pepper59

[pepper59]

I think I cut my trazodone too fast. I am also on xanax. These were both prescribed for debilitating insomnia. 

 

I started at 50mg trazdone at bedtime for sleep. When that stopped working, doctor added xanax. I'm up to 1.25mg xanax.

 

I have been cutting my trazodone. I found out I lack the enzyme that metabolizes m-CPP. I am down to 10mg trazodone, but I think my last cut was too big. My doctor told me to jump off at 20 mg, but I cut to 10mg instead.

 

Last night I forgot to take it. The xanax is messing up my mind and I am forgetting things. Hardly slept at all.

 

Been so sleep deprived for so long, I am losing weight and barely functioning. Unable to work. This all started shortly after we moved, so I have almost no social support network here. 

 

The xanax has not been working well and I think I am tolerant.

 

I went through some kind of withdrawal and/or insomnia hell this morning. Almost checked myself into a hospital. Not sure what to do now. Reinstate the trazodone? Won't that make my m-CPP so much worse? Also, feel like  yoyo on the xanax and anxiety is so much worse. Or is it the tiny does of trazodone. Doc keeps saying such small doses couldn't be causing these problems.

[pepper59]

I'm a divorced mom of 2 college kids. Began to suffer from debilitating insomnia after menopause last spring. Diagnosed with depression, anxiety, ptsd. Tried many meds for the sleep problem. It only deteriorated. I fall asleep OK, but then startle awake within minutes. This goes on most of the night. Hypnotics failed. Trazodone worked, but inconsistently. Tapered off it in the summer. A few weeks later, the sleep collapsed again. Reinstated trazodone. No good. Added Xanax. That helped quite a bit at first. Been trying to taper the trazodone again. When down to 20mg, my doc said to jump off. Instead I cut it to 10mg. A week later, my life fell apart. I am barely sleeping and barely functioning. The xanax is also part of the problem. I am yo-yoing mood and energy all day long. Some days are better than others, but most are awful. 

 

My son just decided to drop out of school for the semester because I cannot take care of myself or work. He will work more and take care of me. :-(

 

Was using a pretty inept psych nurse as my prescriber. My primary wants me to see a psychiatrist. It took months to find one and he is only temporary in our clinic. I see him this week.

 

I would like to get off the trazodone first and then taper the benzo to as low as I can get and still sleep. 

 

Have tried trauma therapy, but therapist says I am too unstable to go forward. So many things are triggering me that I can hardly function. Hoping for more sleep. There is a direct reverse correlation between how much sleep I get and how much anxiety I get. Right now I am in a spiraling loop in the wrong direction.

 

 

[cymbaltawithdrawal5600]

Hi pepper59,

 

I brought your other post from the tapering forum over here to Intros and joined it to your topic so everything is all in one place.

 

I will need to do a bit of research but is the lack of the enzyme allowing the traz to exit your system too quickly, negating its sedative properties? Is that why you want to get off it and the xanax?

 

There is a link right under my post that explains how to fill in a signature strip, if you could give that a go in the meantime. We just need to know your doses and when you started the drugs.

[pepper59]

OK, thanks. 

[cymbaltawithdrawal5600]

I was doing a bit of editing while you posted your reply. According to this PubMed article, mCPP is the active metabolite of trazodone and you had the testing to determine that your liver enzymes could not eliminate the metabolite from your system, is that correct?

[Babs]

Hi Pepper,

 

So sorry you find yourself in this situation.  It does sound like you jumped off Trazodone too fast and are feeling it.  I hope the mods here can help you figure this out.

[pepper59]

Hi. I am wondering if taking trazodone and/or withdrawing from trazodone can cause severe flushing? By flushing, I mean my face, scalp, neck and parts of my torso and arms become bright red and feel burning very rapidly. Then, within an hour or a few hours, it fades. I had this happen a few months ago and then again just this morning, a week after I made a too-big cut to my trazodone (too small according to my psych nurse, who said just quit). After the flush, I came apart at the seams, panic, nausea, painful sensations I can't describe. I just wanted to jump off a bridge. Fortunately, I was too tied to even get out of the bed so I just laid there and cried. It passed after several horrible hours. Now I am just very tired and not looking forward to another night climbing the walls and pacing the floors. Poor sleep=anxiety and panic=poor sleep, and so on.

