nivsun: Trazodone taper help

[nivsun]

Hello fellow members,

 

I am Nicole (not my real name) currently residing in CA bay area(this part is true). December of 2020 I developed some sleep issues. It started occasionally by around early November. I used to wake up suddenly in the middle of the night with a racing heart. The next day , I would take a unisom & then I will be fine the following days. Since this was happening only around once every two weeks & because of the fact that I have never had any mental health issues requiring treatment before, I did not think too much about it. But, starting December 2020, this became frequent. This time coincided with some work stress as well. When I went a few days waking up at 3AM with a rush and being unable to go back to sleep, I freaked out. I got extremely anxious about the fact that something happened to my sleep. At that time, I did not realize I was dealing with anxiety. I consulted my GP, who gave me ambien to tide over for a couple of days. He did mention anxiety to me, but I did not pay attention to it, because according to me anxiety was just something you deal with during exams and interviews. Such was my ignorance. I instead freaked out and took a bunch of tests, including a brain MRI , most of which turned out fine, except for a Vitmain D deficiency (more on this later).

 

Anyway, after the tests came up negative, my neurologist at that time started me on Zoloft 25mg. I took it without knowing much about side effects etc (I was just starting to read about these things at that point). During this time, i was managing my sleep with occassional ambien use. So, the zoloft was started end of december 2020. By January 15, 2021 I was seeing improvements in my anxiety levels, but my sleep was still not returning. I was lying awake all night (but calmly) and dozing off around 4AM or so. At that point, I started taking trazodone 50mg prescribed by my GP. Interesting point to note is, I had still not met with any psychiatrist by this time. After around a month of zoloft, I got freaked out when a sleep doctor I was consulting was shocked why i was taking zoloft for sleep issues. She asked me to come off of it. After about a month on being on 25mg, with my GP's approval I went from 25 to 12.5mg without much withdrawal effects. Still sleeping 6-7 hours with trazodone 50mg. But, I was depressed and anxious which predated the zoloft taper. After the 12.5 mg zoloft reduction, I reduced 50mg of Trazodone to 37.5mg - again without much symptoms. I was like this for a while, I think till mid march, at which point I finally consulted a psychiatrist. He immediately put me back to 25mg of zoloft and 50mg of Trazodone. The zoloft worked its magic, and I finally saw the clouds lifting by April 2021. From April till July, I have been doing GREAT. Back to my old self, sleeping pretty well , gained back weight and overall back to what I was prior to all this starting.

 

So, in July I asked my psychiatrist about coming off the Trazodone and keeping the Zoloft for at least till Spring 2022. The reason being, I wanted to start trying for our second child. Before starting the taper, I made sure to eat healthy and build my resistance up. Incorporated nuts and green smoothies etc. The one this which made a BIG difference to my mood was finally supplementing 1000IU of Vit D for my chronic deficiency. Since I was overall feeling great and healthy and my moods were very good. I thought now would be a good time to start a very gradual taper. I started cutting Trazodone by 5% on July 3 2021. I got a scale and shaved off 5% of total weight of the tablet. I averaged out a few tablets and found that the average weight was about 279mg - 5% of which came to 14mg of total weight , which is what I was cutting. Trying my best to cut as accurately as possible given the factors that the tablets themselves are not all the same weight etc.

 

It has been two weeks since then. I have been sleeping well 7-8hrs till July 15. On July 15th I took a melatonin gummy of 2mg which I have taken (and tolerated) previously few months back as well. I fell asleep immediately, but was feeling a bit of palpitations upon waking. On july 16, I took the same gummy along with my trazdone and had immediate nausea and palpitations, but managed to sleep. I figured maybe the Melatonin dosage is too high for now (maybe vit D supplementation fixed smth?) and the following day did not take any melatonin. I just took my Trazodone on July 17 and in a few minutes I started having severe anxiety and palpitations which went on ALL night. I tried taking melatonin/benadryl after that, but nothing helped. I was still having excessive anxiety which has continued throughout the next day. This is very weird for me , since I have never had this reaction for Trazodone, and this specifically happened as soon as I took the trazodone.

 

Which brings me here. I attributed this reaction to my PMS (my anxiety is always worse at that time). Also, the most important this is that morning I had done an intense 30 minute peloton workout.

 

I need help. Why am I reacting to Trazodone suddenly? Should I wait it out, since this has happened only 2 days? What should my taper plan be. Please advise. I have been lurking on this forum for quite a while now & would appreciate the help.

