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The Amazing Trazodone

Discussion in 'General Treatment' started by msf, Apr 27, 2016.

  1. msf

    msf Senior Member

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    So, I finally followed up on something I read on Cort´s blog a while back. I couldn´t find the article again, but I just googled ´Trazodone microglia´ and came up with this: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4666178/

    As Cort´s blog stated, it seems that Trazodone might be working for some of us not just because it is a sleep promoter and sleep sustainer, but also because of its regulatory effects on the microglia. This makes sense in my case, since how much sleep I get is a product of what food and I eat (and whether I take Trazodone). So if I eat stuff that I can´t digest well I wake up earlier. This has become utterly predictable to me now, so much so that I really have no one to blame but myself and my own greed for a bad night´s sleep.

    This is how I believe it works (this is not my model, rather I have pieced it together from several articles covering different aspects of it): if I eat stuff that I can´t digest well this leads to inflammation in my gut, and this inflammation causes an increase in gut permeability; this increases the translocation of bacterial products into my bloodstream and eventually across the blood brain barrier, which leads to disruption of the HPA and therefore disrupted sleep. So the Trazodone and sticking to my diet work in two different, complimentary ways: the diet by decreasing translocation of bacterial products, and the Trazodone by stopping these products from activating the microglia (notice that its antinflammatory effects in the study above were on astrocytes stimulated by LPS).

    I used to think Trazodone helped my sleep because of its effects on serotonin (this seemed to fit with the reports of low levels of serotonin in some ME patients, but apart from in the first few months of my illness I have not noticed the amount of sunlight I get having an effect on my sleep, which is what I would expect if the improvements in sleep were serotonin-based since serotonin levels positively correlate with exposure to sunlight. I would have thought that if this was the mechanism, moving from the UK to Spain should have a beneficial effect on my sleep, but this has not noticeably been the case.

    Of course, ME is most likely a heterogenous disorder, and just because it helped me doesn´t mean it will help you, but if you have gut AND sleep problems I think Trazodone is definitely worth trying. I think most people WILL have tried it already, but I wonder if they took it at a high enough dose - I found that 75mg was not enough to ensure a good night´s sleep, so I now take 150mg, although I might try going down to 100mg as I have lost quite a lot of weight since then (it´s hard to stay fat when you can´t eat any junk food). Lastly, I would suggest that if you try taking Trazodone again, pay attention to what you eat and how that affects your sleep, as both Trazodone and sticking to the FODMAP diet are necessary for me to get a good night´s sleep.
     
    Last edited: Apr 27, 2016
  2. msf

    msf Senior Member

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    Last edited: Apr 27, 2016
  3. JES

    JES Senior Member

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    I guess this is the Cort article you refer to.

    Reducing neuroinflammation isn't a bad idea, though I don't think many here have fully recovered with this approach. I haven't tried Trazodone yet as it's and old medication and kind of hard to get prescribed in my country. I have used LDN for 3 years and it definitely helps with some inflammation aspects, reduces pain and improves sleep. Trazodone has more side effects than LDN, but it could be useful especially if LDN doesn't produce results.
     
  4. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    I'm not sure that most pwME will have tried Trazodone. The two papers you cited were rather low-key, and there is much better info around, such as here

    which also has lots of warnings.
     
  5. msf

    msf Senior Member

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    Thanks for finding the article. I have heard of side effects with LDN too, particularly sleep disruption. Just to clarify, I didn´t call it title this thread ´The Amazing Trazodone´ because I think it can cure ME on its own, but rather because it has so many different uses/effects. I think it may be used to great effect in some people with ME in combination with dietary changes though. I have gone from ´ill/ME´ to ´tired/CFS´ on this combo.
     
    Last edited: Apr 27, 2016
  6. msf

    msf Senior Member

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    I would agree that whenever anyone plans to take a new drug they should look it up the side effects on Drugs.com or similar sites. I didn´t mean to discuss the side effects here though, but rather the mechanism by which it may work in some people with ME, which is why I linked to those particular studies.
     