[Brandy]

I'm a divorced mom of 2 college kids. Began to suffer from debilitating insomnia after menopause last spring. Diagnosed with depression, anxiety, ptsd. Tried many meds for the sleep problem. It only deteriorated. I fall asleep OK, but then startle awake within minutes. This goes on most of the night. Hypnotics failed. Trazodone worked, but inconsistently. Tapered off it in the summer. A few weeks later, the sleep collapsed again. Reinstated trazodone. No good. Added Xanax. That helped quite a bit at first. Been trying to taper the trazodone again. When down to 20mg, my doc said to jump off. Instead I cut it to 10mg. A week later, my life fell apart. I am barely sleeping and barely functioning. The xanax is also part of the problem. I am yo-yoing mood and energy all day long. Some days are better than others, but most are awful. 

 

My son just decided to drop out of school for the semester because I cannot take care of myself or work. He will work more and take care of me. :-(

 

Was using a pretty inept psych nurse as my prescriber. My primary wants me to see a psychiatrist. It took months to find one and he is only temporary in our clinic. I see him this week.

 

I would like to get off the trazodone first and then taper the benzo to as low as I can get and still sleep. 

 

Have tried trauma therapy, but therapist says I am too unstable to go forward. So many things are triggering me that I can hardly function. Hoping for more sleep. There is a direct reverse correlation between how much sleep I get and how much anxiety I get. Right now I am in a spiraling loop in the wrong direction.

 

Welcome, Pepper.

 

I do not know enough about trazodone to advise you on that, and will leave that to others here to advise you. I do think it would be very helpful to them if you could post the specific information about how your enzyme deficiency is affecting the trazodone metabolism. (I am aware of the issues of how enzymes affect benzodiazepine metabolism, and the wide variation among individuals as well as of food and medication interactions when the enzyme is involved in the meds' absorption and utilization. Just not with the enzyme involved in metabolizing trazodone.)

 

I am all too familiar with xanax. After taking it for approximately a couple of months (long ago), it started wearing off with a crash. I told people I could set a clock by it, honestly. (And I didn't even have a clock visible in my office, but when I checked the time, it would be time to take my next dose even though I hadn't realized that amount of time had elapsed.) (Workaholic here )

 

We have a members-only peer support benzo section here for people dealing with multi-drug issues when both benzos and ADs are involved. You might want to read on there and also start a topic about your xanax. That does not replace this thread as your ongoing med history and questions etc. So absolutely keep and use this thread. But unless the mods disagree, you might want to start an additional topic specifically about the xanax in that benzo section. If you do, I suggest you add a link to this thread in your post (or signature) so we will be able to view and follow your total med situation.

 

(Mods, if that is not appropriate or advisable at this point, please override my advice.)

 

Pepper, I completely understand why you take different doses of the xanax at different times (re the sleep issue), but my experience is that taking divided doses unevenly leads to more problems than it solves, and it might be affecting your trazodone situation as well. Some of us who post in the benzo section could advise you on that. Rhi is particularly experienced and knowledgeable about dealing with benzo/AD interactions and dosing.

 

Your son is wonderful to be helping you through this difficult time!

[SelmaLady]

Began to suffer from debilitating insomnia after menopause last spring

 

Having been through a brutal benzo w/d, I found that in the middle of it, I was in total insomnia.  I had a total hysterectomy a few years before the w/d but had not started on hormone replacement.  I found that once I began taking Premarin (estrogen replacement) that my insomnia disappeared.  And I was also taking a TCA at the time but it didn't touch the insomnia.    I'm wondering if your insomnia was simply a menopause induced hormone imbalance that would have corrected itself in time?  Was that suggested to you at all?  Perhaps that's something that could be looked at?

[pepper59]

I was doing a bit of editing while you posted your reply. According to this PubMed article, mCPP is the active metabolite of trazodone and you had the testing to determine that your liver enzymes could not eliminate the metabolite from your system, is that correct?

Correct. 2 non-functioning alleles for that gene, can't remember what it's called, though.

