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Dr. Bob is Robert Hsiung, MD,
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Posted by blueberry on December 16, 2005, at 15:38:44
In reply to Cymbalta Insomnia- Trazedone?, posted by ShellyM on December 16, 2005, at 9:20:39
Traz can work, but really there aren't many people who have tried it who like it. Some, but not many. It actually made my sleep worse, more fitfull.
Remeron is a possible option. Low dose zyprexa or seroquel are possibilities...they definitely work and have a good chance of helping your symptoms too. Lunesta is worth a try. The good thing about all of these is that you only need 1 to 3 nights on each to find out which one you like the best. No long trials needed.
Posted by ShellyM on December 16, 2005, at 18:40:25
In reply to Re: Cymbalta Insomnia- Trazedone? » ShellyM, posted by flipsactown on December 16, 2005, at 12:39:55
Thanks so much. I will check out Remeron as well. I would really love not to have any weight gain or sexual side effects (wouldn't we all!)...I am really happy about the Cymbalta results so far and have been hoping that the insomnia goes away, but if it doesn't soon, I may knock myself over the head just to get some sleep (joke) :-)
Any experience with Elavil?
Shelly
> Hello,
>
> I have been taking 40mg Cymbalta for 6 weeks now and also have insomnia, but my unipolar depression is under control.
>
> I have been taking 100mg Trazodone which helps get me the deep REM sleep that everyone needs, but it causes anorgasmia for me. I am male. I asked my pdoc to switch me to Remeron, which also helps insomnia, but Remeron causes weight gain, for me me it was over 60 pounds. Now that I have my weight under control, I am trying Remeron again and will be watching my diet very carefully.
>
> I also take 400mg Wellbutrin with the Cymbalta.
>
> Hope this helps.
>
> FST
>
>
>
> > I am hoping you all can give me some advice on best medication for insomnia.
> >
> > I've been on Cymbalta for a month for anxiety and panic attacks. My anxiety and panic is much improved. This is a blessing after trying Paxil, Lexapro, Imimpramine without good results. The bad news is that I am having insomnia since being on the Cymbalta (something to do with neoeph?) and can not sleep. I can't take Benzos (history of abusing them).
> >
> > I am going to talk to my Pdoc about something to help me sleep- I was thinking of Trazedone, as it appears to have some anti-anxiety properties. I want to be careful about taking something that is going to conflict with the benefits I am seeing from SSRI's.
> >
> > Thoughts on Trazedone?
> >
> > Much thanks,
> >
> > Shelly
>
>
Posted by Phillipa on December 16, 2005, at 21:46:16
In reply to Re: Cymbalta Insomnia- Trazedone?, posted by ShellyM on December 16, 2005, at 18:40:25
I've heard a lot of good things about lunesta and ambien now has a long acting version ambien cr. Fondly, Phillipa
Posted by Racer on December 17, 2005, at 13:12:50
In reply to Cymbalta Insomnia- Trazedone?, posted by ShellyM on December 16, 2005, at 9:20:39
> I've been on Cymbalta for a month for anxiety and panic attacks. My anxiety and panic is much improved. The bad news is that I am having insomnia since being on the Cymbalta (something to do with neoeph?) and can not sleep.
>
> I am going to talk to my Pdoc about something to help me sleep- I was thinking of Trazedone, ...While this is only anecdotal, the insomnia I experienced when I started Cymbalta went away on its own. I'd give it a solid six to eight weeks -- I know, UGH! -- to see if it will do that for you, too.
And something like Ambien would be my first choice for insomnia, frankly, since that's what it's made for. I'd bet that a few days of it, to break the cycle of insomnia, would be enough to get you back on track.
Congratulations, by the way, on your good response to Cymbalta.
Posted by spriggy on December 17, 2005, at 15:06:38
In reply to Re: Cymbalta Insomnia- Trazedone? » ShellyM, posted by Racer on December 17, 2005, at 13:12:50
Have you tried just plain ole' Benadryl?
I take that sometimes when I can't sleep- it helps.
Restoril knocks me out but that is a benzo so maybe not a good option for you.
I have Ambien in my cabinet but have never taken it- I'm one of those people who are terrified to try a new medicine. I swallow it and then sit for an hour waiting for every single one of the side effects to hit me.
I'm weird.
Anyway, maybe try Benadryl.
Posted by ShellyM on December 17, 2005, at 18:18:16
In reply to Re: Cymbalta Insomnia- Trazedone?, posted by spriggy on December 17, 2005, at 15:06:38
Thanks, maybe I will try Bendadryl. I am like you! Any time I start a new med I research for hours on the Internet, and am always convinced I am going to experience every type of negative side effect I read about!
