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  1. Hi Friends, I went off of trazadone 5.5 months ago after 15 years of use for insomnia, and have been suffering from protracted withdrawal ever since. The most debilitating symptom is severe depression that often manifests physically as pain in my heart, and a myriad of new drug sensitivities. I have a few questions about other's experience's and/or recommendations. · Has anyone had success with st. john's wort, 5 htp, homeopathy, or other approaches? · Will attempting to treat the symptoms with herbs, or ssris prolong the period of withdrawal? · Does anyone understand the mechanism behind the symptoms of protracted withdrawal coming in waves? My preference would of course be to get through this without having to medicate the symptoms, but there are times when the depression feels so intolerable, I need to have another option for my own safety (I've been very proactive of finding alternative methods to deal with the depression, ie, meditation, exercise, support, etc. but they have a limited effect). I have read that in rare cases, protracted withdrawal can last years or be indefinite. Given that I was on trazadone for 15 years, and I tapered much too quickly, I imagine mine may be a slow process. I have included a detailed history of my experience to give context for anyone who is interested. Thank you. HISTORY: 15 years ago, at the age of 23, I went through a healing crisis of sorts, dealing with issues of childhood trauma. I went to a treatment center for depression, where I was put on a number of different drugs (as best I can remember: celexa, risperdal, trazadone, vistaril, and one or two others). The treatment center was beneficial for me - I did intensive therapy, and worked very hard on my own healing. Within a year or two of returning, I tapered off all of the mediations I'd been put on, with the exception of trazadone. I had had insomnia for most of my life and was under the impression that its only purpose was to treat sleeplessness. I was unaware it was an antidepressant for the next 15 years, until after I began the tapering process. Even my naturopath continued to prescribe it without question. Over the last 15 years, I healed myself through intensive therapy, even becoming a therapist myself. I build a successful business in a field I felt passionate about, combining therapy with an artistic discipline. For years I contemplated getting off the trazadone but didn't feel like I could risk not sleeping with my demanding career. A year ago, I decided to take sabbatical and travel the world, starting with an ayurvedic cleanse program in India. A couple years prior, I started to have the creeping suspicion that my medications (benadryl, alegra-D, singular, trazadone) were creating more symptoms than they were treating, and so began the withdrawal process before leaving for India. At first I cut my trazadone from 150mg to 75mg and cut out the Benadryl completely. I struggled with sleep, but more significantly, horrible nausea for about 6 months. I attributed the sleep to the trazadone, but the nausea to the Benadryl (now I'm not so sure that was accurate - it may have been the large reduction of trazadone). Luckily, I was able to treat the nausea with small doses of medical marijuana. I went off my other allergy mediations much more easily - with a week to two of acute symptoms that afterwards subsided completely. When I began my cleanse in India, I tapered the trazadone from 75mg to 0 in a matter of 5 weeks. Way to fast given what I now know, but again, at the time, I had no idea what I was dealing with. Each time I would decrease, I would have acute withdrawal symptoms for about a week which would then subside; mainly night terrors, sleeplessness, and irritability. For the next three months I only managed between 3-5 hrs of sleep a night, but although it was frustrating, it was manageable, given that I was spending hours each day mediating. My nausea went away after I tapered from 75mg to 50mg but for the first two weeks, I suffered from persistent sexual arousal disorder (pgad, the female version of priapism) - a nightmare which caused incredible discomfort as I was barely able to pee for two weeks. Luckily, I figured out it was due to the trazadone withdrawal after some research. That experience only made me more determined to get it out of my system, and quickly. The PGAD disappeared when I tapered from 50 to 25mg. After my final dosage (I had basically just been taking a crumb for a week), I began experiencing the most horrific emotional pain I have ever experienced. I often find myself at a loss for how to describe it as it's never felt like typical depression. It was something like a combination of an ongoing panic attack with a grief