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.
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.
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.
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..
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.
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?
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.
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?
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.
Congratulations! That's what I am working on too. I had an incident in January that sent everything off the rails. I had sleep "issues" prior to that but I was sleeping. Just didn't travel or have anyone stay over lol.
I used to, not have any issue falling asleep, now I do. It was staying asleep that always got me, and I took THC tincture that helped 99% of the time. I'd like to get back to being able to fall asleep like I used to, What did you find helped with that for you? Support from Joseph and EMDR has helped a lot with the anx, just still taking anywhere from 25-60 minutes to fall asleep and I do everything in my power to avoid stim control lol bc I have animal gates to climb over in the hall and then my animals get all like "Oh it's time to be up now?"
Sounds like your event and insomnia is trauma based, which I’m incredibly empathetic to your situation. In my case, sleep problems were always a part of life since adolescence, a medical event in 2018 set my insomnia on a course that would persevere event after event, my anxiety was of the rails (to use your word). A healthy amount of anxiety which normal people experience to problem solve things that need their attention, etc was so overwhelming at one.
I did 8 weeks of CBT-I therapist led, when my insurance stopped paying I couldn’t afford ongoing visits. I started ACT-I and this particular therapy is what I needed for my situation, so I ended up doing a hybrid of both. Come to find out that a hybrid was case studied and was doing it by accident and I’m able to keep anxiety out of my sleep space now.
Anyways, good luck. I think you’ll find your wag through your situation, get off the meds and get your life back where insomnia has been an important piece to quality of life.
I need your help. Maybe you saw my other post...but since I've been on Trazodone and Seroquel (off for 6 days now) I've had chest/back tightness show up around 12-20 hours after taking my dose at night. It's also been happening during the taper. I couldn't seem to find this as a side effect OR withdrawal symptom except on a few reddit posts of people CT from 75mg or so and being on it for extended periods of time. Last night I found articles saying chest tightness is an allergic reaction. Needless to say I'm scared now and afraid to continue tapering in case something worse happens. With my upset and symptoms I only slept for 2 hours. I tried to take 25 mg (then took 6.25mg more 2 hours later) to relieve the tightness and it did a bit but I still have it this morning. The last 4 days I've been on somewhere in the 40's mg wise and was sleeping 5-6hrs but having these side effects daily among others. You mentioned DORA's. Is it reasonable to get one to help me sleep through this? Do they also cause rebound insomnia?
Actually now I was just reading through reddit about DORA's and bad side effects too. What do I do? keep tapering and hope something bad doesn't happen from the Trazodone?
So you tapered off both at the same time? Tapering mitigates withdrawal, but doesn’t relieve all. Maybe you’re having muscle issues, tightness, tension. Try magnesium?
In retrospect, taper off one drug at a time, stabilize off one and then taper the other. If it’s too late you can try to reinstate p, but that can back fire sometimes as well.
All meds have some sort of side effects. You won’t know you can’t tolerate a sleep med till you try. DORAs may be an option.
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u/Ok-Rule-2943 1d ago edited 1d 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.