 

NOTE: I also take Tart cherry concentrate at 10am , Magnesium citrate ~250mg (1 gummy @4pm , 2 gummies @9pm). I have also been taking a homeopathic spray for sleep for the last 2 months, which I found has been very effective. It has flower essences.

 

Drug history:

 

Dec 2020 - Started Zoloft 25mg

Jan 2021 - Started Trazodone 50mg

End of Jan 2021- Tapered to 12.5mg of zoloft (no withdrawals)

End of Feb 2021- Tapered to 37.5mg of Trazodone (no withdrawals)

March 2021 - Back to 25mg Zoloft + 50mg Trazodone

April 2021 - End of June 2021 - Feeling great.

July 2021 - Started 5% Trazodone taper

 

Supplements: Vitamin D3 1000UI, Tart cherry concentrate 800mg - once @10am , Mag citrate - 1 gummy @4pm , 2 gummies @9pm (total around 250mg), Homepathic flower essences spray for sleep at night (5 days a week), Occasional melatonin use (1-2mg)

 

 

[Go2zero]

Hello nivsun,

 

 

Welcome to this support site. Sorry to read that you are suffering from withdrawal. Before we can answer your questions, please give us more information first. 

 

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

All these these changes disturb the CNS. The more changes in dosage and meds we make, the more disturbance and the more withdrawal effects can occur. 

 

Do I understand that you still take the 25mg Zoloft at this moment? If so, please know that you should not taper 2 meds at the same time. If you want to quit both, choose the one you want to quit first. I get the impression that this is Trazodon. Right?

 

When having WD effects, it is better not to use other drugs or supplements (other then fisoil and/or magnesium). Therefor I advice you to stop the melatonine at least for some time and see if that helps. 

 

I see that you jumped quite a lot in dosages in zoloft and trazodone. 

 

All these these changes disturb the CNS. The more changes in dosage and meds we make, the more disturbance and the more withdrawal effects can occur. 

 

The good news is: You will heal!     But it takes time and discipline!

 

I advice you to make a longer period of holding this dosage of trazodone. The withdrawal effect will slowly go away. They may come back again and change to other WD effects. This is normal. You may have waves and windows. But the longer you hold, the more you will heal. When you feel more stable, you will be able to continue the tapering process. Slowly and listening to your body! Everybody reacts different to tapering.

 

 

 

Edited July 19, 2021 by Go2zero

[nivsun]

Hello @Go2zero

 

Thank you for getting back to me.

 

Yes, I am currently continuing to take Zoloft 25mg and do not plan to taper at this point. The med I would like to taper and get off of is Trazodone 50mg , ideally using a brassmonkey method. I started with a 5% taper beginning of July.

 

I had asked this question in my original post

Quote

I need help. Why am I reacting to Trazodone suddenly? Should I wait it out, since this has happened only 2 days?

 

Thankfully, very thankfully this didn't happen again last night. So, my only guess is probably an intense workout session triggered something in my nervous system.

[Go2zero]

Go as slow as your body and mind suggest. Hold when WD effects are getting too worse. The Brassmonkey Slide Method is a great way to go. Better do it slow and careful. In the end going slow often will be faster then going fast!

Edited July 19, 2021 by Go2zero

[marie123]

Hi there Goto. I tapered off trazodone a couple years ago. Yes, you are right that the intense workout probably caused the bad night with bad sleep and palpitations. I got palpitations frequently when tapering it. Try not to let it get to you, it's just something that happens during tapering. Intense workouts are something that you should avoid while tapering. Try light workouts or nice long walks. I would not take too many supplements either and stay away from benedryl too. It's an antihistamine and trazodone has some antihistamine properties. Keep everything the same and go slow and steady.

 

You are doing well tapering by weight and by 5%. This is the way off by tapering slowly. Hold longer if you need to. Good luck with your taper. Marie.

[nivsun]

Hi Marie123,

 

For the past few months I used to stalk your updates here & read through your whole thread on Traz taper. So great to get in touch with you. Hope you are doing well with your Mirt taper.

For me, sleep is the one big beast. If I can sleep, I dont mind the other symptoms. I know you had Mirt while tapering Traz. I try not to take supplements at all. But I need backups when sleep proves elusive. Do you have any suggestions other than melatonin?

 

Thank you & would love to stay in touch.

[Greatful]

@nivsun  I wanted to stop by and say welcome.  By the sounds of it you have been looking over SA already so you are that much further ahead.

 You sound ready and confident. With the brassmonkey slide it should go pretty smoothly.