[pepper59]

Began to suffer from debilitating insomnia after menopause last spring

 

Having been through a brutal benzo w/d, I found that in the middle of it, I was in total insomnia.  I had a total hysterectomy a few years before the w/d but had not started on hormone replacement.  I found that once I began taking Premarin (estrogen replacement) that my insomnia disappeared.  And I was also taking a TCA at the time but it didn't touch the insomnia.    I'm wondering if your insomnia was simply a menopause induced hormone imbalance that would have corrected itself in time?  Was that suggested to you at all?  Perhaps that's something that could be looked at?

I do think it had something to do with menopause. But I Waited as long as I could and could no longer go on without sleep. My brain was coming apart. My sister has breast cancer, so I cannot get a doctor to prescribe HRT.

[pepper59]

Thank you, Brandy. I will come back to re-read you post maybe tomorrow. Very sleepy right now. 

[SelmaLady]

I'm so sorry that you've had such bad insomnia and I do know there comes a time when coping with it is torture.  I'm just wondering if there is another approach to the possible hormonal imbalance other than HRT?  Maybe just leave this alone until you can sort out the Xanax and Trazodone...   

 

You're in a good place here and you will get good counsel.  I'm glad that you found this support and wisdom.  Hope that things begin to settle for you soon.

[mammaP]

Hi Pepper, welcome to SA. Sorry to see that you are going through this, it seems very hard for you right now. You've made a lot of changes recently and your nervous system is struggling as a result. Not your fault, you are doing your best to try and make things better. Your doctor obviously knows nothing about withdrawal but that is not unusual as most doctors haven't a clue. 

 

Thank you for filling out your signature it is very helpful. Can you tell us a bit more about the doses? 

Did you reinstate trazodone at 50mg? and did you feel worse after reinstating?   Are you still taking the 10mg of trazodone? If you felt better at 20 you may be best to go back to that as it is only a few days since the cut. 

 

I agree that the xanax is probably complicating things, with benzos there seems to be rebound anxiety and many find that it is best to split the dose so there is a constant blood level to avoid interdose withdrawal.  Your nervous system is crying out for stability and needs to settle on a dosing pattern.  You need to hold for a few months to stabilise, then you could start a slow taper from trazodone again once stable. 

 

I sympathise with the problem of insomnia, I too am a chronic insomniac and functioning on very little sleep can be really hard. Hopefully when you have stabilised your sleep might improve some.  I will find some links for you to read when you are feeling up to it. Once you understand what is happening it is easier to deal with. 

 

Tapering trazodone http://survivingantidepressants.org/index.php?/topic/2883-tips-for-tapering-off-trazodone/

 

Withdrawal syndrome. http://survivingantidepressants.org/index.php?/topic/603-what-is-withdrawal-syndrome/

 

Many people find that magnesium and fish oil help with withdrawal. 

 

http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

 

http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

[pepper59]

I was prescribed trazodone at bedtime for sleep. I've been trying to taper it. I'm wondering if there would be any advantage or disadvantage to splitting my current 20mg dose into two 10mg doses (AM and PM) to sort of even out my day? Thanks.

[cymbaltawithdrawal5600]

Pepper,

 

I moved your latest post on 'splitting doses' back here to your thread because it is a specific question having to do with your situation and not a general tapering questions. You can feel confident asking any question here in your thread and if it might be better suited for its own special topic in one of the other forums we will instruct you to ask it there, ok?

 

I did a little searching on trazodone and cannot see that there is any particular advantage for splitting the doses of it. You note that you are feeling a bit better (in your sig) and could that be due to splitting the xanax doses? If it is then you just might as well continue that. I hope you will continue to just stay on the doses of the meds you have right now and give your body time to stabilize before you attempt to make any changes. Perhaps now is not a good time to change the trazodone and take less of it. MammaP suggested a good long hold and she is right. She gave you a lot to read and I do hope you have found it helpful and she also suggested you go back up to your original dose of trazodone, stabilize there and only then resume tapering of it. Perhaps you might want to give that some more thought as that might be the wisest thing to do right now.

[pepper59]

OK.

I did go back to the 20mg as mamaP suggested.

