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marie123: tapering trazodone

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marie123

Hi Sara,

 

I'm holding a few months to let everything settle and catch up, then I'll do a very slow micro-taper all the way down to zero. I plan on even tapering the last tenth of a milligram. I underestimated this med before. I'm feeling really good and out of the fog. I haven't felt that way in a long time so I'll enjoy the summer and take a nice vacation. That's wonderful news that you are down so low. Take care and taper the last bits slowly. Marie.

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marie123

I noticed that I feel good for a few days then have a lousy day. I guess this is the windows and waves I have been reading about. I always thought windows and waves happened after you have completely withdrawn from the med. It seems it happens also if you withdraw too fast/reinstate.

 

The first med I tapered was Ambien. When I jumped it was very predictable. I only had insomnia for a few months and that was it.

 

AD withdrawal is much more difficult than Ambien withdrawal in my opinion. It's just so unpredictable.

 

Marie

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marie123

I feel lousy again today. Withdrawal with the usual culprits, nausea, dizziness along with some anxiety I dont know if I am stabilizing I have a few good days and then a lousy one. Not sure if I should updose? I went to the gym today to burn off some anxiety and I heard a song. I am not sure of the singer but the lyrics were "jump, jump, jump". LOL.

 

It seems to me if I am going to feel lousy taking Trazodone, I might as well not take it. I don't know if my body is accepting it. This is two months from reinstatement.

 

Marie

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marie123

I just updosed to 2 mg after two weeks at 1.5 mg. I was still having withdrawal a few days a week. I am hoping this is what I need to get back to where I was before jumping on New Year's Eve. I did not even plan to jump on that day. It was a spur of the moment decision. I was drinking at a great party and having a wonderful time. I was at 4 mg Trazodone along with 7.5 Remeron. I did not want to take my meds that night because of all the alcohol. The next day I thought to myself that I was feeling so well lately I should just stop the Traz. My last few months of cutting prior to jumping was quick and I did not give enough time for things to catch up.I felt good and I just did not know. I was really at 6 mg in Dec. but in the later part of Dec. went to 4 mg.

 

I was put on these meds to sleep because at the end of 2013 I started having tinnitus. I could not sleep at all This went on for one month straight so I asked my dr for sleeping meds. He did not tell me about discontinuation from the ADs and I assumed it would be relatively easy. I knew Ambien was addictive so I put all of my efforts into getting off that asap. My withdrawal was not bad at all, just some interrupted sleep for a few months. Trazodone has a nastier withdrawal.

 

I guess it's even possible that Trazodone was/is covering up the Ambien withdrawals that I am now feeling. Not sure. It will be 2 years in Oct. that I'm off of Ambien.

Good luck to all.

 

Marie

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marie123

Hello fellow survivors. I've been feeling a bit better since updosing to 2 mg. I just have some slight nausea/bloated belly/churning tummy. Some time ago I used Culturelle to help my gut. It didn't work and went through a few days of insomnia because of it. I believe I am having some food sensitivities, possibly histamine intolerance.

 

Last night I started eating lite vanilla ice cream. Usually I would just have a small scoop. I went all out and had an extra two scoops!, Well I felt that. I started getting stomach cramps. I took a tylenol and went to the fridge to read the ingredients. Now I know it could be a lactose sensitivity, but I wanted to check to see if there were any "bad" ingredients. I found Maltodextrin, Guar Gum, and Carob Bean Gum listed, looked them up and they sounded awful.

 

I read here on this site about Goodbelly a probiotic drink that was low in histamine. I started taking it today, so far so good. I am trying to find out which foods upset my stomach and avoid them for now. I had eggs, coffee, diluted oj, bagel, sweet potato, quinoa pasta with olive oil/sea salt,  and a banana today. Of those, the half banana upset my stomach, so I will avoid for now. I will also try to eat smaller meals. Good luck to all of us.

