First experiment with Trazodone: March 31, 2016

First use of Trazodone, 31 March 2016

Goal: to help her feel more at ease with a large number of people (some new to her) in the house. She normally copes well with my kids’ friends, but today the large number, a few past signs of anxiety with some visitors, and her recent heightened anxiety made me think it worth attempting the drug.

Background: She is on day 13 of fluoxetine. So far this week her stress level has been higher than usual (with few obvious triggers). She has not dealt well at all with the sound testing. I knew that my kids would be bringing home a pile of friends (10 in total): three were new to Lyra; one, Lyra has known forever but has an intense reaction to (90% eager, 10% anxious). It is the largest number of kids at the house in Lyra’s experience. (Two or three at once is more typical, and only now and then.) The group unknown to her was due to arrive between 4 and 5pm, so I gave her the trazodone (50mg) at 3 pm.

Notes: By 4 pm there was no sign of change in her mood. In fact, I began to think “Is 50mg enough?” The kids arrived soon after, and she was keen to see them and slightly anxious. My son shepherded them into the basement and shut the gate; Lyra whined a little at the gate, but I was able to distract her. I think she was simply frustrated. I was torn between wanting to let her see them up close at the beginning, and wanting to give her time to adjust to the noise.

At 2 hours post trazodone (pT) I gave her a tug toy in my office. She could hear the kids’ voices, but was pretty relaxed:

At 2 1/2  hours pT I took her outside to play ball. She seemed a little less excited than usual, but still willing to play. Two anomalies were the gusty wind and a clanking bin. However, she was only mildly affected by both :

At 3 hrs 20 min. pT, I took her down to see my son’s friends (a good crowd! I really like them). She was a little tentative, perhaps, but my main reading of her body language was that she wanted to connect with them (the girls, particularly; she shied away from one boy’s outstretched hand, which is normal for her). I would say that her behaviour was a good notch calmer than I’d expect for the event. Shortly after, one of the girls (new to Lyra) came up to the kitchen and had a visit with her. Lyra was very loving and eager to connect without the kind of anxious demand she’s prone to show.

At 4 hours pT she became sleepy (which may or may not be the new drug) and slept in my closet for two hours.

It is now over 6 hours pT. At 6 hours exactly, a man came to the door to collect his daughter. Lyra (who’d woken up groggily at the knock) was calm until she saw him in the doorway. Then she began to bark in her “please go away I don’t like this” manner. It was quite a volley — which is unlike her: steady barking, with her body lowered and tilted back. I have never seen her like this. (Ordinarily, if a stranger comes to the door, she will either just greet him/her or bark a few times, then settle.) Fortunately he was calm about it and didn’t react (hurrah for fellow dog owners!). I called her into another room, where she could still see him, and she stopped barking right away. I gave her some hot dog pieces, which she took gently. Four kids came up to the hallway to join the man; she was calm by then, and was able to stand near the group (including the man) and eat hot dog gently. So, very strange: an eruption of fearful, warning barks followed by calm. I’m sorry the day ended this way — as she’d been so good (for her) until that moment — but it doesn’t erase the other (more hopeful) data,

Lesson: her sleep at hours 4/5 of the trazodone was very deep. I’m sure she felt groggy and disoriented when she woke up to the knock on the door. In future, closely manage the last stretch of trazodone; e.g., if someone comes to the door, unexpectedly, keep her in another room until she’s calm again.