    Last edited: Apr 27, 2016
  7. msf

    msf Senior Member

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    Just for fun (ME fun), I worked out that, after having been on it for 2 years, I have ingested about 100 grams of Trazodone.
     
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  8. msf

    msf Senior Member

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    It´s interesting that, in the study I linked to above, Prozac had the same effect as Trazodone. I think I will stay with the Trazodone though, if for no other reason than Prozac causes sexual dysfunction whilst Trazodone has the opposite effect.
     
    Last edited: Apr 27, 2016
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  9. JES

    JES Senior Member

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    Yeah, Trazodone has worse side effects than newer antidepressants, in particular the anticholinergic effects can cause problems in long term. Naltrexone does have side effects as well, but it has been FDA approved at a dosage of 50 mg to treat opiate addiction and alcohol abuse. LDN is Naltrexone using 1/10th of that dosage, which alone makes bad side effects much less likely. Hence I would try it first for damping microglial activation.
     
  10. msf

    msf Senior Member

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    I think it is too general to say it has worse side effects, it is more that it has different side effects (for instance, no sexual dysfunction unlike SSRIs, but priapism, and, I just found out, clitorism instead).

    As I said, I have heard stories about LDI side effects in people with ME (just google it on PR), but then I have heard of the same with Trazodone, so it´s hard to say which is better tolerated.

    Also, either you or Wikipedia is confused about the anitcholinergic effects: Because of its lack of anticholinergic side effects, trazodone is especially useful in situations in which antimuscarinic effects are particularly problematic (e.g., in patients with benign prostatic hyperplasia, closed-angle glaucoma, or severe constipation).
     
  11. Crux

    Crux Senior Member

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  12. Thinktank

    Thinktank Senior Member

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    I tried 50mg trazodone last night before bed, my experience has not been pleasant.
    Within 30 minutes i felt very drunk, so drunk that i had the urge to throw everything up. I spent a good 15 minutes at the toilet. At that point i couldn't keep my eyes open and everything was spinning, making me even more nauseous.
    Sleep was broken with multiple awakening all night.
    I woke up feeling like i drank a whole bottle of whiskey, my eyes hurt, lymph glands in throat are swollen, and a crushing headache.
    I like to know WHY this happened.
     
  13. Mij

    Mij Senior Member

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    @Thinktank I'm sensitive to medications and I take 25mg with no problems. When I took 50mg it made my head spin. Have you tried 25mg?
     
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  14. Thinktank

    Thinktank Senior Member

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    Not yet, i will try 12.5mg sometime next week.
     
  15. msf

    msf Senior Member

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    Sorry, to hear that Thinktank. The first time I tried it I had the dizziness/drunkness, but without the nausea. I got around this by taking it when I am already in bed, so there is no danger of falling down the stairs, etc. It has always had a beneficial effect on my sleep though, albeit at a much higher dose of 150mg (I found 75mg wasn´t enough to ensure a good night´s sleep).
     
    Last edited: Jun 11, 2016
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  16. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    I suspect that there is a big difference between men and women in the way people react to some drugs.
     
  17. msf

    msf Senior Member

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    Thinktank and I are both allegedly male.
     
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  18. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    OK. But pwME also probably cover a range of conditions, ages, etc. We seem to be very diverse.
     
  19. Jill

    Jill Senior Member

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    I've just imported trazadone to try in place of nortrip.

    Do any of you know whether it would be on to take it with
    Clonazepam 1mg, gabapentin 600mg.

    I used to take 20 mg nortrip . Just substituting trazadone for the nortrip . Do you think that will be ok.

    I have probe both getting to sleep and maintaining it . Also take ldn which actually is prob the med that has helped the most. I can get out of bed in the morning now.

    I'm not sure what gives me the terrible munchies - could be the nortrip or the gabapentin . Trying to eat less and to loose weight.

    Thanks in advance
     
  20. Mij

    Mij Senior Member

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    @Jill the best person to ask is a pharmacist.
     
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