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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Flipsactown on April 15, 2004, at 19:38:42
Is anyone taking Trazodone alone for depression and if so, how effective is it and how long have you been on it? I am currently on 15mg Nardil once a day. Just started 6 days ago and I am already experiencing insomnia. I have only been getting 2 to 4 hours sleep and am concerned that my unipolar depression will worsen due to sleep deprivation. My pdoc will not rx Trazodone or Ambien with Nardil, so I am thinking maybe I should just stop Nardil and switch to Trazodone since it is a sedating AD. I have been taking AD's mainly SSRI's for 13 years and decided to try something different like Nardil an MAOI. Recommendations or comments?
FST
Posted by snapper on April 15, 2004, at 23:25:59
In reply to Trazodone, posted by Flipsactown on April 15, 2004, at 19:38:42
Hey FST, 12 years ago I was on Parnate(maoi)and I complained of sleep problems to my pdoc and he rx'ed me some trazadone! It definitely knocked me out but too much so...(hangover affect.) I turned out to have Bipolar problems, but if you don't have bi-polar problems and really want to tackle your depression I would reccomend 'pushing your KP -managed care pdoc' to rx you a sleep aid. I def don't think that Traz. has enough AD properties to really impact depression....in fact traz. is known to be really "only useful as an adjuct sleep aid" and it is used often firstline for sleep problems because you don't build tolerance to it like the benzos' or ambien! Sounds like an overly cautious pdoc -but at the same time if he is willing to Rx Nardil than he should be at least sensitive enough to address your problems with sleep. You are def. correct in re: to only 2-4 hrs of sleep causing you an increase in depression. Lack of proper sleep will drive any body into dispair- Call your pdoc back and tell him you want to give Nardil the full run and if he can prove to you that,a short term benzo, ambien(short term) or trazadone will cause you any harm then I would demand that he check his PDR. Don't settle for ineffective treatment-
you probably would regret not giving Nardil a full run for its money and Traz is def not the answer to serious depression. sorry so long winded but just would like to see you get the best possible remission as possible ! :) hope that helps!
Snapper
Posted by Flipsactown on April 16, 2004, at 0:03:59
In reply to Re: Trazodone, posted by snapper on April 15, 2004, at 23:25:59
Snapper,
Appreciate the info and words of advice. I am certainly not going to give up on Nardil so easily as I am running out of AD options. I have taken Prozac, Zoloft, Paxil, Celexa, Effexor, Elavil, Remeron, Desipramine, Lithium, Lamictal, etc. over 13 years and they have all either pooped out or were ineffective. I have already requested a new pdoc but it will take a month for Kaiser to grant it. If within the 1 month I get desperate enough to get an rx for Trazodone, I will go through Kaiser's Patient Assistance, where they will expedite my request or possibly even have another pdoc write one for me. I have had excellent results with Kaiser's Patient Assistance since I first joined them over 20 years ago and am confident that Kaiser's Patient Assistance will come through for me. Thanks again.
FST
> Hey FST, 12 years ago I was on Parnate(maoi)and I complained of sleep problems to my pdoc and he rx'ed me some trazadone! It definitely knocked me out but too much so...(hangover affect.) I turned out to have Bipolar problems, but if you don't have bi-polar problems and really want to tackle your depression I would reccomend 'pushing your KP -managed care pdoc' to rx you a sleep aid. I def don't think that Traz. has enough AD properties to really impact depression....in fact traz. is known to be really "only useful as an adjuct sleep aid" and it is used often firstline for sleep problems because you don't build tolerance to it like the benzos' or ambien! Sounds like an overly cautious pdoc -but at the same time if he is willing to Rx Nardil than he should be at least sensitive enough to address your problems with sleep. You are def. correct in re: to only 2-4 hrs of sleep causing you an increase in depression. Lack of proper sleep will drive any body into dispair- Call your pdoc back and tell him you want to give Nardil the full run and if he can prove to you that,a short term benzo, ambien(short term) or trazadone will cause you any harm then I would demand that he check his PDR. Don't settle for ineffective treatment-
> you probably would regret not giving Nardil a full run for its money and Traz is def not the answer to serious depression. sorry so long winded but just would like to see you get the best possible remission as possible ! :) hope that helps!
