What is Trazodone Used For?
Trazodone is approved by the Federal Drug Administration (FDA) for use in treating depression. However, due to its sedating effects, it is often also used to treat insomnia, anxiety, fibromyalgia, Alzheimer’s disease, and other conditions/disorders. More and more frequently, trazodone is being prescribed off-label for the treatment of anxiety and insomnia.
Medications are considered off-label when they’re prescribed for something that the FDA has not approved them for. The main reason that a doctor may prescribe you something off-label is that no other medication has been effective, so the doctor might prescribe something that is known to work, but doesn’t have FDA approval for that particular purpose. This is perfectly normal and for many people, the pre-approved medications used for depression and anxiety might not work or might have too many negative side effects.
Another use of trazodone is for addiction treatment. Because trazodone can help you sleep, it can be useful during the treatment process of drug addiction.
Trazodone in Addiction Treatment
Trazodone is sometimes used as a part of a treatment plan for someone recovering from addiction. It can be used for people seeking help with alcohol addiction and methamphetamine abuse. It can help improve sleep in people with alcohol disorder and can help improve sleep in people undergoing methadone maintenance treatment. Because many people with drug addictions also struggle with feelings of depression or anxiety, trazodone can help to alleviate some of those symptoms during the process of addiction treatment.
As with all medications, there are potential side effects that can occur. Some side effects that you might experience are:
- Dry, itchy or red eyes
- Memory problems
- Trouble sleeping
- Chest pain
- Erectile dysfunction
- Priapism (painful and prolonged penile erection)
- Dry mouth
- Muscle pains
- Blurred vision
- Difficulty breathing
- Panic attack
- Ringing in the ears
- Weight gain
How to Take Trazodone Safely
It is important to follow your doctor’s instructions for how to take trazodone and to also read the medication guide. You should take the medication as prescribed and not increase the dose or take it more often than prescribed.
A Note on Safely Taking Medications
Taking more trazodone than prescribed will not help improve your symptoms any faster. It is also important to not stop taking this medication without consulting your doctor. There can be negative effects (anxiety, agitation, trouble sleeping) to stopping an anti-depressant medication suddenly.
Understanding Dosages and Administration
Trazodone is typically taken orally, by swallowing a pill once or twice daily after a meal or snack, or as directed by your doctor. Tablets come in immediate-release and extended-release form. Common dosages include 50 mg, 100 mg, 150 mg and 200 mg tablets.
Due to the drowsiness that can be caused by trazodone, it is usually best to take it at bedtime. As with all anti-depressant medications, it takes between 2 to 4 weeks to begin noticing the effects of the medication and before beginning to feel better.
It is possible, especially for young adults, to feel an increase in suicidal thoughts when first beginning to take this medication. For this reason, doctors are often hesitant to prescribe trazodone to teenagers or young adults. This should subside over time but you should communicate how you are feeling to your doctor so that they can monitor your symptoms.
If you are allergic to trazodone or are being treated with methylene blue injection, then you should not be taking trazodone. You shouldn’t use this medication if you have taken an MAO inhibitor (a strong anti-depressant) in the past 14 days. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine that can interact dangerously with trazodone. If you stop taking trazodone, you should wait at least 14 days before taking an MAO inhibitor.
Before using trazodone, you should tell your doctor about your personal and family medical history, particularly if there is a history of bipolar disorder, depression, heart disease, liver disease, kidney disease, blood pressure issues, or glaucoma.
When to Avoid Trazodone
To ensure that trazodone is safe for you, tell your doctor if you have ever had:
•Recent heart attack
•Blood clotting disorder
•Glaucoma (an eye condition)
•Long QT syndrome (a heart rhythm condition)
You should also ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam or others. Using these types of pain killers with trazodone can put you at higher risk of bruising or bleeding easily.
Trazodone is not approved for use by anyone under 18. It also may not be safe to use while breastfeeding, so talk to your doctor before using trazodone if you are pregnant or breastfeeding. You should also avoid alcohol while taking trazodone.
