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Trazodone for insomnia..

My doctor prescribed trazodone 100mg (I think it said mg) for my insomnia that I have suffered with for the last 15 years due to a thyroid problem I had years ago.

I took it for the first time last night, but I did not fall asleep or even come close to falling asleep. I took it at 8:30pm and went to bed at 9pm, but ended up getting out of bed at 10pm because I could not sleep. The only difference I feel is a huge headache this morning. Will this medication eventually work and I just have to give it time?

I have been on Ambien for the last 2 years, but I can only take it once every seven days (20mg) or it will not work. I average about 2-3 hrs of sleep without sleep medication, I can literally go 36hrs straight with out any sleep, and then I crash and can actually sleep 4-5 hrs, but I am used to it and do not have a problem with work or any other activities. I do not fall asleep at my desk. I am unable to nap.I know my body is fatigued, but my mind will not shut down AT ALL, so NO SLEEP.

Just thought I would get opinions on this medication....

Thanks.



23 Responses
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Avatar universal
People mention psychiatrist and depression because this is a website devoted to depression, not sleep disorders. If you object to people assuming you have depression or bipolar then you need to move to a website that is dedicated to sleep problems.
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Avatar universal
Tartive dyskinesia is associated with antipsychotics, not antidepressants. Trazadone is an antidepressant and I looked it up in a PDR. It does NOT list tartive dyskinesia as a side effect.
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Avatar universal
I would caution anyone who is prescribed medication for any use but for use as a sleep aide I would really be cautious.  Most sleep problems are a symptom of something else out of balance.  Fix whatever is out of balance and fix your sleep.  This applies to many ailments that doctors offhandedly prescribe drugs...

Just educate yourself and empower yourself to care of your own body, which can be affected by past issues that need healing.
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Avatar universal
Okay after reading your post, I think I will ask doctor to get me off of it. Like Jennifer78 said, why take something that is not working....

Hopefully my doctor will call today.
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585414 tn?1288941302
I do think any doctor should give full information on a prescription. First of all look at the package insert. The pharmacy should have have a hand out Tardive dyskinesia is a long term neurological disability that is a movement disorder that's clinically similar to Parkinson's. It is often caused by antipsychotics but can be caused by Tradazone and I know people who acquired it from Tradazone. I cut and pasted from a clinical site.
  "The most common type of involuntary movement associated with TD is classified as stereotypy and can be defined as “an involuntary, coordinated, patterned, repetitive, rhythmic, ritualistic, purposeless (but seemingly purposeful) movement, posture or utterance”. Simple stereotypies involve only one body part, such as the mouth or hand, whereas complex stereotypies affect more than one body region and may involve the whole body. The OFL movement, most typically seen in TD, is one of the best examples of stereotypies and is present in over 80% of patients with TD. In a videotape review of 100 patients with TD evaluated at the Baylor College of Medicine Movement Disorders Clinic, 78 exhibited some stereotypies and 61 of these involved the OFL region. The following OFL stereotypies were observed: chewing, blowing, licking, lip smacking and pursing, facial grimacing, tongue protruding (“fly-catcher's tongue”), and coordinated tongue and mouth movements (“bon-bon sign”). Other stereotypies included hand and toe waving, touching and picking, rubbing of face, scalp and other body parts, head nodding, body rocking, shallow and rapid breathing (“respiratory dyskinesia”), pelvic thrusting (“copulatory dyskinesia”), crossing and uncrossing of legs, shifting of body weight from one to the other leg, pacing or marching in place, alternating sitting and standing, and a variety of vocalizations and noises, such as humming, moaning, and eructations. While TD can result in severe disability, such as shortness of breath due to respiratory dyskinesia, up to two thirds of patients are not even aware of the abnormal involuntary movements. Similar to other hyperkinetic movement disorders, tardive stereotypies are usually exacerbated during stress, disappear during sleep, and may be volitionally suppressed, at least temporarily.

