Mesh: Tapering off Trazodone Rebound Insomnia

[Mesh]

Hi everyone,

 

I'm trying to get off Trazodone (now on 12.5mg) and it's not going well. I'm really sensitive to pills and it seems this pill has made me even more sensitive to taking other pills like valerian root and even ibuprofen. I'm feeling pretty desperate and hopeless and thinking upping my dose again. I'm about to start a new job this week and wondering if I should just quit and move back to Europe from China with my cat in this sh*tty condition of panic and crying and muscle pain. The doctors here are no help and can't speak English and just keep giving me strong sleeping pills or say up the dose and then tell me to go home if I don't cooperate because of side effects. I want to go home but it's a huge decision to be making in this state.

 

I was put on Trazodone 25mg for chronic insomnia about 2 months ago (30 mins of sleep a night due to stress) and it worked okay for a while but gave me anxiety and very unpredictable sleep (sometimes 6-7 hours, sometimes 2-4) and nightmares. The doctors wanted to increase and said the inconsistent sleep was due to a low dose. Every time I tried to increase by a tiny bit, I'd actually sleep less for a few nights so I always went back on a slightly lower dose and again and it would be good for a few nights. Did this back and forth a lot. It only seemed to be effective when I was going lower.

 

I took only 12.5mg before that and didn't want to increase for a month because of the side effects (which Xanax and Ambien and not sleeping were giving me too) of vein inflammation and swelling and pain. Does this happen to anyone else? The inflammation never went away (4 months now).

 

I decided to taper off two weeks ago when my sleep went from 7 ours a night to 6 for a week with no change in dose and increased anxiety and decreased sleep when I tried to up the dose. But did it too fast (25% instead of 10%). Took 17mg for a week and now I've been on 12.5 mg for 5 days and I'm not sleeping. I had 2 nights of 30 mins-1h again. Before I was also relying on herbal medications like valerian root for sleep when Trazodone failed but now I have violent reactions to the same pills (no sleep, extreme anxiety, jitteriness, restlessness, feeling very hot and like my hands and feet are burning, heart pounding). I even had this reaction to ibuprofen at night. I'm not taking any other drugs. Is this part of withdrawal? This sudden interaction with herbal meds? I'm not sure how I'm supposed to sleep with nothing.

 

Thanks for reading.

[getofflex]

Hello, and welcome to SA.  We are a peer owned and run forum of people who have been or are getting off of psychiatric drugs.  

 

First of all, can you please give us specific information about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some information about how these drugs actually work.  

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

 Video on Recovery from Psych Drugs

 

What is Withdrawal Syndrome?

 

Tapering is best done extremely slowly, and we taper by 10% of the current dose no more than once every 4 weeks, so that the taper becomes exponentially smaller.  

 

 Why Taper by 10% of my Dosage  

 

Information about Trazodone, Including How to Taper

 

 

Also, as we are recovering, we suggest keeping things slow, simple, and stable. This is extremely important. 

 

Considerations About Stability Stop Jumping Around

 

Keep it Simple, Slow, and Stable

 

 

When we recover, there are times of feeling OK mixed in with times of feeling bad.  This is called windows and waves.

 

Windows and Waves Pattern of Stabilization

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

 

Omega 3 Fish Oil

 

16 hours ago, Mesh said:

Every time I tried to increase by a tiny bit, I'd actually sleep less for a few nights so I always went back on a slightly lower dose and again and it would be good for a few nights.

 

16 hours ago, Mesh said:

I'm feeling pretty desperate and hopeless and thinking upping my dose again.

 

I would not suggest that.  As you stated in the first quote, you are very sensitive to these drugs, and each time you tried to updose in the past your feel worse.

 

16 hours ago, Mesh said:

I was put on Trazodone 25mg for chronic insomnia about 2 months ago (30 mins of sleep a night due to stress) and it worked okay for a while but gave me anxiety and very unpredictable sleep (sometimes 6-7 hours, sometimes 2-4) and nightmares.

This sounds to me like you had an adverse/paradoxical reaction to the trazodone.  If you read the link I gave above about Trazodone, it explains why this can happen.  

 

16 hours ago, Mesh said:

It only seemed to be effective when I was going lower.

 

The statement above is your key to recovery from trazodone, I believe.  This medication does not agree with you, and carefully and gradually tapering off is probably your best course of action.  

 

Based on your drug signature, you have started, stopped, and change doses of several drugs. This, combined with the fact that you are already sensitive to these drugs, has probably thrown your nervous system into significant disequilibrium, and caused you to have these withdrawal symptoms.  It sounds like your system very much needs a break from all the changes in the medications.  

