I Appreciate the comment, we will keep covering more medication and therapy topics

No problem, I appreciate the comment

No problem, I'm happy I could provide some useful information. Please spear the word

Same. I got switched off of it for California rocket fuel but it did wonders for my sleep and gave me awesome morning wood 😆

Thats great, many people post comments about the downsides to taking medication, its always good to hear about a positive experience

How has it worked for you?

@@ElizabethEllisCoach I only took it that night! I had weird dreams and didn't sleep well at all. So, that was it--not for me! I am taking Valerian Root and Glycine and sleeping much better now.

@@lauriebridges4565 can you share what brand and doses for the valerian and Glysine please

@@joecas6484 Life Extension Glycene, 1000 mg per capsule up to 3 times a day and Vitacost brand Valerian Root, 1590 mg per 3 capsules. Vitacost online has great prices too. This has been the best combo sleep aid I've tried.

No problem glad the video was helpful, let me know if there are other topics you would like to see

The things we learn in medical school lol. Appreciate the comment

This is difficult for me to say and I would suggest taking with the doctor about all the options. I couple of observations, first wellbutrin can cause in anxiety in some patient however if there is improvement in the anxiety with it the dose is low and there is room to maximize that prior to adding more medication. My philosophy is to use mono therapy if possible and optimize current medications prior to adding more. we are getting into polypharmacy adding a little of this and a little of that which increases risk for drug interactions and side effects. If tolerated trazodone could be a good option, antidepressant effects do not really start until the dose is above 150 mg/day. I have not used abilify to treat GAD and I have not found too much success with buspar other than to help with sexual side effects of antidepressants. Hope this helps provide a different perspective.

@@ShrinksInSneakers Thank you, you have been very helpful, keep on rocking

There is some anticholinergic burden associated with trazodone so it might cause dryness

Me too

This is not medical advice and you should always talk to your doctor before making any changes. I can only speak in general here not specifically about this case, and what I can say in most cases trazodone and other antidepressant medications can be combined safely. The affect on the serotonin transporter with trazodone occurs at much higher doses, if it's being used off label for sleep the dose is usually 50-150 mg at bedtime. I cannot say if it will work on not work, it's very hard to predict for each individual. I can say I'm not a fan of benzodiazepines in PTSD I think it interferes with therapy which should be the primary intervention for PTSD. For medication timing it depends on the person, I think it's always easier dose everything at night before bed it prevents missed doses makes the process as simple as possible. If someone has activating symptoms like increased anxiety or insomnia on lexapro it should be given in the morning in that case. Hope this helps. If you haven't subscribed to the channel please do and spread the word about the community we are building here.

I think it's an underutilized medication and may have benefit for patients who have failed other medications. In general if someone has failed 5 adequate trials of medication then medication is unlikely to result in full remission. It does not mean there is no hope it just means our expectations have to change from seeking full remission of symptoms to how can we best manage some residual symptoms while leading a healthy productive life. In true treatment resistant cases there are some other options ECT treatment, ketamine treatment, deep brain stimulation and vagus nerve stimulators. In those case you need to understand all the information about each treatment option and weigh the risks and benefits of each treatment. Hope this helps appreciate the comment

@@ShrinksInSneakers Cheers for the reply perhaps I've spoken too soon and got a little bit carried away symptoms have returned to varying degrees have a meeting with my mental health practitioner on 24th November perhaps he may increase dosage currently on 100 mil before bedtime living in hope thanks for taking the time out I guess every little helps

​@jameshamilton734 how are you doing now? X

I think you always have to balance the pros and cons of using a medication. I have not personally had a case of priapism in clinical practice, but we need to be mindful of the possibility. I think slow titration and careful monitoring should be fine but as always discuss i with your doctor and see if there are other options like mirtazapine for example.

This is not medical advice, and you need to talk to your doctor before making any changes to medical treatments. This is a lot of medications from multiple classes and when I see something like this the first thing, I think about is what’s the diagnosis? Sometimes a lack of clinical response is related to the incorrect diagnosis and once that is cleared up things start to make more sense, I’m not sure if that is what’s going on but it’s something to consider. According to Lexicomp there is absolute contraindication to this combination, but careful clinical monitoring is required. Combining CNS depressants and multiple serotonergic medications always has some risk. Weight gain is possible with all these medications a good diet and exercise routine are essential to prevent this. It’s hard to say for sure if one individual will gain weight or not but if there has not been substantial weight gain with Seroquel that is a good indicator. Hope this helps, if you haven’t subscribed to the channel please do and spread the word about what we are doing here.