Other involuntary movements associated with TD include chorea (jerk-like movement than move randomly from one body part to another), dystonia (facial spasms, eyelid contractions, clenching of jaws and grinding of teeth, arching of the neck and back, extension of arms), akathisia (feeling of restlessness, inability to stand or sit still, and a need to move), tics (jerk-like coordinated movements often preceded by premonitory sensations), myoclonus (jerk-like simple movements), and a variety of other movements and abnormal, often uncomfortable, sensations.
  Drugs Causing Movement Disorders: Persons with Parkinson’s disease or tardive dyskinesia should be aware that certain drugs can cause parkinsonism and will aggravate already existing symptoms. The following is a partial list of medications that act as blocking dopamine in the brain and are usually prescribed as a potent tranquilizers or antiemetics (drugs used for nausea and vomiting). The drugs listed below are some of the drugs that should be avoided in patients with Parkinson’s disease and tardive dyskinesia. However, there may be special reasons to prescribe these drugs in certain circumstances and the patient should discuss that reason with their physicians.
GENERIC NAME TRADE NAME

Acetophenazine Tindal
Chlorpromazine Largactil, Megaphen, Thorazine
Clorprothixene Taractan
Fluphenazine Permitil, Prolixin
Haloperidol Haldol
Loxapine Loxitane
Mesoridazine Serentil
Metoclopramide Reglan
Molindone Moban
Olanzapine Zyprexa
Perphenazine Etrafon, Trilafon, Triavil
Pimozide Orap
Piperacetazine Quide
Prochlorperazine Combid, Compazine
Promazine Sparine
Promethazine Phenergan, Stopayne, Synalgos,
Risperidone Risperdal
Thiethylperazine Torecan
Thioridazine Mellaril
Thiothixene Navane
Trazodone Desyrel
Trifluoperazine Stelazine
Triflupromazine Versprin
Trimeprazine Temaril"
Helpful - 0
474256 tn?1237989696
Hey Totie!  Well all I know is from my own experience Trazadone didn't really help me sleep.  All it did was sort of take the edge off.  I could sleep for just a little bit but after just two hours I'd be wide awake again.  I stopped taking it because it's really  not worth it to me to take medication if it doesn't really do anything.  
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Avatar universal
I took the trazodone at 9pm (100mg) and nothing. When is the best time to take the trazodone?  My doctor did not call today. She never mentioned TD (taradive dyskensia- sp?). In all honesty she did not tell me anything of the side effects, other than look it up on the web. I have been taken Ambien, and the two doctors that I have had help me deal with my insomnia never mentioned becoming addicted to it and actually gave me a year long presciption for it. At first it freaked my son out when I started on Ambien because of the weird things I would say, but after awhile I guess I became tolerant to it and can only take every 7th day now.  It does help me sleep for about 3-4 hrs, but does not keep me asleep.  I did not sleep walk or get out of bed, if I got out of bed it was because I could not sleep any longer, but not because I was out of my mind or sleep walking.

I know I am fatigued, but my brain will not shut down.

By the way I am also on Levothyroxine  100mcg for clinical hypothyroidism. They did recently change my dosage on that because of TSH levels. I had hyperthyroidism/graves disease about 14 yrs ago. I have also been on Bactrim for the last month due to a complicated infection and will be on Bactrim for another 5 months. The Levothyroxine will be taken for the rest of my life. I don't know if those two have anything to do with the trazodone not working, the pharmacist did not think it would have any effect .

I will keep you guys updated.....

Thanks for trying to help.

