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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by amigan on November 3, 2007, at 13:05:53
Hello.
I'm thinking of switching from hydroxyzine to another med, like trazodone. The reason that makes me do this, is that although hydroxyzine works great for me, it has a long half-life and it makes me feel very drowsy for half of the next day.
I read that trazodone is extensively used as a sleep aid and it has a much shorter half-life than hydroxyzine.
I would have considered taking Amitriptyline, mirtazapine or doxepin but i read that they have the same problem with hydroxyzine: Long half-life.
Do you think that trazodone is a good choice or do you have a better suggestion? (excluding anti-psychotics because of their side-effects and benzodiazepines because of the addiction/tolerance risk)
Posted by your#1fan on November 3, 2007, at 13:15:39
In reply to Is trazodone a good hypnotic/sedative?, posted by amigan on November 3, 2007, at 13:05:53
yes, sometimes i was on 100mg at night. I dont know why they market it as an antidepressant. Its not really. Its a very sedating antidepressant, and its mechanisms of action are hard to explain.
Anything above 200-300mg you will have trouble getting out of the bed in the mornings. Trust me i had to do it!
It does help with sleep but, it causes a diffrent kind of sleep. Its wierd.
But try it out.
Posted by yxibow on November 3, 2007, at 13:26:02
In reply to Is trazodone a good hypnotic/sedative?, posted by amigan on November 3, 2007, at 13:05:53
Its allright, it carries the risk of priapisms (unwanted erections) in males which happens slightly more than stated although I imagine that varies by person. It also has a metabolite mCPP which isn't good in people prone to psychosis.
Mainly, its something you can habituate to a point where an adult dose starts, e.g. 50, 100, 150.. etc... and then you have to back off and restart.It was something in favor by psychiatists for sleep aids as it is an antidepressant but I dont know if it is de rigueur now.
Make sure you're in bed about 30 minutes after your take it as it a) takes effect and makes you feel dizzy and/or b) makes you want to eat by that same mechanism.
best of luck
Posted by amigan on November 6, 2007, at 11:35:17
In reply to Is trazodone a good hypnotic/sedative?, posted by amigan on November 3, 2007, at 13:05:53
Well, i tried some trazodone yesterday and i'm very disappointed with it.. :-/
At first, i took 50mg and the result was some MILD sedation, dizziness, asthenia and dry mouth. (which is strange because it doesn't have any anti-cholinergic properties)
It was nothing like hydroxyzine, so after 2 hours i took another 50mg. Still, the sedation was not remarkable and the other side effects became more noticeable.. This drug doesn't possess half the potency of hydroxyzine: Just 12.5mg of hydroxyzine (half pill) are enough to knock me out but 100mg of trazodone (a whole pill) are not!
Anyway, after a while, i fell asleep and after seeing some interesting dreams i woke up with a HORRIBLE and looong-lasting headache, (induced by the metabolite mCPP, i suppose) i was nauseous and my stomach was very upset. I was forced to lie down for many hours because of these symptoms.Question: Why everyone experiences extreme sedation, even with lower doses of trazodone, while i don't?
Could i be very sensitive to anti-histamines? (hydroxyzine is a strong anti-histamine, while trazodone is not)
Could it because i'm taking another drug that blocks the action of trazodone? highly unlikely. I only take fluoxetine currently and afaik, it potentiates this drug.Bottom line: Imho, it is not a good drug. It is a rather weak sedative (for me) and it has many nasty side effects.
With hydroxyzine, i experience a strong, clean sedation without any other side effects! What i need is a drug similar to hydroxyzine but with a shorter half-life. Any suggestions? :)
Posted by linkadge on November 7, 2007, at 8:07:19
In reply to Re: Is trazodone good? - It is so NOT!?, posted by amigan on November 6, 2007, at 11:35:17
Trazodone is not officially a sleep agent.
It can work well to improve sleep if patents are very depressed, but tends not to work as well as a casual sleep agent.
That what I have found. When I can't sleep cause I am feeling very low, it works like a charm. But when I am not depressed, it doesn't improve sleep.
Linkadge
Posted by kaleidoscope on November 9, 2007, at 12:06:13
In reply to Re: Is trazodone good? - It is so NOT!?, posted by amigan on November 6, 2007, at 11:35:17
I find diphenhydramine quite short-acting. Personally I find it more sedating than hydroxyzine.
Posted by florence on November 13, 2007, at 17:38:36
In reply to Is trazodone a good hypnotic/sedative?, posted by amigan on November 3, 2007, at 13:05:53
I have no mental illness- just an undiagnosed thyroid disease for over 20 yrs.
I was given trazadone yrs ago for sleep and it kept me awake......Recently tried it again: same thing.
Prozac had the same effect: take it at night it kept me awake.....Take it during the day I am drowsy.