 

16 hours ago, Mesh said:

I decided to taper off two weeks ago when my sleep went from 7 ours a night to 6 for a week with no change in dose and increased anxiety and decreased sleep when I tried to up the dose. But did it too fast (25% instead of 10%). Took 17mg for a week and now I've been on 12.5 mg for 5 days and I'm not sleeping. I had 2 nights of 30 mins-1h again.

 

If I were you, I would go back to the 17 mg dose of trazodone and stay on that very consistently each day for a long time (several months at least).  6 hours of sleep is much better than only 0.5 to 1 hour of sleep.  With all the psych drugs you have started and stopped and changed in the past several months, chances are you will have some symptoms regardless. You have been tapering much faster than we suggest here at SA, because you've been making large decreases and only waiting a week between your last 2 reductions.  Your nervous system doesn't have the time to get used to the new dose, and find it's balance.  

 

I've given you quite a bit of information here.  Please read through it, and mull it over, and we will take it from there. In the meantime, take care of yourself, and take heart.  We in this forum have been through this, and we understand first hand the pain and discomfort you are going through.  Please know that the brain is amazing in it's healing abilities.  It takes time, but healing can and will happen. 

[Mesh]

Updated. Thanks.

[Mesh]

@getofflex Thank you for the help. I'll try going to 17mg. I tried a few more nights as I am now and started taking Ambien again because I just can't do 30 minutes a night. My anxiety is off the charts all night.

 

Is there a general topic on the forum on how to handle panic and anxiety or akathisia at night? Stress over being in bed and lying down? I don't know if other people handle their symptoms more gracefully, but I just pretty much freak out most of the night and walk around and constantly move my body and hyperventilate and rock back and forth sitting on the floor. I listen to guided meditations and mindfulness lectures and calming sounds and write down unhelpful thoughts and what am I believing that's making it worse, and all that too, but the nights are just endless and eventually I loose it. 

 

Thanks.

[getofflex]

19 hours ago, Mesh said:

I tried a few more nights as I am now and started taking Ambien again because I just can't do 30 minutes a night.

Just be very careful, as Ambien is highly addictive, and very difficult to get off of.  Hopefully if you go back to 17 mg on your trazodone, you can go back to getting more sleep at night.  Please let me know if you do this, and if it helps with your sleep.  When you were on 17 mg before, you were able to sleep 6 hours a night, and for someone recovering from WD, that is actually pretty decent. 

 

I'm very sorry to hear about your bad nights.  My heart goes out to you.  I've had some pretty bad nights in WD too, and I get it, I really do.  

 

Here is some information on anxiety, panic, etc.  

 

I highly recommend Claire Weekes.  Her technique is so simple and easy, and it really helps - it's in the third link below.  Check out these links: 

 

Audio:  First Aid for Panic (4 minutes)
 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy
 

Audio:  How to Recover from Anxiety - Dr Claire Weekes
 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

Akathisia, Restlessness, Anxiety, Agitation

 

Akathisia

 

Audio Tracks for Depression Anxiety

 

When I get anxious and restless at night, I listen to a very relaxing and upbeat playlist on Spotify called Harp Music.  It is a 14 hour playlist, and I play it at very low volume.  It usually calms me down, and sometimes helps me go to sleep.  I have the paid version of Spotify for $9.99 a month, because the ads would wake me up and stimulate my nervous system.  Good luck, and please keep us posted.

 

[Mesh]

@getofflex Thank you so much for the resources. They're very helpful.

 

I took 17 mg last night and I think I got 6 hours. I feel calmer and sleepy today.

[getofflex]

I'm so glad it helped going back to 17 mg.  I suggest you stay there for a long time, as in several months.  You've made quite a few drug change in the past 6 months, and your system is craving stability.  Then, once you feel stabilized, you can resume a very slow and careful taper.  Here is a thread about stability: 

 

https://www.survivingantidepressants.org/topic/23081-are-we-there-yet-how-long-is-withdrawal-going-to-take/?do=findComment&comment=492493

 

[Mesh]

@getofflex Thanks. I didn't actually sleep 6 hours on this dose before (that was on 25mg) and at the end it was reducing to 2-3 hours. I got 4 hours on it last night. But luckily, I tried Valerian again after I woke up and it worked normally and gave me a few more hours.

 

Right before I tapered too much a few weeks ago, I moved the Trazodone to the morning hours at around 3 or 5 because it gave me so little sleep but made me jittery when I woke up. I even tried moving it to the afternoon so I could try only Valerian at night, but I tapered off too much at the same time so not sure if that would have worked. Do you think this is a good idea if the Trazodone is giving me so few hours? Or just keep it the same and keep waking up every few hours and taking Valerian? 

