SERTRALINE VERSUS TRAZODONE

[Lettucenotforget]

I have been weaning myself off Sertraline and am now down from 75mg to 25mg daily. It has at times, been a torturous process. I was recommended by Sue to try Trazodone instead of Sertraline so that was why I began weaning off it. However, on reading the leaflet for Trazodone the side effects are quite alarming, including involuntary movements including muscle twitching which was a red flag to me in terms of RSL. At this point I'm thinking of continuing on Sertraline at the reduced dose as I can't see any real benefit to swapping as the list of possible side effects seem equally undesirable. Has anyone swapped from Sertraline to Trazodone with positive results, if so please let me know?

[SueJohnson]

I just looked at the patient leaflet for trazodone. It says "Talk to your doctor straight away if you notice the following side-effects: ... difficulty in walking or walking with a shuffling gait, shaking, uncontrolled muscle twitching and a high temperature (above 38°C). This could be a rare condition known as Neuroleptic Malignant Syndrome.

medicines.org.uk/emc/produc...

Look at the patient leaflet for any medicine and one would be scared of all the side effects.

But obviously it is your choice.

[Lettucenotforget in reply to SueJohnson]

I know Sue, all patient leaflets scare the life out of the prospective users, it's the 'covering your back' policy by listing everything under the sun that can possibly create and have caused adverse effects. However, it was the 'involuntary movements and muscle twitching' that screamed RLS at me, exactly the same as the Sertraline leaflet says. I'm undecided, as I said, I've managed to reduce the Sertraline to 25mg daily so may stay on this low dose. Thanks for your input, much appreciated!

[SueJohnson in reply to Lettucenotforget]

But it is rare on trazodone and not on Sertraline.

[Nikos64]

Same here. I cannot tolerate trazodone either. It really exacerbated my RLS.

[NJB71]

I tried Trazadone last year on recommendation on this site. It was horrendous and didn’t suit me at all. I increased my dose of Pregabalin which my doctor said might help with my anxiety as well as RLS. I found I still wasn’t as settled as when on sertraline so I went back on sertraline. I’m now on 75mg in the morning and 300mg Pregabelin at night. My mood has improved and I am RLS free.

[67Waterman]

Hiya! Yes ... I have.

I started off with Citalopram, which really made my RLS bad. I then went to Sertraline, which also affected my RLS.

Finally, Professor Walker at the Neurology Hospital at Queen Square London told my GP to put me on Trazadone. I am on 150mg a night.

NO side effects whatsoever - nothing. It does not trigger my RLS nor do I have a single glimpse of any of the side effects listed in the patient leaflet.

Based on my own personal experience, I would definitely recommend trying.

I hope this helps. I would be lost without the Trazadone, given various depression and anger issues that suddenly came on half way through Menopause.

[Lettucenotforget in reply to 67Waterman]

Thank you, as I'm almost weaned off sertraline, I will try Trazodone.

[enjoy2013]

Hi,I have both RLS and Parkinson’s disease, and insomnia.

managed to control my RLS with iron supplementation + exercises + niacin / NAD+ supplementation altogether. Because of the insomnia, I've tried Miro and trazodone (at several weeks distance) and I woke up with both next morning RLS. and I stopped immediately

[yhsbirny]

Trazodone is usually not used as an anti-depressant these days, although that was its original use. It is more often given as a sleeping aid at a low dose , less than 25 mg. At low doses it makes you very drowsy, at higher doses (30mg and above) it supposedly energizes you. I took trazodone 20mg for probably 12 or 15 years for sleep. It always knocked me right out. Then it stopped working and I had to switch to mirtazapine for sleep. I tried trazodone at one point for depression, getting up to 80mg/day.That knocked me out even more than the lower dose; could not stay awake. So much for the energizing effect (maybe I needed an even higher dose; I read in one post below somebody had good luck with 150mg). Never had any side effects though, on low or high dose. If you read the potential side effects for anything, including aspirin, people would be afraid to try anything. You just have to try it; nobody else's experience will be the same as yours, and if you get side effects, just go off it. The Internet has helped people manage their health in many ways, but being able to look up every possible side effect for every med out there I don't think is one of them. You have to try it for yourself if your doctor agrees.

[Lettucenotforget in reply to yhsbirny]

Thankyou for your helpful comment. I took one 150mg trazodone last night one hour before bed and it totally knocked me out.. it is now 12 noon and am still feeling like a zombie, my mouth is like parchment and am unsteady walking. Maybe the dose was too high for me but I really don't want to take another if this is how it makes me feel

[yhsbirny in reply to Lettucenotforget]

Yes, that is what I was getting on 80mg; I was sleeping 10 hours at night and still couldn't stay awake during the day, whereas the 20 mg would give me a good night's sleep with no problems the next day. And 80 is about half what you are on! Is that the dose they started you on? Seems like WAY too high a starting dosage. Should probaly start around 50-60 and move up if needed. Maybe try that. If not and u need to switch ADs, Zoloft (sertraline) is an SSRI; if that didn't help another drug of the same class SSRIs is unlikely to help (Celexa, Lexapro, Paxil, etc.). I would ask your doctor about Cymbalta (duloxetine) which is a different class (SNRI). I took it for several years with good success until it stopped working (anti-depresssants "pooping out" or just stopping working is a well-known phenomenon and nobody seems to know why). If you Google Cymbalta, you will find the main complaint is that it is hard to withdraw from. I personally did not have a problem; I withdrew from a fairly high dosage (90mg) in 4 weeks, but this is a real problem many people have. Again, if you and your dr. think it is worth a try, do it; everybody is different and no matter what you read your experience will be different. Good luck.

[Lettucenotforget in reply to yhsbirny]

It's what my GP prescribed but it's obvious he didn't prescribe it often and certainly got the dose instructions wrong for me! If you can't rely on your GP then it's very worrying. I certainly would not take it again at a dose anywhere near 150mg. Have had an awful day!

[SueJohnson in reply to Lettucenotforget]

As yhsbirny said that is a very high dose. Try 20 mg.

[SueJohnson in reply to yhsbirny]

It is used as an anti-depressant for those who have RLS as it is the only safe one available in the UK but yes at a low dose like 20 mg. . SSRI's and cymbalta make RLS worse for most. You were one of the lucky ones. My RLS was completely controlled with gabapentin and I am able to take many medicines that trigger RLS without them doing so but I took cymbalta for pain and it sent my RLS thru the roof.

[yhsbirny in reply to SueJohnson]

Thank you for correcting me. I did not know about the connection between trazodone and RLS. Live and learn. The whole topic of these psychoactive drugs is very interesting to me as i have been on and off (mostly on) antidepressants for 50 years. I have always tried to find out as much as I could about them but the trazodone/RLS connection eluded me. Which raises an interesting point: has a connection ever been found between serotonin levels and RLS, outside of anecdotal stories about SSRIs worsening RLS.? Just about every AD on the market increases serotonin levels to some degree but trazodone I think less than others (certainly less than the SSRIs). I found this: "While trazodone is not a true member of the selective serotonin reuptake inhibitors (SSRIs) class of antidepressants, it does still share many properties of the SSRIs." But since trazodone also acts on other neurotransmitters, maybe the effect on serotonin is mitigated. I always like to talk about this stuff and get new input.