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Trazodone

Common Brand Name(s): Desyrel

Common Generic Name(s): trazodone

Pronunciation: TRAYZ-oh-dohn

Drug Classes: antidepressant, serotonin modulator

Availability: prescription only, generic available

How is it used? tablet that is swallowed

What is trazodone?

Trazodone is an antidepressant that belongs to a group of drugs called serotonin receptor antagonists and reuptake inhibitors (SARIs). While trazodone is not a true member of the selective serotonin reuptake inhibitors (SSRIs) class of antidepressants, it does still share many properties of the SSRIs.

Trazodone is used to treat major depressive disorder.

It may help to improve your mood, appetite, and energy level as well as decrease anxiety and insomnia related to depression.

Trazodone works by helping to restore the balance of a certain natural chemical (serotonin) in the brain.

Uses

What is trazodone used for?

Trazodone is used to control symptoms of depression, but it cannot cure depression. Your healthcare provider may start you at a low dose and gradually increase it.

Trazodone increases serotonin activity in your brain. Serotonin is a chemical that normally promotes a feeling of mental wellbeing. Trazodone is also indicated for the treatment of insomnia and anxiety symptoms.

How is trazodone supplied?

Dosage Forms

Tablet, Oral, as hydrochloride:

Generic: 50 mg, 100 mg, 150 mg, 300 mg

Tablet, Extended-release Oral, as hydrochloride:

Generic: 150 mg, 300 mg

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For depression:

For oral dosage form (extended-release tablets):

Adults—At first, 150 milligrams (mg) per day as a single dose. Your doctor may adjust your dose as needed. However, the dose is usually not more than 375 mg per day.

Children—Use and dose must be determined by your doctor.

For oral dosage form (tablets):

Adults—At first, 150 milligrams (mg) per day, given in divided doses. Your doctor may adjust your dose as needed. However, the dose is usually not more than 400 mg per day.

Children—Use and dose must be determined by your doctor.

For Insomnia:

For oral dosage form (tablets):

Adults—At first, 50 milligrams (mg) per day, given in divided doses. Your doctor may adjust your dose as needed. However, the dose is usually not more than 100 mg per day.

Children—Use and dose must be determined by your doctor.

How is Trazodone Administered?

Oral:

Immediate-release tablet: Administer shortly after a meal or light snack; swallow whole or as a half tablet by breaking along the score line.

Extended-release tablet: Take on an empty stomach; swallow whole or as a half tablet without food. Tablet may be broken along the score line, but do not crush or chew.

How should I store trazodone?

Immediate-release tablet: Store at 20ºC to 25ºC (68ºF to 77ºF); excursions permitted between 15ºC to 30ºC (59ºF to 86ºF). Protect from light.

Extended-release tablet: Store at room temperature of 15ºC to 30ºC (59ºF to 86ºF). Protect from light.

Trazodone Ratings

Trazodone has an average rating of 6.3 - 53% of reviewers reported a positive experience, while 31% reported a negative experience.

Condition	Avg. Rating
Insomnia Off-label	6.2
Depression	6.7
Anxiety Off-label	6.6
Sedation	6.7
Fibromyalgia Off-label	7.2
Major Depressive Disorder	6.3
Headache Off-label	3.3
Reflex Sympathetic Dystrophy Syndrome Off-label	7.6

What are the advantages of trazodone for sleep?

First-line treatment for insomnia and other sleeping problems includes non-pharmacological methods like improving sleep hygiene, practicing relaxation methods, and cognitive behavioral therapy (CBT).

If these treatments are ineffective, a doctor may recommend over-the-counter or prescription medications to help you sleep.

A doctor may prescribe trazodone for sleep for several reasons:

Reduced cost: Trazodone may be less expensive than other insomnia drugs because it’s available generically.

Not addictive: Doctors do not consider trazodone to be addictive like other medications, such as benzodiazepines.

May help prevent cognitive decline: Trazodone might help improve slow-wave sleep, which may slow certain types of age-related mental decline like dementia in older adults.

May be better for obstructive sleep apnea (OSA): A 100 mg dose of trazodone may help improve respiratory arousal threshold if you have OSA. This means you may be less likely to wake up during the night.

What are alternatives to Trazodone?

There are a number of medications that your doctor can prescribe in place of Trazodone. Compare a few possible alternatives below.

Trazodone (Desyrel)	Citalopram (Celexa)	Sertraline (Zoloft)
Used for: Major depressive disorder (MDD)	Used for: Depression	Used for: Major depressive disorder (MDD) Obsessive-compulsive disorder (OCD) Panic disorder (PD) Post-traumatic stress disorder (PTSD) Premenstrual dysphoric disorder (PMDD) Social anxiety disorder (SAD)

Side Effects

What are the most common side effects of trazodone?