I think these drugs ALL disrupt sleep patterns. I forget what it is like to feel drowsy and fall asleep on my own and gradually wake up. I was always in a super deep sleep with prozac.
I also need something like you describe. When I am desperate I take benadryl but I am very sensitive to antihistamines. I need the opposite.
Been using gabapentin (neurontin) with pretty good results... the new sleep aid Rozeram is okay; not addictive and works on melatonin receptors but of course the price is high so insurance doesn't usully cover it. florence
Posted by amigan on November 13, 2007, at 23:49:38
In reply to Re: Is trazodone good? - It is so NOT!? » amigan, posted by kaleidoscope on November 9, 2007, at 12:06:13
@ All
i have tried diphenhydramine (benadryl) But unless i drink 1/3 of the bottle (syrup) it doesn't do much for me...
Hydroxyzine has a special property that other drugs seems to lack:
"Hydroxyzine is an antihistamine that suppressed activity in subcortical regions of the brain"
I don't know the exact meaning of this, but it works well, even in small doses.
Anyone knows a another drug with this property, btw?
Posted by Astounder on November 15, 2007, at 18:34:37
In reply to Re: Is trazodone good? - It is so NOT!?, posted by amigan on November 13, 2007, at 23:49:38
> @ All
> i have tried diphenhydramine (benadryl) But unless i drink 1/3 of the bottle (syrup) it doesn't do much for me...
> Hydroxyzine has a special property that other drugs seems to lack:
> "Hydroxyzine is an antihistamine that suppressed activity in subcortical regions of the brain"
> I don't know the exact meaning of this, but it works well, even in small doses.
> Anyone knows a another drug with this property, btw?
>Hydroxyzine is weird in that it's a sedative/anxiolytic that accelerates fear extinction and the reversal of learned helplessness in animal models (it augments actions of antidepressants). This is unique among anxiolytics, because they usually slow antidepressant response.
I read somewhere that hydroxyzine functionally blocks the reuptake of adenosine, an inhibitory neurotransmitter highly bound to the circadian rhythm (like melatonin). This is opposite of caffeine which blocks adenosine receptors, which is responsible for caffeine's stimulant and anxiogenic action.
Coming off of Ativan, hydroxyzine did nothing for me except help with psychogenic itching. I also found it useless for sleep, but this also was shortly after withdrawal from Remeron, and hydroxyzine's action at the H1 site pales in comparison.
The first generation antihistamines in order of H1/anticholinergic potency go something like this:
promethazine > doxylamine > diphenhydramine > hydroxyzine
But if hydroxyzine works for you, that's all you need.
Posted by amigan on November 16, 2007, at 0:59:46
In reply to Re: Is trazodone good? - It is so NOT!?, posted by Astounder on November 15, 2007, at 18:34:37
> > @ All
> > i have tried diphenhydramine (benadryl) But unless i drink 1/3 of the bottle (syrup) it doesn't do much for me...
> > Hydroxyzine has a special property that other drugs seems to lack:
> > "Hydroxyzine is an antihistamine that suppressed activity in subcortical regions of the brain"
> > I don't know the exact meaning of this, but it works well, even in small doses.
> > Anyone knows a another drug with this property, btw?
> >
>
> Hydroxyzine is weird in that it's a sedative/anxiolytic that accelerates fear extinction and the reversal of learned helplessness in animal models (it augments actions of antidepressants). This is unique among anxiolytics, because they usually slow antidepressant response.
>
> I read somewhere that hydroxyzine functionally blocks the reuptake of adenosine, an inhibitory neurotransmitter highly bound to the circadian rhythm (like melatonin). This is opposite of caffeine which blocks adenosine receptors, which is responsible for caffeine's stimulant and anxiogenic action.I didn't know that hydroxyzine does this!
Hey, perhaps this could partially explain why it is so effective for ME! I drink large amounts of coffee, daily...
Posted by starfox on November 24, 2007, at 8:10:27
In reply to Re: Is trazodone good? - It is so NOT!?, posted by amigan on November 6, 2007, at 11:35:17
I tried this one on several different occasions and all it done was make my nose completely block up and give me the worst nights sleep ever!!. Also had bad nightmares and would wake up feelin like i never even slept a wink with this horrible drug!. But no two body's are the same so unless you dont try it you'll never know I guess, Just my humble opinion.
Posted by amigan on November 24, 2007, at 10:20:20
In reply to Re: Is trazodone good? - It is so NOT!?, posted by starfox on November 24, 2007, at 8:10:27
Just for the record: I discovered that the persisting/intense headache and nauseia are the result of interaction with fluoxetine.
I stopped taking fluoxetine for 5 days to prove this and i was correct. I still think that it is not a very good hypnotic, even without these 2 side effects.
Thank you for your responses.
This is the end of the thread.
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