Michal: Hi, thank you, and Trazodone

[Michal]

Hi everyone and thank you so much for this support community. I wish I had known about it sooner!

 

I am posting now primarily for an urgency I'm feeling, as I am 2.5 months into taking Trazodone 50mg for sleep, and I'm getting strong messages from my body that it's wrong. 

My hope is that because I haven't taken it for a relatively long time, that I could free my body from the debilitating side effects ASAP (headaches, body tension, fatigue and potentially other symptoms I might only realize once they're gone). 

 

Here's some background I remember, as this past year was a horrible experience with a lot of blur (probably due to sertralina failed taper attempt which was according tothe psychiatric protocol, not the 10%).

 

I've been reinstated on sertraline 50mg mid Feb 2024.

I started taking Trazodone 50mg on July 1st 2024. 

Started tapering off sertraline about a 5 weeks ago, according to the DR's protocol, I'm down to 12.5mg (12 days in), plan to follow the 10% guidelines with it moving forward. 

 

I am really experiencing the side effects of Trazodone now. Or at least that's the story that feels right. I wake up too early (so I started going to sleep earlier), headaches when I wake up, I noticed when my sleep is interrupted by the kids that my body is incredibly rigid, like locked, which I never felt before etc. I do associate these with Trazodone, as these symptoms were there when I just started on it, and when I took it for a few days before I had sertraline reinstated back in February. 

 

I want off Trazodone asap, and I'm hoping that maybe because I've been on it for 11 weeks, maybe I don't have to take it as slowly? 

 

Thank you🙏

Edited September 18 by Catwoman73
Name to title

[Catwoman73]

Hi @Michal, and welcome to SA!  We are a community of volunteers providing peer support in the tapering of psychiatric medications, and their associated withdrawal syndromes. 

 

If you could kindly complete your drug signature, we would greatly appreciate it.  A drug signature is a summary of your medication history that appears at the bottom of each of your posts.  This helps us moderators and those visiting your thread to know your history at a glance, without having to weed through a lot of posts to complete the picture.  In order to do this, click the following link, fill in the box with your history, including drugs, supplements and dosages, to the best of your ability, and click save.  That's it!  Please keep your signature updated as you proceed with tapering. 

 

Your Drug Signature

 

I'm so very sorry for your struggles.  

 

So, it looks like over the last year, you have done a rapid taper of your sertraline, taken trazodone briefly before reinstating a full therapeutic dose of sertraline, started trazodone again, and have recently started another rapid taper of sertraline.  That is a lot of change in a relatively short period of time, and has undoubtedly caused your nervous system to be severely destabilized, leading to very typical withdrawal symptoms, and possibly some mild hypersensitivity.  It looks like you've already discovered this, but we do recommend tapering by no more than 10% of your current month's dose of any psychiatric drug, no more often than every four weeks.  This is known as hyperbolic tapering- you can read more about why this is so important in the following link:

 

Why taper by 10% of my dosage?

 

It looks like you have also been reinstated on much too high a dose of sertraline.  When reinstating, it is important to start at very low, sub therapeutic doses, as too high a dose can cause adverse reactions/hypersensitivity.  The idea with reinstatement is to introduce a very small dose of the drug you are experiencing withdrawal from in order to reduce the withdrawal symptoms to a more tolerable level.  You can very slowly updose to find the optimal dose to achieve this goal, and then hold for many months to stabilize, before proceeding with a hyperbolic taper.  It looks like you have been given bad guidance by your psych, as none of this happened for you.  Don't worry- you are not alone!  Most people here have been given really bad guidance from our medical practitioners.  Read more about proper reinstatement here:

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

Hypersensitivity and kindling

 

So here's what I think happened- you were tapered from sertraline too quickly, and experienced withdrawal symptoms.  You went on and off trazodone.  You reinstated sertraline, but at probably much too high a dose, and over a couple of months, you started to experience some hypersensitivity because the dose was too high.  You started trazodone again to try to mitigate the symptoms you were experiencing, and this destabilized you further (this is not at all surprising- happens all the time around here).  And now, you have been guided to taper sertraline again, much too quickly, which is contributing to even further destabilizing your nervous system.  

 

So, in summary, it is not at all likely the trazodone by itself causing the issues you are facing.  It is nervous system instability caused by too many changes, much too quickly.  The trazodone is just a small piece of the puzzle. 

