Chemist did not say anything in force or malice, and 1980Monroe (or any other person) does not have to act on Chemist's or anyone else's suggestions.
>What is your background in prescribing/suggesting meds?
Whether Chemist has a background in prescribing meds or not is besides the point-- beCAUSE s/he did not preSCRIBE anything to anyone. S/he merely made suggestions. And probably most if not everyone who uses this board has a background in "suggesting" meds (to friends, family, or whoever). And there is nothing illegal or even disallowed by Dr. Bob's rules about that. So i am in total confusion as to the reason for your comments (well, questions), particularly why they were focused on one person-- a person who happens to be at least fairly knowledgeable about certain aspects of psychopharmacology.
i am really tired of the unnecessary and excessive criticisms that appear here every so often.
i'm sorry if you did not intend to be as critical or harsh as you appeared to me, but unfortunately, i am not sorry if you did.
Let us try to be slower to criticism in the future. Take care.
Posted by chemist on May 8, 2004, at 22:53:36
In reply to Re: How sedating is Trazadone » fayeroe, posted by Questionmark on May 8, 2004, at 22:44:38
thank you for a very lucid and informative post, i agree with your stance that we are all offering opinions, suggestions, and information and that the final decision for anyone rests in their hands with consult with their prescribing physician.....all the best, chemist
Posted by Cecilia on May 9, 2004, at 2:50:06
In reply to Re: How sedating is Trazadone » Questionmark, posted by chemist on May 8, 2004, at 22:53:36
This is the end of the thread.
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