Quirky girl!
> Have you tried just plain ole' Benadryl?
>
> I take that sometimes when I can't sleep- it helps.
>
> Restoril knocks me out but that is a benzo so maybe not a good option for you.
>
> I have Ambien in my cabinet but have never taken it- I'm one of those people who are terrified to try a new medicine. I swallow it and then sit for an hour waiting for every single one of the side effects to hit me.
>
> I'm weird.
>
> Anyway, maybe try Benadryl.
Posted by Ilene on December 18, 2005, at 20:33:07
In reply to Cymbalta Insomnia- Trazedone?, posted by ShellyM on December 16, 2005, at 9:20:39
I take pretty much the same combo as you, plus 75 mg. of Trazodone for sleep. It works pretty well. I don't know about sexual side effects, since my libido has been hibernating for quite some time.
I.
Posted by ghostshadow on December 20, 2005, at 7:54:46
In reply to Re: Cymbalta Insomnia- Trazedone? » ShellyM, posted by Ilene on December 18, 2005, at 20:33:07
i've been on trazadone for over 10 years to help me sleep, but also for OCD. I take 200mg. at bedtime, but my sleeping problems started many many years before i was able to start getting treatment. And while it helps me get to sleep, even at this dosage i still wake up during the night...
Posted by yxibow on December 23, 2005, at 1:29:23
In reply to Re: Cymbalta Insomnia- Trazedone?, posted by spriggy on December 17, 2005, at 15:06:38
> Have you tried just plain ole' Benadryl?
>
> I take that sometimes when I can't sleep- it helps.It helps temporarily, but I find that it also causes daytime depression, and for me at least it causes racing heart sometimes before it sedates.. but that's just my side effects I guess.
>
> Restoril knocks me out but that is a benzo so maybe not a good option for you.It is a quite powerful benzodiazepine mostly aimed at the hypnotic receptor.
>
> I have Ambien in my cabinet but have never taken it- I'm one of those people who are terrified to try a new medicine. I swallow it and then sit for an hour waiting for every single one of the side effects to hit me.
>
> I'm weird.No, I read the PDR and the 500 possible side effects, which occurred in 1 out of 5000 patients. It's a common fear.
But on a side note, the first time I tried Ambien -- I had taken a midterm on one hour of sleep and desperately needed to have more sleep. Maybe it was the Effexor I was taking at the time ? I forget, it was in college. Wow -- it sucked me in to this cool, relaxing, enticing trance feeling like I've never felt before that said to me, come now, and sleep (no, I didnt hear voices). I slept like a baby, and I've never had that feeling again with Ambien, other than it does sedate me. I guess once a neurotransmitter is hit on me, the second time isn't the same.
tidings.
Posted by ed_uk on December 23, 2005, at 13:41:53
In reply to Re: Cymbalta Insomnia- Trazedone? » spriggy, posted by yxibow on December 23, 2005, at 1:29:23
Hi J
>come now, and sleep
That's what Remeron 7.5mg says to me. It often says 'come now, and eat' first though.
Ed
Posted by yxibow on December 23, 2005, at 23:27:05
In reply to Re: Cymbalta Insomnia- Trazedone? » yxibow, posted by ed_uk on December 23, 2005, at 13:41:53
> Hi J
>
> >come now, and sleep
>
> That's what Remeron 7.5mg says to me. It often says 'come now, and eat' first though.
>
> EdLol.. yes.. the same for me with low dose Remeron. And Trazodone too -- as dizzy as it may make me, there's an instinct to go to the fridge. But Trazodone isn't good for my body chemistry at the moment because of its metabolite MCPP which actually interferes with psychosis, or in my case I guess pseudopsychosis.
Posted by ed_uk on December 24, 2005, at 17:56:39
In reply to Re: Cymbalta Insomnia- Trazedone?, posted by yxibow on December 23, 2005, at 23:27:05
Hi J
I sent you a babblemail, did you get it?
I've never taken trazodone. Of all the sleep aids, diphenhydramine makes me the most dizzy.
Tidings!
Ed
Posted by yxibow on December 24, 2005, at 20:42:05
In reply to Re: Cymbalta Insomnia- Trazedone? » yxibow, posted by ed_uk on December 24, 2005, at 17:56:39
> Hi J
>
> I sent you a babblemail, did you get it?
>Yes, I got it and replied... I had never gotten any babblemail from anyone so I hadn't bothered to look at that account recently, sorry.
