Desyrel Side Effects

Generic Name: trazodone

Note: This page contains information about the side effects of trazodone. Some of the dosage forms included on this document may not apply to the brand name Desyrel.

Not all side effects for Desyrel may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to trazodone: oral tablet, oral tablet extended release

In addition to its needed effects, some unwanted effects may be caused by trazodone (the active ingredient contained in Desyrel). In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking trazodone:

More common
  • Blurred vision
  • confusion
  • dizziness
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • lightheadedness
  • sweating
  • unusual tiredness or weakness
Less common
  • Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • confusion about identity, place, and time
  • decreased concentration
  • fainting
  • general feeling of discomfort or illness
  • headache
  • lack of coordination
  • muscle tremors
  • nervousness
  • pounding in the ears
  • shortness of breath
  • slow or fast heartbeat
  • swelling
Rare
  • Skin rash
  • unusual excitement

Some of the side effects that can occur with trazodone may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common
  • Dry mouth (usually mild)
  • muscle or bone pain
  • trouble sleeping
  • trouble with remembering
  • unpleasant taste
Less common
  • Constipation
  • continuing ringing or buzzing or other unexplained noise in the ears
  • diarrhea
  • hearing loss
  • muscle aches or pains
  • weight loss

For Healthcare Professionals

Applies to trazodone: compounding powder, oral tablet, oral tablet extended release

Nervous system

Nervous system side effects are common and include drowsiness and sedation in as many as 50% of treated patients. Dizziness (10% to 30%), sleep abnormalities, headache, fatigue and, more rarely, seizures, dystonia, akathisia, myoclonus, palinopsia (persistence or reappearance of an image of a recently viewed object), and extrapyramidal symptoms have been reported. One case of serotonin syndrome has been reported which is believed to have been precipitated by the combination of venlafaxine and trazodone (the active ingredient contained in Desyrel) [Ref]

Nearly all selective serotonin reuptake inhibitors, mixed serotonin/norepinephrine reuptake inhibitors, and tricyclic antidepressants cause sleep abnormalities to some extent. These antidepressants have marked dose-dependent effects on rapid eye movement (REM) sleep, causing reductions in the overall amount of REM sleep over the night and delays the first entry into REM sleep (increased REM sleep onset latency (ROL)), both in healthy subjects and depressed patients. The antidepressants that increase serotonin function appear to have the greatest effect on REM sleep. The reduction in REM sleep is greatest early in treatment, but gradually returns towards baseline during long-term therapy; however, ROL remains long. Following discontinuation of therapy the amount of REM sleep tends to rebound. Some of these drugs (i.e., bupropion, mirtazapine, nefazodone, trazodone, trimipramine) appear to have a modest or minimal effect on REM sleep.[Ref]

Psychiatric

Psychiatric side effects have been reported and include mania, paranoia, hypomania (during and following therapy), increased libido, delirium, agitation, psychosis, hallucinations and self- destructive behavior.[Ref]

Cardiovascular

Some investigators have suggested that trazodone (the active ingredient contained in Desyrel) exerts fewer adverse cardiovascular effects than many other antidepressants.[Ref]

Cardiovascular side effects including arrhythmias, hypotension, peripheral edema, postural hypotension, ventricular ectopy, ventricular tachycardia, torsades de pointes, rapid atrial fibrillation, heart block, and other conduction abnormalities have been reported.[Ref]

Genitourinary

Priapism has been rarely reported (0.01% to 0.1%). Priapism has occurred with doses of 50 to 150 mg daily and typically within the first 28 days of treatment. Approximately one-third of affected individuals have required surgical intervention. It has been suggested that trazodone (the active ingredient contained in Desyrel) s alpha-adrenergic blocking properties may contribute to the induction of priapism.

