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GeorgeR

Difficulty sleeping

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Posted (edited)

Hi all- new guy to the forum 🙂

I'm a couple days shy of 12 weeks on Wellbutrin. I got a nice effect for 2 days during the first week but then nothing but heavy tiredness until week 8. At that point there was a clear improvement in my depression and energy level but these 2 bad side effects I've had all along are still with me. I get sleepy a couple times a day- so sleepy I'm incapable of doing anything. That lasts an hour or so- I think it's improving a little bit. But the other side effect- not being able to sleep well... that is not getting better. Every night- up around 1am and sometimes for as long as 2 very not fun hours. 

My question is- has anyone gone thru this and eventually overcome both the tired-during-the-day and the inability to sleep well at night? My job requires full attention for the whole day and sometimes the days are 12+ hours. As things are now I wouldn't be able to work (my work is on hiatus while Covid is rampant). Since Wellbutrin is working for the depression I really want to stick with it but a good nights sleep... oh how I want that.

A little background- I had good luck with Celexa for about a year then it pretty much stopped working. I tried a few other SSRIs and SNRIs- giving each a good 6 weeks before judging. They all worked a little bit for the depression but left me so exhausted during the day I had to quit each one. I weened off the last one (Viibryd) and went 4 months with no medication. NOT FUN. The headache never went and after seeing very little improvement after the 4th month I decided to give Wellbutrin a try on my doctor's recommendation. I take 200mg in the morning and 100mg in the afternoon-- sustained release. 

Thanks for your thoughts

Edited by GeorgeR
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Hi GeorgeR,

I'm sorry this is happening to you.  Unfortunately I have no experience at all with Wellbutrin.  I am on Celexa now and was prescribed Trazadone for SSRI insomnia.  Some nights are very difficult though so my heart goes out to you.  Hopefully people with experience taking Wellbutrin will see your post and respond to it with something really helpful.  I sure you hope you find something that can help with sleep/wakefulness problems!

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Posted (edited)

Thanks Epictetus. You mention Trazadone- I will read about it. Do you like how it works? My doctor asked me to think about taking something to help sleep but I'm wary because the one and only time I tried something (melatonin) it didn't work- kinda had the opposite effect on me. 

Trazadone won't be good for me since I had an aortic valve replacement and kidney nephrectomy last year. Wellbutrin hasn't effected my blood pressure so it's ok but unfortunately a lot of medications are no good because of the heart and kidney business. 

Edited by GeorgeR
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Posted (edited)

I'm back seeking help again. I speak to my doctor tomorrow so some kind of change is going to happen. Welbutrin, even though it helps my depression, has wrecked my sleep. Even Ambien didn't help last night. Ambien was my first try at sleep aids but I think the stimulating effect of the bupropion is just too much. And I really really don't want to rely on a pill for sleep plus there isn't one that fits the bill with all my health issues. They include apnea, one kidney (functions well though), recent aortic valve replacement (also functioning well) and fear of becoming addicted to a sleep aid. 

I read a couple posts about people returning to a medication that worked in the past but eventually stopped working so they moved on to other medications. Celexa is the only one I've had good success with but it started to wear off about about a year (as mentioned above). I slept well on it too.  Welbutrin has this stimulating effect so my doctor thought it was the best next thing to try. 12 weeks later I can't sleep and need to try something else. 

Any thoughts about returning to a previous medication after a year off (roughly)?

Edited by GeorgeR

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Update: I tried Ambien for 2 nights and it didn't work much. And of course it left me groggy the next couple of days. Spoke with my doctor and we decided to try Silenor at night not only to help with sleep but hopefully to enhance the antidepressant effect. I did get a little more easy going the last few days but sleep... no. Still up in the middle of the night with RLS, sometimes for a few hours. Gonna move on to Gabapentin next. 

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Omg I am on week 3 and have the tiredness.  I want to give it the full weeks but like you can't afford to be sleepy during the day and will need to be able to sleep at night.   I may try taking the med at night since it makes me so sleepy for a good chunk of the day.   But of it keeps me up then back to the morning I guess.    I too don't want to take any meds to sleep.  I want that to happen naturally.   I do take a supplement called supersleep so hopefully that will work

 

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I started taking Wellbutrin (Bupropion) about 5 weeks ago (like it very much and effect still seems to be growing).  I had pretty significant insomnia prior to taking Wellbutrin, so my Doctor prescribe Trazadone out of the gate. I had an amazing night of sleep at the first dose. Initial RX was for 25 mg, can go up to 50 mg - but I've been able to keep it at 25 (only take 50 if I have a particularly "busy mind" at bedtime. Easier to fall asleep - and if I do wake up it's brief and I go right back to sleep. (Dreaming for the first time in years!!)