 

Marie

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marie123

PLEASE HELP I DONT KNOW WHATS WRONG. Yesterday I had an okay day but today something has changed. i'm not sure what it is. I woke up had coffee a  small breakfast. I started feeling anxiety.I thought it was from the coffee, but it feels out of control now. i only felt nausea when i came off TRazodone, not this extreme feeling. I think it might be akasthia? Is this a reaction to taking Trazodone? Maybe I should just rapid taper off of it? Something is very wrong. HELP.

 

 

Marie

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marie123

PLEASE I need help. I'm not sure what to to. I reinstated TRazodone 3 months ago currently at 2 mg. I reinstated because I had bad nausea. I've had bad days and okay days until today. Something is much, much different. I woke up had coffee and small breakfast. and started getting anxiety. I though it was just coffee. But this feels so different and intense. Is this because the reinstatement is not working and I should stop the Trazodone? It feels like a really bad reaction. I also take 7.5 Remeron.

 

If I feel this bad I think I should go off, maybe I will still feel it when I get off but at least it's out of my system. Please, I don't know what to do? I feel trapped.

 

Marie

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scallywag

marie, Although it's distressing to have symptoms appear after a period when you've been okay, it's very common to have symptoms such as anxiety and nausea during tapering. It's important not to make things worse by suddenly changing doses or adding any new drugs or supplements.

As you wrote above:

I noticed that I feel good for a few days then have a lousy day. I guess this is the windows and waves I have been reading about. I always thought windows and waves happened after you have completely withdrawn from the med. It seems it happens also if you withdraw too fast/reinstate.

The first med I tapered was Ambien. When I jumped it was very predictable. I only had insomnia for a few months and that was it.

AD withdrawal is much more difficult than Ambien withdrawal in my opinion. It's just so unpredictable.


Remember that right now, you've gone through two drug changes: the jump from 4 mg Trazodone in april this year and the reinstatement. Your nervous system has been on a bit of a roller coaster. Waves and windows are expected. Only the lucky few don't have them.

The Windows and Waves pattern of stabilization

I'm going to quote something Alto posted on another member's intro:
 

We don't know of any immediate cure of withdrawal symptoms. You need to let your nervous system settle down.

 

Record the times of your dose(s) and your symptoms on paper. Hold steady. This wave will pass or be broken up by windows.

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marie123

Thanks Scallywag for your quick response. Yes I understand the windows and waves, but I just don't understand what this is because it's so extreme.  I am not nauseaus, but have extreme chemical type anxiety. That is what is worrying me. It feels more intense than regular anxiety. It's hard to explain. Like it's hard to sit still, but I am unable to do anything. I just keep getting up and pacing, going in and out of the house.

 

 

I this it is akasthia? I can't sit still. My head feels like it's going to explode.

 

Am I having a bad reaction to the Trazodone and should go off if it's akasthia? I only had bad nausea when I came off Trazodone.

 

Marie

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marie123

Two days ago I increased it to 3 mg for one night, but I was too spacy so I went back down to 2 mg 2 nites ago.

 

I only had bad nausea when I went off trazodone, now the nausea is gone but I have this extreme anxiety or akasthia not sure which?

 

Maybe if I would have stayed off trazodone I would still get this akasthia but at least I wouldn't be taking it and healing somewhat.

 

Marie

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savinggrace

Hi Marie,

 

I wasn't quite sure from your signature...are you still taking remeron?

 

Grace

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marie123

Yes I am still on Remeron 7.5. I am wondering if the trazodone could be interacting with the remeron now that I am sensitized. They used to work fine together.

 

The only symptom I had that caused me to reinstate was constant nausea. My stomach is finally calmed down but now I have these waves of anxiety. I am not  sure if I can call the reinstatement a failure or not. Whether or not to continue with this reinstatement is weighing heavily on my mind.

 

Those extremely anxious feelings with the pacing I had today  have calmed down. I think it was akathsia. I never had it the three months I was off Trazodone.

 

I was reading another member's post on Trazodone withdrawal. She was off for 5 days and could never get stable even after 3 months. She rapid tapered and said she was sick for 2 months and then got better. It's been almost 3 months of reinstatement for me. I have good days and bad days. But if I am getting akathasia from the reinstatement I might have to come off.

