Trazodone

Trazodone is an antidepressant used to treat depression and some other mental disorders.

Overview:

Trazodone is an antidepressant medication used to treat depression, anxiety, schizophrenia, and sometimes insomnia. It is often sold under the brand name Oleptro, though a number of pharmaceutical producers make and sell it under different names.

Trazodone is a serotonin modulator, which means that it works by moderating the level of serotonin in the brain. It is both a 5-HT agonist and 5-HT reuptake inhibitor. This means that it works by both facilitating the delivery of and preventing the delivery of messages sent between serotonin and neurons. This process helps to alleviate symptoms of depression and anxiety, as it balances out serotonin levels that may otherwise be causing extreme emotions or agitation.

Trazodone was discovered in the 1960s by Angelini research laboratories in Italy. In Italy, it is sold in a variety of forms (tablets, injections, etc.) and is widely available as part of the government healthcare system. It became widely popular as a new form of anti-depressant because it generally produces fewer side effects and is less risky in terms of overdose than previously used anti-depressants. Unlike previously-used anti-depressants, Trazodone tends to cause less sexual symptoms, does not lead to weight gain over time, is harder to overdose on and tends to be less fatal when overdosed on, has less risk of causing insomnia, and can be produced more cheaply, making it widely available and affordable.

Trazodone is currently available in a number of regions, including Europe, the United States, and Latin America, where it is sold under various name brands.

Trazodone is also currently being experimented with to treat a number of other conditions. While not yet FDA-approved, in the future, Trazodone may be used to also treat Alzheimer’s, Parkinson’s, and MS, among others. These uses are currently being tested in animals, and you should not take Trazodone to treat these conditions. Talk to your doctor about your specific needs to see if Trazodone is right for you.

Conditions treated:

  • unipolar depression
  • anxiety disorder
  • schizophrenia
  • uncontrolled movements that are side effects of other medications
  • insomnia (in some countries)

Other conditions that Trazodone is not FDA-approved for, but is still being investigated in effectiveness for include:

  • diabetic neuropathy
  • migraines
  • bulimia nervosa
  • obsessive-compulsive disorder (OCD)
  • alcohol withdrawal
  • sleep disturbances, especially in patients with Alzheimer's disease

Type of medicine:

  • anti-depressant

Side Effects:

Generally, Trazodone produces very few or mild side effects. This is why it has become one of the most popular anti-depressants on the market. However, there are some side effects to be aware of, and some to watch out for, as they may need to be brought to the attention of a medical professional and can potentially be life-threatening.

Because Trazodone is made to treat conditions like anxiety, its main intent is to have relaxing, sedative effect. While this can help to treat such conditions and is relatively harmless in patients who are hyperactive or anxious, it can also cause some patients to become overly drowsy or fatigued. While mild fatigue is not dangerous, if you find yourself overly tired and unable to function in your day to day duties, Trazodone may not be the right medication for you. Talk to your doctor if you experience extreme fatigue, and do not drive or operate heavy machinery until you know how Trazodone may affect you.

Other common, less serious side effects include muscle ache, headache, drowsiness, changes in vision, blurred vision, confusion, loss of appetite, loss of sex drive, ringing in ears, constipation, nausea, and dry mouth. While none of these side effects are dangerous, they may be uncomfortable and might mean that Trazodone is not the right choice for you. Talk to your doctor about the pros and cons of taking Trazodone if you experience any of these side effects.

There are also more serious side effects, which, if present, should be brought to the attention of a medical professional immediately. Trazodone can cause withdrawal, and you should not stop taking it suddenly. Instead, seek medical attention immediately, so that a doctor can decide what course of action is best.

If you experience a painful erection or an erection that lasts more than six hours, call your doctor immediately. This may be a sign of a more serious condition. Any unusual sexual side effects should be brought to the attention of your doctor.

You should also call your doctor if you have any serious side effects that are similar to and may indicate an allergic reaction to the medicine. Side effects that may indicate you are allergic include severe rashes/hives, trouble breathing, and swelling. Any symptoms you may experience when you have an allergic reaction to something else may also be a sign that you are allergic to something in Trazodone.

Additionally, you should alert a doctor if any symptoms of the condition or conditions Trazodone is intended to treat worsen. This can include depression, suicidal thoughts, anxiety, panic attacks, and difficulty sleeping.

Other serious side effects include seizures, fainting, unusual bleeding, irregular heartbeat, serious fever, severe chest pain, and tremors. If you experience any of these side effects, alert a doctor immediately.

This list is not exhaustive, and you should alert your doctor if you experience any symptoms that are out of the ordinary. Even if they are not serious, your doctor should be aware of how your body reacts to taking Trazodone, in order to provide you with the best advice and most effective treatment.

