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noah    66

You may or may not remember that I have been having difficulty falling asleep.

After trying a few things the doc gave me trazadone 25 mg to start. I had been using 10 ml of 2.5 mg  melatonin and .5 ml of valerian root(she told me I could continue with them in addition to the trazadone)

I have been following the instructions for each one.. Valderian root about 30 minutes before bed, the melatonin about 15 minutes before bed and the 25 mg of the trazadone right at b ed

I usually take the valerian root and the melatoin in the spare bedroom and try to settle myself down before going to bed .  What I am finding is that by the time I am reading to moved into the  bedroom   

I am feeling a liitle fuzzy, I go into my room and take the 25 mg of the trazadone a nd shortly after that I feel groggy and am laying there waiting to fall sleep but after about 15 minutes the feeling is gone   

Does this mean I should talk to my doc about upping the dose.  It has only been 4 n ights. Should the timing I take the meds be different?

Would appreciate your input

Thank you

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MComes RPH    182

Noah,

I think there may be 2 things that can be done. First, I would try taking the Valerian about 45 minutes prior to bed, the Melatonin about 25 minutes prior to bed, and the Trazadone about 10 minutes prior to bed (but make sure you are in bed when you take the Trazadone). I believe this small change could allow all of the medications to be active in the system at the same time. As you know every person has a different metabolization time. It sounds like you may be a slower metabolizer, so taking the meds earlier may help.

Secondly, I think an increase in strength may be needed. With a medication like Trazadone, it is reasonable to increase the strength after being on the medication for about 7 days. The max dose of Trazadone is 150mg per day.

I hope this helps and please keep me posted.

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noah    66

My doctor gave me the go ahead to increase it to 50 mg,

I have been taking that along with the melatonin and valerian.  What is the expectation with this medicine??

When I take it should I expect to see a difference right away. I dont feel anything right away. It is hard to tell whether it is working or no

I have been playing close attention to the timing of the other meds as well

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MComes RPH    182

Noah,

It is hard to tell exactly when one person will feel the effects compared to others. I usually give it an average of 2 weeks to see the full effects. It is also difficult to see the effects that one medication has when you are taking more than one for the same issue. I know you are taking Melatonin and Valerian, so trying to adjust the timing of those along with the Trazadone may be tricky and could call for some trial and error.

I also think other factors can help as well.

1) Have a bedtime routine. Ie. Eat dinner, go for a walk, shower, watch TV, brush your teeth, then go to bed. It is very important to get as much activity during the day to make you tired at night. The less you do during the day, the more difficult it is for you to sleep at night.

2) Trying to go to bed at the same time every night.

3) not eating a big meal before bedtime. Only snacks with low sugar.

4) Avoid "blue light." Ie. Computer's, laptops, tablets, and cell phones.

5) If you watch TV before bed, make sure you limit it to one or two episodes then shut it off. If you have the option of your TV to have it shut off at a certain time, make sure you set it. Many times people will keep it on and fall asleep, then wake up a few hours later with the TV still running, and this will peak their interest to watch or to go through the hassle to shut it off. Just those few seconds to turn it off can stop the sleep cycle you are in.

6) Avoid television or reading that makes you think to much. This can actually keep your brain thinking while trying to sleep.

7) Try the 4-7-8 breathing technique. This has worked well for me because it brings my mind to the "here and now" while I am thinking about breathing and puts all the other stuff in the background. The technique is to inhale for a count of 4, hold the breath for a count of 7, and exhale for a count of 8. This is also used in meditation. It slows the heart rate, reduces anxiety, and actually changes the brain waves. The most important part is to focus on the counting, which should then push all the other thoughts that cause a "running mind" to the background.

I hope this helps and please keep me posted.

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noah    66

There was someone on this thread who saidthat he takes it an hour before bed and he falls asleep fine. If he takes it any sooner he doesnt fall asleep as quickly. Is that safe??

What I have been doing.. is with a goal of going to bed @945 

I take the valeriia @  9 the trazadone @9:15 and the melatinin @ 9:30

Does this timing seem ok

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noah    66

The schedule I have outlined above is helping but as you would expect I am drowsey the next day. When I was on 25 mg trazadon I never tried to play around with the timing b/c nobody suggested it.  I always took it right before bed.  Now that i can see the changing the time can make a big difference. I wonder if I had done that with the 25mg if it would have worked better. 

I hate taking all this medicine. What do you think the changes are I would be successful with the 25 mg if I took it earlier than right before bed.

Do you think it is worth a try??

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MComes RPH    182

Noah,

To your first question, yes it is safe to take it an hour prior to bedtime. That is actually how I take it, but it all depends on how your Dr. told you to take it. If you were to switch the timing, I don't think it will be a big deal.

As far as your second question I believe we taked about timing and keeping a journal. When to take a medication, how fast it works, and side effects are patient specific. The changing of the 25mg to one hour prior to bedtime may have made a difference. You can always try it by cutting in half the 50mg tablets you have.

I also wanted to mention to you that the longer a person is on Melatonin the less effective it becomes. I know you have been on it a while so maybe trying to go without it may have no effect on how well or how effective it may be.

I think at this time it is best to try one thing at a time. First try to take the 25mg one hour prior to bedtime for about three days. if that does not seem to be effective, then increase the dose to 50mg one hour prior to bedtime. If that seems to help, then you may want to think about eliminating the Melatonin. Sometimes when a medications becomes ineffective, people try a "drug holiday." I usually do not recommend this for prescription medications unless authorized by your Dr. In some circumstances being off of a medication, for as short as three day, and then going back on it can "reset" the bodies ability to process it which can make it more effective again.

The reason I say to only change one thing at a time is that if you change more than one thing at a time, a patient or Dr. will have a hard time tell which change was positive and which one might have a negative effect on the body.

I hope this helps and please keep me posted. 

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noah    66

should I expect any kind of withdrawl symptoms if I stop the melatonin?  What about the valeria is  there withdrawl symptoms with that

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MComes RPH    182

Noah,

There should be no withdrawal with either, but make sure you only take away one at a time. I would start with the Melatonin first.

I hope this helps and please keep me posted. 

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noah    66

So you would suggest first getting rid of the melatonin and try 25 mg 1 hr before bed first?

You are such a great resource it would have taken me days to get feed back from my doc

Thank you

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MComes RPH    182

Noah,

Thanks, I'm here to help. Sometimes it may take a few days, but I try to stay on top of things.

What I would do in your case is take the 25mg of Trazadone and continue the Melatonin. You only want to change one thing at a time, so that way you can narrow down the issue.

If all goes well, after 3 days you can then discontinue the Melatonin. 

I hope this helps and please keep me updated. 

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