Ativan vs. Trazadone for insomnia?

[Roozeyk]

If a pt. is started on Ativan for insomnia and has been on it for a few years, why would it be beneficial for a pt. to switch to Trazadone for insomnia? Isn't the pt. then just addicted to the Trazadone? Or is it because Ataivan is considered a narcotic and Trazadone isn't, so the Dr. isn't writing a script and refills for a narcotic?......welcome any ideas..thanks.

[begalli]

Trazadone is a SSRI antidepressant used frequently for it's side effect of drowsiness, especially in inpatient settings.

Ativan is not a narcotic, it's a benzodiazepine and a controlled substance. People can become dependent mentally and physiologically on benzos.

Maybe the doc is trying to get the patient off the benzos because of dependency issues?

I wonder why the doc doesn't try ambien? Why an antidepressant?

edit to add: SSRI's are not addictive.

[Fiona59]

I've never figured this one out myself. I just know that a lot of elderly take ativan to sleep. For a while I thought it was because it was sublingual. But then a few of my seniors have a lot of anxiety issues (health, money, and a few have really bad memories of WW2), and depression is quite common in the elderly, so?? Maybe its for a combined effect, seniors don't like to talk about mental illness, but sleeping pills are socially acceptable.

[lsyorke, RN]

edit to add: SSRI's are not addictive.

But you CAN go through withdrawal if you choose to stop taking them!

[nursex20]

I can't believe that a Doctor would use Ativan in any patient for insomnia but especially an elderly one as they often have reverse reactions to meds.

It is very addicting and an anti-anxiety medication.

Unless the insomnia is caused by anxiety?

Hmmm,

I work 2 sometimes 3 long night shifts a week so that the rest of the week I can be the "stay at home" mom and do carpool, dinner, homework etc. and my body NEVER gets on a rythm of days or nights.

When I need to sleep, I need to sleep and I have had great results with Trazadone and no worries from my doc since there are not addictive issues with it.

Ambien was scary. I not only did not sleep, I had light shows playing in my head whenever I closed my eyes. Flashback to the '70's but without the music!

Called the doc back and apologized for being stubborn and old school but said I would rather not be a guinea pig to test a new drug and to switch the prescription to Trazadone since it has been around forever.

Whatever they do with this patient, there must be weaning from Ativan after using it that long or seizures and psychotic break are very real possibilities with withdrawal.

I do love it though for my Hospice patients on Crisis Care. It is the best for terminal anxiety.