One case of spontaneous orgasms in an elderly postmenopausal woman has also been reported.[Ref]

Genitourinary side effects including priapism, clitoral priapism, ejaculatory inhibition, and anorgasmia have been reported.[Ref]

Other

Anticholinergic (and possibly alpha-adrenergic blocking) side effects have been reported, although much less frequently than with many other antidepressants. The effects reported include dry mouth, blurred vision, constipation, and urinary retention.[Ref]

Hepatic

Hepatic side effects including cases of chronic active hepatitis and drug-induced hepatotoxicity have been reported rarely.[Ref]

One case of severe hepatotoxicity followed a four day course of trazodone therapy.[Ref]

Dermatologic

Dermatologic side effects including erythema multiforme, leukocytoclastic vasculitis, pustular psoriasis, drug eruptions, and acute peripheral edema have been reported rarely.[Ref]

Hematologic

Hematologic side effects have included alterations in laboratory studies such as significant decreases in hematocrit, hemoglobin, red blood cell count, serum cholesterol, serum calcium, and serum albumin levels. Pseudoanemia (laboratory findings suggestive of anemia without pathologic significance) has been reported in 36% of treated patients.[Ref]

Endocrine

Endocrine side effects have included hyperprolactinemia and hyponatremia (in association with the syndrome of inappropriate secretion of antidiuretic hormone).[Ref]

Gastrointestinal

Gastrointestinal side effects have included dry mouth (up to 34%) and constipation.[Ref]

References

1. Lefkowitz D, Kilgo G, Lee S "Seizures and trazodone therapy." Arch Gen Psychiatry 42 (1985): 523

2. Mendelson WB "A review of the evidence for the efficacy and safety of trazodone in insomnia." J Clin Psychiatry 66 (2005): 469-76

3. Albanese A, Rossi P, Altavista MC "Can trazodone induce parkinsonism?" Clin Neuropharmacol 11 (1988): 180-2

4. Demuth GW, Breslow RE, Drescher J "The elicitation of a movement disorder by trazodone: case report." J Clin Psychiatry 46 (1985): 535-6

5. Workman EA, Tellian F, Short D "Trazodone induction of migraine headache through mCPP." Am J Psychiatry 149 (1992): 712

6. Lanes T, Ravaris CL "Prolonged ECT seizure duration in a patient taking trazodone." Am J Psychiatry 150 (1993): 525

7. Kramer MS, Marcus DJ, DiFerdinando J, Dewey D "Atypical acute dystonia associated with trazodone treatment." J Clin Psychopharmacol 6 (1986): 117-8

8. Bowdan ND "Seizure possibly caused by trazodone HCl." Am J Psychiatry 140 (1983): 642

9. Hohly EK, Martin RL "Increased seizure duration during ECT with trazodone administration." Am J Psychiatry 143 (1986): 1326

10. Patel HC, Bruza D, Yeragani V "Myoclonus with trazodone." J Clin Psychopharmacol 8 (1988): 152

11. Hughes MS, Lessell S "Trazodone-induced palinopsia." Arch Ophthalmol 108 (1990): 399-400

12. TeslerMabe CS, Wilkes TCR "Acute dystonic reaction with trazodone." Can J Psychiatry 43 (1998): 1053

13. "Product Information. Desyrel (trazodone)." Bristol-Myers Squibb, Princeton, NJ.

14. Zubenko GS, Cohen BM, Lipinski JFJr "Antidepressant-related akathisia." J Clin Psychopharmacol 7 (1987): 254-7

15. Tasini M "Complex partial seizures in a patient receiving trazodone." J Clin Psychiatry 47 (1986): 318-9

16. Sullivan G "Increased libido with trazodone." Am J Psychiatry 144 (1987): 967

17. Sullivan G "Increased libido in three men treated with trazodone." J Clin Psychiatry 49 (1988): 202-3

18. Warren M, Bick PA "Two case reports of trazodone-induced mania." Am J Psychiatry 141 (1984): 1103-4

19. Perse T, Greist JH "Self-destructive behavior in a patient taking trazodone." Am J Psychiatry 141 (1984): 1646-7

20. Zmitek A "Trazodone-induced mania." Br J Psychiatry 151 (1987): 274-5

21. Damlouji NF, Ferguson JM "Trazodone-induced delirium in bulimic patients." Am J Psychiatry 141 (1984): 434-5

22. Kraft TB "Psychoses following trazodone administration." Am J Psychiatry 140 (1983): 1383-4

23. Jabeen S, Fisher CJ "Trazodone-induced transient hypomanic symptoms and their management." Br J Psychiatry 158 (1991): 275-8