> Snapper
Posted by Iansf on April 16, 2004, at 0:53:03
In reply to Trazodone, posted by Flipsactown on April 15, 2004, at 19:38:42
> Is anyone taking Trazodone alone for depression and if so, how effective is it and how long have you been on it? I am currently on 15mg Nardil once a day. Just started 6 days ago and I am already experiencing insomnia. I have only been getting 2 to 4 hours sleep and am concerned that my unipolar depression will worsen due to sleep deprivation. My pdoc will not rx Trazodone or Ambien with Nardil, so I am thinking maybe I should just stop Nardil and switch to Trazodone since it is a sedating AD. I have been taking AD's mainly SSRI's for 13 years and decided to try something different like Nardil an MAOI. Recommendations or comments?
>
> FSTWhen I started taking Parnate initially I could hardly sleep at all. That lasted probably four weeks. Then suddenly the insomnia just disappeared. I realize it can be difficult to bear with insomnia for so long - though in fact for some reason I didn't find it bothersome to sleep so little - but it's common for MAOIs to cause insomnia at the beginning. Typically you can't sleep at night, then practically fall over dead mid afternoon and sleep for an hour or two. If you can at all find it in yourself to bear with it, I recommend you should do so. It's worth it in the end and for most people the insomnia does end.
By the way, sleep deprivation is sometimes used to treat depression. So not sleeping may actually have some benefits.
Posted by cubbybear on April 16, 2004, at 4:14:46
In reply to Re:Trazodone » Flipsactown, posted by Iansf on April 16, 2004, at 0:53:03
I fully agree with what the 2 previous posters have said. I've been taking Parnate for 20 years and can attest to it's causing insomnia, or as I like to put it, "reduced need for sleep." However, over time, the problem does iron itself out a bit. On the other hand, I've definitely seen an abstract or professional report that Trazodone *can* be used with an MAOI, particularly if insomnia is a problem. I'm sorry I don't have the website address, but I encourage you to do some digging and maybe you (FST) can find it, or someone else here can provide it.
cubbybear
P.S. If you're a male, just be aware of the unlikely side effect of priapism with Trazodone.
Posted by King Vultan on April 16, 2004, at 8:13:38
In reply to Trazodone, posted by Flipsactown on April 15, 2004, at 19:38:42
In this article, in the section "Combinations with other antidepressants," it mentions trazodone being used to treat insomnia with MAOIs and provides a reference to an original journal article. I've carefully looked at the pharmacology of trazodone myself and have come to the conclusion that it is quite safe to use with MAOIs.
http://www.currentpsychiatry.com/2002_06/06_02_maoi.asp
I don't know if your current doctor would consider prescribing a small dose of a sedating tricyclic, either, but Surmontil (trimipramine) does not block amine reuptake and is completely safe to use with an MAOI. I do not quite understand his reluctance to prescribe Ambien, which is a relatively safe and problem free sleep aid. If he is concerned about you building dependence/tolerance, perhaps you could compromise by agreeing to only use it a certain number of days a week or every 2nd or 3rd night.
I've also been suffering with insomnia from Nardil, as I won't be seeing my doctor for another week to talk to him about the trazodone. I did send him some info on it, though (including the above article). I do have a small amount of Ambien left (enough for three nights at 5 mg each) from a very old prescription and have been plugging the gap with a Dr. Jeffrey Thompson sleep/rejuvenation CD--one of those that works on delta waves--because I was absolutely dying only getting two to three hours of sleep a night. The silly thing has worked to some extent, and I've ordered some lightweight headphones to use with it while sleeping, as it is recorded binaurally and is optimized for headphone use.
