Trazodone

What is trazodone?

Trazodone is a prescription-only antidepressant medication approved to treat depression and anxiety. It belongs to a class of drugs called serotonin modulators.

Trazodone is a serotonin antagonist and reuptake inhibitor (SARI), meaning it blocks serotonin receptors in the brain and prevents serotonin from being reabsorbed. By blocking these receptors, trazodone increases serotonin levels in the brain, which can help improve mood and decrease anxiety.

The drug may be prescribed when other antidepressant medications haven’t been effective or have caused side effects.

What is trazodone used to treat?

Trazodone is used to treat major depressive disorder and anxiety.

It is also sometimes used off-label to treat other conditions. These include panic disorder, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and schizophrenia.

Trazodone is also a sedative, meaning it can help people sleep. In 2017, it was described as being one of the most commonly prescribed sleep aids in the US¹, despite not being approved by the Food and Drug Administration (FDA) for this purpose.

How do you take trazodone?

Trazodone is available as a tablet for oral use. The pill is often taken twice daily with a meal or small snack.

A typical adult starting dose to treat depression is 150mg per day², divided into separate doses. Your doctor may choose to increase your dose by 50mg per day.

The maximum daily dose for adults to treat depression is 600mg for inpatients and 400mg for outpatients.

To help you remember to take your medication, take trazodone at the same time(s) each day.

Take care to follow the recommendations on your prescription label, and ask your doctor or pharmacist to explain any information you don’t understand.

Trazodone should be taken exactly as prescribed. Do not take more or less of it, take it more frequently, or take it for a longer period of time than your doctor has advised.

Consume the pills whole or cut them in half along the scoreline.

Seeing results

Trazodone alleviates symptoms of depression but does not cure it. It may take two weeks² or more to experience the full effects of trazodone.

You should maintain your trazodone dose, even if you start to feel better.

Potential side effects of trazodone

As with any medication, there is a risk of experiencing side effects when taking trazodone.

Some common side effects of trazodone include:

• Drowsiness

• Dry mouth

• Dizziness

• Headache

• Nausea

• Vomiting

Get urgent medical help if you develop any of the following serious side effects:

• Hallucinations

• Chest pain

• Seizures

Like other antidepressant medications, trazodone may cause or worsen suicidal behavior or thoughts. Ensure those around you are aware you are taking an antidepressant, and contact your doctor if you notice changes in your thoughts or behavior.

When taken with some other drugs, like monoamine oxidase inhibitors (MAOIs), trazodone may cause a serious condition called serotonin syndrome. Serotonin syndrome symptoms include:

• Agitation

• Restlessness

• Anxiety

• Muscle rigidity

• Jerky movements

• Tremors

• High blood pressure

• Fast or irregular heart rate

Long-term use of trazodone

Trazodone can be prescribed for long-term use. No evidence shows this is harmful. However, long-term trazodone use may cause dependence and withdrawal effects when the medication is stopped.

Missed doses

If you forget to take your trazodone dose, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one.

Overdoses

It is possible to overdose on trazodone. This occurs when someone takes too much of the medication at once. Symptoms of a trazodone overdose include:

• Confusion

• Drowsiness

• Slowed breathing

Taking too much trazodone may cause a coma.

If you or someone else has overdosed on trazodone, seek urgent medical attention.

What to discuss with your doctor before taking trazodone

Before you start taking trazodone, discuss what the drug is and what it is used for with your doctor. Ask your doctor about potential side effects so you know what to expect.

You should also discuss any other medications you are taking, including vitamins and herbal products. Your doctor must have this information to ensure you don’t experience harmful interactions.

You should also let your doctor know if you have liver or kidney disease, as trazodone can affect these organs. Tell your doctor about any other medical conditions you have.

Let your doctor know if you are pregnant or breastfeeding. They should also be aware if you’re planning to become pregnant while taking the medication.

Stopping trazodone

If you have been taking trazodone for an extended period of time, your doctor may taper off the medication gradually. This is because abruptly stopping trazodone can lead to unpleasant withdrawal effects, such as anxiety, sweating, and nausea.

Trazodone and pregnancy

Trazodone is considered a pregnancy category C drug³, which means there may be potential risks to an unborn baby as shown in animal studies. The drug can cause sedation, low blood pressure, and problems with breathing, all of which could be harmful during pregnancy.

The drug is known to cross the placenta and can be detected in umbilical cord blood, but there are few studies on the effects of trazodone during pregnancy. More research is needed.

If you are pregnant or thinking about becoming pregnant, talk to your doctor before starting trazodone.

There is a possibility that trazodone could cause withdrawal symptoms in a newborn baby, although this has not been well studied⁴. Your doctor may decide the benefits of taking the drug outweigh the risks, and they will work with you to make the best decision for you and your baby.

If you are breastfeeding, trazodone can also be passed on to the baby in breast milk. Again, there is limited information available on this, but it is generally recommended that breastfeeding mothers avoid taking trazodone if possible.

Interactions with other drugs

Trazodone oral tablets can interact with a number of different drugs. Taking trazodone with some drugs can reduce the drug’s effectiveness or exacerbate negative effects.

The drugs listed below may interact with trazodone. This list does not include all of the medications that may interact with trazodone:

• Central nervous system (CNS) depressants

• Warfarin (Jantoven and Coumadin)

• Nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin

• Antidepressants

• Digoxin (Digitek, Lanoxin, and others)

• Phenytoin (Phenytek and Dilantin)

• Ketoconazole (Nizoral) or ritonavir (Norvir)

• Carbamazepine (Tegretol, Epitol, and others)

Before using trazodone, inform your doctor and pharmacist about any prescription, over-the-counter, or other medications you are taking. Inform them of any vitamins, herbs, or supplements you use. Sharing this information can help you avoid potentially harmful interactions.

Ask your doctor or pharmacist if you have any concerns regarding potential medication interactions.

Allergy information

Don’t take trazodone if you are allergic to it or any of its ingredients. The active ingredient is trazodone hydrochloride.

Trazodone can cause a severe allergic reaction. Symptoms may include rash, itching, swelling, dizziness, shortness of breath, and trouble breathing. If you experience any of these symptoms, stop taking the drug and seek medical help immediately.

Clinical trial history⁵

Trazodone was approved by the FDA in 1981⁶.

The efficacy and safety of trazodone hydrochloride were established from inpatient and outpatient trials of the trazodone immediate-release formulation in the treatment of a major depressive disorder.

What You Need to Know About Major Depressive Disorder

Tips and advice for taking trazodone

These tips can help you take trazodone safely and effectively:

• Start with a low dose and increase gradually, as needed.

• Take with food to reduce the risk of stomach upset.

• Avoid drinking alcohol while taking trazodone.

• Do not drive or operate heavy machinery until you know how trazodone affects you.

• Stop taking trazodone and seek medical help if you experience an allergic reaction (such as rash, hives, difficulty breathing, swelling of the lips, tongue, or face) or other serious side effects.

Trazodone can be an effective medication for treating depression and anxiety. However, it is important to take it exactly as prescribed.

If you have any questions or concerns about Trazodone, be sure to speak with your doctor.