Dosage:

Trazodone is most commonly a tablet that is taken orally. In some countries, it may also come in other forms, such as injections. In the U.S., it is sold in both an immediate release and extended release form, in various strengths. Sometimes, these tablets can be split apart to make lower dosages. This should only be done under the guidance and recommendation of your doctor though. The tablet should not be crushed or chewed when being ingested. Swallow it whole. There are various dosages that can be taken depending on whether the tablet is immediate or extended release, the type of condition it is being used to treat, and the age and reactions of the patient. Talk to your doctor about which form of medication works best for you.

Generally, doctors will start by prescribing lower dosages and gradually increasing this dosage until they find a level that works for the patient. It's important to note that Trazodone takes some adjustment time, and conditions it is intended to treat may worsen or stay the same when first starting Trazodone. This is why dosages are increased only every few days, after you have had some time to adjust to the medication. After you have been taking Trazodone for awhile, your doctor may still prescribe lowering your dosage. Trazodone is not always needed in the same dosages over the course of your life, and your doctor will monitor you to ensure that dosages are being adjusted accordingly. If you need to stop taking Trazodone, your doctor will help lower your dosage gradually, to avoid withdrawal symptoms and safely wean you off Trazodone. Always follow your doctor's prescribed dosage and instructions for taking Trazodone.

For immediate release tablets in adults, the average starting dosage in adults is 150 mg. This dosage is usually increased in increments of 50 mg every few days. The maximum recommended dosage is 400 mg per day, though this can be increased up to 600 mg for inpatients. These dosages should be divided up throughout the day, no matter what strength is being taken. Immediate release tablets should be taken after a meal or snack. Talk to your doctor about exactly what dosages you should take throughout the day and at what times, and try to take these dosages at around the same times each day.

Extended release tablets for adults also generally start at 150 mg, but are taken once daily at about the same time every day. It's advised that they are taken in the evening or before bed, and on an empty stomach. This dosage can be increased by 75 mg every few days if needed. 375 mg is the maximum advised daily dose.

Pediatric Dosages:

In some cases, Trazodone is also used in children for treating depression (though this is not yet FDA-approved). Children under the age of 6 should never take Trazodone.

In these cases, for immediate release tablets, the recommended daily dose for 6- to 12-year-olds is 1.5 mg to 2 mg per day, divided up into multiple doses over the course of the day. This dosage can be increased up to 6 mg per day, still divided into even doses throughout the day. Just like the adult recommendation, these dosages should be taken after a meal or snack.

For immediate release tablets in patients between the ages of 12 and 18, the initial recommended dose is 25 mg to 50 mg per day, taken in multiple doses over the course of the day. This may be increased to 100 mg to 150 mg, also divided into multiple doses over the day. Like other age groups, it is recommended that Trazodone be taken after meals or food.

Overdose:

It is possible to overdose on Trazodone, though the risk is less common than it is for many other anti-depressants. Overdose can occur either because of someone taking too much Trazodone in one dosage or because of someone mixing Trazodone with other medications. Patients sometimes do this either accidentally, as they take medicine to treat another condition along with Trazodone, or purposefully to achieve a high. If you are taking Trazodone, you should always consult your doctor before taking any new or additional medications, even common medications for pain, cold, congestion, or the flu.

Trazodone is relatively safe in terms of overdose, and fatalities as a result of overdose are rare. Still, overdosing is a serious problem and needs to be addressed as soon as possible to avoid long-term consequences. If you have overdosed, you should seek medical attention immediately. There are treatments that can be administered to combat overdose, though these are usually only effective within the first hour or so. However, if you do overdose, you should remain in the hospital for support and evaluation while you recover. This can ensure you make a full recovery without any permanent damage.

Interactions:

Trazodone may interact poorly with a variety of other medications. Before starting Trazodone, you should talk to your doctor about what other medications you are taking and whether Trazodone is safe or the right choice to take with those medications.

Trazodone may especially interact poorly with other medicines that induce sleep or cause drowsiness, as it is an anti-depressant. If you are taking other medications that may make you drowsy, such as sleeping pills, pain medications that make you tired, muscle-relaxers, and medications used to treat other psychiatric disorders, tell your doctor before beginning Trazodone. Also, monitor your tiredness levels what taking Trazodone. If you find yourself becoming especially fatigued, you should alert your doctor immediately.