Helpful - 0
585414 tn?1288941302
Yes I agree. Truthfully I could not tolerate Rozerem or Lunesta and I had the same side effects from Lunesta (the metallic taste in the mouth). They also caused personality changes in me. Lunesta made me manic. Rozerem brought me into an agitated mixed state. And with all the muscle relexants I need being activating (awakening not addictive, in many people they are sedating but they are clinically related to anti depressents so they keep me up as I have the bipolar aspect of schizoaffective) "bedtime" is 3 A.M. But I could not tolerate those medications. But I only tend to post about side effects that are common or to be watched for in everyone (such as tardive dyskinesia from Tradazone or Stephen's Johnson Syndrome from Lamictal) even if they are uncommon (though with medications that cause tardive dyskinesia it does eventually happen to everyone). I don't know what the standard experience on Lunesta and Rozerem is like. I just know they officially are classed as safe to take every day and are non addictive. And that Rozerem is clinically related to Melatonin and adjusts the sleep cycle. Ambien and Sonata are not meant for long term use.
  Restoril is a good option but it is a benzodizepene like Klonopin (which I take for control of dystonic spasms) so a person can build up a tolerance to it. But if someone needs it every day (like I do the Klonopin) then it makes sense. Its just that being in the same family as Valium if taken every day, if someone decides to stop it, they can't do it all at once or its dangerous. They must titrate off it slowly at the rate their doctor tells them. I may be on Klonopin for life. But since in a ten year period it had to be raised twice as that particular dose was not effective that may not be a good thing. Then again chronic insomnia and day time naps isn't either. As new medications come out for sleep I will try them if warranted.
  Some side effects occur in particular people and some can potentially occur for everyone so it all depends. The first I might discuss but the second I always will.
Helpful - 0
699178 tn?1228256967
Trazodone is a favorite by sleep specialist because it's been around for so long. I would not recommend taking Lunesta because it caused me to have a HORRIBLE taste in my mouth the whole night as well as the next day. I couldn't eat, so that won't help your lack of weight at all. Ambien does work for me, but I see you can only take it every 7 days. Taking 20mg of Zolpidiem (Ambien) is somewhat dangerous because since you wake up while the medication is still in your system you may not be able to remember what you've done....sleep walking in other words. I've experienced this myself, so be careful. I wouldn't recommend alprazolam (Xanax) because I was on it for a long time for my anxiety condition and I just went through hell to get off of it. Since the trazodone isn't working at 100mg, I would expect the doctor to not increase the dose but to change the medication. In my opinion, if 50-100mg doesn't work, there's no use in taking more than that. If you aren't taking any benzodiazipines, I would recommend temazepam (Restoril). It's in the same class as Xanax, Valium, Ativan, ect ect. This medication comes in 15-30mg capsules. Ask your doctor about it and see what she thinks. Be sure to let us know what happens.. thanks for the post, o fellow sleepless one. =)
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585414 tn?1288941302
Sorry yes there was a confusion here because the post was in the depression forum and Tradazone is a common adjunct anti-depressent for insomnia if someone has the activating effects of another anti-depressent and can't fall asleep. I should have read through the initial post more carefully and also I didn't know its usage was for gaining weight as well. With its usage for a physical disability I am less familiar. The caution I put about that particular long term side effect (tardive dyskinesia) is always of concern but if you are aware of it and discussed it with your provider and they have a specific reason to put you on Tradazadone then as I have a specific understanding of psychiatric medication (from a consumer perspective, I don't claim any knowledge other than that but I do confirm it with clinically accurate sites) but not for physical disabilities other than tardive dyskinesia which I have.
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Avatar universal
Someone mentioned "my psychiatrist" and "bipolar". I do not have a psychiatrist. I only have my PCP. I have never been diagnosed with depression, bipolar, or anxiety. She put me on it to help me sleep and gain weight.

I am still on the trazodone, but have not heard from my doctor either. I don't want to stop it until I get permission from my doctor. I am hoping she will increase dosage.

