Posted by Tony P on July 10, 2009, at 21:37:34
In reply to Re: Yes, it seems like I shouldn;t, posted by bleauberry on July 7, 2009, at 9:38:19
> > but it is a sedating AD that doesn;t cause sexual side-effects and that's what I need.
>
> Ok. Whatever. There are far better choices to accomplish those goals.
>
> Sedating, yes, probably so much you won't care about sex. So in that respect, yes, it can have sexual side effects.
>
> You'll get a whole lot more ummph for sleep, sex, and depression, with something like Nortriptyline or Amitriptyline.
>
> Antidepresant? The real-world clinical evidence of traz being a dependable antidepressant is dismal. Experienced psychopharmacologists stopped using it many years ago. The only ones still using it are ones that don't know what they are doing or they are prescribing it as a sleep aid.
>
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Recently went on traz again (been on it a couple of times before), 25-50 mg as needed for insomnia. My pdoc agreed with the above that it's a very poor A/D -- you need to get up around 600 mg/day, and I can't imagine staying awake on that! I find it the best combination of low side-effects and short half-life of all the non-hypnotic sleep aids I've tried.My pdoc said it's important how you take it and what kind of insomnia you have. Taking it 20 min. before bed & expecting to be out like a light will probably NOT work. Some people take it as much as a couple of hours before bedtime. According to him, its best effect is to stop you waking up in the small hours with a panic attack, which used to be a big part of my pattern & still is to some extent. I did have akathisia (like RLS all over) on it a few years ago but this time, touch wood, i'm fine.
I have a friend with the same problem as me -- waking up with my mind spinning its gears off -- and he's been on 50 mg for years without needing to up the dose.
Re the sex/priapism issue, I suspect (but have no citations) that the incidence of _serious_ priapism is very low indeed, or it would be off the market or at least black-labelled by now. For me, there is a slight benefit as I have ED, and am on an SNRI which makes me seriously anorgasmic. So (if I can stay awake) the very mild but definite effect it has on both conditions is very handy!
I did some brief research recently into the half-lives & side effects (both official and personal) of the half-dozen or so AD's & antihistamines I have tried for insomnia, and trazadone came out on top -- for me. Trimipramine gave me the most natural sleep, with Remeron a close runner up, but both have very long half-lives, 24 hr. or more, so I was sleeping for 36 hours at a stretch!
If anyone is interested, I will happily send them my spreadsheet or post a summary here (post a reply or babblemail me), on the understanding that this is a personal evaluation, e.g. I ignored side-effects that aren't a problem for me.
Tony P
poster:Tony P
thread:905179
URL: http://www.dr-bob.org/babble/20090709/msgs/906140.html