I think spreading out the xanax more evenly is better. I didn't get as many or as severe anxiety attacks today. I'm just drop dead tried from lack of sleep. The xanax is a sleep aid, but it doesn't keep me asleep long enough or consistently enough. My daughter had to come home from school yesterday to take care of me and get some groceries. I don't drive most days because I am so tired. My son will take me to doctors this week. Luckily, my appointments are on his days off of work. :-)

[pepper59]

Hi Pepper, welcome to SA. Sorry to see that you are going through this, it seems very hard for you right now. You've made a lot of changes recently and your nervous system is struggling as a result. Not your fault, you are doing your best to try and make things better. Your doctor obviously knows nothing about withdrawal but that is not unusual as most doctors haven't a clue. 

 

Thank you for filling out your signature it is very helpful. Can you tell us a bit more about the doses? 

Did you reinstate trazodone at 50mg? and did you feel worse after reinstating?   Are you still taking the 10mg of trazodone? If you felt better at 20 you may be best to go back to that as it is only a few days since the cut. 

 

I agree that the xanax is probably complicating things, with benzos there seems to be rebound anxiety and many find that it is best to split the dose so there is a constant blood level to avoid interdose withdrawal.  Your nervous system is crying out for stability and needs to settle on a dosing pattern.  You need to hold for a few months to stabilise, then you could start a slow taper from trazodone again once stable. 

 

I sympathise with the problem of insomnia, I too am a chronic insomniac and functioning on very little sleep can be really hard. Hopefully when you have stabilised your sleep might improve some.  I will find some links for you to read when you are feeling up to it. Once you understand what is happening it is easier to deal with. 

 

Tapering trazodone http://survivingantidepressants.org/index.php?/topic/2883-tips-for-tapering-off-trazodone/

 

Withdrawal syndrome. http://survivingantidepressants.org/index.php?/topic/603-what-is-withdrawal-syndrome/

 

Many people find that magnesium and fish oil help with withdrawal. 

 

http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

 

http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

My primary doctor has been wanting to switch me to clonazepam because it is easier to get a steady state than on xanax. I seem to need a pretty high dose of xanax to sleep, but on a high dose I can't function in the daytime, so I don't know how that's going to work for me. I need sleep so badly, that I guess I may try it. I will just have to make sure I am ready to crash before I try it.

[cymbaltawithdrawal5600]

pepper,

 

Your nervous system has become unstable from something, it could still be an aftereffect of the long ago course of AD's or your current attempt to decrease trazodone, which is really an antidepressant and used off label as a sleep aid. The xanax and trazodone are not healing your insomnia, they are just keeping withdrawal symptoms at bay. You will have to go off both drugs very very slowly to avoid further increases in symptoms since your body has obviously become sensitized.

 

Your doctor was wrong, you can't just simply stop the drugs and expect to feel nothing. That is how people find this and other support groups for withdrawal. They use a search engine because they are feeling poorly and they have a vague idea that their drug is involved and are shocked to find out that the doc they trusted, who is supposed to KNOW about all of this stuff DOES NOT HAVE A CLUE. It is not likely to change anytime soon, this has been going on for years and years. Because some people can actually jump on and off these drugs without any problems at all, until they do and then it is too late. The only thing that heals wd syndrome is time (and lots of it) off the drugs. No further chemical interference while the body does its job getting back to the homeostasis it was born with. Slowly tapering off these drugs allows the body to find that homeostasis gradually and not have to deal with the uproar wd causes.

[pepper59]

Problems is I had the debilitating insomnia before I took a drug. Even when I wean off, it will still be there. I was unable to drive, bathe, eat, function. I would make a protein smoothie and drink it because I couldn't chew. I lost 20 pounds. I know I need to taper down the meds, but I have no idea what I am going to do about the insomnia. It was actually worse than the side effects from the meds. Poor sleep is better than no sleep. I at least stopped losing weight.

 

Needed to up my xanax again last night and only got 4 hours of sleep.  Previously to the big trazodne cut disaster from 20mg to 10mg, I was doing micro cuts and had been at 20mg for several weeks. That was when the doctor said to jump. Instead I did a 50% cut. Then I missed a dose because I am so zonked from lack of sleep. Then I went completely wacky on Sunday. Was on the phone begging my friend to help me kill myself. The pain was so awful. I was too weak to move, so that prevented me from actually doing anything dangerous. I felt like my arms and legs were made of lead. I had dry heaves but did not actually vomit. I felt like my brain was going to explode. That lasted a few hours and now I am back to just dragging around depressed and feeling hopeless. I did go back up to the 20mg trazodone on Sunday once I realized I forget to take it.

