Doctor has prescribed Trazadone

Palmetto Peg

My DH been diagnosed with MCI by his PCP.  We are trying to get in to see a neurologist, but our appointment was cancelled due to COVID.  The doctor is only doing telehealth visits with existing patients right now.  We see the PCP November 2, and I plan to ask for a referral to a different neurologist.

In the meantime, DH has been very agitated and is not sleeping well at all.  He is showing signs of greatly increased paranoia (about people he is golfing with - he is sure they are talking about him and trying to embarrass him).  The night before golf he hasn't slept at all and has actually cancelled a few times.  Now it is spreading into other areas where he is getting so agitated that he can't calm down, so I asked him to contact the doctor and mention what was going on.  When he doesn't sleep, I don't get to sleep, either.  He is so agitated and keeps wanting to revisit things.  

The doctor has prescribed Trazadone.  I looked it up online and it appears to be okay for people with dementia, but I am coming here to get any information you might have on possible side effects, if he might improve by taking it, etc.

As always, thank you so much for any help you can give me.

jfkoc

All drugs are a risk and all drugs have side effects and may interact with other meds inc OTC.

That said, life runs on trade offs and Trazadone is not an uncommon drug to be used. Read about it and be aware of side effects etc.

janeymack

My husband has been on trazodone for about three months for agitation, non-stop activity (pacing, rearranging, packing bags to move "home"), and aggression. Doc told me to give as needed. It worked well for two months, then the doc switched him risperidone due to worsening delusions and hallucinations caused by Alzheimer's. I can also add trazodone, as needed, when the risperidone isn't calming him down. 

The only side effect thus far is that I get to keep my sanity!

EDITED my post to point out that delusions and hallucinations were EXISTING before we began trazodone. Did not want anyone to think they were a side effect of trazodone.

Ed1937

Here is some information on it, and if you scroll down a bit, you will find side effects. 

\https://www.drugs.com/search.php?searchterm=Trazadone  

M1

Peg trazodone is commonly prescribed for sleep and depression, but I suspect it wont have much effect on the delusions. You will probably need and antipsychotic for that, like seroquel among others. Btw watch for constipation as a side effect, along with dry mouth.

Hal42

My wife has dementia and has has Tardive Dyskinesia. She has been on Trazodone for about a year. She started on 50 mg at bed time and after a while she was cut to 37.5 mg. Just this week her doctor cut her down to 25 mg at bed time. 

The only thing we can say about Trazodone is that she gets a good night’s sleep because it helps her to sleep and her Tardive Dyskinesia is not active. We have not seen any of the side effects as listed on mayoclinic.org.

I’ll add this: The few times Trazodone didn’t work, and I just learned this a couple months ago,  was after we had watched movies with lots of violence. That type of movie must have played in her mind all night long. She tossed and turned all night. I did not get any sleep. I asked her about it the next day. She did not remember any of it. Now we usually turn on easy listening music a couple hours before bed. 

Palmetto Peg

Thank you all for your responses!  I am happy to at least start with something for him that has worked for others.  I will watch for the side effects, and it this at least calms down some of the agitation and lets him sleep a little, I will consider it a win.  I don't know if the PCP would prescribe something like Seroquel - she might want to leave that to a neurologist.  If I can get a little quiet time without him talking about "these people who don't like him" I will be a much better caregiver!

Doby

Hi Peg.

My DH started taking Trazadone a few months ago for sleep, because he was having similar issues with paranoia and delusions and we were both up at night. Unfortunately the Trazadone would knock him out early, but then he would wake up during the night hearing/seeing people in our house, etc. I asked his PCP to prescribe Seroquel, and he did but said to stop the Trazadone. DH now takes 200 mg of Trazadone each night and so far seems less agitated, but still delusional and paranoid. Last night he woke me up about 4 times telling me that someone was in the house, and that someone was talking to him through his CPAP machine, threatening to kill him. This morning he came downstairs very early while I was getting ready for work, and told me that men had been in the attic last night and they got lost, but one of them had an emergency whistle and they found their way out!