The most common side effects of trazodone are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

Swelling

Blurred vision

Dizziness

Sleepiness or tiredness

Diarrhea

Stuffy nose

Weight loss

There may be other side effects of trazodone that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of trazodone?

While less common, the most serious side effects of trazodone are described below, along with what to do if they happen.

Severe Allergic Reactions. Trazodone may cause allergic reactions, which can be serious. Stop using trazodone and get help right away if you have any of the following symptoms of a serious allergic reaction.

Breathing problems or wheezing

Racing heart

Fever or general ill feeling

Swollen lymph nodes

Swelling of the face, lips, mouth, tongue, or throat

Trouble swallowing or throat tightness

Itching, skin rash, or pale red bumps on the skin called hives

Nausea or vomiting

Dizziness, feeling lightheaded, or fainting

Stomach cramps

Joint pain

Suicidal Thoughts or Actions. Trazodone or other antidepressants may increase the risk of suicidal thoughts or actions in a small number of children, teenagers, or young adults in the first few months of taking the medicine or when the dose is changed. Depression or other serious mental health conditions are the most important causes of suicidal thoughts or actions. If you or your child is about to harm themselves, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your healthcare provider right away if you have any of the following symptoms.

New or increased thoughts of suicide or death

Suicide attempt

New or increased feelings of anxiety, depression, or other unusual changes in your mood or behavior

Serotonin Syndrome. Serotonin syndrome is when there is too much of a substance called serotonin in your body. Trazodone can cause serotonin syndrome when it is taken alone or with other medicines that affect serotonin. This condition can be life-threatening. Get emergency help if you have any of the following symptoms of serotonin syndrome.

Sweating, fever, or flushing

Confusion

Feeling agitated or restless

Seeing or hearing unusual things

Dizziness

Fast or racing heartbeat

Nausea, vomiting, or diarrhea

Muscle twitching, stiffness, or tremor

Seizures

Heart Rhythm Changes. Trazodone may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take some medicines for other heart rhythm problems. Tell your healthcare provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.

Low Blood Pressure Upon Standing (Orthostatic Hypotension). Trazodone may cause a sudden drop in blood pressure when standing up from a seated or lying position. To help prevent this, be careful not to get up too quickly. If you feel dizzy, sit or lie down right away until the dizziness stops, then take your time getting up again. Tell your healthcare provider right away if you have any of the following symptoms of orthostatic hypotension.

Dizziness, feeling lightheaded, or fainting upon standing

Blurred vision

Confusion

Feeling weak

Abnormal Bleeding. People taking trazodone or other antidepressants may have an increased risk of bleeding or bruising. You may be at higher risk if you are also taking aspirin, a nonsteroidal anti-inflammatory drug (NSAID), like ibuprofen or naproxen, or a blood thinner such as warfarin (Coumadin, Jantoven), apixaban (Eliquis), or rivaroxaban (Xarelto). Tell your healthcare provider if you notice any changes in how easily you bruise or bleed.

Painful, Prolonged Erection (Priapism). Trazodone may cause an unwanted erection that is persistent, painful, and that may occur without sexual arousal. Permanent damage to the penis may occur if priapism is not treated quickly. Stop taking trazodone and get emergency help right away if you have any of the following symptoms of priapism.

Erection lasting for more than 4 hours

Erection that is unrelated to sexual stimulation

Painful or tender penis

Extremely Elevated Mood (Mania). People with bipolar disorder have severe high and low moods. The first symptom of bipolar disorder may be depression. People with bipolar disorder who take an antidepressant, such as trazodone, may have a higher risk of having mania or a manic episode. Call your healthcare provider right away if you have any of the following symptoms of a manic episode.

Dramatic increase in energy

Significant trouble sleeping

Your thoughts are racing and fast-paced

Engaging in reckless behavior

Having unusually grand ideas

Feeling excessively happy or irritable

Talking more or faster than usual

Glaucoma. Trazodone may increase pressure inside the eye and cause or worsen narrow-angle glaucoma, which can lead to blindness. Tell your healthcare provider right away if you have any of the following symptoms of glaucoma.

Loss of vision

Eye pain, swelling, or redness

Changes in vision

Decreased Alertness or Coordination. Trazodone can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how trazodone affects you.

Low Sodium Level (Hyponatremia). Trazodone may cause low sodium levels. Call your healthcare provider if you have any of the following symptoms of a low sodium level.

Headache

Drowsiness

Muscle weakness or cramps

Nausea, vomiting, or loss of appetite

Tiredness or sleepiness

Dizziness

Weight gain

Restlessness or irritability

Change in your mental condition such as hallucinations, confusion, decreased awareness, or alertness

Seizures

Warnings & Precautions

Who should not use trazodone?