 

I am going to stop drinking coffee and keep a steady dose (2mg) for the next few days. I need to make a decision though whether to continue with Traz. If I am going to be sick I would rather be sick off it and healing. Thanks for responding grace.

 

Marie

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Altostrata

When do you get the waves of anxiety? Please keep daily notes about your symptoms, when you take your drugs, and their dosages.

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scallywag

Marie, withdrawal effects can appear after several symptom-free months.  It's entirely possible that you would have experienced these sensations with out the reinstatement.

 

Some members have posted in the Akathisia thread reporting that akathesia showed up weeks and months after discontinuing a psych drug.

 

The symptoms you've listed are consistent with the condition called akathisia. Have you read the topic in the Symptoms and self-care forum about Akathisia?  Members have also posted what they've done to deal with it.

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SquirrellyGirl

Hi Marie, 

 

Do you normally have coffee every morning? Many folks have become sensitized to coffee.  Before you jump off and destabilize yourself further, can you do some self-care for the day and see what tomorrow brings?  There are windows and waves with reinstatement, and some waves are worse than others. What time do you take your trazadone?  Are you keeping notes on paper about your daily symptom pattern?  After three months I'd really not expect trazadone to go paradoxical. 

 

I see that you also posted on your thread and are getting replies there.  

 

Hang in there!

SG

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marie123

Thanks Alto for your response. I have been keeping good notes. I take the Trazodone at 10 pm 2 mg and Remeron 11 pm 7.5 mg. I take no supplements. I use the Gemini scale to weight the Trazodone.

 

The anxiety I get is in the AM after breakfast. It will either build thru the day and its still there at night or it will just be light and fade by the early afternoon. It's not everyday. Today was the only day it was this bad and turned to what I think was akathsia. That lasted a few hours. Right now I feel okay with no anxiety. Maybe the caffiene is setting off the anxiety? Not sure it could be the Trazodone or the Trazodone interaction with Remeron. Stomach issue is resolved. Some days are okay.

 

I am going to eliminate coffee from now on and see if it helps. Other than that I am not sure what I should do. My history below does not show but I also went off Trazodone for a week right after I stopped Ambien but went back on and was okay with that.

 

Should I just stay at the dose where I am now for now? Thanks again.

 

Marie

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marie123

Thanks scallywag for responding. I did some reading on the link you posted about akasthia. It's interesting that some people notice withdrawal gets worse at about 6 months. It's about six months into my withdrawal (I jumped new years day).

 

I went to the movies to try and distract but couldn't watch the movie. I was too rattled from my experience today. I'm trying to get family to understand withdrawal and gave them some links. There was mention by family in my discussion with them that it's not withdrawal is discontinuation, you know withdrawal you crave the drug and I don't.  I guess it just can't be explained so easily. The depth of the suffering can't be seen except in extreme cases like today. I hope better days are ahead for all of us. No more coffee for me. Thanks again.

 

Marie

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marie123

Hi SG. Yes I normally have coffee every AM, just one cup. Today I am only going to have a half cup and taper off during the next week. I never had this extreme feeling before on the Trazodone or when I jumped and was off 3 months. Needless to say it was a bit alarming. I take the TRazodone at 10 PM.

 

My symptom pattern is like this:  wake up, have breakfast (with coffee). By then I can usually tell how my day will be, good or bad. I mean I might start to feel some anxiety (mild) but it putters away by early afternoon. Sometimes it will increase a bit but stay until the evening (bad day). Some days I don't notice it at all. I have no other symptoms. Sleep and stomach are fine. Most of the time the evenings I feel almost normal.

 

I woke up today and had half cup of coffee. I feel okay. I am going to hold steady on the 2 mg Trazodone.

 

If I stay stay on the dose for a while is what happens is that the w/d becomes milder and milder, and then you know it's time to taper?

 

Thanks for responding SG and all of the mods for their great help.

 

Marie

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savinggrace

Hi Marie,

 

I think there is definitely a chance that the remeron is more stimulating now that you have so little trazodone in you.  I am sure you know that remeron is less activating at lower doses, and this may well turn out to be the case for you.  It could be that the activating part of the remeron is more prominent right now.  If it were me, though, I would not consider tapering remeron for quite some time.  I think your body/brain are working on achieving a new homeostasis and you don't want to throw any more variables in the mix.