Now, the important stuff - while I try to get a full 7 - 8 hours a night and waking up well rested, if I have a short night of 6 hours or so - I might be a little groggy, but nothing a quick shower can't wash away.  It is not habit forming, and I can easily skip a night if I need to. In fact, I feel like it has improved my overall sleep hygiene that my sleep has gotten better rather "organically".  With my Doctor's okay, I continued taking 3 - 6 mg of melatonin, also. 

Bottomline, I am extremely pleased with my combo of Wellbutrin and Trazadone. 

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Thanks for that. I was so happy with the Gabapentin... until last night. I was up for about 4 hours in the middle of the night. I already sent a message asking my cardiologist if I can try Trazadone 😄    It has the potential for QT prolongation so that might mean I can't take it. 

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Last night was worse than the night before. I hope to report that Trazadone works. I have the same 50mg pills that need to be cut in half. Apparently the risk of QT prolongation is not a problem with small doses.

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Good luck! I found the pills break in half easily, otherwise if you need you should be able to grab a cheap little pill cutter at the drugstore. My prescription was 25 mg for a week then up to 50, but as I said, I've found 25 mg to work very consistently.  As my psychiatrist told me, take the pill then make the bedroom cold, dark, and quiet. Sleep well, let us know how the night goes. 

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I became an expert pill splitter after heart surgery last year. I left the hospital with 10 different medications to take. Had to make a spreadsheet 😄

I'm sorry to report that I didn't sleep but an hour last night. It was rough. Tomorrow I have a phone appointment with my doctor and we'll try to come up with a new AD medication so, hopefully, I won't need anything to help me sleep. It's sad because Wellbutrin has worked great for the depression. Regardless-- tonight I'll take a whole 50mg pill and hope for some relief.

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I'm sorry to hear you had another rough night. I hope you respond well to Trazadone; or are able to find the outcome you are looking for. I'm still trying to find a bedtime routine (ritual) that will help with my sleep hygiene on top of the trazodone. Keep on trying and keep us posted. Good luck. 

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Posted (edited)

Thanks for the support. Wow- last night I took the whole 50mg like I said and I slept like a log straight thru the night- 9 solid hours😁  Haven't done that in months. It's a fair assumption that the giant sleep debt I built up had something to do with that heavenly night but maybe all I need is to take the whole 50mg to sleep. However that experiment turns out-- after I talk to the doctor today there's gonna be an alternative on deck in case Trazadone doesn't continue to help me sleep. Lamictal maybe- that looks like a good candidate and doesn't have any big conflicts with my health situation.

Edited by GeorgeR

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Many pdocs give Trazadone as a sleeping aid. It's a very old school SSRI that never worked that great for depression, unless you consider falling asleep constantly a cure... That's why today it's given as a sleeping aid. For me it kills the racing thoughts and spinning, real quick. I take half a pill, as needed. So you don't need to take it every night. It is not addictive. 

 

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Thanks for another vote of Trazadone confidence. Since it worked well last night I'm definitely willing to keep trying it. Wellbutrin is working well for my depression and going thru another weeks or even months long break-in period with a new AD med just to see if it works... not appealing.

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After going through several SSRIs and finding that none are good for me I know that feeling of no more experiments... I've had Trazadone as my sleeping aid for 5+ years now and it rarely ever fails to work. I only take it when I go through rough periods and have never felt addicted to it. The only drawback you can expect is feeling a little hungover in the morning. Get up and move. If you don't it'll let you sit around and be lazy.

Btw, you mentioned taking Gabapentin and that you have heart issues. Be careful with Gaba. Primary negative with it is weight gain. Quite a lot for some people who can't remain very active. It makes you hungry all the time. Any of the family members of anti-consultants (nerve damage, epilepsy, etc) all have that effect. I've been on Cymbalta for the past 2 years and it's not as bad as the others for weight gain, but I also work out a lot. 

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5 years- that's outstanding news. I hated it when Celexa stopped working for me. If I could rely on Trazadone that'd be a really big deal. 