Allergies to Ingredients. People who are allergic to any of the following should not use trazodone.

Trazodone

Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific trazodone products they stock.

Drug Interactions. Trazodone should not be taken while you are using certain other medicines. Before taking trazodone, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, Vitamins/minerals, herbal products, and other supplements you are using.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first

Trazodone has severe interactions with at least 17 other drugs.

Trazodone has serious interactions with at least 124 other drugs.

Trazodone has moderate interactions with at least 415 other drugs.

Trazodone has minor interactions with at least 137 other drugs.

What should I know about trazodone before using it?

Do not take trazodone unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share trazodone with other people, even if they have the same condition as you. It may harm them.

Keep trazodone out of the reach of children.

Take trazodone shortly after a meal or light snack.

Do not crush or chew trazodone. If needed, trazodone may be broken in half along the score line.

Trazodone can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how trazodone affects you. Tell your healthcare provider if you feel sleepy or tired after taking trazodone. Your healthcare provider may change your dose of trazodone or tell you to take trazodone at a different time of the day.

Do not stop taking trazodone without talking to your healthcare provider. Stopping too quickly may cause serious side effects, such as anxiety, agitation, and sleep problems.

What should I tell my healthcare provider before using trazodone?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, Vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if trazodone is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

Heart conditions, including a family history of QT prolongation (a rare dangerous heart rhythm problem)

History of heart attack

Bipolar disorder or mania

Liver or kidney problems

Glaucoma

Bleeding problems

Low sodium levels

Peyronie’s disease

Sickle cell anemia, multiple myeloma, leukemia, or other serious medical conditions

Pregnancy. It is not known if or how trazodone could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take trazodone while you are pregnant or trying to get pregnant.

Breastfeeding. Trazodone may pass into your breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take trazodone while breastfeeding.

Interactions

Does trazodone interact with foods or drinks?

There are no known interactions between trazodone and foods or drinks.

Do not drink alcohol while taking trazodone. The risk of dizziness or sleepiness may be increased if you drink alcohol while taking trazodone.

Does trazodone interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, Vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using trazodone.

A monoamine oxidase inhibitor (MAOI) within the past 2 weeks, which is a medicine usually used for depression or Parkinson’s disease

A selective serotonin reuptake inhibitor (SSRI) or a serotonin norepinephrine reuptake inhibitor (SNRI), which are medicines commonly used for anxiety or depression

A tricyclic antidepressant, such as amitriptyline or nortriptyline, even if it is not used for depression

An antipsychotic, which is a medicine for certain mental health conditions

A type of medicine called a triptan, such as sumatriptan (Imitrex and others), eletriptan (Relpax), and others, which are used to treat migraine headaches

Lithium, which is a medicine for certain mental health conditions

Buspirone (Buspar), which is a medicine for anxiety

Opioid pain medicines, including tramadol or fentanyl

A non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which are contained in many prescription and OTC products for pain, swelling, and fever

A medicine that affects bleeding, such as aspirin, warfarin (Coumadin, Jantoven), rivaroxaban, dabigatran, or clopidogrel

Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures

Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure

A barbiturate, such as phenobarbital, butalbital, or primidone which is a medicine that may be used to treat insomnia, migraines, or seizures

Medicines that can cause QT prolongation, which is a dangerous heart rhythm problem, including amiodarone or sotalol

A medicine for high blood pressure, such as lisinopril or losartan

A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure

St. John’s Wort or tryptophan

Many other medicines may alter the blood levels of trazodone. Tell your healthcare provider about all medicines that you take or have recently taken.

Overdose/Missed Dose

What should I do if I accidentally use too much trazodone?

There have been reports of overdose with trazodone use. The risk is higher if you combine trazodone with alcohol, benzodiazepines, or other central nervous system depressant drugs that can slow your breathing and reactions.

Drug overdose could be fatal. If you suspect you have taken too much trazodone, call 911 or local emergency services and seek medical attention immediately.

Symptoms of an overdose may include:

Loss of consciousness

Seizures

Shortness of breath

Vomiting

Long-lasting, painful erection in men

If you or someone else has used too much trazodone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of trazodone?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

FAQ's

Is trazodone a controlled substance?

No, trazodone isn't a controlled substance because it doesn't have a risk of addiction, misuse, or dependence.

Is trazodone an SSRI?

Trazodone isn't a selective serotonin reuptake inhibitors (SSRI). It's considered an atypical antidepressant, and more specifically a serotonin antagonist and reuptake inhibitor (SARI). Trazodone is similar to an SSRI in that it also affects serotonin levels in the brain. But unlike SSRIs, trazodone isn't a first-choice medication for depression.

