Trazadone and its effects?
January 25, 2011 4:14 PM   Subscribe

I was just prescribed Trazadone to help with sleep. I am not worried about the drug as it is widely prescribed, but would like to hear some first hand experiences. Will this knock me for a loop each night and how long will the effect last?

In other news, as a recovering alcoholic (5 years, yay!), what do I have to look out for with this drug in relation to that?

I am also on Zyprexa and Citalopram for depression. While I am not worried about the interaction of these drugs, I am curious as to what will happen after taking a dose of Trazadone before bed. Does anyone have experience with this combination?

(Sorry for the rambly-ness of this question. I generally don't ask personal questions on AskMeFi)
posted by anonymous to Health & Fitness (26 answers total) 8 users marked this as a favorite
I think it really depends on the person. I have a friend who uses it as an occasional sleep aid and he has to have teeth brushed/face washed/be in bed before taking because it hits him like a ton of bricks within a very short time frame. For me, it takes much longer to kick in, and if I'm having a particularly bad bout of insomnia, doesn't always put me to sleep, though it certainly makes me sluggish. When it does work, I'm generally out for a solid 6-7 hours, though I also tend to have a sleep hangover the next day that takes at least an hour if not more to shake.

Sorry, I do not have any information about the combination.
posted by HonoriaGlossop at 4:22 PM on January 25, 2011

I took one once and it kept me up all night!
posted by mareli at 4:26 PM on January 25, 2011

My doc says Trazodone (two "o"s) takes about an hour to kick in, which matches my experience. I can feel it when it does but it's pretty mild. If I wanted to stay awake, it would be very easy. Ambien was more powerful. Dosage matters, of course. 100-150mg is enough for me.
posted by chairface at 4:27 PM on January 25, 2011

Personal experience in conjunction with SSRIs: weird dreams, occasional sense of being hungover or groggy on waking.
posted by holgate at 4:36 PM on January 25, 2011

I tried it once, on a flight to made me loopy and my head was spinning the whole fight. I thought that was pretty cool, actually. Your mileage may vary.
posted by dfriedman at 4:37 PM on January 25, 2011

I was put on Trazodone a few weeks ago after Ambien quit working on me -- was waking up in the middle of the night and being up for hours, ultimately having to take another half of an Ambien pill to get back to sleep. I've found Trazodone to be a miracle drug for helping me get an uninterrupted 8+ hours of sleep. Only side effect I've experienced is bizarre dreams.
posted by porn in the woods at 4:40 PM on January 25, 2011

I've used it once in a while, primarily when some shoulder pain was keeping me awake. I used a small dose, I slept soundly, there were no problems with it.

Based on the responses, it sounds like YMMV with this. I probably won't hurt to try it once, see if it is effective and make the decision based on that. Your physician should know if there will be complications due to other meds, that's his/her job.
posted by HuronBob at 4:41 PM on January 25, 2011

I think it really depends on the person.

It depends on the DOSE. (I'm a primary care physician with 15 years practice experience.) 25 mg will do little for most people, 50 mg is the usual minimum effective dose, 100 mg is the most commonly used. Anything over that makes me uneasy although I'm comfortable prescribing 100 mg to those under age 30.

Always start low and work up. If you're over 60 I'd start at 25 mg, otherwise start at 50 mg. But that's for someone who's not on Zyprexa. You should start on 25.

Trazodone and Zyprexa can both cause orthostatic hypotension wherein the blood pressure drops when you stand up. If you have a BP gadget you can check this yourself. Sit for at least 5 minutes, check your BP. Then stand, wait 30-45 seconds, and check the BP again. If your BP drops more than 10 points, that's significant. If it drops over 20 points, it's a big problem.
posted by neuron at 4:42 PM on January 25, 2011

Trazodone has saved my life. I've had periods of intermittent insomnia my whole life, and it was getting worse and lasting longer and longer. By the time I finally went to the doctor, I was getting 2 or 3 hours of sleep and breaking down in hysterics in the middle of the night because I was so exhausted but unable to sleep. So I started taking Trazodone, and lo and behold: I sleep. Every night. I have never experienced any side effects at all.

Before Trazodone, I would occasionally take a Benadryl, which would make me groggy as hell when I woke up in the morning - not so with Trazodone. I take one 30 to 60 minutes before bed, go to sleep like a normal person, and wake up in the morning feeling great. I don't actually feel it "kicking in" like you would with an antihistamine or other sleeping pill; to me it just seems to shut off that part of my brain that rattles on and on and on when I'm lying awake in the middle of the night. If I'm in the middle of a good book I can read for hours after taking a pill, but when I shut off the light I'm still able to fall asleep normally.