 

I see my primary today. She is going to say again that I should just quit the trazodone. My son is driving me because I am in no shape to drive. I hope my brain is clear enough to explain all this stuff to her. My friend thinks I should ask her to be hospitalized. I think that will make me worse. They will do a rapid detox and I will be worse than when I went in. Right?

 

I know exactly what my body needs-get off the meds and heal. But, off the meds I get no sleep and then cannot heal either. I was rapidly deteriorating pre-meds. Now I am slowly deteriorating. 

[cymbaltawithdrawal5600]

Hospitalization is always a risk because the usual approach is to throw more drugs at the problem which only makes it worse.

 

Right now you cannot solve your original problem of insomnia while your system is in an uproar. Your system needs stability and calmness and a steady state of whatever drugs it had gotten used to before all the drastic changes were made. Your system could not cope with them and the cumulative effects of the insomnia.

 

The time for solving the insomnia is AFTER you get stabilized. And probably drugs won't be the answer.

[pepper59]

Yes, I need to stabilize. My primary referred me to a psychiatrist. I suspect that he will have the same answer as a hospital, more drugs. She also seemed to think a hospital might be the answer because I am losing weight and failing at self care. She told me to eat more. I can't imagine eating more. My stomach feels like it has rock in it. 

 

So how to stabilize? A long-acting benzo? My primary said the xanax is a bandaid and I need something else, a different med. She has great confidence in this psychiatrist. My primary is not typically a drug pusher. She is very nutrition oriented. So when she say I may need to be hospitalized, I am concerned. I really don't want to go. I want to stay at home. If I had relatives in the area to look after me, I could stay home. But I just have my 2 college-age kids nearby who obviously can't be my full-time caretakers. They're not really adults yet themselves.

 

It was bad at the doctor appointment. I tried to tell her things about my anxiety and it just made it worse. I had to hold my son's hand to stay in the room and not freak out. Problem is, one of my worst traumas happened at the hands of a healthcare provider. This whole doctor-hospital thing is just freaking me out more.

[Fresh]

Hi Pepper ,    lots of people find that melatonin helps enormously with sleep , tho it's an individual thing.    It's safe for you to try.

 

If you're considering taking anything else , check out  the website    drugs.com     and put what you're taking into the interaction checker.

 

Hope you feel better soon  ,   Fresh 

[Altostrata]

Welcome, pepper.

 

What were the symptoms you had from mCPP?

 

As you know, mCPP is generated from metabolism of trazodone (see Tips for tapering off trazodone (Desyrel) ).

 

The liver enzyme that metabolizes mCPP is governed by P450 cyp 2D6. Even in people with normal cyp 2D6, if you take another drug that utilizes this enzyme for its metabolysis, it will cause a traffic jam in the liver and backup of mCPP.

 

Are you taking any other drugs of any type? Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and post the results in this topic.

 

As mammaP noted, fish oil and magnesium can be calming. You might do better with magnesium glycinate taken several times a day.

[pepper59]

Yes, that's what I don't have. I have 2 non-functioning alleles for cyp2d6. Got the same one from each parent.  

 

I only take the xanax and the trazodone. I suspect that the trazdone first helped with sleep and then stopped working, possibly because of the mCPP. THen I started the Xanax. This all started as  asleep issue and then snowballed into affecting me all day. I struggle with anxiety around the clock now. 

 

I have been taking magnesium and fish oil for years. I have a chelated form of magnesium I take with every meal. And I take a multi and extra D because I tested low normal for D. I had a couple of weeks that I skipped my vitamins most days because I was so sleepy and lost track of my regular eating routine. Back on track with that.

