6 replies to this topic

[Cuddljunkie]

Hi
First I hope it is okay that i ask this question here. I have ADHD, with anxiety and some depression related to the ADHD. I was hospitalized for severe anxiety and thoughts of wanting to hurt myself. In the hospital i was taken off zoloft, and put on first Geodon, but that gave me tremors, and then seroquel for help with anxiety and sleep. I have been on seroquel since, it has technically been for anxiety but also to help me sleep. (It doesn't help me sleep anymore). Since then I was diagnosed with migraines as well and put on maxalt.

I don't get them often, I really don't I don't think I have taken a migraine pill since november. I tend to get them in the spring and fall and sometimes in the summer, if I keep hydrated I usually am pretty good and my migraine at least are all sinus related, I get stuffed up and my sinuses get clogged, and I get a migraine. THey are not hte OMG I can't get out of bed type of deals, but enough that bright light hurts, and nothing else takes away the pain, and they are annoying. I had avoided going to the doctor about them for years because they simply didn't seem like migraines at least not the ones my friends get, but then found out that what i thought was a sinus headache was a migraine (although it still had to do with my sinuses) I still get them although as I said the last time I took a maxalt had to be at least a month ago.

Anyway now I am on, adderall 20mg 2x a day for ADHD, klonipin .5mg as needed for anxiety and my psychiatrist wants to switch me from Seroquel (something I have wanted to do for a while) to trazodonen as needed for sleep, according to the prescription and up my klonipin. Well the klonipin is no problem, but I just read about a major interaction between maxalt and trazodone. Should I be concerned the article in drugs.com talked about

serotonin syndrome which sounds scary, but is also said to be rare? My question sorry it has taken so long to get to is should I be concerned? I swear psychiatrist knows I am on maxalt. Anyway I am not that worried about the trazodone for everyday use, but what about my migrianes. Should i take Maxalt or is there something else I can try? That is if the trazodone works? I would much rater take the trazodone then the seroquel but I don't want to run into the issue of not having anything to take for my migraines. And I thought this and perhaps the trazodone forum would be the best places to ask for help

Thanks in advance

[bergsonisme]

Switching from Seroquel to traz is often a good idea, particularly if your main use for Seroquel is a sedative. Tricyclics have a bad rap because there's a risk of self-induced (suicidal) overdose -- which is minimal with traz, btw -- and traz is vastly underused. I succesfully switched from Susie Q to traz for a while after pdoc1 became worried about weight gain. It was good, it was a chil pill that even short-acting benzos can't match. I got out of it because I went into my usual post-DST depression. (I have a kind of predictable yearly cycle, it seems).

Again, tricyclics (traz isn't even an orthodox tricyclic in chemical structure) get much bad rap because of the Prozac Marketing Machine, the perceived outpatient risks and a general, equivocal perception that all pre-SSRI antidepressants are made equal, whether MAOIs, stims or tricyclics. MAOIs are the big guns and carry the big risks. You should be ok with traz; serotonin syndrome is rare and easily discernible.

When everything fails, there's always lithium. But give traz a good (>4-6 months) try.

[Cuddljunkie]