> I've never taken trazodone. Of all the sleep aids, diphenhydramine makes me the most dizzy.
Interesting, I never knew it was causally related to orthostatic hypotension -- in fact its cousin dimenhydrinate is supposed to calm vertigo and motion sickness, it is the 8-chlorotheophyllinate salt of diphenhydramine.
Trazodone also has, um.. well that male thing... priapism. And its quite more common than stated, I experienced it mildly but I had to continue to take the drug for a while at that time in my life. Doxepine was an atrocious experiment, fortunately it was weekend at college because I was knocked, fogged out clear 18 hours or so.
Cheers.- J
Posted by ed_uk on December 24, 2005, at 21:05:06
In reply to Re: Cymbalta Insomnia- Trazedone?, posted by yxibow on December 24, 2005, at 20:42:05
Hi J
>Yes, I got it and replied... I had never gotten any babblemail from anyone so I hadn't bothered to look at that account recently, sorry.
........and I just replied to your reply :)
>Interesting, I never knew it was causally related to orthostatic hypotension
I don't think it is. I was dizzy sitting or standing. Diphenhydramine can treat vertigo too - but it wouldn't be ideal for me!
Regards
Ed
Posted by Dawnie on December 27, 2005, at 0:02:19
In reply to Cymbalta Insomnia- Trazedone?, posted by ShellyM on December 16, 2005, at 9:20:39
I have been on Trazedone for 10 years. Currently I am taking 150mg. From the first night I took it I got a good night's sleep and of course that improved my anxiety and depression. I sometimes take Ambien as needed meaning if I hav a long day coming up or I wake during the night and can't go back to sleep (which is rare since being on Trazedone) I also take Lexapro. Trazedone is the one med I have not and would not give up.
Posted by flipsactown on December 28, 2005, at 20:27:36
In reply to Re: Cymbalta Insomnia- Trazedone?, posted by Dawnie on December 27, 2005, at 0:02:19
I have been on 60mg Cymbalta for 7 weeks and have been experiencing insomnia for which I take 100mg Trazodone. I sleep very well on Traz getting quality REM sleep. However, I am male and also experience anorgasmia with Traz. I tried taking Remeron which is also very sedating, but Remeron gives me quite an appetite and I pack on the pounds. I hope the sexual side effect of Trazodone will subside in time.
FST
> I have been on Trazedone for 10 years. Currently I am taking 150mg. From the first night I took it I got a good night's sleep and of course that improved my anxiety and depression. I sometimes take Ambien as needed meaning if I hav a long day coming up or I wake during the night and can't go back to sleep (which is rare since being on Trazedone) I also take Lexapro. Trazedone is the one med I have not and would not give up.
Posted by yxibow on December 28, 2005, at 22:57:19
In reply to Re: Cymbalta Insomnia- Trazedone? » Dawnie, posted by flipsactown on December 28, 2005, at 20:27:36
> I have been on 60mg Cymbalta for 7 weeks and have been experiencing insomnia for which I take 100mg Trazodone. I sleep very well on Traz getting quality REM sleep. However, I am male and also experience anorgasmia with Traz.
I'm a natural insomniac so I can't say that Cymbalta has contributed significantly to it like Effexor did years ago when I tried it.
>I tried taking Remeron which is also very sedating, but Remeron gives me quite an appetite and I pack on the pounds.
Definately -- I'm just pushing off 40% of it in the gym.
>I hope the sexual side effect of Trazodone will subside in time.
It probably will -- but one thing, and I assume your doctor knows, is that Trazodone and Cymbalta are both metabolized by P450 CYP2D6, which means there is a slight potential for drug-drug interactions. The anorgasmia is probably more due to the Trazodone, but could also be due to the combination.
Decreased libido was reported in 1.3% of the outpatient community in Trazodone tests. Of course then there is "the problem" with Trazodone to watch for in relation to this -- priapism. Occurs more often than not, not to scare you (I experienced it mildly mostly about once every few months but continued to take the drug for a while) -- although if you're younger, you're probably likely not to be in too much danger of such a situation.
Posted by Dawnie on December 30, 2005, at 23:08:32
In reply to Re: Cymbalta Insomnia- Trazedone? » flipsactown, posted by yxibow on December 28, 2005, at 22:57:19
> > I have been on 60mg Cymbalta for 7 weeks and have been experiencing insomnia for which I take 100mg Trazodone. I sleep very well on Traz getting quality REM sleep. However, I am male and also experience anorgasmia with Traz.
>
> I'm a natural insomniac so I can't say that Cymbalta has contributed significantly to it like Effexor did years ago when I tried it.