stricken/shock-like feeling - like when you learn that your beloved has died and it knocks the wind out of you. I felt a palpable heart pain -though it was clearly emotional in nature. It is not the first time I've felt that heart pain, and may just be how my body metabolizes severe depression - but it was the most extreme experience I've had, and totally devoid of content. At the time, I had never heard of protracted withdrawal and so assumed I was having some kind of spiritual crisis. I was staying at an ashram, and so spent many hours in meditation. The symptoms gradually got a bit better over the first month, but then came back with a vengeance, though usually with some breaks of relief during each day when the heart pain would subside briefly and I'd get a bit of perspective. The odd thing was that this 'depression' came seemingly out of the blue at a period in my life where I felt stronger and happier than I'd ever been before. After some research, and consulting with a colleague who specializes in psychiatric drug withdrawal, I realized I could be experiencing protracted withdrawal. I tried to stay in India as long as possible to heal myself there, hoping it would pass quickly and I could continue my travels, but at some point the pain became too intolerable and I decided to come back to the States where I would have more resources to treat the symptoms (or so I thought). I decided to stay with my family in the midwest while I figure this out, and enlisted the help of a wonderful holistic psychiatrist, who luckily recognized the symptoms (at that time - depression, arthritis, and gum pain) as protracted withdrawal. I first tried supplements, homeopathy, and st. john's wort, in an attempt to stay off SSRIs. The St. John's Wort did provide some relief after week 5, but I was experiencing extreme fatigue and rapid hair loss. My psychiatrist suggested I try a small dose of prosaic after weaning off the SJW in order to get through the protracted withdrawal. Over the next month I tried 4 different SSRIs in miniscule doses (Prozac, lexapro, celexa, wellbutrin) and had horrible adverse reactions to all - sleeplessness, panic, wired/restless leg syndrome, loss of appetite, migraines, nausea, diarrhea. I had to take Clonazepam (luckily only one dose for each attempt at a new SSRI) to counter the reactions. Next we tried SAM-E at 50mg/day. I had some mild reactions, but after 6 days, felt wonderful - depression had subsided though I was a bit wired, but on day 7, I ended up with the same reactions as the other SSRIs and had to discontinue. Interestingly, I've taken almost all of these medications in the past without issue. I was given zoloft twice during my life (once for chronic mononucleosis when I was a teenager and for two years for 12 days out of every month for endometriosis). I had no problem on the drugs, but did experience acute withdrawal symptoms when I was going on and off the zoloft each month. I had horrible dizziness, and only after thousands of dollars of mris and other tests did I realize from my own research that it was caused by my body going into withdrawal for two weeks of each month. A few weeks after my final dose however, I was fine. I swore never to touch another antidepressant - totally unaware that trazadone was one! I also tried SAM-E at one point when I was experiencing depression after a total hysterectomy (for the endometriosis). It didn't help but it also didn't have any adverse effects at the time. The depression subsided when we were able to get my estrogen levels back on track. My psychiatrist works in cooperative clinic, so together we saw the nutritionist there, who tested me for deficiencies and then started me on a regiment of supplements. As far as I can tell, I have not had any adverse reactions to the supplements, but have not felt improvement from them either. For the past three months I have been on a very strict diet: no grains, no dairy, no sugars, no caffeine, no alcohol, and no meat (my choice). I basically just eat vegetables, lentils, lots of fish, and a few nuts. I've also been adamant about making sure I get 1-3 hours of mild to moderate exercise/day. This seems to be the one thing that routinely brings me a bit of relief, though only while I'm walking, moving, etc. I am lucky to have a wonderful support system and minimal external stressors in my life at the moment. I have tried my best to keep a positive attitude and am often successful, though I continue to get knocked out by the intensity of the heart pain when it arises, even with my myriad of coping strategies. Having tried so many ssris, and then the SAM-E (last dose was 12 days ago), it's hard to know what my norm off of meds will be - if there is one.
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