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Have insomnia, blood work normal. What is your opinion on a low dose of Trazadone?

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General & Family Physician
Practicing since : 2009
Answered : 983 Questions
I have had insomnia since February of this year, lately it has gotten worse. I used to go to bed around 10 & wake up between 2 & 3. I would go back to sleep around 4 & sleep until 6. Now when I wake up, I don't go back to sleep. I'm exhausted.

I have cut out all caffeine & alcohol. My bloodwork doesn't show anything abnormal.

What is your opinion on a low dose, like 25mgs, of trazadone?
Posted Fri, 21 Sep 2012 in Sleep Disorders
Answered by Dr. Aparna Kohli 2 days later
Thank you for sharing your concern with us.
Insomnia can be a debilitating issue, since it hugely impacts the quality of your life. Trazodone as such is approved for only treatment of depression and even in that, its not a first line drug. It would help the insomnia ( and that too for a short while only) but would not address the cause. Addressing the cause so that you get a more lasting solution is the required approach.
Can you recall any possible trigger ( a personal or professional stressful situation) that could have led to this?
Also, what about exercise and other soothing exercises like yoga or XXXXXXX breathing techniques ( such as pranayama) which can really help this? Are you doing any of this?
Let me know these details and we can make this discussion more meaningful
Above answer was peer-reviewed by
Follow-up: Have insomnia, blood work normal. What is your opinion on a low dose of Trazadone? 5 hours later
I cannot think of a trigger. I have a very good job which I love. I have 2 fantastic teenagers & am very happily married.

I do yoga 2-3 times a week, ride bike & also take an exercise class called TRX.

Answered by Dr. Aparna Kohli 1 hour later
Thank you for providing the additional input.
Instead of Trazodone, I think it would be better if we start you on a drug like zolpidem. This is much better than considering trazodone. Please see your physician. This is a prescription drug.
Hope that helps
Let me know if you have any more questions
Above answer was peer-reviewed by
Follow-up: Have insomnia, blood work normal. What is your opinion on a low dose of Trazadone? 2 hours later
Thank you for your response. I'm not sure what zolipiderm is, but a number of years ago after my father died, my dr tried ambien. I was one of those people who walked in my sleep, did laundry, cooked......and had no recollection in the morning. I thought I slept fine, but my husband sat by the bedroom door all night because he was afraid of what I would do.

Another your experience do people get over insomnia? Or will I need to take a medication forever?

Also if I were to try trazadone does it have anti-depressant effects at that low dose? The older I get, I just don't feel like myself anymore. Even with normal bloodwork, I am gaining a lot of weight & starting to wonder if we are missing something.
Answered by Dr. Aparna Kohli 21 hours later
Thanks for writing back.
Zolpidem is one of the best drugs we have for insomnia. Its non addicting and safer than the drugs we used to use earlier. Ambien is the trade name for Zolpidem.
Sleep walking is something which needs to be treated. There are different alternatives available like hypnosis, and medication.
Usually insomnia would be secondary to a traumatic event and gradually does go away. I think it would be good if you have one session with the therapist. It may unravel something both of us are unaware about.
Its unlikely that trazodone would have an anti-depressant action at 25 mg/day. The dose is atleast 150 mg/day in the acute phase.
Also, have you been tested for hypothyroidism with a TSH level? That would explain the depression, sleep problems and weight gain. Please do get a TSH and free T4 level done if you have not been tested.
Above answer was peer-reviewed by
Follow-up: Have insomnia, blood work normal. What is your opinion on a low dose of Trazadone? 7 hours later
I have had bloodwork done & although I don't know the levels I was told all bloodwork was fine.

As for a therapist I do see one. She is the one who prescribed Ativan & would continue to do so if I would like it.

Any other ideas if I can't take ambien? My therapist is in agreement that trazadone isn't a good idea. She suggested I take naps when I can & work on my breathing.
Answered by Dr. Aparna Kohli 5 hours later
I would like you to specifically inquire on whether a TSH level has been done or now. Otherwise, we are missing a potentially treatable cause of your case. I would agree with your therapist. Medication is not such a good idea when it comes to taking care of insomnia.
Practicing sleep hygiene is much more important. The measures would include
a. Fixing a time for sleeping
b. If you dont feel sleepy, dont keep lying down. Get up and do something
c. No exercise 3-4 hours before sleeping
d. Make you room look like a cave
e. Try and have some chamomile tea before you sleep off
f. Breathing exercises such as these would also help. WWW.WWWW.WW WWW.WWWW.WW
Hope this helps
Above answer was peer-reviewed by
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