 

Still having horrible slow-motion panic attacks. I wonder if this is from trying to  taper the trazodone. I reinstated a couple of days ago, but the panic continues. And the Xanax did almost nothing for my sleep last night, so add exhaustion. My therapist and my primary doctor have discussed sending me to an inpatient unit. The nearest one that is not a hell hole is two hours away. I live in the sticks. I don't want to go, but I am struggling with self care and I am afraid that these panic attacks are getting so bad that I might do something I don't want to do. I can't think straight when they happen and they last for hours. The only comfort is I am too wasted to hardly get up out of the chair so it's unlikely that I could jump off a bridge or something. And I never forget that I have kids and don't want to leave them. I call the crisis line about every other day. They help to talk me through the attack. I think they are getting sick of me. If this is the trazodone withdrawal, I wonder how long it will go on. I finally get to see  a psychiatrist on Thursday, a guy who started filing in at my clinic when the other one left a few months ago. My primary has other patients with serious psych issues, so she has been in contact with this guy and says he is great. I sure hope so. I am trying to hang on until thursday, but also preparing that I may beed to drive all the way to the Milwaukee area and try to check myself in for detox. If I wait until I come apart at the seams, I will end up in one of these nasty places around here. That would certainly make me worse, not better. :-(

[Altostrata]

What were the symptoms you had from mCPP?

What is your daily symptom pattern relative to when you take your drugs? Please keep notes on paper about this.
 
Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and post the results in this topic.

[pepper59]

I think the mCPP made my insomnia worse and possibly made me slightly more anxious. Other than that, I'm not sure. 

 

I have been noting my symptoms. I think they are usually the worst in the evening, before I take my big xanax dose. But I can get them randomly, too. And some days are better than others. I have things that trigger my ptsd. I can feel awful even when I have taken a big xanax dose.

 

I have had a few of these awful fireworks-in-my-brain episodes since I cut and then reinstated my trazodone. It feels like I want to die or I am going to die. I want to hold at 20mg trazodone and see if they go away. I was OK on that dose for several weeks before I made the too-big cut last week.

 

My doctor and therapist have been talking about my doing a voluntary inpatient detox because my symptoms are sometimes so bad and I am losing so much weight. Not to mention scaring my kids. (Young adults, actually, but kids to me.) I would have to drive 2 hours to a decent detox place and then would be very alone, away from everybody I know. And, who knows if they would even have an opening. I could end up waiting in the ER for hours or days. This is an emergency-admit place and it's first come first serve. I want to stay home. Even as I type about the detox, I start to get anxious. I see my therapist today, but even seeing her makes me anxious these days. I had a trauma related to healthcare in hte past and now anything remotely resembling healthcare/hospitals/doctors makes me jittery. I'm hoping this is just the drug combo and the trazodone withdrawal and will pass. 

[pepper59]

Drug interactions: Using ALPRAZolam together with traZODone may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. 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.

 

Ha ha, that's me. Impaired thinking and judgement! My kids say I have dementia. I say no kidding! I no longer drive on the highway or unfamiliar streets. I drive like I'm 80. Most days I'm too tired to drive anyway. Come to think of it, this pretty much described me on acute sleep deprivation, too, before I started any of these meds. 

[Altostrata]

I think the mCPP made my insomnia worse and possibly made me slightly more anxious. Other than that, I'm not sure. 

 

I have been noting my symptoms. I think they are usually the worst in the evening, before I take my big xanax dose. But I can get them randomly, too. And some days are better than others. I have things that trigger my ptsd. I can feel awful even when I have taken a big xanax dose.

 

I have had a few of these awful fireworks-in-my-brain episodes since I cut and then reinstated my trazodone. It feels like I want to die or I am going to die. I want to hold at 20mg trazodone and see if they go away. I was OK on that dose for several weeks before I made the too-big cut last week.

 

My doctor and therapist have been talking about my doing a voluntary inpatient detox because my symptoms are sometimes so bad and I am losing so much weight. Not to mention scaring my kids. (Young adults, actually, but kids to me.) I would have to drive 2 hours to a decent detox place and then would be very alone, away from everybody I know. And, who knows if they would even have an opening. I could end up waiting in the ER for hours or days. This is an emergency-admit place and it's first come first serve. I want to stay home. Even as I type about the detox, I start to get anxious. I see my therapist today, but even seeing her makes me anxious these days. I had a trauma related to healthcare in hte past and now anything remotely resembling healthcare/hospitals/doctors makes me jittery. I'm hoping this is just the drug combo and the trazodone withdrawal and will pass. 