I'm sorry to hear that about the lack of psychiatrists. This is a problem everywhere, not enough good people doing the job

Awesome, let me know if there is any other topics you want covered

I would talk with your doctor about the treatment and discuss rational for using the medication. Appreciate the comment let me know if there is anything I can cover for you

This is not medical advice as I am not your doctor, you should always consult your doctor before making any changes to medication or treatment. Information provided is for educational purposes only.I usually recommend doses of 50 mg to 150 mg at bedtime as an adjunct treatment for depression with insomnia. It can be used on an as needed basis although many patients will use it nightly. Hope this helps

It can cause weight gain, when I use this for insomnia I only use it on an as needed basis meaning the person should only use it on nights where sleeping is an issue. My starting point for sleep is sleep hygiene and possibly melatonin before jumping to sedating antidepressant medications. I covered sleep hygiene in a pervious video if you are interested. Appreciate the comment hope this is helpful

@@RealityofaSecondLife It's possible with most medications but not always the case. When we talk about a side effect you can never make a blanket statement like "no one gains weight" or " everyone gains weight" or "all medications cause weight gain" we should be mindful that every patient is an n=1 and all patients will have different experiences based on many factors. I agree with the NP that we should be mindful of the propensity for weight gain, we should educate our patients about the risk depending on what medication we are talking about, and we should start lifestyle interventions (diet exercise) before starting the medication. We should always reassess the need for continued medication after 6-12 months without symptoms and attempt to lower doses when possible. Hope this clears up some of the ideas, appreciate the comment

@@RealityofaSecondLife There is always risk, but some are better than others. Weight gain is the main concern for most patients 60% of patients report that as their main concern

I have CPTSD and depression and I’m on four different meds (Fluoxetine, Doxazosine (for PTSD nightmares), Haloperidol and Trazodone). It didn‘t affect my appetite or weight at all. Trazodone is actually known to reduce weight more than increasing is.

I have not observed this in clinical practice, and would not consider this a common side effect but muscle pain is possible.

Slow tapper is the best way to avoid withdrawal. Many times I will restart the medication or increase it for a short time and then restart the tapper at a slower rate to avoid these symptoms. This medication does have the propensity for weight gain. I made a few videos about weight gain in medications might be worth a view. There are other options including non pharmacological things like CBT. Hope this helps, appreciate the comment

I didn’t know this drug caused weight gain?

@@j-uk2189 yes, this medications até terrible tô gain weight

@@babynaysc really? I thought mirtazapine was the only weight gainer! Does it help for sleep though?

@@j-uk2189 Almost all psychiatric medications affect weight because they alter metabolism, especially antipsychotics and mirtazapine. if you're over 30 it's even worse, because the body slows down, it's terrible, that's why I decided to stay only on Zoloft.

Not sure what you mean by included? In most commonly prescribed it wouldn’t because you cannot prescribe it, it’s currently a schedule I drug, that’s not to say there isn’t research and excitement around the world of psychedelics. We will see what the research shows but like cannabis it will come down to what the federal government decides. Hope this helps, if you haven’t subscribed to the channel please do, and spread the word about what we are doing here.

@@ShrinksInSneakers with cocaine and the other drug you mentioned. Seeing as it works on the same serotonin receptor

That they shouldn’t be taken together

@@evangranville3475 possibly, as of now no one has combined psychedelics with antidepressants to find out about interactions. I would say if someone is experimenting with these medications it's best to avoid mixing them with trazodone. All the research I've seen excludes people who are on antidepressants from the clinic trials and things like serotonin syndrome are possible.

Me too!

Me too.... I've been taking it on and off since the 90's. First used for depression 300mg a day but now I'm in menopause and have insomnia 100mg at bedtime. I feel it does help me a little with mild depression as well

@@Mhel2023 does it help with your insomnia at 100mg? Also, did it cause you to gain weight? I'm going to ask my GYN for it as I cannot stay asleep now I'm post menopausal. I've tried so much and nothing helps. She suggested Trazadone but I refused. I'm rethinking that now being so desperate to sleep though the night

I did not gain any weight not 1 pound. Everyone is different. This medicine is life changing for me. 🙃

Yes I wake up much happier