Trazodone for Sleep (A complete guide)

In this blog, we will discuss Trazodone for Sleep, most common uses of Trazonde, side effects, precautions, potential interactions with other drugs and substances

Trazodone for sleep: is it effective?

Trazodone is not prescribed primarily for sleeping problems.

It was designed as an antidepressant to treat depression.

However, according to the American Addiction centers Trazodone as a sleep aid is used to treat issues with sleep at lower doses and it is safer for elderly individuals than other sleep aids. 

So what is it really to have a sleeping problem? Well, it depends.

If you occasionally have trouble sleeping it doesn’t necessarily mean you have a sleeping problem per se.

If it is a frequent and constant problem falling asleep or staying asleep that is now affecting your life, then it is necessary to find professional help. 

If you found this guide, it is likely that you are wondering if trazodone for sleep is the best option for you but, here are some things you might want to consider before going any further.

What is Trazodone?

Trazodone is considered an antidepressant drug that belongs to the group of Serotonin Reuptake Inhibitors or SSRIs.

It is used frequently as a treatment for depression. 

This drug was developed in Italy in the 1960s as antidepressant medication.

Initially, due to the side effects, this antidepressant wasn’t widely accepted in the medical community, however, it became recognized by many internists and clinicians because of the potential benefits of the drug, especially when administered at low doses.

Under the name trazodone (generic) in 1981, it was approved by the U.S Food and Drug Administration (FDA) under the brand name Desyrel.

Today, it is prescribed under the brand name Olepro to treat sleep disorders such as insomnia as well as anxiety disorder and unibipolar depression.

Is it safe to take trazodone for insomnia?

Trazodone is widely prescribed as a nighttime sleep aid for people with acute insomnia, even though it was originally designed to treat depression and anxiety disorders. 

Trazodone for sleep is prescribed off-label and it has been suggested to be prescribed at doses between 25 mg to 100 mg.

It acts as a serotonin antagonist and reuptake inhibitor which is believed to act on several receptors in the brain affecting the balance levels of serotonin. 

How do I know if I have insomnia?

It is necessary to share the symptoms with your doctor so he/she can assess if it is really a sleeping disorder or if its a secondary symptom of another medical condition. 

However, if you are suffering from insomnia the common symptoms are having mood problems, feeling fatigued or “drained” most of the day and reduced performance in your daily life activities. 

There are two possibilities, either having acute insomnia, where you have problems falling asleep short term and it is related to your context.

Let’s say you have something really important at school or a big presentation at work and you feel so anxious you start having problems falling asleep but as soon as that exam or the presentation have passed then you get to sleep as normal.

The other possibility is having chronic insomnia, this is characterized mainly because opposite to acute insomnia, this goes long term at least three nights a week and lasts for a minimum of three months. 

Are there advantages of trazodone for sleep?

If you have tried already other types of therapy like cognitive behavioral therapy or even hypnosis then looking out for a drug that can help you recover those long lost nights seem to be the only option right now.

Well, there is actually scientific data backing up the effectiveness of trazodone for sleep. 

In a 2017 systematic review about trazodone for insomnia, evidence for the efficacy of trazodone for sleeping problems was demonstrated for primary and secondary insomnia, including for symptoms that are a result of depression and dementia when administered in low doses. 

Is trazodone different from other “sleeping pill” drugs?

The most commonly prescribed drugs as sleeping aids are Ambien, Sonata or Lunesta, but Trazodone differs from them in a few ways such as:

  • Ambien and Lunesta have the potential for misuse and abuse (dependence or addiction) so they are classified as controlled substances.
  • Trazodone is not considered to be an addictive substance, hence it is not a controlled substance so physicians aren’t limited in how many pills they can prescribe
  • Compared to other drugs it is an inexpensive generic drug covered by most insurance companies
  • Trazodone is not recommended to be taken by pregnant women or women who are breastfeeding. 

Trazodone for Sleep (A complete guide)

Does trazodone cause sleepiness?

For many people, this drug has a sedative effect that causes a relaxing effect and can make you feel very sleepy.

In prescribing the drug for sleep disorders, physicians typically recommend taking a low dose at bedtime in order to limit the effects of drowsiness.

Still, some people report lingering effects, including sluggishness and feeling drained or low energy, particularly upon waking.

How does Trazodone work?

Trazodone is meant to restore the depleted chemicals in the brain (neurotransmitters).

One of the most important neurotransmitters is serotonin which when balanced, improves your mood, appetite, memory, sexual function and desire, energy levels, decreases anxiety and insomnia related to depression.

Researchers have found that depression is caused by an imbalance among the neurotransmitters acetylcholine, norepinephrine, dopamine, and serotonin.

