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I have serious issues with fatigue and trazadone seemed to help me quite a bit, but i keep having to take more.  250mg is not working so I'm thinking 300mg might be enough.  But my doctor (family practice) says 200mg is the max dose, which seems low.  There are plenty of people taking 400 out there.  Thoughts? 

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6 minutes ago, SquareOne said:

I have serious issues with fatigue and trazadone seemed to help me quite a bit, but i keep having to take more.  250mg is not working so I'm thinking 300mg might be enough.  But my doctor (family practice) says 200mg is the max dose, which seems low.  There are plenty of people taking 400 out there.  Thoughts? 

I have yet to meet anyone who's had a good experience with Trazadone, but keep in mind that anything you hear from us or from other consumers is anecdotal. I suggest that you trust your body. If you're comfortable experimenting a bit and have enough support to help you if the side effects turn ugly... that's your call.

(Full disclosure: I overdosed on Trazadone. It didn't feel that great. Please be careful.)

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Hi SquareOne,

     Sometimes a psychiatrist can prescribe higher doses of mental health medications . . . I mean in comparison to other types of doctors.  Don't know enough to offer you any meaningful advice.  I myself am on Trazadone for sleep and find it very effective for that.  I take 50mg for sleep.  I have some interest in Trazadone as it seems to prevent and reverse senile dementias like Alzheimer's Disease in some very, very limited and preliminary research studies.  I will be watching how that goes.  Best to you!!

- epictetus

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it varies per person, and their metabolism. talk to your doctor about your concerns and see what he/she says.. also if you feel tired/sleepy but it's working maybe they can give you a stimulant to help with the sleepiness ..

provigil is one of them..

 

how do you feel?

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On 3/11/2019 at 4:51 PM, SquareOne said:

I have serious issues with fatigue and trazadone seemed to help me quite a bit, but i keep having to take more.  250mg is not working so I'm thinking 300mg might be enough.  But my doctor (family practice) says 200mg is the max dose, which seems low.  There are plenty of people taking 400 out there.  Thoughts? 

i just googled it and depending on the type you are taking it says 400 can be a daily dosage : but ask your doctor he will know better..

Adults

For the immediate release tablets, 400 mg/day PO for outpatients and 600 mg/day PO for inpatients; for the extended-release tablets, 375 mg/day PO.

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I weaned myself off of this medicine because it stopped working after 2 to 3 weeks. I cut back to 25 mg. I was only taking 50 mg to being with. I sleep better. When I was taking it, I had horrible nightmares. I would ask your doctor to put you on another medicine.

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6 minutes ago, Shy80 said:

I weaned myself off of this medicine because it stopped working after 2 to 3 weeks. I cut back to 25 mg. I was only taking 50 mg to being with. I sleep better. When I was taking it, I had horrible nightmares. I would ask your doctor to put you on another medicine.

I didn't have that side effect but it stopped working for me. Glad you can sleep better.

BW

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Posted (edited)

200 mg is the max dose for sleep, because after that, the blood levels of the active metabolite, mCPP, raise to a level where the medication actually becomes stimulating rather than sedating. 300-400 mg, as @ladysmurf said, are for depression outpatients, and 600 mg is the maximum dose used for depression inpatients. That's a lot of trazodone! 😮

If you have developed a "tolerance" to this med, which often happens to many people, including myself, you may wish to discuss a different sleeping med with your doctor... Something like low-dose Seroquel (25-50 mg), low-dose doxepin (10 mg)/Silenor (3-6 mg), low-dose Remeron (7.5-15 mg), Belsomra, Rozerem, Atarax/Vistaril, Saphris (if your insurance will let you get it without step therapy), Ambien/Ambien CR/Zolpimist/Edluar, Lunesta, ProSom, Halcion, Restoril, Ativan, Serax, Dalmane, Doral, gabapentin, etc. Heck, even low-dose Thorazine will definitely get the job done! (25-100 mg) Just watch for acute dystonic reaction to Thorazine... it happened to me my first time taking it (I took half a 100 mg tablet), but never again thereafter.

Seroquel and Saphris are atypical antipsychotic, newer than the typical antipsychotic Thorazine. A word about Saphris, it is sublingual only, and tastes awful. They try to add some cherry flavoring in there, so it tastes like a disappointing cherry liquor... lol

Doxepin (Sinequan) is a tricyclic antidepressant, but at low doses and even microdoses (Silenor), it acts as one of the most potent antihistamines and puts you to sleep. Remeron is a NaSSA (Noradrenergic and specific serotonergic antidepressant) and is, I believe, the most potent antihistamine on the market, but it will definitely put some weight on you and increase your appetite--some people need that, some don't.

Rozerem is a melatonin receptor agonist at MT1 and MT2 receptors, but one could arguably just take melatonin (low dose) and get the same effect.