Interaction With Other Drugs
Taking multiple drugs or medications at the same time can impact how each of those drugs work. It is important to tell your doctor what medications you are taking prior to being prescribed anything else. Some of the drugs that have interactions with trazodone that you should inform your doctor(s) about are:
Phenytoin (an anti-epilepsy drug)
St. John’s wort (used for depression)
Tramadol (pain medication)
A diuretic (used to help urination)
Medicines used to treat anxiety, mood disorders, or mental illness (e.g. fluoxetine, paroxetine, duloxetine, venlafaxine)
Blood thinners (e.g. warfarin, Coumadin, Jantoven)
Migraine headache medication (e.g. Sumatriptan, Imitrex, Maxalt, Treximet)
You should also inform your doctor of any illicit drugs you are taking, as mixing trazodone with certain drugs such as ecstasy can increase the chance of having a negative reaction (e.g. overdose). You should also inform your doctor of anything you are taking that causes drowsiness such as alcohol, marijuana, allergy medications, medications for sleep or anxiety, muscle relaxants, or narcotic pain relievers. This is because trazodone has sedative properties that on its own can make you very tired.
Can You Overdose on Trazodone?
Although it is uncommon, you can overdose on trazodone. It is possible to take too much trazodone and therefore it must be taken with caution and according to direction.
Symptoms of trazodone overdose include:
•Dizziness or fainting
If you or someone you know is experiencing symptoms of overdose, seek emergency medical help immediately.
How Often is Trazodone Prescribed?
Can Trazodone be Abused?
While trazodone is not typically thought to be addictive and isn’t habit forming, in theory, almost any drug can be abused. Like the old saying goes, too much of anything isn’t good. Typically, however, antidepressants are abused in conjunction with other drugs. In other words, people who are abusing trazodone are typically abusing other drugs (such as ecstasy) as well.
Trazodone by itself is not typically someone’s primary drug of abuse. For people who do abuse trazodone, the pill is typically crushed to be inhaled, added to marijuana and smoked, added to an alcoholic drink, or snorted. Destroying the pill form increases the effects of trazodone and results in quicker effects. Because of trazodone’s sedative effects, some people will abuse it in order to feel a calming and relaxing effect.
Signs of Trazodone Abuse
•Taking trazodone without having a prescription
•Using more than prescribed, more often than prescribed
•Not using as prescribed (e.g. snorting it)
•Using together with other drugs such as alcohol, painkillers, marijuana, etc.
•Attempting to access more than prescribed by purchasing it illegally or stealing it
•Spending more and more time trying to get trazodone
•Continued use despite negative consequences
•Not keeping up with work, school, and home responsibilities
•Health issues as a result of drug use
•Using for purposes other than prescribed (e.g. to feel high or to enhance other drugs)
•Increased tolerance towards the drug
•Experiencing withdrawal symptoms
Trazodone Withdrawal Symptoms
When using large amounts of trazodone for long periods of time, stopping suddenly can cause withdrawal symptoms. For people who abuse trazodone, withdrawal symptoms can be particularly severe. Using trazodone balances the brain’s chemicals, so the brain becomes used to the daily presence of trazodone to keep serotonin levels balanced. When trazodone use stops suddenly, those levels become unbalanced and withdrawal symptoms can occur.
•Increase in heart rate & palpitations
•Sensations of electrical jolts in the brain
•Dizziness & balance problems
Factors that affect the severity and duration of withdrawal symptoms include:
•Duration of trazodone use
•How quickly you stop using trazodone
•Use of other substances with trazodone
Trazodone withdrawal can last anywhere from a few weeks to a few months depending on each individual. Typically, withdrawal symptoms should subside within 2 to 12 weeks of stopping use. Overcoming withdrawal symptoms doesn’t mean someone who has abused trazodone is automatically recovered and treatment should still be sought out.
Withdrawal symptoms are worse when someone tries to quit “cold turkey,” so it is advisable to enroll in a medical detox program to safely and comfortably manage withdrawal symptoms.
As those abusing trazodone are frequently also abusing other drugs, a treatment plan needs to consider all substances that someone might be abusing. Developing a treatment plan will include the following:
In order to avoid experiencing severe withdrawal symptoms, a medical detox is needed. This way, you can slowly taper off the medication.
Treatment For Co-occurring Disorders:
This includes other addictions or mental illnesses. Treatment can occur in intensive outpatient programs or residential inpatient programs.
Learn more about drug addictions and relapse prevention strategies.
Therapy and Counseling:
Various therapy programs that target the causes of drug abuse, developing coping skills, relapse prevention programs, and more. Therapy can be individual or in a group setting.
12- Step Meetings:
These meetings help to create a sense of community and contribute to the long-term aftercare treatment plan.
Sober Living Programs:
These programs provide safe group housing options for people recovering from addiction. The goal of sober living program homes is to help people transition from residential or outpatient care into independent living.
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