Combinations - Follow up to benzos and trazodone

Discussion in 'Benzodiazepines' started by k0nfLiCt, Jan 13, 2018.

  1. k0nfLiCt

    k0nfLiCt Newbie

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    As a follow up to https://drugs-forum.com/threads/benzodiazepines-and-trazodone.53060/page-2... I couldn't post it there... it said the thread was too old. I feel I have some valuable information to add and/or would like to reignite this discussion.

    The original question: I heard somewhere that the Trazodone can enhance the goofy feelings that Temazepam gives you?

    First of all I am prescribed both alprazolam (xanax) and trazodone (oleptro) by the same doctor.

    While I will not be addressing Temazepam directly I do have just a few points, but first my own personal empirical experience:

    Trazodone was prescribed to me for depression because I did not respond well to SSRI's (prozac, lexapro etc). However I do not take it on a daily basis. I only take it when I really need some solid sleep. Having been taking xanax for 8 years at a consistent dose it (xanax) does little for insomnia. Trazodone however works wonders for sleep. I get some of the most consistent sleep while taking it. Now.. Mixing it with xanax is sacrilegious because it's a total waste of xanax. However, that doesn't mean that trazodone can't benefit, in some ways, the effects of xanax (which leads me to a few points, mostly relevant, others random);

    Trazodone, as previously mentioned, is an anti-depressant in a class of its own (well a very few). Not an SSRI, SNRI, MAOI, NDRI, or even a Tricyclic. However as an SARI "tetracyclic" it inhibits the the reuptake of serotonin, norepinephrine, AND dopamine. It does also antagonize α1-adrenergic receptors (which gives it minimal antihistamine properties). All of that on top of being an anxiolytic and a hypnotic makes it a quite, and quietly, diverse compound.

    Here's the kicker though and stay with me on this... being that trazodone is metabolized by the hepatic enzyme CYP3A4 and it's a "tetracyclic" (like nefazodone or "serzone") it will substantially potentiate (increase half-life, blood plasma concentration) triazolobenzodiazepines (alprazolam, triazolam, among others) Via CYP450 3A4 inhibition. However this potentiation won't happen until the cessation of trazodone itself (i.e. the next day or two). This could be significant in both harm reduction (by avoiding having too much of said drug in system) or conservation/titration (by making said drug last longer in smaller amounts).

    So the very clear answer here is that as a combination these concomitant compounds are utterly worthless but properly spaced could not only cause harm reduction, but say, help someone more successfully taper off of the triazolobenzos (which, trust me, are a bitch to come off of) by increasing their half life WITH titration.

    Other random facts about Trazodone:

    It is being researched as an erectile dysfunction medication. Priaprism is not the same thing. That is when the blood in your stiffy coagulates and said arteries in your shaft harden while still erect. (YIKES) ... it's VERY rare. It also helps with premature ejaculation (at least in my experience). Since taking it on an intermittent basis my sex life has improved ten fold and I can go much longer (sorry if that's TMI).

    Not surprising due to it's potential for the above it has shown to lower blood pressure. Trazodone also has many other off-label uses including management of certain types of pain, bulimia, dementia, OCD, as well as to help withdrawal from a plethora of substances including alcohol, opiates, or even benzo's themselves.

    One bad thing about Trazodone (or good if you're a klubkid from the early 2000s) is its active metabolite (and this applies only to people who take it daily in high doses where build up occurs) is mcPP.

    And, finally, there isn't a whole lot of "released" information out there about SARI drugs or why clinical off label research is lacking. Not to sound like the conspiracy theorist but many times when there is so little information on something there's a reason for said lack of information. Hrmm. :confused:

    P.S. I see this drug being a controlled in the next decade or so as it does come with some pretty nasty withdrawals. Anybody remember when tramadol was uncontrolled and doctors where like... oh no it's not addictive! WRONG!!!
     
  2. aemetha

    aemetha Sexy Potato Palladium Member Donating Member

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    Would this not make it a weak alpha blocker? The antagonism of the H1 receptor makes it a weak antihistamine.

    Otherwise, interesting post. I doubt it will become controlled though. Controlled substances are usually controlled because they have some potential for abuse (which is really doesn't unless you consider sedation getting high). Just about all antidepressants have some form of cessation syndrome. Venlafaxine in particular is hell on earth. It's not addictive because it doesn't cause cravings, it, like most of the other antidepressants creates dependence which is a function of tolerance and neural compensatory mechanisms (we need to be careful about those terms because they do mean different things).
     
  3. k0nfLiCt

    k0nfLiCt Newbie

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    Yes, my bad. I was thinking H1 and copied and pasted the wrong quip. Thanks for clarifying.

    There have been subjective reports of people getting high off of trazodone (mostly by insufflation) however I've never tried it that way and don't intend to. Typically though drugs that have anxiolytic and hypnotic properties usually do find a way to get abused. Tramadol for example, at first, was thought to have no potential for abuse. Granted it's a whole different type of drug although it (tramadol) does have SNRI properties.

    Having taken trazodone myself I agree that it has no recreational value but I have read, as mentioned above, reports of people who do swear to have found some recreational use from it.

    I do understand what you mean about the difference between addiction and dependence. Unfortunately most behavioral therapists, social workers, and the medical field don't really differentiate. At least not in my experience but I fully agree with you there. Thanks for the reply!