Belsomra is an orexin receptor antagonist. Orexin is responsible for wakefulness, vigilance, feeding behavior, and energy expenditure. Antagonizing the receptors (blocking them) keeps orexin from making us want to stay awake more. It's a pretty good medicine, I must admit (when it works, it's a little hit or miss for me). You have to titrate up to your dose though, whereas some doctors and pdocs just prescribe the max dose of 20 mg right off the bat.

Atarax and Vistaril are the same medicine (hydroxyzine), except the Atarax is "hydrochloride" and VIstaril is "pamoate," the latter of which permeates the central nervous system more easily and can thus help you with anxiety and insomnia, however you take it. The pamoate is a capsule though (Vistaril), so it can't be split if you discover 25 mg or 50 mg is too high a dose for you.

Ambien is zolpidem, a nonbenzodiazepine or "Z-drug." It has some variations out there, including Ambien CR (controlled release), Zolpimist (oral spray, tastes worse than Saphris!), and Edluar (orally disintegrating tablets). Lunesta is another Z-drug, but it lasts a little longer than Ambien and probably even Ambien CR. Definitely lasts longer than Sonata (which I didn't include because it only works for sleep induction, not sleep maintenance, but if that's all you need, I'd recommend Sonata actually. It worked far better for me than Ambien.)

Halcion and Serax are short-acting benzodiazepines; ProSom, Restoril, and Ativan are intermediate-acting benzodiazepines; and Doral and Dalmane are long-acting benzodiazepines. You could throw Klonopin in there too for a long-acting one. It's generally better to stay away from the long-acting ones for sleep as you may likely experience next-day sedation (hangover).

Gabapentin (Neurontin) is an anticonvulsant that has pro-sleep properties. It doesn't necessarily make you go to sleep, it kind of "lets" you fall asleep. It may be good as an adjunct medicine to your sleep medicine. It promotes slow wave sleep if I recall correctly.

I hope this list is of some help to you, and if not you, then somebody! lol 🙂

 

Edited by mikl_pls

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11 hours ago, mikl_pls said:

200 mg is the max dose for sleep, because after that, the blood levels of the active metabolite, mCPP, raise to a level where the medication actually becomes stimulating rather than sedating. 300-400 mg, as @ladysmurf said, are for depression outpatients, and 600 mg is the maximum dose used for depression inpatients. That's a lot of trazodone! 😮

If you have developed a "tolerance" to this med, which often happens to many people, including myself, you may wish to discuss a different sleeping med with your doctor... Something like low-dose Seroquel (25-50 mg), low-dose doxepin (10 mg)/Silenor (3-6 mg), low-dose Remeron (7.5-15 mg), Belsomra, Rozerem, Atarax/Vistaril, Saphris (if your insurance will let you get it without step therapy), Ambien/Ambien CR/Zolpimist/Edluar, Lunesta, ProSom, Halcion, Restoril, Ativan, Serax, Dalmane, Doral, gabapentin, etc. Heck, even low-dose Thorazine will definitely get the job done! (25-100 mg) Just watch for acute dystonic reaction to Thorazine... it happened to me my first time taking it (I took half a 100 mg tablet), but never again thereafter.

Seroquel and Saphris are atypical antipsychotic, newer than the typical antipsychotic Thorazine. A word about Saphris, it is sublingual only, and tastes awful. They try to add some cherry flavoring in there, so it tastes like a disappointing cherry liquor... lol

Doxepin (Sinequan) is a tricyclic antidepressant, but at low doses and even microdoses (Silenor), it acts as one of the most potent antihistamines and puts you to sleep. Remeron is a NaSSA (Noradrenergic and specific serotonergic antidepressant) and is, I believe, the most potent antihistamine on the market, but it will definitely put some weight on you and increase your appetite--some people need that, some don't.

Rozerem is a melatonin receptor agonist at MT1 and MT2 receptors, but one could arguably just take melatonin (low dose) and get the same effect.

Belsomra is an orexin receptor antagonist. Orexin is responsible for wakefulness, vigilance, feeding behavior, and energy expenditure. Antagonizing the receptors (blocking them) keeps orexin from making us want to stay awake more. It's a pretty good medicine, I must admit (when it works, it's a little hit or miss for me). You have to titrate up to your dose though, whereas some doctors and pdocs just prescribe the max dose of 20 mg right off the bat.

Atarax and Vistaril are the same medicine (hydroxyzine), except the Atarax is "hydrochloride" and VIstaril is "pamoate," the latter of which permeates the central nervous system more easily and can thus help you with anxiety and insomnia, however you take it. The pamoate is a capsule though (Vistaril), so it can't be split if you discover 25 mg or 50 mg is too high a dose for you.

Ambien is zolpidem, a nonbenzodiazepine or "Z-drug." It has some variations out there, including Ambien CR (controlled release), Zolpimist (oral spray, tastes worse than Saphris!), and Edluar (orally disintegrating tablets). Lunesta is another Z-drug, but it lasts a little longer than Ambien and probably even Ambien CR. Definitely lasts longer than Sonata (which I didn't include because it only works for sleep induction, not sleep maintenance, but if that's all you need, I'd recommend Sonata actually. It worked far better for me than Ambien.)