Weight gain is something I want desperately to avoid. I'm moving well in the opposite direction (10 pounds lost in the last month, about 20 more to lose) now so I gotta keep that going. Pdoc phone appointment is in an hour 🙂

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Good news bad news: the good is that 50mg makes me sleep well. Bad news is 25mg doesn't. Slightly not good news is I'm pretty hazy in the morning after that 50g dose. Hopefully I can get used to that and not let it slow me down.

Yesterday I asked the doctor about staying on the Wellbutrin/Trazodone regimen. He and I were both ready to begin making the (really really long) switch to Lamictal but between the good sleep and stuff I heard from you guys here I felt it's definitely worth at least staying the course for a while. I'm a little worried that I'll need to take Trazodone every night though because Wellbutrin obliterates my ability to fall asleep. Before about 10 days ago I always fell asleep easily but got up after a couple hours and had trouble going back to sleep. Actually the first several weeks on Wellbutrin I was able to sleep just fine. Now it just keeps me up all night. Thank you Trazodone 🙂

Maybe this will help someone-- my titration instructions (slow because all these medications hit me really hard). This is the plan if I change from Wellbutrin to another AD. Now I take 200mg in the morning and 100mg in the afternoon. Goes like this: first week 100mg each morning and afternoon. Second week reduce one or the other [am/pm] by 50mg. Week three reduce the opposite time by 50mg. When I get to 50/50mg I'd start up on the Lamictal. This slow titration is partly because I had a headache and was angry for fully 3 months the last time I weened off an AD medication. Also it's to be clearer on what the new medication is doing. Switching right over makes it hard to know if the changes are from the old med or new. 

 

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You can split the Trazadone. I do it all the time. So if you have 25mgs then split one. You'll get to 37.5mg. See if that works and how much it helps the groggy morning. That seems to be the only drawback to Trazadone for me. Too much and you feel hung over.

I was on Lamictal years ago as one of the first AD meds I took. All it did was make me want to sleep and numbed my emotions badly. It is said to be horrible to get off but I had no issues. My pdoc titrates all patients off all meds. That should be a standard practice. Sadly I've seen enough posts on here of people just stopping. Most crash. I don't consider it an AD med issue. Any med you take for any length of time will cause you problems if you just stop. Btw, If you do try Lamictal and you get a rash you need to call your doc immediately. It is one of those that a rash can be a fatal issue. Your doc should warn you about that.

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I use Trazadone for sleep.  I started out at 100mg.  That was way too much!  Finally down to 25mg and that works good for sleep and I'm not groggy.  The pills split really good with a pill splitter.  

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Thanks for the info folks. 25mg doesn't work at all and last night I took 50mg and still only got 3 hours of sleep. I'm not giving up on it yet though. This morning the hangover feeling wasn't bad, which was nice. Regarding the rash, aka SJS syndrome-- the doctor did warn me in no uncertain terms and told me to look it up online. Yikes! Thanks for mentioning it. 

 

 

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50g of Trazodone is wiping me out so I'm gonna halve that and supplement with 2.5mg of Melatonin and see if that's any better. On the bright side-- I've had 2 good nights of sleep in a row. The saga continues 🙂

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I'm a major lightweight when it comes to medications these days. Funny thing is the opposite was true back in my rambunctious college days 😄 

After laying awake so many nights I was a daytime zombie-- add to that 50mg of Trazodone, which works for sleep but leaves me dizzy, weak and seeing stars during the day so I decide to switch gears; I'm weaning off the Wellbutrin now. That's a real shame because it work well for depression plus I get the energy boost too. Insomnia just isn't worth it though 😞  In case you're just tuning in-- I tried 4 other sleep aids and they pretty much did nothing. 

Starting first 5 days ago I lowered my 200mg morning dose to 100mg and continued taking 100mg more in the afternoon. The first night I took only 25mg of Trazodone but added 5mg of Melatonin. Right off the bat I got a great night's sleep but by day 3 I was back to being up for 3 hours in the middle of the night. Yesterday I dropped down to 50mg Wellbutrin in the morning, still 100mg more in the afternoon. And at night 25mg Trazodone and 7.5mg melatonin-- had the best night of sleep in months! I hope for a repeat tonight. Gonna continue the 5 week titration and then decide what to do at that point. Thanks everyone for your support.

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