I've been taking Trazodone basically every day for at least 2 years and, honestly, I don't imagine I will ever stop. I suffered from insomnia for most of my life and I'm not willing to give up the good sleep it's given me. My doctor says as long as I'm not experiencing a tolerance she isn't concerned about it.
posted by something something at 4:47 PM on January 25, 2011 [2 favorites]

P.S. I take 50 mg.
posted by something something at 4:48 PM on January 25, 2011 [1 favorite]

Crazymeds is your friend for questions like this. Not that the information will all be accurate, but you will get the full range of anecdotal evidence from people who take the drug for on and off label reasons.
posted by The Bellman at 4:53 PM on January 25, 2011

Ambien did nothing to help me sleep; I could take five and still be awake all night. Trazodone was like being shot with an elephant gun, and after the first experience of landing halfway on my bed with all my clothes on, I always made sure to wait until I was in bed etc. to take it. I did have some grogginess/hangover effects from it the next day, too. But as related by those above and as far as I know, everyone reacts differently.

neuron makes a very good point about orthostatic hypotension as well.
posted by vers at 4:53 PM on January 25, 2011

I took trazodone for a while for sleep (25mg). While it worked great for the sleep part, the crazy dreams were unbearable - bizarre, violent stuff, when I was accustomed to never dreaming at all (or not remembering my dreams, whichever). I don't recall there being any withdrawal when I stopped taking it.
posted by chez shoes at 5:09 PM on January 25, 2011

It worked for me for a bit (a month or two), then quit working. I took 75 mg. Tried adding it to my sleep cocktail (which includes six drugs) again recently and all it did was raise my heart rate. I have some seriously treatment-resistant insomnia caused by a neuroimmune disease, though.
posted by jocelmeow at 5:25 PM on January 25, 2011

I was prescribed Trazodone for insomnia and it made me bonkers; couldn't sleep and if I did I had nutso dreams. Went on to Temazepam (which I like to call the velvet hammer) and slept like a baby.
posted by poissonrouge at 6:18 PM on January 25, 2011

I took Trazodone for about six months about 5 years back for insomnia. I didn't experience the crazy dreams that others have however I did have to make sure I had a solid chunk of time to sleep (8+) otherwise the next morning would be extremely difficult. My doctor at the time described it as "The Trazodone Hangover" and it's apparently very common.

It's not something I experienced while taking Ambien for the same reason, FWIW.
posted by splitinfinitive at 6:38 PM on January 25, 2011

From a MeFite who would prefer to remain anonymous:
I am currently taking Citalopram (20mg) for depression and Trazodone for sleep. I just started a week ago. The Citalopram made me shaky/trembly/jittery for the first few days but that has leveled off. I feel a little calmer during the day now (I take it first thing in the morning) and they may increase my dosage in another week or so.

The Trazodone (50mg) has been very pleasant and not at all jarring or zombie-making. I was advised to take it in the evening around dinnertime, rather than at bedtime. I've found that it starts to kick in within a half hour to an hour or so; it's not an instantaneous knockout, but a slower-growing doze, fairly close to natural sleepiness. I had been self-medicating with Benadryl for some time (most OTC sleeping pills are basically Benadryl) and while that stuff tended to provide a quicker knockout, it left me massively cranky and hung over the next day and I had to keep taking more and more to get any sleep. I'm finding the Trazodone (which is actually an antidepressant itself) really helpful and I feel rested and refreshed in the morning after a full night's sleep with no hangover effect. I have always had peculiar dreams and haven't noticed anything more outlandish than usual in that department.
posted by jessamyn at 7:22 PM on January 25, 2011 [2 favorites]

I've been taking Trazodone nightly for ten years (50mg usually, sometimes 25mg), in combination with a wide variety of SSRIs, an MAOI, and anxiety meds (including Alprazolam, though never Zyprexa). I've found Trazodone to have different effects for different people. For me it has been a mild, but very effective sleep aid. Here are my experiences:

-About 15min. after taking a pill my eyelids get very heavy, and I'm usually out for the rest of the night. My memory of events which take place from taking the pill to falling asleep is pretty much non-existent. I won't remember what I read, and neither will I usually remember anything anyone tells me.
-If for some reason I need to attend to something after taking a pill, I am able to do so with relatively little problem (though I wouldn't recommend driving). I really like this med because the effects are quite controllable, I can stay up if I need to. I don't feel foggy, just sleepy.
-No weird dreams.
-I usually get about 6-7 hours of sleep, though I'll sleep much longer if I'm able to. That being said, I've taken a Trazodone and gotten up fine three hours later (well, as fine as one can feel after three hours of sleep).
-It has always been difficult for me to get up in the morning, but I don't feel a particular hangover from Trazodone. Much less intense than any OTC sleep aids. Since I take it every night, I do feel a bit "off" if for some reason I DON'T take it the night before. This is a mild discontinuation syndrome, and though not intense, it is present.
-The Trazodone should pose no problems for your recovery from alcoholism. Although I've been taking it a long time, I've never wanted to take more than the minimum dose possible. Basically it's not at all intoxicating for me (or anyone I've personally spoken with).