I hope the Trazadone works for you and allows you both to get some decent sleep. I'm trying to convince my DH to stay on the Seroquel for a few more weeks. He's resistant because he said it's making his eyesight worse and he's "losing time," I think meaning that he's sleeping too late in the mornings. Hopefully those effects will wear off.

storycrafter

Can his doctor refer him to a Psychiatrist and get him in more quickly than to the neurologist? A psych doctor was a big help with the meds for my dh in the early days. The primary care doctor did go ahead and immediately prescribe Seroquel for him until we could get in to see the psychiatrist. It was a relatively low dose but did help immediately calm dh, his paranoia, impulsiveness, severe depression, agitation, and anxiety.

It was a month before we could see the psychiatrist. The psych dr immediately increased the Seroquel in increments over the course of several months until dh reached a therapeutic dose of 300 mg. The initial marked sleepiness at each increase took about two weeks to get over. My husband found great relief of his FTD symptoms and improvement of sleep at night. This med gave back quality of life.

Everyone responds individually to meds and it's always trial and error for a bit. Don't be discouraged if something doesn't work. There are other options to try. A psychiatrist familiar with dementia issues can be a great help in managing meds until you get to see a neurologist for further recommendations. Our pcp now manages all the meds and we haven't seen a psych or neuro for years as dh is relatively stable with slow decline in our case.

Several years later now, dh also takes Trazadone for sleep. Hope some of this feedback is of help.

Best wishes to you...

Palmetto Peg

Thanks for the suggestion about seeing a psychiatrist.  I will check with her today and see if I can get a referral.  I'm not sure if we have geriatric psychiatrists near here, but I will see if she has one to refer us to.  I would be so happy if there was something that would help him.  It seems like his disease is accelerating so rapidly.

Iris L.

Hal42 wrote:

I’ll add this: The few times Trazodone didn’t work, and I just learned this a couple months ago,  was after we had watched movies with lots of violence. That type of movie must have played in her mind all night long. She tossed and turned all night. I did not get any sleep. 

Disturbing movies and the news can be triggering for PWDs.

Iris L.

Doby

Peg,

Are you in SC? I thought you might be because of your username. We're in Columbia and there is a Senior Primary Care practice here that includes PCPs, social workers and a geri psych on staff. You might be able to get in to see them.

Palmetto Peg

Yes - we are in Hilton Head, but I would gladly travel to see the right doctor.  Thank you for the suggestion!  DH has taken the Trazadone three nights now, and it appears to be helping him sleep.  I know it takes a few weeks for the antidepressant/anti-anxiety benefit to kick in, but just being able to sleep for a few hours without interruption is helping both of us.  I find it so hard to be patient at 2 a.m.! He is better, too - not so tired and agitated.  I am keeping my fingers crossed that this isn't just a coincidence and it is the med that is helping.  All of your suggestions have been so helpful, and the support here is wonderful.  I love the fact that any subject is not off limits and useful tips are always offered!

Doby

Hi Peg. I'm glad the Trazadone seems to be helping! 

My DH is actually from your neck of the woods! He grew up in Bluffton and misses it terribly.

The practice here in Cola is Palmetto Health Senior Primary Care. The have a PCP on staff who specializes in dementia, plus the geri psych and social worker I mentioned earlier. We have our first appointment with the social worker in early November, and then will see the PCP a few weeks later. If you're interested I can touch base with you after we see the doctor to let you know what I think of the practice. Fingers crossed!

Palmetto Peg

Doby - I would love to hear what you think after you visit the practice.  We are still in the early stages, but I definitely want a neurologist and perhaps a geri psychiatrist to evaluate him.  It seems like his paranoia is accelerating more rapidly than the memory loss part, and we are going to need help on that soon.  It is frustrating, to say the least, to see this happening and not having any real idea as to which form of dementia he has.  I know there isn't much to be done for any of the forms, but I think it would help me if I could see some kind of pattern.  Thanks so much!