Post often, we are here to help in anyway we can.

[nivsun]

Hi @Greatful

 

Nice to meet you & happy to be here. I was feeling a bit lonely in this journey, but now am glad to connect with you and everyone else. I had a question which I hope someone can answer.

I am tapering 5% of the total weight of the tablet. Should i be worried about how much active vs inactive ingredient i get every time i cut? I am wondering if that is going to have an effect.

@marie123 - Please share your thoughts as well.

 

Thank you both.

[Greatful]

@nivsun 

 

 

1 hour ago, nivsun said:

I am tapering 5% of the total weight of the tablet. Should i be worried about how much active vs inactive ingredient i get every time i cut?

I would encourage you to tag on of the  mods,  @Go2zero.  You really want to be careful.  They are good at this and will be able to assist you.

 

 

 

[brassmonkey]

No need to worry about that. The active ingredient is evenly mixed throughout the tablet so there is no problem there.

 

The ratio of active ingredient weight (pill strength) to total pill weight will remain the same as you remove material from the pill. Because of this a 5% reduction in pill weight will result in a 5% reduction in dose strength.

 

We recommend basing your new reduction weight on the previous weight of your dose, not on the total pill weight. (Except for your first reduction which will naturally be using a whole pill). If you use the total pill weight or reduce by a specific weight each time you get what is called a "linear taper". Because of the mathematics involved this will give a larger and larger reduction each time and will soon cause an increase on symptoms and a possible crash.

 

If you reduce by using the previous weight you get a hyperbolic taper. This will take longer to do because the reduction size gets smaller each time. But it will make your symptom load much easier to live with and it much gentler on the body.

 

https://www.survivingantidepressants.org/topic/1024-why-taper-by-10-of-my-dosage/

 

 

[nivsun]

@brassmonkey - Thank you for your response. And yes, I am looking to do what you suggested with the previous pill weight. The problem am facing currently is the inaccuracy of my scale (Gemini 20) & the fact that pills themselves are not all of the same weight. I went ahead and averaged out a few pills to come to a ballpark. I would still like more accuracy with my scale. Looking at more expensive options out there. I would love some recommendations if you have any.

 

Thank you!

[marie123]

Hello again. I wouldn't worry so much about inaccuracy. I know each pill weighs a bit different, but you used the average of a few pills. That's good enough. Just doing it the same way every time gives it a bit more accuracy, meaning if you crush it first then weigh continue that or if you break small pieces off and then weigh continue that way. I weighed my dose all the way to the end of the taper. I cut little pieces off the pill and then weighed it. It was not easy but it gets the job done. Use a level surface without any air or heating vents or open windows. Keep it away from pets and children. You'll do fine. Marie.

[nivsun]

Thanks @marie123

[nivsun]

Hello!

 

Haven't posted here in some time. 3 weeks after my very first cut of 5%, I have been doing well. No withdrawal symptoms to speak of, except for that one bad day I had after an intense workout session. So, I cut my next 2.5% on Friday (July 23). It has been 3 days and am still doing well. No symptoms right now. Planning to wait out the rest of the week and see if i can make another 2.5% cut coming Friday or Saturday.

 

 

[Greatful]

@nivsun  Awesome, you are doing great.   How often are cutting?  You are giving me the nudge to cut a little off of my Lexapro.

 

I like it when I read someone is cutting and doing well with it.  I get scared when they are struggling with minor cuts.

 

[nivsun]

My first 5% cut was three weeks back. I wanted to wait a bit and see what kind of symptoms show up. Going forward I might do more frequent 2.5% cuts, maybe weekly? or probably once in 1.5 weeks? I will just decide on the go based on how I feel.

[Carmie]

26 minutes ago, nivsun said:

My first 5% cut was three weeks back. I wanted to wait a bit and see what kind of symptoms show up. Going forward I might do more frequent 2.5% cuts, maybe weekly? or probably once in 1.5 weeks? I will just decide on the go based on how I feel.

Hi Nivsun, 

 

Its great that you’re wanting to go slowly, but just remember that the holds are just as important as the amount you taper. If you taper too much, even in small amounts, you might not feel it straight away, but it can catch up with you later on. My body is extremely sensitive to these meds and I’ve been tapering under 5% and holding for three months lately. I’ve been listening to my body. 
 

I learnt the hard way in the past a few times. I’d taper and then wouldn’t hold long enough because I was doing okay with the drop, but it caught up with me later on. 

