question-icon

Suggest remedies for intolerance to Trazodone

default
Posted on Fri, 24 Feb 2017
Question: what can I do about the brain's build up of intolerance to trazadone?
doctor
Answered by Dr. Dariush Saghafi (3 hours later)
Brief Answer:
Tolderance to trazodone

Detailed Answer:
Good evening and thank you for your question on the tolerance to trazodone.

Unfortunately, without knowing WHY your doctor is using trazodone to treat you in the first place I wouldn't be able to hazard any good guess as to what they are referring to that would "counteract" the body and brain's tolerance. As a neurologist I can tell you that in my field my colleauges are typically not in favor of using trazodone for sleep induction (likely most common use) by GP's and Internists since it builds up a tolerance, lowers seizure threshold in susceptible individuals of which you would qualify due to age, and has between a 20-35% incidence rate of causing severe headaches as well as other rather untoward side effects.

It is not a specific agent for sleep purposes and as an antidepressant (comes from the Tricyclic Antidepressants) is cosidered very weak with a low potency for therapeutic effect compared to the risks of side effects and production of physical tolerance.

In my opinion you would be MUCH BETTER OFF and if I were your treating physician I would argue that a more comprehensive and longterm view of things for you would be to discover the reasons for your insomnia or trouble sleeping for which you are being given trazodone in the first place (if that's what's being treated) and to treat that set of problems. For example, do you have akasthisia of the legs (constant sensatiion to move), do you have sleep apnea (can cause frequent awakenings at night...in which case trazodone is definitely NOT a good drug as it merely makes hypoxia worse by keeping you in that state longer and potentially more deeply if your overall movement goes down due to the sedative effects of the drug.

In short, the drug trazodone is not really a good drug of choice in my opinion and anything that would supposedly make the brain resistant to its effects of tolerance and encourage its use is only promoting the problem as opposed to finding a solution.

Things that are more specific for inducing sleep would be melatonin. From a holistic perspective other agents that do not cause substance abuse, tolerance, nor interact to any great extent with other medications would be Inositol and Threanine. I'm a fan more of Inositol but you have to use it in good therapeutic doses....but again.....MY PREFERENCE is always to FIND THE CAUSE of the problem for which the trazodone is being prescribed. If it's not insomnia...then, whatever other reason they're using it....but I would definitely opine that you should have a discussion with your doctor and ask to be either sent to a sleep specialist to run a sleep study, run necessary lab tests to see if metabolically something is not right and could be interfering with normal functioning, address chronic pain issues if that's the problem, etc.

But just trying to find drugs to "put you to sleep" I believe is a losing battle and one that has no end game.

Remember, if you want the cure something.....you must know its cause. The body is unforgiving when it comes to simply placing BAD bandages over festering wounds.....you need a different approach.

If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 18 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Dariush Saghafi (38 hours later)
Thank you doctor for your prompt reply. I did forget to mention my use of trazadone
for the past 20 months was for severe sleep insomnia. I do not suffer from restless
leg syndrome but have mild sleep apnea. My severe insomnia 2 years ago was a
result of going "cold turkey" off of zolpidem without medical supervised titration.

In light of the above, do you have any further all natural holistic remedies you can offer? I do have an all natural sleep solution called Nature's Sleep Solution consisting of L-Theanine, melatonin, valerian extract with lemon balm, hops extract,
passionflower & chamomile, but it only works for 2-3 hours per night
doctor
Answered by Dr. Dariush Saghafi (2 hours later)
Brief Answer:
Sleep apnea contributes to insomnia due to EDS

Detailed Answer:
Thank you for your clarifications...very helpful information so I can recommend further input.

The condition of sleep apnea (in whatever severity form one wishes to choose, mild, Hot, or Spicy Ranch...:) ) is a contributing factor to insomnia due to your being a setup for excessive daytime sleepiness (EDS) which can cause you to "catnap" at unnecessary or better yet, UNWANTED times. At night then, because you've already had some "time in bed" your body thinks that it needs less sleep and your hypothalamus, via the suprachiasmatic nuclear synchronization mechanism will actually work to wake you up at times when you feel you should be sleeping....hence at least PART of your problem of insomnia. If you went "cold turkey" from Ambien then, I can understand any rebound problems you may have had at that time. However, I would've expected that situation to have corrected itself by now if you've not been using the drug.

Again, the basis for the insomnia really REALLY needs to be investigated by a SLEEP SPECIALIST..and preferably one who deals with INSOMNIA more than sleep apnea. There may be other reasons that you're not sleeping well, metabolic reasons, anxiety, depression, etc. You've already said that you've not been diagnosed with RESTLESS LEGS....but do you have something called PLM (periodic leg movements). This could also be waking you up...even if it is not an RLS type of situation.

