Trazodone Vs Elavil: Which Is Better For Rem Sleep?

Trazodone and Elavil are two medications that are sometimes used to treat sleep disorders, although neither is a sleep medicine. Trazodone is a prescription drug used to treat depression and anxiety, while Elavil (also known as amitriptyline) is primarily approved for treating depression but is also used off-label to treat chronic insomnia. Both medications can aid in falling asleep, but their effects on sleep quality, specifically REM sleep, can vary. Trazodone has been found to reduce the time it takes to fall asleep, while Elavil may suppress REM sleep and have variable effects on slow-wave sleep, potentially leading to mood and memory issues.

Trazodone's impact on REM sleep

Trazodone is a prescription drug used to treat depression and anxiety. It is also sometimes prescribed off-label to treat sleep disorders such as insomnia due to its sedative or hypnotic effects, which cause drowsiness. However, it is important to note that trazodone is not a sleep medicine and is not approved by the U.S. Food and Drug Administration (FDA) for sleep disorders.

Trazodone has been found to have an impact on REM sleep. While it does not suppress REM sleep like some other antidepressants, it has been shown to reduce the time spent in REM sleep. This means that people taking trazodone may experience a shorter duration of the sleep stage associated with dreaming, memory consolidation, emotional processing, and brain development.

A study by I Montgomery, I Oswald, K Morgan, and K Adam in 1983 found that trazodone reduced the time spent in REM sleep in a group of nine volunteer poor sleepers who took 150 mg of trazodone nightly for 3 weeks. Another study by Yongliang Zheng and Yumeng Lyu in 2022, which reviewed 11 randomized controlled trials with 466 participants, found no significant effect of trazodone on REM sleep. However, this study also noted that the impact of trazodone on REM sleep may depend on whether the participants had comorbid depression, as people with depression tend to have increased REM sleep.

While trazodone can be effective in helping people fall asleep and stay asleep throughout the night, it is important to consider the potential side effects and risks associated with its use. The American Academy of Sleep Medicine does not recommend the use of trazodone for insomnia, as the potential risks and harms may outweigh the benefits. Additionally, there is limited clinical evidence supporting the effectiveness of trazodone for treating insomnia, and it may only slightly improve sleep time without improving sleep quality.

Elavil's impact on REM sleep

Elavil (also known as amitriptyline) is a prescription medication that is commonly used off-label to treat chronic insomnia. It is in a drug class known as tricyclic antidepressants and works by altering the levels of certain chemicals in the brain. Elavil increases the serotonin and norepinephrine in the brain, which can have a sedative effect, as well as reducing anxiety and improving mood. It also blocks histamine, which can cause drowsiness.

Elavil has been shown to have variable effects on sleep quality, specifically on the stages of slow-wave sleep (SWS) and rapid eye movement (REM) sleep. It may suppress REM sleep, which can lead to problems with mood and memory, and potentially cause a decline in mental health and feelings of anxiety or depression. However, not everyone who takes Elavil will experience these side effects.

When it comes to the impact of Elavil on REM sleep, it is important to note that it may suppress this stage of sleep. REM sleep is crucial for memory consolidation, emotional processing, and brain development. Suppressing or reducing REM sleep can have potential negative consequences on cognitive function and overall mental health.

It is worth mentioning that the use of Elavil for sleep is off-label, meaning it is not specifically approved by the Food and Drug Administration (FDA) for this purpose. While it can aid in falling asleep, its effects on sleep quality and REM sleep can vary among individuals.

In summary, Elavil can be beneficial for treating insomnia by increasing serotonin and norepinephrine levels, which promote sleepiness. However, its impact on REM sleep and potential side effects on mood and memory should be considered. It is always advisable to consult a healthcare professional before taking any medication, including Elavil, to ensure it is suitable for your specific needs and to weigh the benefits against any possible side effects.

Trazodone's side effects

Trazodone is a prescription drug used to treat depression and anxiety. It is sometimes also prescribed off-label to treat sleep disorders such as insomnia, as it can make you sleepy. It is fast-acting and short-lasting, and has a relatively low risk of addiction compared to other sedatives.

However, like all medicines, trazodone can cause side effects in some people. Many people experience no side effects or only minor ones, and common side effects will often get better as your body gets used to the medicine.

Common side effects

• Feeling sleepy or tired
• Feeling sick (nausea)
• Dry mouth
• Muscle aches or pains
• Trouble with remembering
• Continuing ringing or buzzing or other unexplained noise in the ears

Serious side effects

Serious side effects are rare, occurring in less than 1 in 1,000 people. However, it is important to be aware of them and seek medical help if they occur.

• Yellowing of the eyes or skin – this can be a sign of liver problems
• Difficulty pooing (constipation) or inability to pee
• Bruising more easily than usual or having unexplained bruising
• Getting more infections than usual, such as a sore throat or skin infections
• Fast, slow, or abnormal heartbeat
• Long-lasting and painful erection (priapism) – this may happen even when not having sex
• Thoughts of self-harm or ending your life
• Serious allergic reaction (anaphylaxis) – symptoms include swelling of the lips, mouth, throat or tongue, breathing difficulties, skin rash, or sudden confusion, drowsiness or dizziness
• Hyponatremia (low sodium in the blood) – symptoms include muscle weakness or cramps, nausea, vomiting, loss of appetite, tiredness or sleepiness, restlessness or irritability, hallucinations, confusion, decreased awareness or alertness
• Serotonin syndrome – symptoms include sweating, fever, feeling agitated or restless, seeing or hearing unusual things, fast or racing heartbeat, nausea, vomiting, or diarrhea, muscle twitching, stiffness or tremor
• QT prolongation and torsade de pointes (rare, dangerous heart rhythm problems)
• Orthostatic hypotension (low blood pressure when standing)
• Abnormal bleeding – you may be at higher risk if you are also taking aspirin, a nonsteroidal anti-inflammatory drug (NSAID), or a blood thinner
• Glaucoma – symptoms include eye pain, swelling or redness
• Mania (extremely elevated mood) – symptoms include a dramatic increase in energy, significant trouble sleeping, racing thoughts, engaging in reckless behavior, having unusually grand ideas, feeling excessively happy or irritable, talking more or faster than usual
• Worsening psychosis (losing touch with reality, experiencing delusions and hallucinations)
• Neutropenia (low white blood cell count)
• Hepatitis (liver inflammation)
• Syndrome of inappropriate antidiuretic hormone secretion (SIADH) – the body retains too much water

Elavil's side effects

Elavil (generic name: amitriptyline) is a prescription-only tricyclic antidepressant that works by increasing the levels of certain chemicals in the brain, namely norepinephrine and serotonin. It is used to treat symptoms of depression, eating disorders, post-herpetic neuralgia, and to prevent migraine headaches.

• Inability to empty the bladder
• Breathing problems or wheezing
• Fever or general ill feeling
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching, skin rash, or pale red bumps on the skin called hives
• Dizziness, feeling lightheaded, or fainting
• Suicidal thoughts or actions
• Glaucoma
• Severe headache or vomiting
• Seeing bright, colorful circles around lights (vision halos)
• Extremely elevated mood (mania)
• Heart rhythm changes
• Weakness or tiredness
• Difficulty urinating
• Pain, burning, or tingling in the hands or feet
• Changes in sex drive or ability
• Changes in appetite or weight
• Slow or difficult speech
• Dizziness or faintness
• Weakness or numbness of an arm or a leg
• Rapid, pounding, or irregular heartbeat
• Severe skin rash or hives
• Swelling of the face and tongue
• Yellowing of the skin or eyes
• Jaw, neck, and back muscle spasms
• Uncontrollable shaking of a part of the body
• Unusual bleeding or bruising
• Hallucinations

Trazodone's benefits

Trazodone is a prescription drug used to treat depression and anxiety. It is considered an older-generation antidepressant and was FDA-approved for treating anxiety and depression in 1981. Trazodone is not a sleep medicine, but it has sedative or hypnotic effects, meaning that it causes drowsiness. For this reason, it is often prescribed off-label to treat insomnia or acute insomnia. Here are some of its benefits:

Fast-acting and Short-lasting

Trazodone is fast-acting and short-lasting, making it a suitable option for those who need quick relief from insomnia or acute insomnia. It typically takes about 30 minutes to make you drowsy, and its effects can last between five to nine hours.

Low Risk of Addiction

Compared to other sedatives, trazodone poses a relatively low risk of addiction. A 2017 research review noted that trazodone has a low risk for dependency and addiction, and an older study found that it had less abuse potential than other popular sleep medications like zolpidem and triazolam.

Improved Sleep Quality

Trazodone enhances sleep quality by reducing the time it takes to fall asleep and improving sleep maintenance. It also increases the duration of slow-wave sleep and reduces the number of arousals interrupting sleep. Additionally, trazodone can make you sleepy by blocking histamines, similar to the effects of the common antihistamine Benadryl (diphenhydramine).

Flexibility in Dosage

When used for sleep, trazodone is typically prescribed at low doses, ranging from 25 to 100 milligrams. These lower doses reduce the risk of drug tolerance and daytime sleepiness. For some individuals, even lower doses may be effective and cause fewer side effects.

Increased Serotonin Levels

Trazodone acts on neurotransmitters, specifically serotonin, by blocking it from entering nearby cells. This allows serotonin, a neurotransmitter that helps improve mood, to build up in the spaces between nerve cells.

Frequently asked questions