Once I hear from her I will let you know.
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Avatar universal
I think you should try the Seroquel creston 1966 mentioned. I could only handle 1/2 a tablet and I was out like a light. Trazadone gave me terrible, vivid nightmares. Lunesta left such a horrifying taste in my mouth the entire next day, it was intolerable. On Rozerem I would wake up frequently during the night with extreme difficulty falling back to sleep. With Ambien I would wake up and go down to the kitchen and eat in the middle of the night. Presently I do well with 1 mg of Xanax, but your situation sounds a lot more severe. I would try Seroquel if I were in your position.
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Avatar universal
Trazadone works a real treat for me.  I sometimes have mid-sleep-cycle partial wakefulness, and can't get up or go back to sleep for two hours. I lose about three hours out of my day and never get them back.  If it happens to me two or three days in a row, I take 50 mg an hour before bedtime the next night, and I usually sleep soundly.  To break the cycle, I sometimes take it two or three nights in a row.  If I take it for more than three nights, it stops working.
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Avatar universal
While I'm skeptical of most dr's and drug dealers....uh, I mean drug companies, I do think this is the case with Trazodone as sleep aid.  In fact, for quite some years now it is the primary reason it is prescribed.  Trazodone was originally put on market as an anti-depressant, and drs and patients alike noted the sedating effects.  The fact is Trazodone to be effective as an antidepressant usually has to be taken at higher doses, such that, the sedating effects would be limiting.   But taken at lower dosage, folks found it to be a decent sleep aid, with less chance for withdrawal side effects of most anti-depressants.
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585414 tn?1288941302
No a doctor can prescribe a medication for any usage off label. They don't have to be approved. There are often drug trials just to expand a prescription's ability to be patented and not have competition from generics. That's why Wellbutrin was remarketed as Zyban for smoking cessation so the patent would extend another 7 years. The initial research is funded by the government and when a medication is "viable" then the pharmaceutical companies are handed the result. Yes I do get concerned that they use profit over people but that's not something my psychopharmocologist would disagree with or psychiatry as a whole. They can't regulate what becomes a prescription and the FDA has less say than it should. Clearly things should be further regulated.
   As for anti-depressents working on anxiety though, there you are of course correct. But here we are talking about Tradazone being used as a sleep aid. I would say in this case or in any case the best reason to find out why a psychiatrist picked a particular prescription and for what aspects of your disability is to ask them. There are multiple forms of depression and bipolar and various medications are helpful on some more than others. I can't figure out exactly what is going on but clearly if someone's psychiatrist has there's no reason not to ask and get a detailed clear explanation.
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Avatar universal
"Why are doctors so quick into anti-depressants for other symptoms? "

I don't know about your sleeping problems, but antidep are prescribed for anxiety because the 2 can go hand in hand. My pharmacist and other docs gave me that data since I had more of a problem with anxiety, while the antidep manufacturer's drug info line person said she couldn't comment on whether the drug would help with anxiety because it was just tested for depression. She took all my story for their research files though.
Drug trials can cost $500,000,000 so if a drug gets approval for something but will work for a related issue maybe the drug company won't waste money on another set of trials. Possibly the patent would expire for the second usage when the first usage expires, but that is just a guess.
I have to assume this antidep also work for sleep since your doc prescribed it, but you might check with your pharmacist.
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627145 tn?1230305626
My experience with trazodone was that it made me sleep, but I lost at least 12 lb in 2 weeks on it, which was a shock.  Weight loss is a common short-term side effect.  It also made me a little irritable during the day - impatient or something.  

