Trazodone is a prescription medication primarily used to treat major depressive disorder, though it is also commonly prescribed off-label to manage insomnia, anxiety and certain mood-related conditions. It belongs to a class of drugs known as serotonin antagonists and reuptake inhibitors (SARIs), which work by increasing serotonin levels in the brain a neurotransmitter that plays a key role in regulating mood, sleep and emotional balance. By restoring serotonin activity, trazodone helps improve mood, reduce feelings of sadness, and promote better sleep. One of its notable characteristics is its sedative effect which makes it particularly useful for patients experiencing depression accompanied by sleep disturbances.
Trazodone is typically taken orally in tablet form with dosing depending on the condition being treated and the patient’s response. Common side effects may include drowsiness, dizziness, dry mouth, blurred vision and nausea, while more serious but rare risks include irregular heartbeat, low blood pressure, or prolonged and painful erections (priapism). As with other antidepressants, it may increase the risk of suicidal thoughts in young adults, especially during the early stages of treatment. Therefore, trazodone should always be used under medical supervision, with careful monitoring to ensure safety and effectiveness.
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Trazodone
Trazodone is a prescription antidepressant medication used primarily to treat major depressive disorder, and it is also frequently prescribed to help manage insomnia and anxiety-related conditions. It belongs to a class of medications known as serotonin antagonists and reuptake inhibitors (SARIs), which work by balancing serotonin levels in the brain. Serotonin is a neurotransmitter that influences mood, emotions and sleep, and by increasing its availability, trazodone helps improve mood stability and promote restful sleep. Although it is officially approved for depression, many healthcare providers prescribe it in lower doses to treat sleep disturbances because of its calming and sedative effects.
Trazodone is usually taken orally in tablet form, either once daily or in divided doses, depending on the condition being treated. Common side effects may include drowsiness, dizziness, dry mouth, headache, and nausea, while less common but serious side effects can include irregular heartbeat, low blood pressure or a rare condition called priapism, which involves a prolonged and painful erection. Like other antidepressants, trazodone may increase the risk of suicidal thoughts in young people during the initial stages of treatment, so careful monitoring by a healthcare professional is important. Trazodone is widely used for both mood and sleep-related disorders when prescribed and monitored appropriately.
Warnings
You should not take trazodone if you are allergic to it or any of its ingredients or if you are currently being treated with a methylene blue injection. Using trazodone under these conditions may lead to serious health risks. In addition, you must not use this medication if you have taken a monoamine oxidase inhibitor (MAOI) within the past 14 days, as a dangerous drug interaction can occur. MAO inhibitors include medications such as isocarboxazid, linezolid, phenelzine, and tranylcypromine, among others.
Some young people may experience suicidal thoughts when they first begin taking an antidepressant like trazodone. Because of this risk, your doctor will need to monitor your progress through regular check-ups while you are using the medication. Family members and caregivers should also watch for any noticeable changes in mood, behavior, or overall mental health.
Contact your doctor immediately if you notice new or worsening symptoms including:
- Changes in mood or behavior.
- Increased anxiety or panic attacks.
- Difficulty sleeping.
- Feeling impulsive, irritable, agitated, hostile, or aggressive.
- Restlessness or unusual hyperactivity.
- Worsening depression.
- Thoughts about suicide or self-harm.
Do not give trazodone to anyone under 18 years of age without medical advice. This medication is not approved for use in children.
Dosing Information
Usual Adult Dose for Depression
The typical initial dose of trazodone for treating depression is 150 mg per day taken orally in divided doses. The dosage may be increased by 50 mg per day every 3 to 4 days, depending on the patient’s response and tolerance to the medication.
Maximum dose:
- Inpatients: Up to 600 mg per day.
- Outpatients: Up to 400 mg per day.
Comments:
- Patients should be carefully screened for any personal or family history of bipolar disorder, mania, or hypomania before starting treatment.
- When stopping therapy, patients should be monitored for possible withdrawal symptoms.
- After achieving an adequate therapeutic response, the dosage may be gradually reduced based on the patient’s progress and clinical response.
- If excessive drowsiness occurs, a larger portion of the daily dose may be taken at bedtime, or the overall dosage may need adjustment.
- Trazodone should be taken shortly after a meal or a light snack to help improve absorption and reduce stomach discomfort.
Trazodone Side Effects
Get emergency medical help immediately if you notice signs of an allergic reaction to trazodone, such as hives, difficulty breathing, or swelling of the face, lips, tongue or throat.
Stop taking trazodone and contact your doctor right away if you experience a painful erection or an erection lasting 6 hours or longer. This is a medical emergency that could result in a serious condition requiring surgical treatment.
Inform your doctor promptly if you develop any new or worsening symptoms, including changes in mood or behavior, anxiety, panic attacks, trouble sleeping, or feelings of impulsiveness, irritability, agitation, hostility, aggression, restlessness, hyperactivity (mental or physical), worsening depression or thoughts of suicide or self-harm.
Call your doctor at once if you experience:
- Fast or pounding heartbeats, fluttering in the chest, shortness of breath, or sudden dizziness that may feel like fainting.
- Slow heart rate.
- Unusual thoughts or behavior.
- Easy bruising or unusual bleeding.
Signs of low sodium levels in the body, such as headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, or feeling unsteady.
Seek immediate medical attention if you develop symptoms of serotonin syndrome, including agitation, hallucinations, fever, sweating, shivering, rapid heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Common side effects of trazodone may include:
- Drowsiness, dizziness, or tiredness.
- Swelling.
- Weight loss.
- Blurred vision.
- Diarrhea or constipation.
- Stuffy nose.
This is not a complete list of possible side effects, and others may occur. Contact your doctor for medical advice about side effects. You may also report side effects to the FDA at 1-800-FDA-1088.
Which other medications can interact with trazodone?
Using trazodone together with other medications that cause drowsiness may increase sleepiness and slow your breathing or reactions. Consult your doctor before combining trazodone with opioid pain medications, sleeping pills, muscle relaxers, or medicines used to treat anxiety or seizures.
Inform your doctor about all the medications you are currently taking, as many drugs can interact with trazodone. These include:
- Other antidepressants.
- Phenytoin.
- St. John’s wort.
- Tramadol.
- Diuretics (water pills).
- Medications used to treat anxiety, mood disorders, or mental illnesses such as schizophrenia.
- Blood thinners, including warfarin (Coumadin, Jantoven).
- Migraine medications such as sumatriptan (Imitrex), rizatriptan (Maxalt), Treximet, and others.
This is not a complete list of possible drug interactions. Many other prescription medicines, over-the-counter drugs, vitamins, and herbal supplements may also interact with trazodone. Always consult your healthcare provider to ensure safe use.
Conclusion
Trazodone is a widely prescribed antidepressant that plays an important role in treating major depressive disorder and is also commonly used to manage insomnia and certain anxiety-related conditions. By helping to balance serotonin levels in the brain, it supports mood stability, emotional well-being and improved sleep quality. Its sedative properties make it particularly beneficial for patients who experience depression alongside sleep disturbances. However, like all medications, trazodone carries potential risks, including drowsiness, dizziness, low blood pressure, heart rhythm changes, serotonin syndrome and rare but serious conditions such as priapism. It may also increase suicidal thoughts in some individuals, particularly during the early stages of treatment which makes close medical supervision essential. Patients should take trazodone exactly as prescribed, avoid sudden discontinuation without medical advice, and promptly report any unusual or worsening symptoms to their healthcare provider.
