Trazodone

Generic Name: trazodone (TRAZ oh done)
Brand Names: Desyrel, Desyrel Dividose, Oleptro

What is trazodone?

Trazodone is an antidepressant that belongs to a group of drugs called selective serotonin reuptake inhibitors (SSRIs). It affects chemicals in the brain that may be unbalanced in people with depression.

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.

Important Information

You should not use trazodone if you are allergic to it, or if you are being treated with methylene blue injection.

Do not use this medicine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using trazodone. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Do not give this medicine to anyone younger than 18 years old without the advice of a doctor. Trazodone is not approved for use in children.

Before taking this medicine

You should not use trazodone if you are allergic to it.

Do not use trazodone if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

After you stop taking trazodone, you must wait at least 14 days before you start taking an MAOI.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

liver or kidney disease;
heart disease, or a recent heart attack;
a bleeding or blood clotting disorder;
seizures or epilepsy;
narrow-angle glaucoma;
long QT syndrome;
drug addiction or suicidal thoughts; or
bipolar disorder (manic depression).

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with trazodone and cause a serious condition called serotonin syndrome.

Ask your doctor about taking this medicine if you are pregnant. It is not known whether trazodone will harm an unborn baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant. Do not start or stop taking this medicine without your doctor's advice.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of trazodone on the baby.

It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.

Trazodone is not approved for use by anyone younger than 18 years old.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line. An overdose of trazodone can be fatal when it is taken with alcohol, barbiturates such as phenobarbital, or sedatives such as diazepam (Valium).

Overdose symptoms may include extreme drowsiness, vomiting, penis erection that is painful or prolonged, fast or pounding heartbeat, seizure (black-out or convulsions), or breathing that slows or stops.

What should I avoid while taking trazodone?

Do not drink alcohol. Dangerous side effects or death could occur.

Avoid driving or hazardous activity until you know how trazodone will affect you. Your reactions could be impaired.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Trazodone side effects

Get emergency medical help if you have signs of an allergic reaction to trazodone: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking trazodone and call your doctor at once if you have a penis erection that is painful or lasts 6 hours or longer. This is a medical emergency and could lead to a serious condition that must be corrected with surgery.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness (like you might pass out);
slow heartbeats;
unusual thoughts or behavior;
easy bruising, unusual bleeding; or
low levels of sodium in the body - headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common trazodone side effects may include:

drowsiness, dizziness, tiredness;
swelling;
weight loss;
blurred vision;
diarrhea, constipation; or
stuffy nose.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

What other drugs will affect trazodone?

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with trazodone may cause you to bruise or bleed easily.

Using trazodone with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your current medicines. Many drugs can interact with trazodone, especially:

any other antidepressants;
phenytoin;
St. John's wort;
tramadol;
a diuretic or "water pill";
medicine to treat anxiety, mood disorders, or mental illness such as schizophrenia;
a blood thinner - warfarin, Coumadin, Jantoven; or
migraine headache medicine - sumatriptan, Imitrex, Maxalt, Treximet, and others.

This list is not complete and many other drugs may affect trazodone. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

In Summary

Commonly reported side effects of trazodone include: blurred vision, dizziness, drowsiness, headache, nausea, vomiting, and xerostomia. Other side effects include: syncope, edema, ataxia, confusion, diarrhea, hypotension, insomnia, sedated state, and tachycardia. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to trazodone: oral tablet

Oral route (Tablet, Extended Release; Tablet)

Antidepressants increased the risk compared to placebo of suicidal thinking and behavior in children, adolescents, and young adults with major depressive disorder (MDD) and other psychiatric disorders in short-term studies. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared with placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared with placebo in adults aged 65 or older. The use of trazodone hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Closely monitor patients of all ages for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Not approved for pediatric use.

Along with its needed effects, trazodone may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking trazodone:

More common

Blurred vision
confusion
dizziness
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
lightheadedness
sweating
unusual tiredness or weakness

Less common

Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
confusion about identity, place, and time
decreased concentration
fainting
general feeling of discomfort or illness
headache
lack of coordination
muscle tremors
nervousness
pounding in the ears
shortness of breath
slow or fast heartbeat
swelling

Rare

Skin rash
unusual excitement

Some side effects of trazodone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Dry mouth (usually mild)
muscle or bone pain
trouble sleeping
trouble with remembering
unpleasant taste

Less common

Constipation
continuing ringing or buzzing or other unexplained noise in the ears
diarrhea
hearing loss
muscle aches or pains
weight loss

A total of 556 drugs are known to interact with trazodone.

118 major drug interactions
423 moderate drug interactions
15 minor drug interactions

Most frequently checked interactions

View interaction reports for trazodone and the medicines listed below.

Trazodone alcohol/food interactions

There is 1 alcohol/food interaction with trazodone

Trazodone disease interactions

There are 8 disease interactions with trazodone which include: