Xanax vs. Ativan vs. Trazadone

Pdoc put me on Ativan (.25-1mg) for insomnia which works fine for getting me to sleep but takes waaaay too long to kick in. If I take it before 9pm, I can remain wide awake until 1 am. So, I can't take it on nights that I have to be at work 6:45 am the next morning because then i'm tired allll day (and will sleep if allowed) because it kicks in after the fact.

So, he suggested Trazadone (50-200mg) which is supposed to kick in within 30minutes. I found a similar drug to work extremely well, but I grew too used to it (it was not a narcotic) and pDoc says that medicine can cause heart complications over time.

He also prescribed 0.25 mg of Xanax (the dose I was on in the past), to take when I wake up in the middle of the night with racing heartrate (I do not have ptsd or night terrors, etc. I just wake up like that) because its quick acting, or in the daytime when I have spurs of anxiety.

I feel like that is a lot of potent medicines in my possession (along with Celexa and Lamictal) but I am stable these days and suggested making a chart on how they work for me (he loved the idea). He also says that he finds me to be one of the most proactive patients in therapy who does the things i'm supposed to do to help myself - so I guess he trusts me.

Has anyone taken a combination of two or all of these medicines? Whats your experience on efficacy for anxiety and insomnia?

Hi Teal

I've taken trazodone for years and it does make me sleepy, but I noticed if I eat too close to bed time or have caffiene in the afternoon it doesn't work as well. I've also noticed it kicks in quicker if I don't lay down right after I take it. (I have no experience with the others.)

Trazodone has a paradoxical effect on me -- it makes me wired and makes me unable to sleep.

I used to take ativan for sleep, and it worked fairly well, but now I take klonopin and I think that it's a lot better. It works better and it lasts longer. Maybe ask about that? And maybe with that you could get rid of the xanax. Just a thought.

I take Trazodone but it takes 300mg to get me to sleep (it still takes an hour or more). If I'm having a lot of anxiety even that won't help and I have Valium (I have to take the Trazodone within about an hour or else the Valium starts to wear off a little and I'm back where I started).

Its good you are finding the combination that works for you!

Thanks! He told me to stop at 200 mg because after that dose it starts to work as an antidepressant.

I take Trazadone to help me sleep. It works fairly well. I also take Xanax for anxiety and it helps. I've only had Ativan in the hospital.

Trazadone didn't work for me, but I can take Xanax and go to sleep whether it is before bed or during the night when I awaken and can't sleep

Trazadone, Ativatin, and Xanax, personally I think you should only be taking one of those. But ask your doctor. 0.25 mg Xanax is a very low dose, doesn't seem like enough to me. I don't know the dosing of the others. I take Lamictal and used to take Lexapro (similar to Celexa), Lexapro didn't work for me but Lamictal helps me.

Trazadone does absolutely nothing for me. It's never functioned as better than a mild antidepressant from all accounts. I don't see why your doctor would care if you had that side effect. As far as all three drugs I would only be concerned about taking two different benzodiazepines (Ativan and Xanax) at the same time, though you're at a very low dose.

The other concern I have for myself is that I will inevitably develop a tolerance for a benzo. That would really bother me because there are other things for sleep but nothing that works as well for anxiety and panic as Xanax for me.

I have taken both Ativan and Trazadone before. Trazadone above 200 mg would make me sleepy and dizzy like its supposed to, however above 200 mg it also makes my legs restless and I end up not sleeping.

My doc will give me a 30 day script of Ativan at a time, .5 mg to take at bed time or an hour before bed. Sometimes it works, sometimes it doesnt. I would rather not be able to sleep at night than take something like Ambien again. That stuff would knock me out all night long and I would still feel the effects of it well into the next afternoon.

I think as long as you are keeping everything written down and sharing this with your doc regularly, there shouldnt be a problem. There are some meds that you have to be careful taking together, but thats why its a good idea to meet with your doc every 4 weeks (Ive had docs not want to see me for up to three months and I refuse) and discuss your meds and how you are reacting to everything both mentally and physically.

did someone say trazadone causes heart complications?

I can't say anything positive about two benzos. I guess if you only had one and only took it when you were having a strong panic attack, it would be okay.
First, there is no low dose of Xanax. ( .25 of Xanax is equal to 10 mg of Valium ).

I've been dancing with this devil for years. When you hit tolerance, or interdose withdrawal, it gets bad. Actually, when I was hitting tolerance, I would wake up in the middle of the night with a racing heartbeat and have to dose. When I told my pdoc, he increased the Xanax. Lol. He was an idiot.
Best of luck to you.

Ah. I've taken all three of those.
Xanax for me was awesome for calming me down; it didn't really put me to sleep, it made me tired but not TERRIBLY drowsy where I had to sleep that instant.
Ativan... I barely remember anything from when I took that. I remember it ****ed up my memory.
Trazadone was AMAZING. I fell asleep the whole entire night but I wouldn't remember much the next morning, first night taking it (50mg I believe) I woke up very disoriented and dizzy, but once I got adjusted it was awesome...
I took Trazadone and Xanax at the same time (different hours) and I didn't really notice a combination or addiction issue with them.

Hey everybody! Thanks for all of the responses! So in my experience so far; i'm most a fan of Trazadone. 100mg seems to be the most effective dose and has little to no side effects (the first time taking 50mg hit me hard though between headache, sinus and a dry cough).

The Xanax i'm iffy about. It works for when i'm in hyperactive cant sit still or physical agitation type anxiety including palpitations but it does not help with the irritable anxiety that makes me want to lash out. Well, it works for both but when I use it for agitated anxiety it bottoms me out and sends me into tearful depression. Is that an adverse effect? I remember having that happen the last time I was on it but forgot.

The Ativan which i've been takin the longest takes too long to kick in (four hours on average) and causes me to oversleep for work and/or sleep all day if not. Im afraid to up the dose for anxiety because of the sleep effect.

So I'm thinking that I'm interested in continuing the Trazadone but I wish I could find an alternate anxiety med for moments that I don't need to be sleeping. Suggestions?

Klonopin makes me less sleepy than xanax and ativan. It also works better IMO, and in my pdoc's as well. For me to get sleepy I have to take 2mg, and for a panic attack 1mg will generally be good enough. For smaller bouts of anxiety .5mg is enough.

I would stay away from the benzodiazepines since they cause drowsiness (most of them. If you want to stay with the benzo's give Serax a try. Try an SSRI (SMALL DOSE since these are very addicting, don't take paxil (13 years and hooked). You should play around with the dosages with your psychiatrist.

Thanks guys, I started freaking out with the xanax so I called my psychiatrist, who took to long to call back. So I called my family doctor who said that the "emotional lability" IS a side effect of the xanax (spontaneously going from laughing to crying) but that the symptoms would tone down as I get used to it. My pDoc called back though and he said to stop taking the xanax because he doesn't like things making me depressed for fear they will spiral into something worse (ending me back up inpatient). So we're going with 0.5-1mg Ativan during the day since it doesn't have a true sedating effect on me, and 50-100 mg Trazadone at night. I did remember (after the fact) that xanax did that to me last time as well - so even though its a low dose, my hormones just don't really agree with it. Yay for cancelling out one possible benzo addiction lol

I take Trazodone. Apparently to sleep. Started at 150mg which was too much, went down to 50mg which is OK, but not if the anxiety is too high or if my body is dealing with caffeine. So I'm going back to 100mg. I take Klonopin prn - mostly when I feel myself spiral or when I have too much anxiety.

I didn't - but I did mention that pDoc said Doxepin eventually does.

I've taken Trazodone before... not a fan. Knocked me out, as intended, but the headaches were just disastrous. The Xanax, however, worked very well for my anxiety. The down side to that is the half-life is very short. Is good for panic attacks though, or things like the racing heart in the middle of the night, which kind of sounds like panic attacks, like you're describing.

Ativan oral doesn't do much for me, but I've been treated in the ER with IV Ativan for bad Conversion Disorder for some temporary relief twice before and it works well.

I'm currently on Klonopin and have been since September. Long term benzo usage=not ideal, but my doc is keeping me on it to help treat my Conversion Disorder. It is one way to treat it, and it seems to help manage symptoms for many people. It's prescribed PRN (as needed), but it is more of a maintenance anxiety drug despite most being advised to keep patients on benzos for as short of a time as possible due to liver damage/addiciton risk.

Best of luck to you, my friend.

I've been on Xanax and Ativan, but never Trazadone.

-Xanax: The fact it kicks in fast can help with sleep on at least 1-2 mg, but it never in itself helped me really stay asleep, except with the help of stronger sleep meds in conjunction with it. Works wonders for anxiety though as a result of how fast-acting it is, but it wears off fast for me.

-Ativan: Takes longer to kick in than Xanax and not as initially powerful, but 2 mg works well for me as a sleep aid with my other meds. Actually, I prefer Ativan and Klonopin as benzos for sleep other than Xanax. For anxiety, I still find the Xanax and Klonopin to be a bit more effective though, but Ativan works well too for me.

The pdoc won't prescribe me Trazadone, since it is her belief it can induce mania in Bipolar 1 patients. I have a history of being sensitive to antidepressants as far as them making mania worst, so does not recommend it for me or most BP1/Schizoaffective patients. That doesn't mean that it won't work for certain people with BP1 though. I do hear it being prescribed more commonly to Bipolar II people/unipolar depressive individuals with successful results though.

I take .5 for Xanax for anxiety. Thats pretty low dose but I like it, it's enough to work without getting a high from it which I don't want. It doesn't put me to sleep on its own but it calms me down enough so that I can actively make other attempts to get to sleep, so it works in a way. .25 can be effective a little, but I find .5 is much better. I don't take it everyday though. I'm nervous to... But I'm contemplating it because I do have insomnia that needs to be controlled.

Thanks for the replies guys! Since i've cut out the Xanax, the Ativan and Trazadone have worked quite well with each other. I'm at a happy medium with .5 mg Ativan and 100 mg Trazodone in conjunction with my 40mg Celexa and .5 mg Lamictal. I've been at a consistent "normal" on this regiment which is great because I start graduate school in two weeks.