Duloxitine or Trazadone, which to taper first?

[Jilla]

Hi there! I have been healing from a CT withdrawal from Paxil (13 years on it) since last March. It has not been an easy ride to say the least. I was put on 50 mg of Trazadone for sleep and 60 mg of Duloxitine at the hospital, they were treating my symptoms as a relapse, which I now know it was not a relapse at all, but rather PAWs. When I feel strong enough, I want to start tapering off these other meds. I was wondering which you all would suggest I go for first….the Traz or the Duloxitine? Anxious to hear your thoughts. Thanks!

[Gridley]

Welcome to SA, Jilla.  Thanks for completing your signature.

 

Good question about which to taper first.  Generally we recommend tapering the more activating drug first and leaving the more sedating drug in place to aid sleep.

 

Taking multiple psych drugs? Which drug to taper first

 

With Duloxetine and Trazodone, the question is bit nuanced.  Trazodone is more sedating than Duloxetine (though Duloxetine is known to be the least activating of the SNRI's) but as you'll see from the link below Trazodone is a particularly nasty drug.  After reading the links, you'd need to weigh a couple of factors to help you make your decision:

1. How does each affect you?  Side effects?

2.Sleep benefits of Trazodone vs. the negatives of the drug as described in the link

Tips for tapering off duloxetine (Cymbalta)

 

Tips for tapering off trazodone (Desyrel)

 

We recommend tapering by no more than 10% of your current dose every 4 weeks.  

 

Why taper by 10% of my dosage?

 

The links above tell you how to get the nonstandard doses needed for a 10% taper.

 

It's good you plan to get off one of the drugs as there's a major drug interaction between the two:

Using traZODone together with DULoxetine can increase the risk of a rare but serious condition called serotonin syndrome,

 

Doctors misdiagnosing withdrawal as relapse is all too common.  Here's some information on the withdrawal you've been experiencing.

 

What is withdrawal syndrome.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.  I hope you’ll find the information in the SA forums helpful for your situation.  I'm sorry that you are in the position that you need the information, but I am glad that you found us.

 

 

 

 

 

 

 

[Jilla]

Thanks for this info Gridley. I have been leaning towards the Trazadone taper first👍