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Trazodone Patient Tips

Medically reviewed on Sep 12, 2017 by C. Fookes, BPharm

How it works

  • Trazodone is an antidepressant that may be used to treat insomnia.
  • Experts aren't sure exactly how trazodone works but suggest it improves the symptoms of depression by inhibiting the uptake of serotonin by nerves in the brain. This increases levels of serotonin in the nerve synapse (the space between two nerves).
  • Trazodone has a unique chemical structure and is unrelated to selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCA) or monoamine oxidase inhibitors (MAO inhibitors). It is structurally related to nefazodone. Trazodone and nefazodone belong to the class of drugs known as serotonin modulators.

Upsides

  • Effective for the treatment of major depressive disorder (MDD).
  • May be used “off-label” for insomnia (problems with sleeping) in adults. Off-label means the use is not FDA approved but may be an accepted use.
  • Has not been associated with drug-seeking behavior.
  • Not classified as a controlled substance.
  • Generic trazodone is available which makes trazodone a cost-effective sleep-inducing treatment.

Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Dry mouth, headache, constipation, diarrhea, and sexual dysfunction.
  • Trazodone may cause a discontinuation syndrome if abruptly stopped, symptoms include anxiety, agitation, and sleep disturbances. When the time comes to withdraw trazodone the dosage should be tapered off slowly under a doctor's advice.
  • May increase the risk of suicidal thoughts or behavior in young adults, children, and teenagers within the first months of treatment (similar to other antidepressants).
  • May cause drowsiness or dizziness and affect a person's ability to drive or operate machinery. Alcohol should be avoided.
  • Hyponatremia and low blood pressure (particularly when going from a sitting to a standing position) may occur. Rarely, may cause ECG changes in the heart and priapism (painful erections lasting more than 6 hours in duration).
  • May precipitate a manic episode in people with undiagnosed bipolar disorder.
  • Interaction or overdosage may cause serotonin syndrome (symptoms include mental status changes [such as agitation, hallucinations, coma, delirium]), fast heart rate, dizziness, flushing, muscle tremor or rigidity and stomach symptoms (including nausea, vomiting, and diarrhea).
  • May increase the risk of bleeding, especially if used with other drugs that also increase bleeding risk.
  • May cause lowering of total body sodium (called hyponatremia); elderly people or people taking diuretics or already dehydrated may be more at risk.
  • Rarely causes seizures.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

Bottom Line

Trazodone is mostly used for its sleep-inducing effects (an off-label indication) rather than as an antidepressant. Only generic forms are available which makes it a lot cheaper than some other sleep-inducing alternatives, and it is not classified as a controlled substance. However, it may cause withdrawal symptoms on discontinuation.

Tips

  • Take immediate-acting tablets shortly after a meal or light snack. If approved by your doctor, may take the majority of the dosage at bedtime to limit the side effect of drowsiness.
  • Slow-release tablets should be taken at the same time every day in the late evening, preferably at bedtime, on an empty stomach. The tablets should be swallowed whole unless only half a dose is needed and then they should be broken along the score line. Do not chew or crush slow-release tablets.
  • Your doctor may start you on a lower dosage of trazodone and titrate the dosage up slowly to minimize the risk of developing side effects. Follow his or her instructions.
  • Do not stop trazodone suddenly as withdrawal symptoms may occur. Slow dosage reduction over weeks to months is recommended.
  • Families and caregivers should monitor patients for worsening of depression or suicidal thoughts, particularly during the first few months of therapy, and communicate concerns with the prescriber. Also, monitor for symptoms of serotonin syndrome (agitation, confusion, fast heart rate, muscle rigidity or twitching, heavy sweating, diarrhea).
  • Trazodone hydrochloride tablets should not be used within 14 days of a monoamine oxidase inhibitor (MAOI) drug.
  • Have your pharmacist check for drug interactions.
  • Report any fever, sore throat (or other signs of infection) to a doctor.

Response and Effectiveness

  • Peak concentrations are reached within 1 hour if taken on an empty stomach or 2 hours if taken with food.
  • In clinical studies, approximately 75% of patients saw an improvement in symptoms of depression by the second week of treatment; however, some patients may require at least four weeks for the full effects of trazodone to be noticed.

References

Trazodone [Package Insert]. Revised 07/2017. Sun Pharmaceutical Industries, Inc. https://www.drugs.com/pro/trazodone.html

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Trazodone only for the indication prescribed.

  • Disclaimer: Every effort has been made to ensure that this information is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This drug information does not endorse drugs, diagnose patients or recommend therapy. It is an informational resource designed as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of this information. 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 drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2017 Drugs.com. Revision Date: 2017-09-12 02:48:17

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