24. Gartrell N "Increased libido in women receiving trazodone." Am J Psychiatry 143 (1986): 781-2

25. Theilman SB, Christenbury MM "Hypomania following withdrawal of trazodone." Am J Psychiatry 143 (1986): 1482-3

26. Knobler HY, Itzchaky S, Emanuel D, Mester R, Maizel S "Trazodone-induced mania." Br J Psychiatry 149 (1986): 787-9

27. Lennhoff M "Trazodone-induced mania." J Clin Psychiatry 48 (1987): 423-4

28. van de Merwe TJ, Silverstone T, Ankier SI, Warrington SJ, Turner P "A double-blind non-crossover placebo-controlled study between group comparison of trazodone and amitriptyline on cardiovascular function in major depressive disorder." Psychopathology 17 (1984): 64-76

29. Vlay SC, Friedling S "Trazodone exacerbation of VT." Am Heart J 106 (1983): 604

30. McCracken J, Kosanin R "Trazodone administration during ECT associated with cardiac conduction abnormality." Am J Psychiatry 141 (1984): 1488-9

31. Aronson MD, Hafez H "A case of trazodone-induced ventricular tachycardia." J Clin Psychiatry 47 (1986): 388-9

32. Glassman AH "The newer antidepressant drugs and their cardiovascular effects." Psychopharmacol Bull 20 (1984): 272-9

33. White WB, Wong SH "Rapid atrial fibrillation associated with trazodone hydrochloride." Arch Gen Psychiatry 42 (1985): 424

34. Spivak B, Radvan M, Shine M "Postural hypotension with syncope possibly precipitated by trazodone." Am J Psychiatry 144 (1987): 1512-3

35. Himmelhoch JM, Schechtman K, Auchenbach R "The role of trazodone in the treatment of depressed cardiac patients." Psychopathology 17 (1984): 51-63

36. Barrnett J, Frances A, Kocsis J, Brown R, Mann JJ "Peripheral edema associated with trazodone: a report of ten cases." J Clin Psychopharmacol 5 (1985): 161-4

37. Rausch JL, Pavlinac DM, Newman PE "Complete heart block following a single dose of trazodone." Am J Psychiatry 141 (1984): 1472-3

38. Irwin M, Spar JE "Reversible cardiac conduction abnormality associated with trazodone administration." Am J Psychiatry 140 (1983): 945-6

39. Lippmann S, Bedford P, Manshadi M, Mather S "Trazodone cardiotoxicity." Am J Psychiatry 140 (1983): 1383

40. Pellettier JR, Bartolucci G "Trazodone and cardiovascular side effects." J Clin Psychopharmacol 4 (1984): 119

41. Vitullo RN, Wharton JM, Allen NB, Pritchett EL "Trazodone-related exercise-induced nonsustained ventricular tachycardia." Chest 98 (1990): 247-8

42. Janowsky D, Curtis G, Zisook S, Kuhn K, Resovsky K, Le Winter M "Trazodone-aggravated ventricular arrhythmias." J Clin Psychopharmacol 3 (1983): 372-6

43. Janowsky D, Curtis G, Zisook S, Kuhn K, Resovsky K, Le Winter M "Ventricular arrhythmias possibly aggravated by trazodone." Am J Psychiatry 140 (1983): 796-7

44. Sacks M, Miller F, Gunn J, Paul E, Sellew A "Unusual erectile activity as a side effect of trazodone." Hosp Community Psychiatry 36 (1985): 298