Can I take trazodone to help with sleep?

Currently, trazodone is only FDA-approved for depression. But healthcare professionals (HCPs) sometimes prescribe this medication off-label in lower dose to help with sleep. The typical dose for sleep ranges from 25 to 100 mg by mouth, taken about 30 minutes before bedtime. But keep in mind that there's limited research on whether trazodone works well or is safe to take for insomnia, especially in people who don't have depression. Current guidelines don't recommend trazodone for sleep. If you have insomnia, let your HCP know. They can recommend lifestyle changes or talk with you about medication options that are appropriate for you.

Does trazodone help with anxiety?

Trazodone isn't FDA-approved to treat anxiety. A small study suggests trazodone might help with anxiety, but more research is needed in this area. Let your psychiatrist know if you're having anxiety problems. They can talk with you about lifestyle changes and medication or therapy options to ease your symptoms.

How long does it take for trazodone to work?

Typically, it takes about 1-2 months before you experience the maximum benefit from trazodone for depression. But some people might notice their moods improving about a week after starting treatment. Keep in mind that your HCP will have you start with a lower dose first to lower your risk of side effects. They'll slowly raise your dose over time until you reach a dose that works best for you. Contact your HCP if you're not sure if trazodone is working.

How much trazodone can I take?

Only take trazodone as directed by your HCP. If you're taking trazodone for depression, your HCP will typically have you start with 150 mg by mouth daily, but split up and taken in 2-3 smaller doses throughout the day. The maximum recommended dose for depression is 400 mg per day. But if your HCP prescribes trazodone to you off-label for sleep, the dose ranges from 25 to 100 mg by mouth, taken about 30 minutes before bedtime. Ask your HCP if you're not sure how much trazodone you should take.

Can I drink alcohol while I'm taking trazodone?

No, it's best not to drink alcohol while taking trazodone because doing so can worsen certain side effects, like sleepiness and dizziness. Additionally, drinking alcohol can worsen your depression symptoms and ability to sleep. Talk with your HCP if you've more questions about trazodone and alcohol.

Does trazodone cause weight gain?

Though rare, both weight gain and weight loss were reported by people who took trazodone in clinical trials. If you're concerned about changes in body weight, talk to your HCP. They can give you recommendations on how to plan meals that are nutritious and nourishing. They can also give you tips on building a regular exercise routine that's appropriate for you. But let your HCP know if you experience significant weight changes while taking trazodone so they can check to see whether you have any other conditions that needs more medical attention.

One Final Note..

Trazodone is a medication approved for use by the FDA in 1981 as an antidepressant.

Given in lower doses, it may help improve sleep and cause less daytime sleepiness or drowsiness.

Although trazodone use for sleep is common, the American Academy of Sleep Medicine doesn’t recommend it as a first line of treatment for insomnia.

Consider speaking with a healthcare professional about ways to improve your sleep, which may include lifestyle, dietary, and behavioral changes.

IMPORTANT WARNING:

A small number of children, teenagers, and young adults (up to 24 years of age) who took antidepressants ('mood elevators') such as trazodone during clinical studies became suicidal (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may be more likely to become suicidal than children, teenagers, and young adults who do not take antidepressants to treat these conditions. However, experts are not sure about how great this risk is and how much it should be considered in deciding whether a child or teenager should take an antidepressant. Children younger than 18 years of age should not normally take trazodone, but in some cases, a doctor may decide that trazodone is the best medication to treat a child's condition.

You should know that your mental health may change in unexpected ways when you take trazodone or other antidepressants even if you are an adult over age 24. You may become suicidal, especially at the beginning of your treatment and any time that your dose is increased or decreased. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor when you are unable to seek treatment on your own.

Your healthcare provider will want to see you often while you are taking trazodone, especially at the beginning of your treatment. Be sure to keep all appointments for office visits with your doctor.

The doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with trazodone. Read the information carefully and ask your doctor or pharmacist if you have any questions. You also can obtain the Medication Guide from the FDA website.

No matter your age, before you take an antidepressant, you, your parent, or your caregiver should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or with other treatments. You should also talk about the risks and benefits of not treating your condition. You should know that having depression or another mental illness greatly increases the risk that you will become suicidal. This risk is higher if you or anyone in your family has or has ever had bipolar disorder (mood that changes from depressed to abnormally excited) or mania (frenzied, abnormally excited mood) or has thought about or attempted suicide. Talk to your doctor about your condition, symptoms, and personal and family medical history. You and your doctor will decide what type of treatment is right for you.

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Most recent revision July 12, 2025 08:38:15 AM

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