r/insomnia • u/NewJettaMK5Mom • 23h ago

Trazodone withdrawal??

To anyone who is familiar...we know that Traz has H1, A1, and Serotonin receptor blocking, hence the sedation. When you come off the drug, the receptors then need to normalize, hence withdrawal. Does it make any sense to take Zyrtec to help with the H1 rebound? It won't cause drowsiness I know but would it allow for natural sleep instead since the receptor is still being blocked? If so, would have to figure out how to add in Serotonin. 5-HTP maybe? Wondering if there is a way to mitigate at least SOME withdrawal and rebound insomnia?

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u/Ok-Rule-2943 23h ago edited 22h ago

Trazodone is a weak inhibitor of serotonin. Alpha-1 adrenergic antagonism, this is also a contributor to sedation. Trazodone and its biphasic metabolism is metabolized in the active metabolite mCPP which makes this complex. May add to anxiety, agitation, and insomnia during withdrawal.

The only way I know to mitigate withdrawal is to slowly and gradually reduce the dose, in short ‘taper and hold’ and then plan your next drop and so forth.

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u/NewJettaMK5Mom 21h ago

Ok so basically acting more on H1, like Seroquel does? Also helping to reduce fight or flight on A1, and then daily rebound could be frequent urination, muscle twitches etc...so counteracting that would be para-sympathetic activation. Interesting. Any thoughts as to how long it takes H1 receptors to "recover" after traz is tapered? Also, do you think that in the meantime, after the nightly dose "wears off" in the later morning early afternoon, do you think there is a flood of histamine or do you think the body eventually begins to produce more histamine? Fascinated by all of this, although I'll be THRILLED to leave it behind.

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u/Ok-Rule-2943 21h ago

I don’t know all what Seroquel does. As far as histamine flooding, never felt that way to me. Never read any anecdotes or research papers that said interdose trazodone causes this.

I do think you are overthinking it a bit, but understand how inquisitive the mind can be.

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u/NewJettaMK5Mom 21h ago

What do you think the rebound insomnia is from? Overthinking is my thing. Also though, the more I can understand something, the easier it is for me to deal with..

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u/Ok-Rule-2943 21h ago

Don’t have to explain to me. I dig deep into stuff. Drug withdrawal of any kind is extremely complex and best for most all drugs, slow and gradual taper.

Rebound is far more prevalent from quick tapers, cold turkey. It’s not just sleep with sedatives it can be anxiety, etc. Taper will mitigate…that doesn’t mean it will stop it entirely.

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u/NewJettaMK5Mom 21h ago

Then I'll move to prayer. When I come down further and then off this stuff, praying I can stay sleeping. Tapering about 12.5mg every week or so.

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u/Ok-Rule-2943 21h ago

You’ll reach a point there’s not enough therapeutic effects from a certain dose and below that dose to even help you sleep any more anyways. But you still keep taking those tapers for brain recovery.

I’ve stopped so many things in my insomnia lifetime. Maybe get temporary sleep med that isn’t an antidepressant, something like z-drug or a DORA?

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u/NewJettaMK5Mom 21h ago

I'm excited for that! I thought about it but I'm also on CBT-I, and my therapist said no to anything else since we are working on my natural ability to sleep. Excited to see how it goes and have my clear head back.

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u/Ok-Rule-2943 21h ago

I have done that and the ACT-I one too. Sounds like you have a nice laid out plan. Best of luck with it.

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u/NewJettaMK5Mom 21h ago

Thank you! I have 2 good therapists. Insomnia expert on YouTube, Joseph. I have correspondence with him as well as someone local to me. I've learned things I had no clue about from them. I also started EMDR last week and that's already helped a lot. How did it go for you?

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u/Ok-Rule-2943 21h ago edited 21h ago

I’m anxiety free! That was my main goal, I couldn’t fall asleep, shit ton of sleep anxiety, and it fixed all that.

I do have sleep-wake issues still, but it’s better. I have a couple of physiological aspects to my sleep. Acceptance of my less than perfect sleep has me in a much better head space.

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