Other antidepressants

<p>From: Reviving the Broken Marionette: Treatments for CFS/ME and Fibromyalgia</p>

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Trazodone is an antagonist of the 5–HT2 serotonin receptors with some effect on serotonin reuptake. As an antidepressant it generally starts working faster than most, usually within two weeks. It is very sedative and its effects resemble those of the tricyclic antidepressants. In CFS/ME and fibromyalgia it is primarily utilized as a sleep aid.

A few studies have found trazodone useful for some kinds of chronic pain102, but most have shown no benefit.103,104 Nonetheless improved sleep may indirectly improve pain, especially in fibromyalgia. Trazodone is particularly good for those who tend to constantly wake up during the night. CFS/ME doctor Charles Lapp prefers a combination where clonazepam helps the patient fall asleep and trazodone aids in maintaining sleep.105

Based on the experience of Dr. Roseanne Armitage, nefazodone is more useful for women in the treatment of CFS/ME, but trazodone works better for men.106 The dosage used varies greatly between 25 and 450 mg. Some patients benefit from small doses, but larger ones often cause orthostatic hypotension.107 The website eMedicine which is aimed at medical professionals recommends starting with 25 mg in the treatment of fibromyalgia.108

The sedative action may cause daytime sleepiness. Other common side effects of trazodone (neurological symptoms, nausea, headache, nasal congestion) can be confused with the symptoms of CFS/ME and FM as well. Nonetheless, compared to tricyclics the drug is well tolerated and has much fewer cardiac effects. The blood levels of trazodone can be affected by ketoconazole and carbamazepine. Grapefruit juice should only be consumed in moderation.

Trazodone is available in the United States, the United Kingdom, Canada and many other markets, but not in Australia. It is very inexpensive.</p>