Other potentially dangerous interactions include:

  • other antidepressants, such as Anagrelide, droperidol, methadone, and ondansetron
  • antibiotics, such as azithromycin, clarithromycin, erythromycin, levofloxacin, moxifloxacin, and pentamidine
  • medicines used to treat cancer, such as arsenic trioxide and vandetanib
  • anti-malaria medications, such as chloroquine and halofantrine
  • medicines used to normalize heart rhythm, such as amiodarone, disopyramide, dofetilide, dronedarone, flecainide, ibutilide, quinidine, and sotalol
  • blood thinners, such as aspirin and ibuprofen
  • cough and cold medicines (even over the counter)
  • medications used to treat AIDs and HIV, such as atazanavir (Reyataz), indinavir (Crixivan), and nelfinavir (Viracept)
  • seizure medications, such as carbamazepine (Tegretol), ethosuximide (Zarontin), phenobarbital (Luminal, Solfoton), and phenytoin (Dilantin)
  • other medicines used to treat other psychiatric disorders, such as chlorpromazine, haloperidol, pimozide, and thioridazine

Trazodone may also interact with medications not on this list. Before beginning Trazodone, you should consult with your doctor about all medications you currently take and what medications you may use rarely (like certain painkillers or cold medications). Never begin taking another medication while on Trazodone before consulting with a medical professional.

Warnings:

There are a few FDA-mandated safety warnings for Trazodone, which are often explained on the box. These warnings are important to understand before you begin taking Trazodone.

First, Trazodone may increase the risk of suicide, especially when you first begin taking it. This is especially true for patients under the age of 24 taking Trazodone. If you begin Trazodone and continue to or begin to have suicidal thoughts, you should consult a medical professional immediately.

When Trazodone is used for treating depression, it may make symptoms of depression worse before they get better. You and your doctor should watch out for increased aggression, irritability, panic attacks, anxiety and extreme worry, restlessness, abnormal excitement, and thoughts of suicide when you first begin taking Trazodone. Be aware of what symptoms your disorder causes before starting Trazodone, and be aware whether or not these symptoms continue or worsen. If any of these occur or worsen, you should tell someone immediately. It may be a sign that your dosage needs to be adjusted or you should try a different medication.

You should be careful not to stop taking Trazodone without proper medical guidance. Suddenly stopping Trazodone could lead to withdrawal symptoms. A doctor can help you to safely stop using Trazodone.

In some cases, Trazodone has been abused as a form of drug. High doses of Trazodone can induce a high or hallucinations. If you or someone you know is abusing Trazodone, alert someone immediately. Abuse of Trazodone can lead to overdose, which can be potentially lethal.

Storage:

Trazodone should be stored in its original packaging, sealed tightly, and kept somewhere where children cannot reach and open it. The container it comes in should always have a child safety lock. The medication should be stored at room temperature, preferably in a bedroom or kitchen, and out of sunlight or other areas that could cause extreme heat or moisture. When you put Trazodone away, ensure that the child safety lock on the bottle is properly in place.

If you need to dispose of Trazodone, you should do so by taking it to a medication take-back facility or program. If you cannot find a medicine take-back program near you, you can also consult the FDA's approved list of methods for disposing of this medicine. You should not throw Trazodone in the garbage or flush it down the toilet.

If you cannot find a medicine take-back program, the FDA recommends reading the bottle label carefully for any instructions about how to properly dispose of the medication. You can mix the medicine with dirt, kitty litter, or coffee grounds and place them together in a sealed container, which you can then throw away in your household disposal unit. Do not crush the pills.

When done with a prescription of Trazodone, the medicine container can be thrown away with your usual garbage, but you should first be sure to scratch out all of your personal details on the container before doing so.

Summary:

In summary, Trazodone is an effective and relatively safe medication for the treatment of depression and some other psychiatric disorders. Like all medications, it is important that you consult your doctor before beginning treatment with Trazodone.

Trazodone generally has less and less serious side effects than other anti-depressants, which is why it has become one of the most popular medications for treating depression and other mental disorders. It does, however, still have some side effects. Milder side effects include fatigue, headaches, drowsiness, and muscle aches.

Serious side effects include painful erections, symptoms similar to those from an allergic reaction, extreme fatigue, seizures, and suicidal thoughts. If you experience any of these more serious side effects, you should speak to a doctor immediately. Never stop taking Trazodone without medical guidance, as this can cause withdrawal symptoms.

Trazodone is available in both immediate and extended release form, and should be taken orally following the instructions of your doctor.

There are a number of other medications that should not be mixed with Trazodone, so you should familiarize yourself with its interactions and warnings before starting Trazodone. You should always tell your doctor what medications you are currently taking and never take a new medication with Trazodone without consulting a medical professional first.

Trazodone is relatively safe and has a lower risk of overdose than other anti-depressants. It does, however, still have the potential to be abused and can be lethal when overdosed or taken with other medications. If you or someone you know are not following a doctor's instructions on how to take Trazodone, you should alert someone immediately.

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Last Reviewed:
December 22, 2017
Last Updated:
December 22, 2017
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