 

I, too, took both ambien and remeron together for about a decade. (along with trileptal and a benzo)  That is/was a lot of sedation.  You could still be adjusting to the reduction of ambien (technically not a benzo but it really acts like one) and trazodone as well. When I cut out ambien, I up-dosed my valium by 5 mg. to go off the ambient all at once,  and I found that to be a pretty close equivalent dose.  The point is your brain has done a lot of adjusting in less than 2 years.  It might just need a nice long hold until you feel ready to make another change.

 

I truly hope the akathisia lets up for you soon.  I would live in a hot epsom salts bath if I were you!  

 

Oh, there are just so many unknowns for all of us, and the answers are just often best guesses at best.  If only there were a 'one size fits all" for drug tapering.  

 

Best wishes for a calmer feeling day,

Grace

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savinggrace

Oh,  also, Marie,  please consider cutting back on your coffee very seriously, if you haven't already done so.  I don't think one realizes how stimulating it is, until you stop drinking it for a while.

 

I used to be an avid diet coke and coffee drinker.  Now just a few sips (like 4) of coffee cause almost shock-like adrenaline surges in my body.  I know this is easier said than done.  Cutting out caffeine was not a linear process for me; it took nearly a decade, but with akathisia, I would do anything to relieve it...anything.

 

I guess I don't think an every day coffee drinker can actually feel what the coffee is doing to their brain until they have had significant time away from it.  I am in awe of people who are calm and sleep and also drink coffee at liberty. (like my husband)  What calmness their brain must enjoy all the time!

 

 

I know it's so hard to manage all of this and take away something that may be somewhat comforting right now.  I think you will be doing yourself and your brain a big favor.  Start with half-caf if you have to....then de-caf...then off?

 

I just googled natural akathisia treatments (RLS landed me on bentos 14 years ago).  Gentle stretching, gentle exercise, massage, and baths...they all make sense.

 

You probably know all this but sometimes we need a gentle push to spur us into action!

 

Grace

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marie123

Hi Grace. The akasthia was only yesterday for a few hours. I felt some strong anxiety upon waking but it lifted this afternoon. Just had a half cup of coffee and it did not agree with me so I will be having decaf tea in the Am. I drink no other caffienated beverages.

 

Yea it could be some leftover Ambien withdrawal. It's similar to a benzo. I jumped in Oct 14 so over one year and a half. The Trazodone could have been covering it at the higher dose.

 

Yes a good long hold might do good, but If I am feeling worse than the 3 months off of Trazodone than why am I on Trazodone. Sure the nausea is gone, but is it creating more problems like anxiety, akathsia, etc.?

 

Sometimes reinstatements don't work. Would I be better off of Trazodone now? That's the billion dollar question.

 

The answer to this is elusive to me.

 

My husband mentioned prozac ugh. I am in a little window so off to do some laundry.

 

Thanks for stopping by grace.

 

Marie

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SquirrellyGirl

I would think that if you can get stable enough that you don't have these waves for a few weeks, then you could resume tapering.  You had done some fast tapering late last year and it may be that your nervous system is still getting caught up with the 2 mg level.

 

SG

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Altostrata

It could be the coffee. Do you take any other drugs or supplements with breakfast?

 

Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html
and copy and paste the results in this topic.
 

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marie123

Hi Alto. Thanks for coming back to my thread. No I do not take any drug/supplements/vitamins, etc. in the AM. Just the 2 meds at night.  I did notice that when I first woke up I was okay. I had a half gluten free bagel with half cup of coffee. I wasn't able to finish it and only took a few sips. Then the anxiety started, but could have happened anyway. Would a few sips set me off like that? Tomorrow I will not have any coffee and see what happens. There was no pacing today.

 

I took a ride to a few stores with my husband for distraction at around noon. Indoor lights were unusually bright and vision was distorted more. During tapering I've had times where lighting in stores were bright, glaring, etc. but this was much worse. People seemed off too. I felt mentally slower with heavy body.

