Trazodone is an antidepressant also known by the brand names Desyrel, Desyrel, Dividose, and Oleptro. It is most commonly used to treat major depressive disorder with or without anxiety. Doctors will sometimes prescribe Trazodone off-label to treat alcohol dependence and insomnia as well. Trazodone can definitely cause dependence, although whether Trazodone addiction is possible is debated.
Trazodone falls under the category of drugs called selective serotonin re-uptake inhibitors (SSRIs), which affect chemical balance in the brain. Serotonin is a neurotransmitter that regulates emotions and, low levels of it results in depression and other mental disorders. SSRIs such as Trazodone block the brain’s neurons from using serotonin, leaving more available to facilitate connections between neurons. More serotonin leads to a healthier and more balanced brain, relieving disorders that cause depression, anxiety and trouble sleeping. Health practitioners will sometimes prescribe Trazodone over a sleeping barbiturate because it is less likely to lead to addiction or cause severe side effects.
Trazodone is available in the form of 25 mg, 50 mg, 100 mg, 150 mg, and 300 mg tablets for oral ingestion. Dosage typically starts at 150 mg daily and can be increased in 50 mg increments based on a patient’s response to the medication. This prescription should be taken with food and avoided if a MAO inhibitor has been used within the past 14 days. Trazodone is generally safe, and research has shown that it is effective in treating depression and insomnia. However, like any substance, it carries risk for misuse, dependence, withdrawal, and overdose. Anyone who is taking Trazodone is at risk for addiction, and should only use it as prescribed by health professionals.
Trazodone Dependence and Addiction
Trazodone is a long-term medication and, although it is not inherently dangerous to take for months or years, it can still cause dependence. If a person needs to take Trazodone in order to feel normal or, if they feel withdrawal symptoms without it, they have become dependent. Whether or not antidepressants are addictive is up for debate since people do not typically crave these drugs. Regardless, people who stop taking Trazodone suddenly may experience uncomfortable withdrawal symptoms. Patients who no longer want to take this medication should talk to a healthcare provider about tapering off until it is safe to completely end treatment.
In order to avoid the experience of withdrawal symptoms, a person may continue to use Trazodone even if it is no longer needed. In extreme cases, those with a dependency or addiction will visit different doctors for more prescriptions or purchase it illegally. The cycle between withdrawal and relapse is characteristic of an addiction disorder but fortunately, prescription drug addiction can be treated with detox and combination therapy at a rehab facility.
Symptoms of Trazodone Withdrawal
Trazodone withdrawal is a form of SSRI Discontinuation Syndrome (SSRIDS). Symptoms are similar to those of depression and anxiety and begin to manifest when medication has been stopped abruptly. Withdrawal symptoms are a result of changes in the brain that cause alterations to serotonin receptors. While taking Trazodone, the brain “down-regulates” the number of receptors in response to the increased levels of serotonin. When a person stops taking the drug, the decreased volume of receptors creates a short-term deficiency of serotonin activity. The body will typically correct this on its own, but one may experience uncomfortable symptoms during an adjustment period. Experiencing withdrawals from Trazodone does not always mean a person is addicted but it does indicate a physical dependency to the medication. Symptoms of Trazodone withdrawals may include:
- Dizziness or lightheadedness
- Shock-like sensations
- Suicidal Thoughts
- Vertigo or difficulty walking
- Trouble concentrating
To avoid withdrawal symptoms, a person should always take Trazodone as prescribed without skipping doses. If one wishes to stop or switch their medication, they should consult a medical professional and discuss options. The best way to end treatment is by using the “tapering strategy” under medical supervision, which gradually reduces the prescribed dose until it reaches zero. Symptoms of SSRIDS can start as soon as one day after last dosage and remain for two to three weeks.
Side Effects and Risks of Trazodone
As is with all medications, Trazodone may cause side-effects. The most common side-effects are not long-lasting or life-threatening, but there can be cases where the medication may cause serious side-effects that require medical attention. Common side-effects of Trazodone include:
- blurred vision
- drowsiness, dizziness, or tiredness
- weight loss
- stuffy nose
Less common side effects include:
- dry mouth
- diarrhea or constipation
- sexual dysfunction
- priapism (painful and persistent erection of the penis or the clitoris)
- cardiac arrhythmia
Call your healthcare provider if you experience:
- skin rashes
- fast or pounding heartbeats, shortness of breath, and sudden dizziness (feeling like passing out)
- slow heartbeats
- easy bruising or unusual bleeding
- low sodium levels in the body
A “black box warning” has been issued by the FDA for Trazodone. A black box warning is used to inform consumers about dangerous potential effects of a prescription drug. According to the label, Trazodone can produce or increase suicidal thoughts in children and young adults. Women who are pregnant or breast-feeding should ask their doctors about the risks involved in taking this medication. Drug interactions can also be dangerous when mixing different substances. People who have used an MAO inhibitor (MAOI) such as isocarboxazid, linezolid, phenelzine, rasagiline, or others, must wait at least 14 days before taking Trazodone. Likewise, those who wish to stop taking Trazodone should wait 14 days before taking an MAOI.
Although it is not very common, it is still possible for someone to suffer an allergic reaction to Trazodone. Symptoms of an allergic reaction include hives, difficulty breathing, and swelling. One should never use Trazodone if they are allergic, or being treated with methylene blue injections. Allergic reactions can be life-threatening and require emergency medical attention.
Symptoms of Overdose
It is possible to overdose on Trazodone. Overdosing on Trazodone is usually not life-threatening but can occur if someone takes too much of the medication. When serotonin accumulates in the body it is referred to as serotonin syndrome and can result in mild to severe symptoms that include:
- Agitation or restlessness
- Twitching muscles
- Rapid heart rate and high blood pressure
- Shivering and goosebumps
One should have immediate medical attention if they experience:
- High fever
- Irregular heartbeat
Trazodone overdose can be fatal when mixed with alcohol, barbiturates, or sedatives such as valium. One should avoid drinking alcohol while taking this medication.