 

Have these symptoms gotten better or worse since you reduced trazodone?

 

How long have you been on 20mg this time around? What time of day do you take it?

 

Are you taking any drugs other than trazodone and Xanax?

 

Generally, detox facilities deal with addictive drugs (such as benzos), they don't know much about going off "non-addictive" drugs such as trazodone.

[pepper59]

No other drugs, but I do take some dietary supplements related to keeping my neuropathy under control. And I use a tiny amount of progesterone cream, about 1/4 of what the tube says. All approved by my doctor.

 

I was on 20mg trazodone for 3 weeks. Before that I was on 22mg for about 3 weeks. (My son makes the cuts for me and weighs them on a jeweler's scale) The last week of January, I cut to 10mg. That was when psych nurse told me to drop the trazodone entirely. I take it at 9PM, though I have been known to forget and take it later. I reinstated at 20mg after the bad week. My perception is that my symptoms intensified and became more frequent a couple of days after the cut. Then I had two days with hours of hell and what I call "brain fireworks" after I accidentally forgot to take a dose. Physical and mental pain that is hard to describe. I reinstated the trazodone and also moved part of my night dose of xanax to the morning. I improved.

 

I was always blaming my symptoms on the xanax, but as I look back at my sleep diary, it seems my sleep always got bad for a few days shortly after making a trazodone cut. So I think they are both in play here. 

 

There's another thing in play here, too. This all started after menopause. I have had some very occasional "female symptoms" off and on over the past year that make me think my body is not quite done with trying to reproduce. I often have mood problems and worse sleep when those symptoms pop up. Happily, those symptoms have been lessening in the past month or so.

 

I really don't want to go to detox, but I scare myself and my kids when I get brain fireworks. I have no control over my thoughts and I'm afraid I may do something foolish. Fortunately, however, when I have brain fireworks, I am physically collapsed and unable to get up even get up to go to the bathroom. So not likely I could harm myself. And I don't want to harm myself. I strongly desire to get well and be here for my kids, who have no other family nearby and whose father walked out on all of us 5 years ago. I'm all they have. But sometimes I feel like my brain is going off on its own and I can't control it. This got worse with the xanax. It's the worst feeling I've ever had. Makes me feel creepy just writing it down. I wonder how I can make it through withdrawal or a med switch on my own like this. And yet, I figure a detox place would just stop the trazodone and rapidly withdraw the benzo and I could be permanently damaged. 

 

And one more monkey wrench in the equation. There is a county psych hospital near me that is an absolute hell hole. If I were to freak out and say or do something foolish (such as threaten self harm), I would end up there as an "involuntary" and they could keep me for a long time. I don't think they do detox. They do drug-pushing. I hear this from mental healthcare workers I know. I would come out much worse than I went in. My trauma counselor told me she has clients who are in therapy for ptsd because of things that happened to them there. So, I wonder, better to drive the long way, get far away from that place, and do a voluntary admission to a real hospital or to try to gut it out on my own and hope I don't get taken to the hell hole against my will. 

[Altostrata]

Have these symptoms gotten better or worse since you reduced trazodone?

 

You've only reinstated 20mg on Feb 1? What time of day do you take it?

 

(You need to take trazodone at the same time each day for at least 4 days to let it reach steady-state in your system.)

 

What supplements are you taking?

 

It's your choice to go to detox. If you don't wish to go, stop worrying about it. Do your best to stay calm and realize you are having symptoms that have nothing to do with your sanity or your personality.

 

Please focus and answer my questions -- I need this information to make an informed guess about your situation.

[pepper59]

I don't quite understand the first question. I've reduced the trazodone many time over many months. Poor sleep got worse with each cut but then improved a bit later. Anxiety and panic have been trending worse with both use of Xanax and cutting of trazodone. 

 

Anxiety and panic are also directly related to how much sleep I am getting. I have no sleep reserves left, so one bad night can cause waves of anxiety all the next day.

 

Yes, reinstated February 1st after a week at the lower dose. I take trazodone at 9PM, though I have been known to forget and take it later. The week I cut it in half, I was taking it whenever I thought of it, sometimes earlier, sometimes later. I believed the psych nurse that such a small amount wasn't really affecting me.

