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Dr. Andrew Rynne

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Exp 50 years

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Does Klonopin interact with Remeron and Trazadone?

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Dr. Ashok Kumar

Psychiatrist

Practicing since :2000

Answered : 2712 Questions

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Posted on Fri, 10 Mar 2017 in Mental Health
Question: Hello, my name is Soniya XXXXXXX and I take 15 mg of abilify in the morning, 1 mg of klonopin three times a day, 5 mg of L-methylfolate 2 times a day, and 45 mg of remeron at night to help me sleep. The remeron doesn't always work in helping me sleep. I take 30 mg at first, and then 15 mg in the middle of the night to help me fall back asleep and sometimes I can't fall back asleep. Do you know of any other good medication that would help me fall asleep which wouldn't interact with my current medications? I tried ambien and trazadone but they didn't work. Can I take 50 mg of seroquel along with 7.5 mg of remeron at the same time, and then if I wake up in the middle of the night take 7.5 mg more of remeron until I can visit a psychiatrist in person? Is this safe with my other medications?
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Answered by Dr. Ashok Kumar 56 minutes later
Brief Answer:
I think you need to cut down with Remeron

Detailed Answer:
Dear Soniya,
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

First option in your current profile can be created with slight dose adjustments. It is well known fact that when we go for higher dose of remeron the effect on sleep lowers down. I mean to say that mirtazapine (Remeron) has best sedative properties when the dose is below 30 mg and around 22.5 mg in most individuals. When the dose goes up like 30 mg or 45 mg the effect on sleep decreases rather than increasing.

Considering the above fact I feel (if sleep is only indication for mirtazapine) you can use only 15 mg of mirtazapine at bedtime and keep another 7.5 mg for night time rather than using 30 mg at bedtime (which you are doing now).


The second best option is obviously seroquel but I am not convinced with seroquel and remora together for single purpose. It will be better if you can just use 25 or 50 mg of seroquel for sleep which will ensure uninterrupted sleep for next 6-8 hours.

I hope this answers you.
If you have more questions I will be glad to assist you further.
If you do not have more questions, please close the discussion and if possible rate the answer for my future patients.

In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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