 

The question is, what would the be the best course of action from here?  Well, you're not likely going to like what I have to say here, but making any further changes while in such a destabilized state is not wise.  It would certainly be best to hold your dosages of both drugs, likely for many months, in order to give your nervous system a chance to catch up.  You have been on both drugs for long enough now that your body has adapted to their presence, making biochemical and genetic changes that cannot be undone quickly or easily.  A rapid removal of either drug could be disastrous for you.

 

If you came to me and said that you had been taking trazodone for three months ALONE, without the addition of the ups and downs with the sertraline, I would say that you could likely taper the trazodone over three months, but given that you've also been on and off of sertraline, and are very destabilized, that would not be the best course of action here. 

 

I would recommend holding both drugs for now.  Start a symptom journal, rating each symptom you are experiencing on a scale of 1-10 daily for severity.  As you stabilize, you will notice that you experience days where you feel better, and days where you feel worse.  This is a normal part of the healing process, known as the windows and waves pattern of stabilization.  It is a good sign that your nervous system is starting to move towards homeostasis again.  Read more about windows and waves in the following link.  I will also include a link to an excellent list of typical withdrawal symptoms that can be used as a template for a journal, if you wish.

 

Windows and waves pattern of stabilization

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

Once your nervous system has settled down, and you are in a more stable state, you can start tapering. Tapering one drug at a time is very important, so that you don't produce any confusion about which drug is causing any uptick in symptoms as you taper.  Typically, we recommend tapering the more activating drug first, which would be sertraline in your case, but that's always up to you.  Read more here about choosing which drug to taper first in the following link:

 

Taking Multiple Psych Drugs?  Which Drug to Taper First?

 

While holding to stabilize, this is a good time to start working on some non-drug coping mechanisms to deal with your symptoms.  From your post, it seems like sleep issues are your primary concern, so I will include some links on coping with sleep issues.  Almost everybody here has sleep issues when we have nervous system instability/ withdrawal- it is a very common issue around here. 

 

Tips to help sleep: so many of us have that awful withdrawal insomnia

 Path to Better Sleep FREE online for everyone from the US Veterans Administration

 Magnesium, nature's calcium channel blocker 

 Melatonin for sleep

 Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

 

Do be mindful that, when in withdrawal, it is very common for us to experience hypersensitivity to all sorts of things, including medications, supplements, and even foods.  It is best to start with very low doses of supplements, even the ones we recommend (like those above, plus omega-3 fatty acids), to see how you fare.  You can increase slowly over time if you tolerate them.  I am a prime example of hypersensitivity- I do not tolerate it at all.  It gives me brain zaps and worse insomnia!

 

There are other things you can do to help with healing and finding stability.  Most are intuitive.  Eat a balanced, whole foods diet, stay adequately hydrated, engage in gentle exercise, and rest as much as you need to.  Avoid all neurologically substances, such as caffeine, nicotine, alcohol and recreational drugs- using these is like pouring gasoline on the fire of your symptoms.  And avoid adding any further psychiatric medications- as you have discovered, the effects of these drugs are unpredictable on a destabilized nervous system, and they can make you worse.  Not to mention, adding other drugs will only create a situation where you have something else to taper down the road, thereby prolonging your withdrawal journey.  

 

If you are experiencing cognitive and emotional symptoms, we have many threads here on coping with those as well.  I will link some below.  You may find some of your own methods of coping as well.  I'm a big fan of living mindfully, using guided meditations/yoga Nidra/nature sound recordings at night to help with my symptoms.  I also love distractions that make me feel good- I enjoy swimming (I feel normal in the water!), cooking, and taking on artistic projects. 

 

Non-drug techniques to cope with emotional symptoms

 Easing your way into meditation for a stressed-out nervous system

Ways to cope with daily anxiety

"Change the channel" - dealing with cognitive symptoms

Dealing With Emotional Spirals

 

Of course, what you do with your body is 100% your choice.  If you insist on tapering your trazadone right away, that's entirely your decision.  If you do choose to do that, I would recommend moving very slowly, and watching for a minimum of 1-2 weeks after each drop to ensure you are not getting worse.  But I think stability would be much better achieved by a longer hold, and taking very good care of yourself in the meantime with all of the above tips and tricks.

 

This is your introduction topic- each member gets one intro topic.  Please post updates or questions here, on this thread.  Don't hesitate to explore the rest of the forum though- there's lots of good info here!  And feel free to read the intro threads of other members, and drop a comment/word of support.  Withdrawal can be a lonely journey.  I've found it very helpful to engage with this community in order to surround myself with people who fully understand the challenges that I am facing.  The support here is wonderful!

 

I look forward to following your journey.  Sending healing vibes!❤️‍🩹