 

At the same time I reinstated, I took advice from forum to spread xanax out to 3 doses instead of only 2. That seems to have helped, too. I suspect I was having Xanax withdrawal every day. Again, my doctor and nurse said that was impossible on such a small dose and not to change anything. I did change and I do think I'm better.

 

Multivitamin (not mega-dose, just normal), vitamin D (doc checks levels and they are good), benfotiamine, calcium, magnesium, inositol (3 grams, prescribed by psych nurse), C, horse chestnut, curcumin, fish oil, B12.

 

​I don't know what started the insomnia except for menopause and ptsd (which I was not even aware of before menopause, therapist/nurse said I had it and I didn't believe them). Working on the ptsd but it's teeny tiny baby steps and each step seems to make my anxiety worse. Seeing a real psychiatrist today. It took months to get in to him. Previously was seeing a psych nurse who apparently was in over her head and caused this problem.

 

I think what I hear people on this board saying is I need to get stable (sleep, emotions) right now and not reduce anything until I am. For how long? I just hate being on this stuff. 

[Altostrata]

It sounds like every time you reduced the trazodone, you got withdrawal symptoms and your sleep was affected. This was not from the mCPP.

 

You will need to stabilize for as long as it takes for your nervous system to settle down. This may take months.

 

You are taking 20mg trazodone every night now, correct?

[pepper59]

Yes, I have gone back to 20mg every night. I'm just going to leave it there for now, I guess. I really wanted to get it out of the picture before I tried any new meds, but that looks impossible. Got 4 hours of sleep last night. Need to do something to get sleep and get my brain and body working again. I think I can't heal because I am so exhausted. Psych wants to try adding a small dose of seroquel at bedtime. He thinks the lack of sleep is what's keeping me from being able to taper off anything and do my trauma therapy. Sounds scary, but what I'm doing now is not working. I'm guessing that seroquel is going to be like an AD and need tapering eventually. Oh, and he also said to spread my xanax out to 4 doses, and start to get them more even so I am not having xanax withdrawal every day. I started that the other day. Sleep got wobbly with reduction of bedtime dose. If I get sleep on the seroquel, then he wants to taper me off the other stuff.

[Petunia]

Hi pepper,

I just read through your thread.  I'm so sorry you are going through this.  I wish you had been able to get some proper help and support for your insomnia, rather than being put on drugs, but this is so common, it makes me both sad and angry.  We deserve healthcare which is able to uncover the real cause of our symptoms and find lasting solutions, not just cover symptoms with drugs which often end up doing more harm in the long run.

 

I've had to deal with some of the same problems as you, menopause, raising a teenager/young adult alone, drug effects/withdrawal.  I also have PTSD from previous traumas.

 

We really can't advise you regarding the addition of Seroquel, there's no way to know if it would help, make things worse or do nothing at all. Its an atypical antipsychotic, sometimes used off label in a low dose for insomnia, but there are risks and side effects, even at a low dose.  If you did start taking it, and took it for more than a few days, it would need to be tapered eventually. 

 

If you are able to get 4 hours of sleep per night, that's not too bad, of course its far from ideal, but many people are able to manage on that amount of sleep for months, sometimes years. The anxiety caused by believing we are not getting enough sleep can cause a viscous cycle.

 

I hope you are able to get some relief soon.  Please keep us updated with any changes that you make.

 

Petunia.

[pepper59]

Thanks, Petunia. I've been going on little to no sleep since last April. I was collapsed from lack of sleep before I ever took a medication. It was really to the point that the lack of sleep was going to kill me, so I'd better take something. Every night I would fully expect I was so tired I absolutely would sleep. And I would, for about 5 minutes and then get startled awake by some kind of switch in my subconscious brain. And I'd fall right back asleep. And be awake again. All night long. This started after menopause. 

Most recently I have been trying evening out my xanax (new doctor who seems much more savvy about meds). This seems to have helped my sleep, even though it seems counter-intuitive that a lower bedtime dose would make my sleep better. Once I get the xanax schedule right, I want to go back to tapering the trazodone. I have the seroquel as an emergency backup if my sleep collapses again because of withdrawal. Haven't taken it yet. Hoping I never have to. 

 

BTW, I don't do caffeine, sugar, or processed foods either. They all mess me up!