Thanks....that makes me feel better. Now I have another question (I will look up the answer as well) but when starting Trazodone, should I really be quitting Seroquel XR cold turkey? that is what my doctor had me do, and I was nervous about, because I had always heard that just stopping any drug was a bad idea, but since I was 'under a physician's care I figured it might be okay.. Well it was hell.
I took the Trazodone around 11 and began to get dizzy and wanting to lay down by 11:30....but I didn't sleep, I still had thoughts going through my head. Not racing thought I just couldn't turn off my brain and I was feeling cold, cold enough that I switch pj's to something warmer (and last night was one of the warmest night we have had in a week, which I found odd since I had been comfortable in my light weight pjs even when it was cold). I also felt my heard beating for a little while but it wasn't fast or anything and went away after about an hour.
Anyway after about two hours I broke down and checked the drugs.com interaction checker and took 2 500mg of Tylenol and 400 mg of valerian root. The Tylenol dose was high I know but I have been on a higher dose of it since I was a teen (of course I think I was on double dose of 250mg not 500mg but I have been taking a higher dose for so long I am not sure, and I am trying to wean down, but that is another discussion) and tried to sleep. They didn't help at all, I continued to be restless and somewhat dizzy when I stood up or moved around.
I tossed and turned for a bit and I then noticed my skin was hurting (at first it felt like my skin was so cold it hurt, but after a while it just sort of hurt and then felt itchy). IT was about 3:30 I figured I needed to focus on something else other than sleeping I looked up information about signs Trazodone was not working. I saw something about getting a rash, so I went to the bathroom and checked my skin. No rash, but it definitely itched badly so I put some Benadryl cream on it (which stung) and came back to bed, the stinging went away.
I rested for few more minutes but really couldn't settle so I continued to look up stuff on my phone. I found an blog about Seroquel and Trazodone or questions it wasn't that helpful, I don't think, but it made me look up Seroquel withdrawal symptom, and I found a blog about someone who tried to stop taking Seroquel cold turkey without telling their doctor and was alarmed at her reaction (and that she tried without tell her doctor but she was fine so didn't worry about, but then continued to look at Seroquel withdrawal and found out that as Seroquel has an antihistamine effect and other people have had itchiness when they get off of it. Reading that I went and took 2 Benadryl and well tossed and turned yet again about ten minutes, (I really was trying to sleep) but now was worrying about the withdrawal symptoms of the Seroquel.
So I continued to look up the symptoms again, and they matched a lot of what I was feeling, restless, slightly agitated, (but that could because I was tired of not sleeping and really, really wanted just sleep. I looked up drug interactions again on drugs.com and didn't see anything hugely concerning. There were several 'moderate' interactions with what I had taken but I had taken all the same things with Seroquel and I had been fine so I figure I was tired enough to try again (I know I shouldn't assume but I was so tired and frustrated) This time I took 1 mg of klonipin, this was about 4:00 am and I still hadn't slept.
I then figured I needed to try and stop worrying about everything so I watched some Firefly on my phone which has Netflix, (the second half of one episode and fast forwarded through another) then realized that wasn't working and found some sleep hypnosis stuff on YouTube which helped, sort of, but one wanted me to stare a screen which is hard to do comfortably lying in bed with a cell phone and I my earphones in my ears and my phone on my side and wanted to make sure I put them back before I slept, and my thoughts usually began to drift after a while. At five I finally broke down and took some Seroquel my dr. had given me a 50 mg dose and I slept, I felt like ass in the morning and had cancel my work session but I slept. So I was wondering does this sound normal, has anyone else had a withdrawal reaction like this? I guess I should go to the Seroquel forum for that.

Thank you for the support, it is very helpful and good to hear.
`

[notfred]

Antidepressants alone do not produce serious SS. Even mild SS is very rare with just AD's.

[bengaltiger]

Agree with NF and Syntax. No real concern IMHO in taking the traz. You don't say your dose of quel or traz.... how much of each are you on?

Seems that a lot of docs toss quel at insomnia, when there might be a more benign option. I'll second the endorsement for the tricyclics.

PS.... and if you cannot sleep, keep off the net and don't research insomnia!! (teasing ya... but serious)

[VAL]

I can barely read your last post as the font is too small. Ok, I would be considered legally blind if my eyesight were not correctable, but still...I think anyone would have trouble reading it.

Your symptoms can be the sudden discontuation of Seroquel or the start up of Trazaone without regard to any potential interaction...in other words, it's normal stuff for starting up trazadone to feel dizzy for instance. I don't have an opinion about discontuing Seroquel cold turkey as you start up Trazaone .....I'll leave that to your pdoc but it certainly can result in different symptoms.

I have taken Trazadone (though not for the last four months or so) for around 15-20 years depending upon which thread I'm in (I just can't remember but I think since 1993...I know I was on it just before a big earthquake here in '94),

Anyways, start up can be a bitch and each titration further up can be a bitch but the side effects may very well go away and you will hopefully be left with a very good sleep med that's cheap and not the overkill that taking an anti-psychotic like Seroquel is (in my opinion...and I did it for awhile). I was groggy and "hungover" from Trazadone when I begin and with each upwards titration until I reached my magic spot of 200mg and eventually the unpleasant side effects: hungover feeling in morning, dry mouth, constipation, fatique, etc went away. It has nearly always worked with occasional poop outs....like I experienced last August. I'm not taking it presently but that is because I'm on a heavily sedatingt anti-psychotic for hypomania (Saphris) and therefore, do not need the Traz anymore. I love it though...I think it's great and it's fairly weak in general and I wouldn't worry about the interactions much. All the drugs I'm on supposedly will kill me together but they don't because my body gradually adjusted to each one as it was added. It's good to be vigilant but not paranoid (and I'm not suggesting you are being paranoid).

[notfred]

Antidepressants alone do not produce serious SS. Even mild SS is very rare with just AD's.

Except for MAOI's, most AD's are contraindicated if you take a MAOI.