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Trazodone
Trazodone HCl is an antidepressant primarily used to treat major depressive disorder (MDD). It is also frequently prescribed off-label for the treatment of insomnia due to its sedative properties. Trazodone belongs to the class of drugs known as serotonin antagonist and reuptake inhibitors (SARIs), which help increase the levels of serotonin in the brain to improve mood and reduce symptoms of depression. Its sedative effects make it a popular choice for managing sleep disturbances associated with depression and anxiety.
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Frequently Asked Questions
How long does it take for Trazodone to start working?
Trazodone may begin to improve sleep within a few days, but its antidepressant effects can take 2 to 4 weeks to be fully felt.
Can Trazodone be used long-term for insomnia?
Trazodone is often used long-term for insomnia, particularly in patients who also have depression. However, it is important to follow your healthcare provider's recommendations regarding its long-term use.
What should I do if I miss a dose of Trazodone?
If you miss a dose, take it as soon as you remember unless it’s close to your next dose. Do not double the dose to make up for a missed one.
Can I stop taking Trazodone abruptly?
No, you should not stop taking Trazodone suddenly. Doing so can cause withdrawal symptoms such as anxiety, irritability, and sleep disturbances. Your doctor will guide you on how to taper off the medication gradually.
Is Trazodone addictive?
While Trazodone is not considered addictive in the same way as benzodiazepines or opioids, it can cause dependence in some individuals, particularly when used long-term for sleep.
Comprehensive Drug Guide
How Does Trazodone Work?
Trazodone works by inhibiting the reuptake of serotonin, increasing its availability in the brain, which helps improve mood and alleviate symptoms of depression. Additionally, it blocks certain serotonin receptors (5-HT2A), which contributes to its sedative effects. This dual action helps patients with both depression and associated sleep disturbances.
What is Trazodone Used For?
Common Dosages
- 50 mg
- 100 mg
- 150 mg
- 300 mg
Typical Dosing
- For depression: The usual starting dose is 150 mg per day, divided into multiple doses. The dose may be gradually increased up to 400 mg daily, depending on the patient's response.
- For insomnia: A lower dose of 25 to 100 mg at bedtime is typically prescribed.
Typical Dosing
FDA Approved Indications
- Major depressive disorder (MDD)
Off-label uses include:
- Insomnia
- Anxiety disorders
- Post-traumatic stress disorder (PTSD)
Off-Label Uses
Who Shouldn't Take Trazodone?
- Hypersensitivity to trazodone or any of its components
- Concurrent use of MAO inhibitors or within 14 days of discontinuing them
Advice From The Pharmacist
- Take Trazodone with food, especially if you are using higher doses, to reduce the risk of dizziness or nausea.
- Avoid alcohol while taking Trazodone, as it can enhance the sedative effects and increase the risk of drowsiness or dizziness.
- Do not stop taking Trazodone suddenly, as this can lead to withdrawal symptoms. Your healthcare provider will guide you on how to taper the dose if necessary.
- Monitor for mood changes or worsening depression, especially in the initial weeks of treatment.
Side Effects of Trazodone
Common Side Effects
- Drowsiness: Feeling sleepy or tired during the day.
- Dry Mouth: A lack of saliva in the mouth may cause discomfort or difficulty swallowing.
- Headache: Mild to moderate pain in the head.
- Nausea: Feeling sick or having an upset stomach.
- Dizziness: Feeling lightheaded or unsteady.
Uncommon/Severe Side Effects
- Priapism (prolonged, painful erections)
- Orthostatic hypotension (sudden drop in blood pressure upon standing)
- Serotonin syndrome (especially if taken with other serotonergic drugs)
- Suicidal thoughts (particularly in young adults and children)
Risks and Warnings of Trazodone
- Risk of Priapism: Trazodone can cause prolonged and painful erections, a condition known as priapism. Seek medical help immediately if this occurs, as it can cause permanent damage if left untreated.
- Serotonin Syndrome: Trazodone can increase the risk of serotonin syndrome, especially when used with other serotonergic drugs such as SSRIs or SNRIs.
- Suicidal Thoughts: Like other antidepressants, trazodone may increase the risk of suicidal thoughts or behaviors, particularly in younger individuals. Close monitoring during the early stages of treatment is important.
Interactions with Trazodone
Common Drug Interactions
- MAO inhibitors: Using Trazodone with MAO inhibitors can lead to serious and potentially life-threatening interactions, including serotonin syndrome.
- CNS depressants: Combining trazodone with alcohol, benzodiazepines, or other sedatives can increase the risk of drowsiness and respiratory depression.
- SSRIs/SNRIs: Using trazodone with other antidepressants can increase the risk of serotonin syndrome.
Alternatives to Trazodone
- Mirtazapine (Remeron): An antidepressant with sedative effects often used to treat depression and insomnia.
- Amitriptyline: A tricyclic antidepressant that is also used off-label for insomnia.
- Sertraline (Zoloft): A selective serotonin reuptake inhibitor (SSRI) used for depression and anxiety.
- Zolpidem (Ambien): A sedative-hypnotic used primarily for insomnia, not depression.