45. Hanno PM, Lopez R, Wein AJ "Trazodone-induced priapism." Br J Urol 61 (1988): 94

46. Jani NN, Wise TN, Kass E, Sessler A "Trazodone and anorgasmia." Am J Psychiatry 145 (1988): 896

47. Purcell P, Ghurye R "Trazodone and spontaneous orgasms in an elderly postmenopausal woman: a case report." J Clin Psychopharmacol 15 (1995): 293-5

48. Jones SD "Ejaculatory inhibition with trazodone." J Clin Psychopharmacol 4 (1984): 279-81

49. Pescatori ES, Engelman JC, Davis G, Goldstein I "Priapism of the clitoris: a case report following trazodone use." J Urol 149 (1993): 1557-9

50. Patt N "More on trazodone and priapism." Am J Psychiatry 142 (1985): 783-4

51. Scher M, Krieger JN, Juergens S "Trazodone and priapism." Am J Psychiatry 140 (1983): 1362-3

52. Raskin DE "Trazodone and priapism." Am J Psychiatry 142 (1985): 142-3

53. Warner MD, Peabody CA, Whiteford HA, Hollister LE "Trazodone and priapism." J Clin Psychiatry 48 (1987): 244-5

54. Montalbetti DJ, Zis AP "Cholinergic rebound following trazodone withdrawal?." J Clin Psychopharmacol 8 (1988): 73

55. Gershon S, Newton R "Lack of anticholinergic side effects with a new antidepressent-- trazodone." J Clin Psychiatry 41 (1980): 100-4

56. Chan CH, Ruskiewicz RJ "Anticholinergic side effects of trazodone combined with another pharmacologic agent." Am J Psychiatry 147 (1990): 533

57. Longstreth GF, Hershman J "Trazodone-induced hepatotoxicity and leukonychia." J Am Acad Dermatol 13 (1985): 149-50

58. Sheikh KH, Nies AS "Trazodone and intrahepatic cholestasis." Ann Intern Med 99 (1983): 572

59. Rettman KS, McClintock C "Hepatotoxicity after short-term trazodone therapy." Ann Pharmacother 35 (2001): 1559-61

60. Chu AG, Gunsolly BL, Summers RW, Alexander B, McChesney C, Tanna VL "Trazodone and liver toxicity." Ann Intern Med 99 (1983): 128-9

61. Beck PL, Bridges RJ, Demetrick DJ, Kelly JK, Lee SS "Chronic active hepatitis associated with trazodone therapy." Ann Intern Med 118 (1993): 791-2

62. Fernandes NF, Martin RR, Schenker S "Trazodone-induced hepatotoxicity: A case report with comments on drug-induced hepatotoxicity." Am J Gastroenterol 95 (2000): 532-5

63. Mann SC, Walker MM, Messenger GG, Greenstein RA "Leukocytoclastic vasculitis secondary to trazodone treatment." J Am Acad Dermatol 10 (1984): 669-70

64. Barth JH, Baker H "Generalized pustular psoriasis precipitated by trazodone in the treatment of depression." Br J Dermatol 115 (1986): 629-30

65. Maguire J, Singh AN "Allergic type response to trazodone." Br J Psychiatry 150 (1987): 271-2

66. Ford HE, Jenike MA "Erythema multiforme associated with trazodone therapy: case report." J Clin Psychiatry 46 (1985): 294-5

67. Cohen LE "Drug eruption secondary to trazodone: a recently introduced antidepressant." J Am Acad Dermatol 10 (1984): 303-5

68. Rongioletti F, Rebora A "Drug eruption from trazodone." J Am Acad Dermatol 14 (1986): 274-5

69. Cohen LE "Drug eruption secondary to trazodone." J Am Acad Dermatol 11 (1984): 526-7

70. Spigset O, hedenmalm K "Hyponatremia in relation to treatment with antidepressants: a survey of reports in the World Health Organization data base for spontaneous reporting of adverse drug reactions." Pharmacotherapy 17 (1997): 348-52

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

Hide
(web3)