Trazodone Withdrawal & A Swim

For more than a decade, I have been on some kind of psychoactive medication to help me to sleep. One of the horrible things about depression/PTSD/etc, is that the sleep-wake cycle can go completely haywire. When I was most ill, I was on a combination of tranquillisers and sedatives just to get some kind of sleep at night. The alternative was long, anguished night's, wide awake and feeling increasingly tired, ill and desperate for relief. Anyway, I was later put on Trazodone, a sedating anti-depressant, which I take just after getting into bed. I have been on that for, well, who knows how long, perhaps just under 10 years.

In my attempt to figure out what on earth is causing my disabling mental fatigue, I looked up the side-effects of Trazodone. I also reasoned that on gym days, I feel tired through the afternoon but rally and feel fine/alert by the evening. It's only after I have taken the Trazodone (and other daily anti-d) that I feel utterly drained/rubbish etc the following the day. It occurred to me that it might be the Trazodone which is causing the daily mental fatigue. Over the past 11 days, I have first reduced the dosage (by emptying some of the contents of the 50mg capsules) and then finally stopped taking my nightly dose.

The main side-effects have been great difficulty in sleeping and emotional instability (i.e. crying/laughing easily). The problem whilst trying to get to sleep is that my body and brain feel wired. It's like my nervous system is raw and heightened and every nerve fibre is primed. There's also a kind of horrible feeling through my body, the sort of feeling you get when you know you're going to be sick but it hasn't happened yet. Almost like you've been poisoned and your body hasn't yet expelled the venom. The whole body feels uncomfortable and twitchy and horrible. Finally, the biggest issue is hypnic jerks (Link) or sleep starts. I've had these the whole time I've been on anti-depressants but during this withdrawal they have been awful. Every single time I'm just about to fall asleep, my body does a shocking startle response and I'm zapped awake again. It's like being hit with an electric shock. And this happens over and over and over again, for hours as I try to fall asleep. Last night, it was beginning to feel a bit like torture. I was aching for sleep but my nervous system would not allow it.

So far, I have done 3 nights without Trazodone. The general pattern is to be kept awake until between 2 and 3am, then sleep fitfully for about an hour or so, then perhaps get another 2-3 hours between 5 and 8am. It's a very unpleasant sleeping experience but doesn't seem to be adversely affecting my days. I actually feel more awake and alert during the day.

The only thing I've found to help with the hypnic jerks is paracetamol. It seems to have something of a calming effect on the nervous system. Not sure if that's scientifically possible but, even if it's just a placebo effect, it's helping. The problem is I don't want to have to take paracetamol long term. It does make me angry that when they stick you on these drugs they don't say that getting off them is going to be a nightmare! When I reduced my Venlafaxine dose right down, it took a good year before my nervous system really started to feel more 'normal' again. I was an emotional wreck for months simply due to the withdrawal effects on the nervous system.

In terms of physical rehab, I hit the pool this week. With all the heat, I fancied a nice cool swim. Having not swum since January, I wasn't sure how I'd cope. But, it went well. I did 32 lengths (0.5 miles) in about 35 mins. No cramps in my feet or calves (for the first time ever) and no pain through the front of my left shoulder (for the first time ever). I also seem to have recovered well physically, managing a good 2.5-3 mile walk this morning. The gym work and running are making a difference! 

Right, I've run out of steam so will leave it there....