Halcion and Serax are short-acting benzodiazepines; ProSom, Restoril, and Ativan are intermediate-acting benzodiazepines; and Doral and Dalmane are long-acting benzodiazepines. You could throw Klonopin in there too for a long-acting one. It's generally better to stay away from the long-acting ones for sleep as you may likely experience next-day sedation (hangover).

Gabapentin (Neurontin) is an anticonvulsant that has pro-sleep properties. It doesn't necessarily make you go to sleep, it kind of "lets" you fall asleep. It may be good as an adjunct medicine to your sleep medicine. It promotes slow wave sleep if I recall correctly.

I hope this list is of some help to you, and if not you, then somebody! lol 🙂

 

This helped. Thanks! I see my doctor in a couple of weeks, so I will ask her.

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18 hours ago, Shy80 said:

This helped. Thanks! I see my doctor in a couple of weeks, so I will ask her.

Good luck! 🙂 Hope your doc is able to give you something that helps.

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5 hours ago, mikl_pls said:

Good luck! 🙂 Hope your doc is able to give you something that helps.

Thank you. I just hope she doesn't want to up the dosage for Trazadone. 

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good luck, what i liked about atypical antidepressants is that many people i've met *including myself* have said that it does not **** their creativity, libido, etc.. thats how i felt when i took them for a while..which is why idont understand the medical field keeps on making SSRI's many complain it kills their libido and makes them feel like a zombie, but oh well. good luck.hope you feel better

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When I got off of Lexapro, I went cold turkey because my doctor didn't tell me to wean myself off. I started getting sick and vomiting. I weaned myself off of Trazadone during this time because I was having brain zaps all of the time. Well, the brain zaps went away because I assume the Lexapro is out of my system. I went back to Trazadone just to see. No side effects, but I have been sleeping better. When I was taking Lexapro, when I was wake up, I felt dizzy. I still take Lamictal (50mg), but no dizziness. So, I guess I'll stick with Trazadone for a while to see if it will wear off.

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On 7/16/2019 at 1:11 PM, Shy80 said:

When I got off of Lexapro, I went cold turkey because my doctor didn't tell me to wean myself off. I started getting sick and vomiting. I weaned myself off of Trazadone during this time because I was having brain zaps all of the time. Well, the brain zaps went away because I assume the Lexapro is out of my system. I went back to Trazadone just to see. No side effects, but I have been sleeping better. When I was taking Lexapro, when I was wake up, I felt dizzy. I still take Lamictal (50mg), but no dizziness. So, I guess I'll stick with Trazadone for a while to see if it will wear off.

are you taking it for sleep only?

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i know its supposed to help for insomnia and all but my friend has been on it for a few weeks and saw no improvement on her depression or sleep. ..i guess everyone reacts different its so weird.

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On 7/19/2019 at 6:30 PM, ladysmurf said:

are you taking it for sleep only?

I was taking Lexapro for major depression and anxiety, but it made me sad and more depressed. My dr. put me on generic Lamictal because she said I have a mood disorder. I'm on 50mg now. She said she's going to up it every two weeks. So, I see her tomorrow, she'll probably tell me to take 75 mg and 100 mg in another two weeks. She said after a while my insomnia should go away. I tried Trazadone again, but it does nothing. I mean I'll fall asleep, but anything can wake me up and I can't go back to sleep. In the past, one doctor put me on valium for anxiety and I went to sleep fast. He just kept upping it because it didn't help my anxiety the way I wanted it to. I think at the time the doctor was trying to find inexpensive drugs for me. I was on Elavil and valium.

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20 hours ago, Shy80 said:

I was taking Lexapro for major depression and anxiety, but it made me sad and more depressed. My dr. put me on generic Lamictal because she said I have a mood disorder. I'm on 50mg now. She said she's going to up it every two weeks. So, I see her tomorrow, she'll probably tell me to take 75 mg and 100 mg in another two weeks. She said after a while my insomnia should go away. I tried Trazadone again, but it does nothing. I mean I'll fall asleep, but anything can wake me up and I can't go back to sleep. In the past, one doctor put me on valium for anxiety and I went to sleep fast. He just kept upping it because it didn't help my anxiety the way I wanted it to. I think at the time the doctor was trying to find inexpensive drugs for me. I was on Elavil and valium.

yeah i took all of those but did nothing..good luck i hope you figure it out.

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Well, I saw my dr. yesterday and she upped my Lamictal to 100 mg and after a week 200 mg. As for Trazadone, she upped it to 100 mg. I told her that 50 mg didn't work and I wanted to try something else. She said well, try taking 100 mg. Last night I took it, it didn't make me go to sleep fast. She said Trazadone is the best thing out there for insomnia. Then she said she might put me on Prozac next month. I don't want to get on that because I've heard some bad stuff about that.

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