Trazodone.

[Bumble34]

Just been advised by my GP that that the above can no longer be prescribed without confirmation from a higher authority, letters need to be wrote etc. answer perhaps in 7/10 days. It just gets worse does it not.

[ChrisColumbus]

Hmm - this is already the case with bupropion (where it's available at all): which NHS Trust area are you in?

General NHS guidance is: "Doctors usually prescribe trazodone when other antidepressants have not worked or have caused side effects.

It can take 1 to 2 weeks before trazodone starts to work, but it may be 4 to 6 weeks before you feel the full benefit.

Trazodone can make you feel sleepy. If you take it once a day, it's best to take it in the evening or before you go to bed.

If you and your doctor decide to take you off trazodone, your doctor will usually recommend reducing your dose gradually to help prevent withdrawal side effects."

[Bumble34 in reply to ChrisColumbus]

Portsmouth.

[ChrisColumbus in reply to Bumble34]

I can't find anything to tell whether this a GP Practice, Primary Care Network, or PHU Trust issue. Hope you get it prescribed without too much delay - do let us know!

(With bupropion, in some Trusts it has to be referred to a psychiatrist who will make a decision - often negative. But bupropion isn't licensed for depression, whereas trazodone is!)

[Bumble34 in reply to ChrisColumbus]

Thank you, yes I will.

[Joolsg]

Does he mean recommendation from a neurologist? If so, ask for an urgent referral.Trazodone is one of only 2 safe anti depressants in UK that can be used for RLS.

So you will need a neurologist to confirm that cheaper, standard anti depressants cannot be used as they will all trigger/worsen RLS.

NHS and NICE guidance on RLS talk about reviewing medications and when you click the link, Guy Leschziner, a neurologist, lists anti depressants as worsening RLS.

cks.nice.org.uk/topics/rest...

So write a letter to GP surgery

Dear Dr....

I take trazodone for [ depression/ anxiety]. I am unable to take other anti depressants because they all trigger or worsen Restless Legs Syndrome.

I understand that trazodone is more expensive than standard anti depressants used to treat depression and anxiety, but, in my case, it is one of only two anti depressants that are RLS safe.

I attach NICE cks guidance on RLS and the recommendations relating to medications that exacerbate the disease.

cks.nice.org.uk/topics/rest...

It would be cruel and barbaric to stop my prescription of trazodone. I have been taking it since [ ] and I am unable to switch to an alternative without worsening my RLS. RLS is a chronic, progressive, neurological disease that causes unbearable sensations in the limbs at rest and when trying to sleep. The severe sleep disruption affects my physical and mental health.

If you are seriously considering stopping my prescription of trazodone, would you please arrange an urgent referral to a neurologist, sleep clinic or psychiatrist so I can receive a recommendation from an 'expert' that trazodone should be continued.

Stopping any medication that affects brain chemistry cold turkey is dangerous and negligent.

I look forward to hearing from you as a matter of urgency.

Yours sincerely

[Bumble34 in reply to Joolsg]

Thank you for your response, I believe it is a cost issue, so I will have to wait and see and if no, will march into the Surgery armed with you letter.

[JunieBJones]

In the US, Trazodone is frequently used for sleep, probably more so than for depression and anxiety. Although it originally came out as an antidepressant, there were others that came later that were more effect. I personally use duloxetine in the am for depression and trazodone at bedtime for sleep, and Ativan as needed for anxiety. Although I have moderately severe RLS, I don't feel duloxetine affects them. I am off of a dopamine agonist and am on an opioid for RLS and chronic pain. I hope your situation can be resolved quickly.

[Bumble34 in reply to JunieBJones]

Thank you.