Todd
Posted by Flipsactown on April 16, 2004, at 11:42:08
In reply to Re: Trazodone » Flipsactown, posted by King Vultan on April 16, 2004, at 8:13:38
Todd,
I can't thank you enough in sharing this current info regarding using Trazodone with Nardil. I will fax it to my current pdoc immediately. However, I am not too confident that he will be impressed as I have faxed him info on high dosage use of Prozac of up to 200mg in successfully and safely treating treatment resistant unipolar depression written by Dr.Ivan Goldberg. My pdoc, through his nurse, was not impressed and thereby never bothered to let me know one way or another until I called them back a month later and that is when his nurse informed me that my pdoc had no comment. I naturally became upset and told his nurse that when someone like myself takes the time to fax info, it usually means that it is very important to the sender and they could have at least had the courtesy of calling me to tell me what they thought. Instead they ignored me completely. His nurse is a very nice person and she was quite apologic about never getting back to me. BTW, I was up to 160mg Prozac and was feeling depression free but I decided it would be a financial burden on me to continue using high dosage Prozac especially if I had to pay the full price. Since I am with Kaiser, I only paid a $10 copay for meds. You rock, your Highness!
FST
> In this article, in the section "Combinations with other antidepressants," it mentions trazodone being used to treat insomnia with MAOIs and provides a reference to an original journal article. I've carefully looked at the pharmacology of trazodone myself and have come to the conclusion that it is quite safe to use with MAOIs.
>
> http://www.currentpsychiatry.com/2002_06/06_02_maoi.asp
>
> I don't know if your current doctor would consider prescribing a small dose of a sedating tricyclic, either, but Surmontil (trimipramine) does not block amine reuptake and is completely safe to use with an MAOI. I do not quite understand his reluctance to prescribe Ambien, which is a relatively safe and problem free sleep aid. If he is concerned about you building dependence/tolerance, perhaps you could compromise by agreeing to only use it a certain number of days a week or every 2nd or 3rd night.
>
> I've also been suffering with insomnia from Nardil, as I won't be seeing my doctor for another week to talk to him about the trazodone. I did send him some info on it, though (including the above article). I do have a small amount of Ambien left (enough for three nights at 5 mg each) from a very old prescription and have been plugging the gap with a Dr. Jeffrey Thompson sleep/rejuvenation CD--one of those that works on delta waves--because I was absolutely dying only getting two to three hours of sleep a night. The silly thing has worked to some extent, and I've ordered some lightweight headphones to use with it while sleeping, as it is recorded binaurally and is optimized for headphone use.
>
> Todd
Posted by Verazil on April 16, 2004, at 12:19:20
In reply to Re: Trazodone » King Vultan, posted by Flipsactown on April 16, 2004, at 11:42:08
Hello All,
I love this babble site! So useful...
I tried Trazodone two times in my life and in both i had panic attacks, fast heart beat and the usual awfull things... felt like i was going to die, just terrible. It helped me to sleep, though. It took me and my doctor some time to figure out that Trazodone had that effect on my body.
I take now Wellbutrin 150XL in the morning and Lexapro 10mg, 1/2 in am, 1/2 pm. It is working fine. I can sleep ok. Still depressed a little, but I started 1 week ago only.
I sometimes think that I will feel bad all my life. If not sleepy, depressed, or... but i am doing psychotherapy and praying a lot. Time is the best medicine, isn't it?
Hope you all find your way.
Good luck!
Vera
Posted by KathrynLex on April 16, 2004, at 15:41:54
In reply to Trazodone, posted by Flipsactown on April 15, 2004, at 19:38:42
Hi FST,
A lot of people have success with Wellbutrin, but my brother had a horrible experience on it. He took it for insomnia, and it knocked him out but caused him to skip the REM sleep cycle. He became cranky, irritable and impatient...not the kind of results you want from an antidepressant.
Although, you might have better luck with it.
K.
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