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Will trazodone help me sleep?

Medically reviewed by Sally Chao, MD. Last updated on Aug 31, 2021.

Official answer

by Drugs.com

Trazodone can help you sleep, and sleepiness is a side effect of the medication. Doctors will sometimes prescribe trazodone for insomnia, particularly for people who have both depression and difficulty sleeping.

However, the benefit of taking trazodone for insomnia is not well established. The American Academy of Sleep Medicine recommends that trazodone and other antidepressants only be used for insomnia when other treatments have failed or in patients who also have depression.

Trazodone is not intended to be a sleeping pill. It is meant to be used to help manage depression, and it is not approved by the U.S. Food and Drug Administration (FDA) to treat insomnia, though doctors may prescribe it off-label for insomnia.

  • If your doctor prescribes trazodone for insomnia, he or she will likely direct you to take the medication shortly before you go to bed.
  • The drug’s effects peak around 30 minutes to 2 hours after it is taken.
  • For sleep problems, doctors typically prescribe low doses of trazodone, between 25 and 100 milligrams (mg). In this low-dose range, trazodone is thought to help encourage sleep while limiting the risk of daytime sleepiness.
  • As a treatment for depression, higher doses of trazodone (150-600 mg) are needed.

Your doctor will tell you how long treatment with trazodone will last. Research on the long-term efficacy and safety of trazodone for insomnia is limited. The existing evidence suggests that trazodone should only be used as a short-term solution for sleep problems, as very little research has been done on continuation treatment.

Trazodone is not recognized by the FDA as a controlled substance, meaning that the existing evidence does not suggest that it has a high potential for abuse or addiction. However, no extensive research has been done to study the abuse potential of trazodone, particularly for off-label uses such as insomnia.

In clinical trials, people taking trazodone for depression showed no signs of addictive behavior related to the drug. Compared to some other medications used to treat sleep problems, such as benzodiazepines, trazodone is thought to carry a lower risk of abuse.

However, you may have difficulty sleeping after discontinuing trazodone, particularly if you stop taking the medication suddenly. Sudden discontinuation of trazodone can cause anxiety and agitation and make it difficult to fall asleep or stay asleep. Your doctor will be able to help you avoid these symptoms by advising you to taper off the medication with gradually lower doses.

References
  1. National Health Service (NHS). Trazodone. Last reviewed: December 13, 2018. Available at: https://www.nhs.uk/medicines/trazodone/. [Accessed August 3, 2021].
  2. Everitt H, Baldwin DS, Stuart B, et al. Antidepressants for insomnia in adults. Cochrane Database of Systematic Reviews 2018, Issue 5. Art. No.: CD010753. https://doi.org/10.1002/14651858.CD010753.pub2.
  3. Ringdahl EN, Pereira SL, Delzell JE Jr. Treatment of primary insomnia. J Am Board Fam Pract. 2004;17(3):212-219. https://doi.org/10.3122/jabfm.17.3.212.
  4. Sateia MJ, Buysse DJ, Krystal AD, et al. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2017;13(2):307–349. https://doi.org/10.5664/jcsm.6470.
  5. Ramakrishnan K, Scheid DC. Treatment options for insomnia. Am Fam Physician. 2007;76(4):517-526. https://www.aafp.org/afp/2007/0815/p517.html.
  6. Lieberman JA. Update on the safety considerations in the management of insomnia with hypnotics: incorporating modified-release formulations into primary care. Prim Care Companion J Clin Psychiatry. 2007;9(1):25-31. doi:10.4088/pcc.v09n0105 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1894851/.
  7. Patel D, Steinberg J, Patel P. Insomnia in the Elderly: A Review. J Clin Sleep Med. 2018;14(6):1017-1024. Published 2018 Jun 15. https://dx.doi.org/10.5664%2Fjcsm.7172.
  8. Jaffer KY, Chang T, Vanle B, et al. Trazodone for Insomnia: A Systematic Review. Innov Clin Neurosci. 2017;14(7-8):24-34. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842888/.
  9. U.S. Food and Drug Administration (FDA). DESYREL® (trazodone hydrochloride) tablets, for oral use. Last updated June, 2017. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018207s032lbl.pdf. [Accessed August 3, 2021].
  10. Schroeck JL, Ford J, Conway EL, et al. Review of Safety and Efficacy of Sleep Medicines in Older Adults. Clin Ther. 2016;38(11):2340-2372. https://doi.org/10.1016/j.clinthera.2016.09.010.
  11. U.S. National Library of Medicine MedlinePlus. Trazodone. Last updated April 15, 2017. Available at: https://medlineplus.gov/druginfo/meds/a681038.html. [Accessed August 3, 2021].

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