>
> >I tried taking Remeron which is also very sedating, but Remeron gives me quite an appetite and I pack on the pounds.
>
> Definately -- I'm just pushing off 40% of it in the gym.
>
> >I hope the sexual side effect of Trazodone will subside in time.
>
> It probably will -- but one thing, and I assume your doctor knows, is that Trazodone and Cymbalta are both metabolized by P450 CYP2D6, which means there is a slight potential for drug-drug interactions. The anorgasmia is probably more due to the Trazodone, but could also be due to the combination.
>
> Decreased libido was reported in 1.3% of the outpatient community in Trazodone tests. Of course then there is "the problem" with Trazodone to watch for in relation to this -- priapism. Occurs more often than not, not to scare you (I experienced it mildly mostly about once every few months but continued to take the drug for a while) -- although if you're younger, you're probably likely not to be in too much danger of such a situation.
Are you aware othe dangers of men taking Trazedone. A new psychiatrist (one covered by our insurance) put my son on it a few years ago (along with a number of other med changes) and when he started getting extremely manic we went back to our old psychiatrist. He took him off the Trazedone immediately. Apparently a side affect in men is a painful erection that wont go away and often needs surgery. The late Freddie Prinze had this happen to him. I would ask your doc about this. Ask him about Ambien instead.
Posted by yxibow on December 31, 2005, at 23:34:16
In reply to Re: Cymbalta Insomnia- Trazedone?, posted by Dawnie on December 30, 2005, at 23:08:32
> > > I have been on 60mg Cymbalta for 7 weeks and have been experiencing insomnia for which I take 100mg Trazodone. I sleep very well on Traz getting quality REM sleep. However, I am male and also experience anorgasmia with Traz.
> >
> > I'm a natural insomniac so I can't say that Cymbalta has contributed significantly to it like Effexor did years ago when I tried it.
> >
> > >I tried taking Remeron which is also very sedating, but Remeron gives me quite an appetite and I pack on the pounds.
> >
> > Definately -- I'm just pushing off 40% of it in the gym.
> >
> > >I hope the sexual side effect of Trazodone will subside in time.
> >
> > It probably will -- but one thing, and I assume your doctor knows, is that Trazodone and Cymbalta are both metabolized by P450 CYP2D6, which means there is a slight potential for drug-drug interactions. The anorgasmia is probably more due to the Trazodone, but could also be due to the combination.
> >
> > Decreased libido was reported in 1.3% of the outpatient community in Trazodone tests. Of course then there is "the problem" with Trazodone to watch for in relation to this -- priapism. Occurs more often than not, not to scare you (I experienced it mildly mostly about once every few months but continued to take the drug for a while) -- although if you're younger, you're probably likely not to be in too much danger of such a situation.
> Are you aware othe dangers of men taking Trazedone. A new psychiatrist (one covered by our insurance) put my son on it a few years ago (along with a number of other med changes) and when he started getting extremely manic we went back to our old psychiatrist. He took him off the Trazedone immediately. Apparently a side affect in men is a painful erection that wont go away and often needs surgery. The late Freddie Prinze had this happen to him. I would ask your doc about this. Ask him about Ambien instead.
>
>There are several problems with Trazodone. Those who are borderline or have psychotic disorders generally should not take Trazodone as its metabolite mCPP is known to cause psychosis.
"The problem" is definately also a reason I wouldn't recommend it, especially for older men whose organs are, um.. more sensitive. I was much younger when I took it and I bounced back from the occasional problems in ways we won't discuss in polite company. :) But you're right, it is a serious problem with Trazodone with some and I believe it is a separate internal black box for Desyrel. My conjecture is that it is probably related to the changes in blood pressure that Trazodone causes.
It generally hits you over the head like a hammer, it causes orthostatic hypotension (low blood pressure), and if you can stand that and not sleep , you are probably emptying the refrigerator if you have enough to have a true psychiatric dose of the medication as it promotes hunger.
I would much rather people attempt to convince their doctors to take the relatively safe pseudobenzodiazepine related sleep agents such as (in order of general effectiveness), Ambien (esp above 10mg up to 20mg), Lunesta (esp at 3mg), and Sonata (although wierd visual sensations have been reported with Sonata).