I like the use of melatonin and Valerian extract along with lemon balm. I know patients who also use theanine but cannot tell you much about that agent since I don't recommend it except to people who've already been on it and tell me that they feel it's beneficial....but that's purely anecdotal information and therefore, I wouldn't necessarily think it should work for the majority of people. I can tell you that Inositol can have a calming effect when used just prior to bedtime and even during the day...but dosages can vary from as little as a few grams to as much as 18-20 daily.

Once again, I can't emphasize enough the concept of getting to the root issue of your insomnia and would much prefer you divert resources whether they be financial or otherwise to getting a good SLEEP SPECIALIST who can work this up. For sure, if you have SLEEP APNEA....then, in my opinion that calls for intervention either by way of losing weight, improved dieting, exercise, or if necessary use of a CPAP or bipap machine at night. Remember, drugs are drugs in the end and whether or not they are by prescription or not we're talking about ingesting chemical substances into the body. The "Natural" industry is not something I pay attention to in terms of labeling....if it exists in the universe...as far as I'm concerned...it's a NATURAL SUBSTANCE...even if made by a processing plant machine...get my drift?

We have to always ALWAYS ALWAYS be looking for the root cause of problems and prefer that road to using medications (natural or not) that tend to give temporary or even bad results, cost much more money to sustain in the long run, and get the body itself into a rut of expecting more and more sustenance from things other than good diet, good exercise, good breathing, good thinking, Healthy living in a word.

I think that doing things like taking a warm bath at night before sleep, drinking WARM MILK and cookies (fat free), and getting a good workout in the afternoon before dinner are other excellent PRODUCTIVE ways of tipping the body's sleep functions in your favor.

If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 45 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2474 Questions

premium_optimized

The User accepted the expert's answer

Share on
Suggest remedies for intolerance to Trazodone

Brief Answer: Tolderance to trazodone Detailed Answer: Good evening and thank you for your question on the tolerance to trazodone. Unfortunately, without knowing WHY your doctor is using trazodone to treat you in the first place I wouldn't be able to hazard any good guess as to what they are referring to that would "counteract" the body and brain's tolerance. As a neurologist I can tell you that in my field my colleauges are typically not in favor of using trazodone for sleep induction (likely most common use) by GP's and Internists since it builds up a tolerance, lowers seizure threshold in susceptible individuals of which you would qualify due to age, and has between a 20-35% incidence rate of causing severe headaches as well as other rather untoward side effects. It is not a specific agent for sleep purposes and as an antidepressant (comes from the Tricyclic Antidepressants) is cosidered very weak with a low potency for therapeutic effect compared to the risks of side effects and production of physical tolerance. In my opinion you would be MUCH BETTER OFF and if I were your treating physician I would argue that a more comprehensive and longterm view of things for you would be to discover the reasons for your insomnia or trouble sleeping for which you are being given trazodone in the first place (if that's what's being treated) and to treat that set of problems. For example, do you have akasthisia of the legs (constant sensatiion to move), do you have sleep apnea (can cause frequent awakenings at night...in which case trazodone is definitely NOT a good drug as it merely makes hypoxia worse by keeping you in that state longer and potentially more deeply if your overall movement goes down due to the sedative effects of the drug. In short, the drug trazodone is not really a good drug of choice in my opinion and anything that would supposedly make the brain resistant to its effects of tolerance and encourage its use is only promoting the problem as opposed to finding a solution. Things that are more specific for inducing sleep would be melatonin. From a holistic perspective other agents that do not cause substance abuse, tolerance, nor interact to any great extent with other medications would be Inositol and Threanine. I'm a fan more of Inositol but you have to use it in good therapeutic doses....but again.....MY PREFERENCE is always to FIND THE CAUSE of the problem for which the trazodone is being prescribed. If it's not insomnia...then, whatever other reason they're using it....but I would definitely opine that you should have a discussion with your doctor and ask to be either sent to a sleep specialist to run a sleep study, run necessary lab tests to see if metabolically something is not right and could be interfering with normal functioning, address chronic pain issues if that's the problem, etc. But just trying to find drugs to "put you to sleep" I believe is a losing battle and one that has no end game. Remember, if you want the cure something.....you must know its cause. The body is unforgiving when it comes to simply placing BAD bandages over festering wounds.....you need a different approach. If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out. Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. This query has utilized a total of 18 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.