It is believed that trazodone affects the brain’s neurotransmitters by inhibiting the uptake of serotonin by nerves and consequently, the increase of this neurotransmitter end up stimulating other nerves.

How quickly does it work?

Some people who use this drug for sleep disorders have indicated that they get to experience the sedative effect within 30 mins after the intake, but remember that every person can react differently to the drug.

People who take it as an antidepressant may start noticing benefits after 1 or 2 weeks of consistently taking the medicine, and it may even take up to 4 weeks to experience the full benefits and desired results. 

Trazodone for Sleep (A complete guide)

How should I take it?

The initial dose is usually reported as 150 mg orally per day in divided doses. This may be increased by 50 mg orally per day every 3 – 4 days.

The maximum dose reported for inpatients is 600 mg a day and for outpatients is 400 mg a day.

Administration

Trazodone’s strengths are as follows:

– 50 mg

– 100 mg

– 150 mg

– 300 mg

The tablets can be swallowed whole or taking it as a half tablet by breaking it along the scoreline. The tablets should not be chewed or crushed. 

When will I see results?

It can take up to 2 weeks before you start seeing improvement.

If your symptoms are not improving, do not stop the medication and talk to your doctor about it because you could have some unpleasant withdrawal symptoms. 

Trazodone for Sleep (A complete guide)

What happens if I miss a dose?

If you miss a dose, take the missing dose as soon as you remember.

If it is almost time to take the next scheduled dose, discard the missing dose and keep taking it as usual.

Do not take an extra or doubled dose to compensate. 

What happens if I overdose?

If you overdose with Trazodone, seek immediate medical attention.

An overdose can be fatal if it is combined with alcohol, barbiturates such as phenobarbital, or sedatives such as diazepam (Valium).

Overdose symptoms may include:

  • Extreme drowsiness
  • Vomiting
  • Prolonged and painful erection
  • Faster heartbeats
  • Seizures 
  • Breathing that is slow or stops

Symptoms of an allergic reaction

Trazodone allergic reactions need medical assistance.

If you are experiencing the following symptoms while taking Trazodone, it is very likely that you are allergic to it:

  • Hives
  • Difficulty breathing
  • Swelling of your face, lips, tongue or throat

Side effects

Report to your doctor any sudden changes related to your mood or behavior, as being impulsive, aggressive, restless, feeling irritable, increased anxiety, panic attacks, trouble sleeping or if you are feeling agitated, hyperactive, even more depressed than before or if you are having suicidal thoughts or wanting to hurt yourself. 

Moreover, if you have shortness of breath, faster or slower heartbeats, sudden dizziness, easy bruising or unusual bleeding; low levels of sodium in your body that will manifest in headaches, confusion, slurred speech, feeling fatigued, vomiting, loss of coordination or feeling unsteady. 

Serotonin syndrome

Serotonin syndrome (SS) happens when certain drugs (antidepressants), being taken 2 or more at a time, that have the purpose of affecting the neurochemistry of the brain (synaptic serotonin levels) cause a severe and toxic interaction. Symptoms may include:

  • Hallucinations
  • Fever
  • Sweating
  • Overactive reflexes
  • Fainting
  • Shivering
  • Faster heart rate
  • Muscle stiffness
  • Twitching
  • Loss of coordination
  • Nausea
  • Vomiting
  • Diarrhea

Common side effects

The common side effects of Trazodone intake may include:

  • Drowsiness
  • Dizziness
  • Tiredness
  • Swelling
  • Weight loss
  • Blurred Vision
  • Diarrhea
  • Constipation
  • Stuffy nose
  • Headaches
  • Nausea
  • Vomiting
  • Dry mouth

Other side effects

  • Temporary loss of consciousness
  • Swelling 
  • Loss of control of your movements
  • Confusion
  • Diarrhea
  • Hypotension
  • Insomnia
  • Sedated state
  • Faster heart beating

Less common side effects 

  • Burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
  • Confusion about identity, place, and time
  • Decreased concentration
  • Fainting
  • A 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

Trazodone Drug interaction

There are many drugs that can interact with Trazodone, especially:

  • Any other antidepressant
  • Anagrelide
  • Droperidol
  • Methadone
  • Ondansetron
  • Antibiotics such as azithromycin, clarithromycin, erythromycin, levofloxacin, moxifloxacin, pentamidine
  • Cancer medicine such as arsenic trioxide, vandetanib
  • Anti-malaria medication such as chloroquine, halofantrine
  • Heart rhythm medicine such as amiodarone, disopyramide, dofetilide, dronedarone, flecainide,  ibutilide, quinidine, sotalol
  • Medicine to treat a psychiatric disorder such as chlorpromazine, haloperidol, pimozide, thioridazine.
  • Phenytoin
  • St John’s wort
  • Tramadol
  • Diuretic or “water pill”
  • Anti-anxiety medication
  • Other drugs to treat mood disorders or other mental illnesses such as schizophrenia
  • Blood thinners such as warfarin, coumadin, and jantoven
  • Migraine headache medicine such as sumatriptan, imitrex, maxalt, treximet, among others

This is not a complete list of the drugs that can interact with Trazodone for more information about additional drugs that may interact ask your doctor. 