 

All the best🤗

 

 

[nivsun]

Thank you! Yeah, I am trying to be extra cautious, both with the amount and frequency. What are you tapering currently?

 

[Carmie]

I’m tapering Seroquel @nivsun, I’m down to 4.30mg now. It’s still going to take me many, many years to get off this amount as my body is so sensitive due to being on so many meds. My med journey started because of chronic pain. I’ll eventually get there.

 

Have a good day🤗

[nivsun]

Good luck with your taper. I just thought I will put it out here , in case it helps someone. I have recently, in the last two weeks, started a pranayama practice. I specifically do the anulom vilom (alternate nostril breathing), followed by brahmari pranayama (bumblebee breath). I have been reading a lot about the Parasympathetic nervous system & activating the vagus nerve. My practice is 15 mins in the morning & 15 mins in the evening. I can definitely feel an overall improvement in my anxiety levels and my sense of calm through the day. I am kicking myself for not starting this practice sooner, because my mom has been going on about how I need to be doing pranayama for the past 6 months or so.

 

If you can take some time out, I would highly recommend this for reducing anxiety levels.

[Carmie]

Hey there Nivsun, 

 

Yes, I’ve been doing a bit of research on the vagus nerve myself. There’s lots of things that can help it. Cold showers, brrrrr!!! I’ve done that a few times😁, walking in nature, laughter, singing, probiotics etc etc. You don’t want to hear me singing though, that would probably stress you you out as I’m an awful singer😁. I love music though, and used to go to millions of concerts. 
 

Hope you have a happy day☀️

[nivsun]

Hello to folks on this thread

 

@Carmie@marie123@brassmonkey@Go2zero

 

I am having a unique situation here. I have taken 1.5 months to do my first 10% cut. The last cut I did was August 3, 2021. I have been doing pretty well with every cut. Hardly any symptoms. 2 weeks back I also started my breathing exercises which have helped tremendously. My anxiety is non existent during the day. My mood is good and I am overall cheerful. But, the past few nights I have started having some issues. I go to bed in a very relaxed and sleepy state. Once I take my nightly dose of Trazodone though, in 15 mins or so I start getting palpitations. This has been happening for the last 3-4 nights. Note that I have absolutely no palpitations during the day time. And I am not anxious about going to bed or anything. But it seems like Trazodone is causing some reactions for me. What could be the reason for this? Any ideas ? My taper is currently on hold @ first 10%.

[brassmonkey]

Palpitations are a pretty common side effect/ WD symptom. The timing of them does indicate that your body doesn't like the Trazodone. As you continue to taper the affect should calm down. It would not be a good idea to try and rush things just to calm the symptom, that could cause even more trouble. I try to think of it as "free cardio", cardio exercise without the sweat.

[marie123]

Hello. I remember getting palpitations as I was tapering from trazodone. I got them so often so I just ignored them. I also remember getting them at night as I was in bed before I fell asleep. I did the same thing as you asked about it from others tapering, and they told me it was common. I get them now with mirtazapine. I ignore them. You may get other strange symptoms as you taper. It sounds like your taper is going well. Be well. Marie.

[nivsun]

Hi @marie123 - was your palpitations right after taking the night dose? For me, I don't have any palpitations any other time. It happens around 15 mins after my dose of trazodone. I am wondering if this is some sort of paradoxical reaction. I wouldn't mind it so much, but the issue is the palpitations prevent me from falling asleep & in general removes my sleepy feeling.

[nivsun]

@brassmonkey - I am not worried about the palpitations per se. But it just prevents me from sleeping. If I can someone get around that.. i would be ok with my heart palpitating away.

[marie123]

Hello. Yes I remember after taking the dose getting palpitations. It was not every time, but it did feel to me that I could be reacting to the dose. I was able to sleep because it did not last that long. I have found once I start tapering the drug, it never works the way it used to. Odd reactions happen and withdrawal symptoms. When the palps happen try to relax and get comfy in bed even if the sleepy feeling stops. I used to put on relaxing low volume National Geographic episodes of the oceans. You'll get sleepy again and fall asleep. Marie.

[nivsun]

Thank you so much for the advice @marie123!

[nivsun]

Hello folks. Had another question. When I am trying to sleep, i get some weird muscle twitches. Not too many, but when I do get them it wakes me up. What are some things that can help with this? Appreciate the input.

 

Also an update, Trazodone is still giving me palpitations after i take it. I am trying to wait for a few days to see if this is going to continue. Not sure what to do if it continues.