I agree with Neuron that you (and anyone) should start with a low dose, and work your way up if needed. Good luck, I hope Trazodone works as well for you as it does for me.

On a side note relating to the previous response, to get any antidepressant benefits from Trazodone one must take a much larger dose than is prescribed for insomnia.
posted by lrrosa at 7:50 PM on January 25, 2011 [1 favorite]

I just started taking trazodone for insomnia. I was waking at around 3 every night and unable to get back to sleep. It works like a charm for me and I'm hoping that the effect won't wear off like it seems to do for some. I was prescribed 50 mg, which totally knocks me out but I don't have a problem waking up, as long as I have 8 hours to sleep. I more often cut it in half and just take 25mg which seems to work well enough without making me feel like I wouldn't wake up even if I needed to get up in the middle of the night (I have a toddler who occasionally needs something in the middle of the night). The 25 mg seems like a good balance of keeping me asleep but not making me feel like I'd sleep through the apocalypse.
posted by otherwordlyglow at 9:05 PM on January 25, 2011

As always, different meds affect different people, well, differently. I was on it briefly at 25mg and when I took it I would say "I am going to get trazostoned" because I would sleep for 14 hours upon taking it. The doctor quickly got me off it.
posted by IndigoRain at 1:30 AM on January 26, 2011

I was put on Trazodone for insomnia. I'd wake up in the middle of the night and be up for at least an hour - screwing up with my sleep. And then I'd start watching Who's the Boss reruns, which also screwed with my sleep.

So I took it exactly once, 25 mg, about four weeks ago. I woke up with the worst splitting eyeball headache that I couldn't fully get rid of for 24 hours. I don't know if it was the Trazodone or what, but I haven't decided to give it another try. I Googled the side effects and headache was one of them (I think headache is a side effect with everything though). My brother was on it a few years ago and confirmed the whacked out dreams. Going to talk to my doctor about the headache concerns.

It's safe with Celexa, by the way, I am on it for anxiety. Celexa will cause some weird dreams too. Nothing scary violent, more entertaining and hysterical. Last night, me and several people I knew from HS lived in the back of a souped up UHaul van from Pimp My Ride. The night before that, my cousin was kidnapped and the family (myself included) was very apathetic about it. I was also a world famous magician last week.

And congrats on your sobriety, that's awesome!
posted by jerseygirl at 7:24 AM on January 26, 2011

Count me in as another one who hates, hates, hates Traz and will not touch it with a bargepole. Like chezshoes, it gave me nightmares - horrible night terrors (my cats burning alive, lovely things like that). It also stuffed up my nose to the point where I couldn't breathe, and gave me an awful hangover the next day - I felt like a zombie until well in the afternoon.

I am bipolar type I, so I suspect this is one reason Trazodone affects me so horribly. My psychiatrist now has me on Seroquel, backed up by Ambien and Ativan (yes, I'm a chronic insomniac from childhood). The Seroquel works like a charm and you can have it when you pry my cold dead hands from the bottle.
posted by Rosie M. Banks at 7:58 AM on January 26, 2011

I take 50mg trazadone, and have for years. Weird dreams yes, but I don't mind them. (I don't take anything else.)

Honestly, it has been a lifesaver for me, as far as insomnia goes. I fall asleep 30 min after taking it, and I have no problem getting out of bed if I need to attend something. No problem getting up after 6-8 hrs sleep, either.

It can cause some constipation, if you don't eat properly. And I understand you shouldn't drink and take them. It overtaxes your liver.
posted by RedEmma at 8:52 AM on January 26, 2011

As an additional data point to what I already wrote above, last night I took 25 mg right before I got into bed but then decided to watch a 90 minute movie. I had no problem staying awake for the movie, though I was definitely super relaxed. And then as soon as I turned the light off when it was over, I fell asleep and slept soundly all night. I'm in love with my trazodone.
posted by otherwordlyglow at 9:46 AM on January 26, 2011

Mod note: From the OP:
"Thanks to all for the great response. I really appreciate the time taken to answer the question. In particular, it was great to hear from pros and cons of the drug from a personal perspective. I feel much more confident in the treatment now. Thanks again."
posted by jessamyn (staff) at 12:07 PM on January 26, 2011

I'm on 80mg Citalopram and I used to take Trazodone for sleep, I took 150mg. It worked well - I felt fine at night, I could stay up if I wanted to but was tired, then fell asleep easily, and woke up easily with no drowsiness. Then, all of a sudden, it was too much and made me sleep for 12 hours, so I went down to 100mg, which was fine for a while - until that was suddenly too much too, and I switched to another med.
posted by insectosaurus at 4:11 PM on January 26, 2011

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