 

Very strangely at about 2 pm on the drive home all the weirdness lifted along with the anxiety. Well now I am just anxious about the anxiety I had if you know what I mean. I know I'm in for a long ride and I just want to make the best moves medication wise.

 

More specifically if Trazodone is something I still should be taking. I realize at the same time that the 2 mg might still be covering up even worse withdrawals.

 

What are you recommendations? Thanks again.

 

Marie

Edited by scallywag
add emphasis on answer to previous question

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marie123

There is a major interaction between Trazodone and Remeron. It's something I've know about and always concerned me. See below:

 

Interactions between your selected drugs

 

Major trazodone mirtazapine

 

Applies to: trazodone, mirtazapine

 

Using traZODone together with mirtazapine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications.

 

Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

 

 

Seratonin syndrome is a possibility with the two meds together. Of course no mention of this when doc prescribed them.

 

 

Marie

Edited by scallywag
add white space and emphasis

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savinggrace

Hi Marie,

 
It seems like serotonin syndrome would have reared its ugly head much before now, especially w/ the low dose of trazodone you are on.  You don't have most of the extreme physical symptoms, so in my opinion, it is highly unlikely.  I do think that this is everything catching up, in a sense...your ambien taper, with little time to recover, then your sensible, but perhaps not slow enough trazodone taper, started perhaps before the ambien withdrawal had registered fully with your brain.  I cut 25% of all my meds in twice as much time, (sad though that sounds) and am feeling much better having made a decision to hold for an indefinite amount of time and let my brain/body catch up.  I feel better already and it's only been a month.
 
I really have no opinion about those last 2 mg. of trazodone.  Perhaps it wasn't a high enough reinstatement?  I know that is not something you want to hear, and probably don't even want to consider.  I think trying to make peace with your decision, and sticking with it, will help the anxiety.  The decision is a very tough one and causes its own vicious cycle of worrying/symptoms.
 
Anxiety about the anxiety sounds so right!  Try to talk to yourself about these symptoms as signs that you are...healing...because you are!
 
I am sorry that you are in this difficult decision place.  None of this is easy.  I feel your angst about this decision as I am constantly in that place about a lot of pretty big things in life...no clear answers.
 
Grace

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marie123

Hi Alto. I did not have any coffee today and the anxiety was mostly gone this AM, so I think you were right about that. I'm foggy this morning/early afternoon I think because of the lack of coffee. I guess the reinstatement brought sensitivities out for me. I wanted to taper the coffee, but I was to afraid to deal with any anxiety.

 

I feel foggy today and I'm sure it's the lack of coffee. Any recommendations on how to wake up besides caffeine?

 

Even though it will be 2 years this October the day I was Ambien free, I think there might be residual healing left from it. Interesting enough, I only felt interdose withdrawal from the Ambien and when I started cutting I felt better and better. When I stopped taking it I just had interrupted sleep. So I never felt withdrawal before even when I was tapering the Trazodone I was feeling much better

 

Hi Grace. I guess I get the same reaction almost as you do with coffee. Never before had this happen. Once I started meds I cut down from two cups to one cup a day and was fine with that up until now. Who knew? In my younger days I would have three cups during the day and one at night and slept like a baby. I went out today and got a mani/pedi and felt okay but my head was spacey. No anxiety which is a great thing.

 

At least with my recent experience I got my husband googling AD withdrawal last night. I guess the best thing to do would be to hold. I am going to make a couple week's worth of 2 mg pills to ensure accuracy. Good luck to all of us.

 

Marie

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scallywag

Marie, you're wise to consider the interactions. It's frustrating and maddening that your doctor did not mention, let alone actually discuss, the interactions with you. Unfortunately this discussion rarely occurs between prescriber and patient.

 

It's possible, but unlikely that this has started now after you've reduced your trazodone dose to 2 mg. It is far more likely to have occurred at higher doses of traz, for which typical doses are 50 mg - 150 mg.

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marie123

Hi scallywag. It's just unreal what the docs don't tell you, isn't it. I have researched so much and I know what I am dealing with. The reinstatement/start up could have triggered something with the Remeron, but who knows?