If your mind isn't shutting down and allowing sleep, have you considered relaxation therapy with biofeedback?  You may be able to learn alternative behaviors to that racing mind habit.  I learned how to relax for the first time with that.  
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585414 tn?1288941302
Well I can tell you as regards insurance "hope" won't work. If you are denied you have to appeal the denial of coverage. I have some knowledge of benefits appeals as I have helped people in this regard as a volunteer and I myself and am in the middle of a Medicare Part D appeal for Zofran.
   Someone did make a fair point about what a psychiatrist would reccomend so I think the best way to restate what I said is to know that Tradazone can cause tardive dyskinesia. You can google "patient education, tardive dyskinesia" for more information. Best to ask your psychiatrist why they chose it. If they have a specific reason that I would not know then that would be their decision. But if its because of pricing then in that case I would strongly suggestion appealing coverage for something else. Ambien is problematical because a person can build up a tolerance over time. Lunesta can be given every day (that's clinically valid information, on the website). If the Tradazone isn't working though why not ask about Lunesta. As for "brain energy like a hyper feeling'' remember Tradazone's standard usage is an anti-depressent and in someone with bipolar can set off mania. You might want to report the side effect to your psychiatrist in that regard. I was prescribed Anafranil for what was originally classified as ocd and since I have the bipolar aspect of schizoaffective it made me dangerously manic. Regardless though you have physical disabilities so I know things are more complex but do keep your psychiatrist up to date and let them know if its not helping and any side effects you are encountering and ask if Lunesta might be an option.
The only "reccomendation" I would give is not to chose a prescription because of pricing or to let a denial for coverage stand but I can give you more specifics about insurance denials if you pm me. Thanks.
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Avatar universal
Okay i have been on trazodone for six nights now, and all it does is decrease my appetite. Funny thing is the doctor gave it to me for insomnia and hoping for weight gain, but all it does is the opposite. (Could be I need a higher dosage) I did get rid of the headache 2 days ago. It does give my brain energy, like a hyper feeling.

I want to take my ambien, but the on call doctor told me not to and to continue the same dosage until my regular doctor comes back from vacation.

I don't know if I need the sleep, but doctor tells the amount of sleep I get is not normal. I do not have trouble getting up in the morning, or doing my job, or any other activity. I do not nap, and can honestly function on little sleep, always have since I had graves disease 14 yrs ago.

The reason for treating the insomnia is that my doctor thinks i have a weak immune system (constant infections of one sort or another) and feels that the lack of sleep is causing my body to become weak. I guess that is a good theory.

I will let you guys know what she says next week. I am being scheduled for a sleep study. Hoping insurance pays for it, but if not, no big deal. Like I keep saying, I am used to it. It does not bother me to get little sleep. I do go on stretches of going on 36hrs with no sleep, than I sleep for about 3hrs, but that is it. I either watch TV or listen to music, or if I am bymyself, clean house or do laundry.
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Avatar universal
I've had some success with trazodone.  I've never heard that it can cause tardive dyskinesia.  Suppose its possible. Dont suppose I'd give up and trying it just one night.  Give more time, if you are able to handle the side effects.  For me, I do sometimes feel tired and with headache following day, but not always.  Trade-off for me as I, like you, cannot sleep.  

I tried Ambien, but was very spacey (more than normal :)) the next day.  And would sleep walk (and talk, and eat) with Ambien.  But if it works for you?  Maybe Lunesta.  

I was on Seroquel for a short time.  That stuff would absolutely knock me out.  It was the only thing I've found which could do that.  It's not usually prescribed just for insomnia alone though.

Good luck.  Let us know if you find something which works for you!!
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Avatar universal
Do you feel like you don't need sleep (i.e. can function normally with 2-3hrs per night)?  Or like you need to sleep but can't fall asleep?
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Avatar universal
I tried the Rozerem and Melatonin and they did nothing for me. I have not however tried the Lunesta. I will ask my doctor about that one.

I have even been put on Symbytax (sp) in order to try and help me gain weight. I gained 4lbs, but that was it. I looked that one up and it is for severe bipolar disorder. I am not even diagnosed with depression.

Why are doctors so quick into anti-depressants for other symptoms?

I guess I will just have to live with the insomnia.

Thanks for your input....
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585414 tn?1288941302
I wouldn't reccomend it because it puts a person at risk for acquiring tardive dyskinesia, a long term Parkinsonian condition which I have from the use of anti-psychotics. Unlike the current generation of antipsychotics (as opposed to the ones in development) there are many anti-depressents (Trazadone's original use) and sleep aids that do not cause this risk. Lunesta can be taken every day without risk of addiction. Rozerem can as well and since it was developed from Melatonin even though it is a prescription medication it actually adjusts the sleep cycle as well as promoting sleep. I would ask about those two instead.
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