[getofflex]

On 6/27/2021 at 8:03 PM, Mesh said:

I was put on Trazodone 25mg for chronic insomnia about 2 months ago (30 mins of sleep a night due to stress) and it worked okay for a while but gave me anxiety and very unpredictable sleep (sometimes 6-7 hours, sometimes 2-4) and nightmares.

 

 

On 6/27/2021 at 8:03 PM, Mesh said:

Every time I tried to increase by a tiny bit, I'd actually sleep less for a few nights so I always went back on a slightly lower dose and again and it would be good for a few nights. Did this back and forth a lot. It only seemed to be effective when I was going lower.

So it sounds to me like you had a paradoxical reaction to the trazodone.  This means that your system was fighting the sedating effects of trazodone to the point where the drug did the opposite of what it was supposed to do - help you sleep.  

 

13 hours ago, Mesh said:

I moved the Trazodone to the morning hours at around 3 or 5 because it gave me so little sleep but made me jittery when I woke up.

 

13 hours ago, Mesh said:

Do you think this is a good idea if the Trazodone is giving me so few hours? Or just keep it the same and keep waking up every few hours and taking Valerian? 

It's hard to tell what part of your sleeplessness is your original insomnia, what part is withdrawal, and what part is adverse/paradoxical effects.  Also, changing the  time you take it frequently can throw your system off even more and cause more trouble.  As a mod of an online forum, whose purpose is just to help people taper off psych meds, I can't tell you what to do about your sleep issues.  Only a doctor can do that.  

 

If it were me, I would get to the bottom of why I had sleep issues in the first place.  You mentioned it was from stress. I would try and find non drug ways of coping with and reducing the stress, and gradually try to get off the trazodone.  Perhaps talking to a therapist or counselor would help.  It sounds like your body is fighting the trazodone, and it is causing you trouble with sleep, and at the same time, your body became dependent upon it and is suffering from withdrawal as well. Here is a thread with many links about symptoms, including how to deal with sleep issues: 

 

Important Topics about Symptoms Including Sleep Problems

 

Try keeping a daily log of your symptoms, the time you take any drugs or supplements, when you eat and sleep, etc.  See if there are any patterns to see what is causing what.  Here is an example:  

 

6 AM woke with anxiety

8 am took 2.5 mg lexapro

10 am stomach is upset

10:30 am ate breakfast

11:35 am got a headache, lasted one hour

12:35 ate lunch

4 pm feel a bit better

5 pm took 2.5 mg lexapro

6 pm ate dinner

9:20 pm headache 

10:00 pm took 50 mg Seroquel

10:30 pm feeling dizzy

10:30 pm fell asleep 

2:30 am woke, took 3 mg Ambien

2:45 am fell asleep

4:30 am woke, but got back to sleep 

Edited July 2, 2021 by getofflex

[Mesh]

@getofflex Thanks for the input and the links. I appreciate the help. I did resolve most of my initial problem and have talked to a psychologist, now it's just chronic insomnia and the anxiety I've always had. 

[getofflex]

I'm sorry to hear about the chronic insomnia and anxiety. I hope your psychologist can help you get to the bottom of this.  There are many ways to overcome these issues without drugs.  They take more work, but they get to the root of the problem instead of just covering the symptoms, which is what the psych drugs tend to do.  

[Mesh]

Update:

 

I've been on 18mg of Trazodone for 3 weeks now and bought a scale to keep a steady taper. My sleep is still kind of erratic. But the biggest issue is that the Trazodone is now giving me nightly breathing issues that last about 2-3 hours and prevent me from sleeping (I can't breathe through my nose). On the scale, I lowered my dose from 0.075 mg of pill weight (18mg I guess) to 0.073 over a week in hopes of reducing the breathing issue time but no luck. 

 

I was taking Valerian successfully all this time but a week ago it suddenly stopped putting me to sleep. I tried Melatonin in small doses 2x a night (1 or 2 1.5 mg pills) and it sometimes works and sometimes doesn't. I get 2h tops per pill but if I take too much it irritates me. The last five days I've also been experiencing horrible muscle aches, especially in my thighs. My anxiety and depression are worse from sleeping less. I'm averaging 5-6 hours. I've taken Ambien at 5AM out of desperation the last 3 days after the Valerian or Melatonin refused to work.  

 

I'm not sure if the muscle pain and anxiety when taking Valerian and Melatonin and the breathing issues are all some other kind of withdrawal now or if I'm feeling the pain from 5 months of insomnia more on a lower dose. Trazodone is evil. Thanks for reading.