 

I could have Ambien withdrawal, but who knows?

 

Or my brain is no longer accepting Trazodone, who knows?

 

I'll hold steady and hope for the best.

 

Marie

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savinggrace

Hi Marie,

 

You know, like you,  a lot of my physical symptoms got quieter after I quit Ambien.  I covered the w/d (I had been on it for 10 years...for a year up to 20 mg....what was I thinking?..what was my doctor thinking? ) all that along w/ remeron and klonopin! It's amazing I survived.   For a while I was on tramadol too, at least one pill a day, but I started getting serotonin syndrome.  I think had I not recognized what was happening, it would have escalated into a very serious situation.  I started having heart palpitations and all kinds of weird symptoms that were different, and scarier than interdose w/d i was used to.   Fortunately, I recognized it, without my doctor's help of course, and just stopped taking the tramadol.  As I write this, I realize how jarring that must have been to my CNS at the time.  Though I was on just one pill/day for almost a year, I stopped it abruptly w/o any thought to a  taper needed.  All in the midst of 4 other p-drugs...YIKES...no wonder my brain is so sensitized.

 

I covered my ambien withdrawal with valium, updosing and then tapering from there as the half-life was so very much longer. (on the advice of an on-line forum)  It worked seamlessly  for me...but then I had an additional 5 mg. of valium to taper, which technically I have not yet successfully done.. I guess that is what you are doing now...dealing with  the trazodone and remeron which covered the ambien w/d.   I, like you, do not look forward to tapering remeron for so many reasons, but I think it is what I am going to try next, after I feel some more CNS calming.  I was so optimistic; I guess i sort of had a window last week, which isn't great for me but it is 50% better.  Last night I hit bottom again w/ my GI, anxiety and sleep issues...sigh...

 

I feel your pain about the coffee.  Going to Starbucks for a de-caf Americano used to be what got me out of the house and talking to other human beings.  I had to cold-turkey this 15 year habit (even the de-caf) after my Barrett's esophagus diagnosis.  My husband still gets it and sometimes I just can't help but take a few sips but boy do I feel it!  Your CNS is thanking you for every sip you don't take.  Some day you will be all healed and may tolerate it again.  I recommend a nice walk in the sun for energy....or just getting out of the house to do an errand.  (written by someone who is still in their nightgown at 3:30!  I DO have plans to shower and walk today, and I will!

 

You haven't mentioned akathisia for a couple days so that's a relief I hope...

 

Grace

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marie123

Hi grace. What kind of side effects were you getting besides heart palps that made you think you were getting seratonin syndrome? I don't think that's what's going on with me, but I would like to watch out for any symptoms.

 

I only had some mild anxiety this AM so that's good.

 

Marie

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Altostrata

Sounds like you might have been reacting to the coffee. Please keep daily notes of your symptom pattern in case it's something else.

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marie123

Yes I do think it was the coffee and my sensitized CNS.  I will continue to keep good notes Alto. I have been keeping notes since I started the Ambien taper. You are doing great work here. Thanks.

 

Marie

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Altostrata

You're welcome, Marie.

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savinggrace

You know, Marie, it was over a decade ago and I can't remember much more than heart symptoms, shortness of breath, especially upon waking and sleeping a lot, almost a drunken stupor kind of sleep. I actually think I was on the verge of serotonin syndrome; I recognized what was happening and stopped the tramadol C/T. I think tramadol is a known risk factor for serotonin syndrome. The symptoms cleared up in a couple days.

 

I have been experimenting with herbal teas; some of them are quite tasty though some interact w/ my meds. Current favorite is herbal Rooibos chai. There are lots of choices but, sadly, none of them replace the energy; just help fill the coffee cup!

 

Grace

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marie123

This morning has not been the greatest. Sleep was not that good because of anxiety. I was tired and a little nauseous this AM. I had breakfast with no coffee.

 

I took a shower and I started to feel like I was fainting. I quickly got out and made it to the bed.

 

It sounds like I am going to have to stop Trazodone.

 

Marie

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