Posted by HappyGirl on January 1, 2006, at 1:17:11
In reply to Re: Cymbalta Insomnia- Trazedone? » Dawnie, posted by yxibow on December 31, 2005, at 23:34:16
Hi:
The 'low-blood pressure' related to the Trazodone is quite intereisting to me. Because, in early last Fall, I got an awful dizziness after having taken two 'Tums' Ultra(Maxiumum Strength) for my 'stomach' problem(indigestion and acid reflux) while I was on the 150 mg. Trazodone. At that time, however, I blamed on other med., the 900 mg. Lithium and the 'Tums' mix that was said to cause a low-blood pressure among some of Bper's, because of Tum's 'Calcium' component interaction with the Lithium.I am NOT an old person, but I might be a tendency of getting blood pressure as seeing 'dizziness' after having taken one of SSRIs in the past. For that reason, I am NEVER on any of SSRIs since.
In my curiosity, ... which med., do you think, the Trazodone or the Lithium made me 'dizzy' with 'two' Tums?
Thanks for your response if you can.
Posted by ed_uk on January 1, 2006, at 2:51:16
In reply to Re: Cymbalta Insomnia- Trazedone? » Dawnie, posted by yxibow on December 31, 2005, at 23:34:16
Hi Yxi :)
How did trazodone affect your appetite compared with Remeron?
Regards
Ed
Posted by yxibow on January 1, 2006, at 4:28:29
In reply to Re: Cymbalta Insomnia- Trazedone? » yxibow, posted by ed_uk on January 1, 2006, at 2:51:16
> Hi Yxi :)
>
> How did trazodone affect your appetite compared with Remeron?
>
> Regards
>
> EdHappy new years / hogmanay :)
Trazodone contributed only a bit to it, maybe gained 10 pounds or so here or there. Remeron was the awful culprit for weight -- I can't place an exact point when I started but a good 50 pounds I would say.
It helped immensly with my disorder like I thought it would -- my doctor didnt place as high a value on those transmitters but I do believe that the 5HT2 blockade that Remeron has secondarily to its alpha adrenergic action is similar to a neuroleptic without the dopamine blockade. Eventually weight though was a stopper for it after I reached a point where I felt while I wasn't clinically diabetic, I wasn't getting that far away from that range.
In a few weeks, I will be exiting the "obese" range of the BMI, if my excercise plan continues as it has. And this is weight that was put on quite a while back. The Seroquel is a bit of an additive so I will always have to excercise a bit to fight that off.
Posted by flipsactown on January 1, 2006, at 9:53:39
In reply to Re: Cymbalta Insomnia- Trazedone? » flipsactown, posted by yxibow on December 28, 2005, at 22:57:19
>
> Decreased libido was reported in 1.3% of the outpatient community in Trazodone tests. Of course then there is "the problem" with Trazodone to watch for in relation to this -- priapism. Occurs more often than not, not to scare you (I experienced it mildly mostly about once every few months but continued to take the drug for a while) -- although if you're younger, you're probably likely not to be in too much danger of such a situation.>>
yxibow,I guess I am one of the lucky men not to experience priapism, not that I want to, as I have been on Traz at least 6 months and have noticed my dreams are very vivid, but not nightmarish.
The combo of Cymbalta and Traz seem to have sped up my metabolism and have lost 30 pound with the help of high protein/low carb diet for 6 months.
Although I have only been on Cymbalta almost 2 months, I was on Lexapro and Traz previously for over a year. When I briefly switched back to Rem last month, I started putting on weight even when my diet was the same.
As far as the anorgasmia is concerned, it seems to be subsiding, although I still have to work extra hard. I am male and 54 years young.
FST
Posted by ed_uk on January 1, 2006, at 12:50:26
In reply to Re: Cymbalta Insomnia- Trazedone? » ed_uk, posted by yxibow on January 1, 2006, at 4:28:29
Hi Yxi :)
Happy New Year!
>I do believe that the 5HT2 blockade that Remeron has secondarily to its alpha adrenergic action is similar to a neuroleptic without the dopamine blockade.
Yes, I agree. Also, in combination with neuroleptics, Remeron may be useful in the treatment of schizophrenia.
>In a few weeks, I will be exiting the "obese" range of the BMI, if my excercise plan continues as it has.
:)
Warm regards
Ed
Posted by Sarah T. on January 6, 2006, at 1:10:39
In reply to Re: Cymbalta Insomnia- Trazedone? » Dawnie, posted by yxibow on December 31, 2005, at 23:34:16
One doesn't have to be psychotic to experience problems with Trazodone's metabolite, mCPP. Anyone who has a genetic polymorphism for the cytochrome P450 enzyme, 2D6, can have problems with that metabolite. The mCPP (meta-chloro-phenylpiperazine) metabolite is used in experiments to induce anxiety and panic attacks.
This is the end of the thread.
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