Trazodone and alcohol interaction

It is advised to preferably avoid or limit alcohol consumption while being treated with Trazodone.

Alcohol intake while using Trazodone can increase the side effects and in addition, some people may also experience impairment in thinking and judgment. 

Trazodone for Sleep (A complete guide)

Are there risks while taking trazodone as an antidepressant?

For someone under the age of 24, there are heightened risks in regards to mental health.

According to MedlinePlus, the following side effects and symptoms can occur among patients under age 24: “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.” 

It is important to be aware that the manifestations of any of these symptoms or side effects should be discussed with your doctor immediately. 

When treated with Trazodone, it is important to be aware of avoiding taking other medicines classed as SSRIs, SNRIs or other antidepressants.

Additionally, if you have a cold, an allergy or you are having trouble sleeping, before you take over-the-counter medication to treat the symptoms consult with your doctor.

Trazodone for Sleep (A complete guide)

Is it safe to use trazodone with alcohol or other drugs?

It is recommended to avoid or limit the consumption of alcohol while using Trazodone since both substances affect the central nervous system, and the consequences have been described as fatal.

Additionally, missing this medicine with drugs of abuse can cause serotonin syndrome, potentially fatal as well.

While trazodone is not considered addictive, any amount over 600 mg in 24 hours is an overdose.

Can you become addicted to trazodone?

Trazodone is a non-controlled substance and it is considered non-addictive and non-habit-forming, however, it should only be taken as prescribed and under a physician’s care in order to avoid misuse, especially if you have a history of substance abuse or other drug addiction.

Some of the warning signs of drug misuse can be using the medication without a prescription, using it at higher doses than recommended/prescribed or snorting or crushing the tablets to speed up the intended effects.

Why is this blog about Trazodone for sleep important?

If you are considering taking Trazodone for sleep, depression or anxiety, it is important to be aware of any side effects and warning signs of a major medical complication that can be manifested. 

Additionally, it is important to follow the instructions provided by your doctor on how to take the medication correctly and inform immediately if there are complications.

Although we consider this guide “trazodone for sleep” compiles accurately and up to date information from trustworthy medical sources, it is not intended as a strict how-to guide, it is only informative.

Additional questions or concerns should be answered by your doctor.

Please feel free to comment on the content of this guide in the comments section below.

Side Note: I have tried and tested various products and services to help with my anxiety and depression. See my top recommendations here, as well as a full list of all products and services our team has tested for various mental health conditions and general wellness.

Frequently Asked Questions (FQAs) of trazodone for sleep

How long before bed should I take Trazodone?

Take trazodone several hours before going to bed if you have problems getting to sleep.

If you have trouble falling asleep, take it within 30 minutes before bedtime.

Is Trazodone 50 mg a sleeping pill?

Trazodone is mostly used as an antidepressant but it can be prescribed off-label to treat insomnia.

Trazodone is available as 50 mg or 100 mg tablets.

Is trazodone good for sleeping?

Trazodone has sedative and relaxing effects that can help you to fall asleep. 

What is the best sleeping pill for insomnia?

The best sleeping pills for insomnia are considered:

– Eszopiclone (Lunesta): helps you fall asleep and stay asleep.

– Ramelteon (Rozerem): helps you fall asleep.

– Temazepam (Restoril): helps you fall asleep and stay asleep

– Triazolam (Halcion): helps you fall asleep.

How many hours does trazodone last?

After a single dose taken by a healthy adult, it will be mostly out of your system in 1 to 3 days.

The half-life for trazodone is approximately 5 to 13 hours. 

Recommended reading

  1. Trazodone Hydrochloride; Third Edition
  2. Trazodone 627 Questions to Ask that Matter to You 
  3. Trazodone: Webster’s Timeline History, 1973 – 2007
  4. Trazodone: New Clinical Applications and Safety Considerations for a Third Generation Antidepressant 4th World Congress of Biological Psychiatry, … Antidepressant – Symposium Proceedings
  5. Trazodone – A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

References

Drugs.com

Cigna

Hazelden Betty Ford Foundation

American Addiction Centers

MedPlus

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