Trazodone is a prescription medication primarily used to treat symptoms of depression. Once branded, trazodone hydrochloride can now only be found in generic form. Trazodone is also routinely prescribed off-label, meaning it’s used for other purposes than what is indicated by FDA (Food and Drug Administration) approval. These include the following:
- Alzheimer’s disease
- Substance use disorder
Trazodone is sometimes used for insomnia because it has mild sedating properties that help address sleep disorders.
How Trazodone Works
Trazodone increases the bioavailability of serotonin, a feel-good brain neurochemical strongly linked to mood. Adequate amounts tend to reduce depression symptoms and induce sleep.
Unlike benzodiazepines, trazodone is not believed to have an addiction-causing mechanism. For this reason, it’s often prescribed for persons with a history of benzo abuse.
How Trazodone Should be Used
Trazodone is usually found in the form of oral tablets. The dosage depends on the condition it’s being used for and any other medications a person might be taking. Tablets come in varying strengths—50mg, 100mg, 150mg, and 300mg.
The typical starting dosage is 150mg a day in multiple doses. This dose can be increased by 50mg every few days if prudent, up to a maximum dosage of 400mg in divided doses. In a clinical setting, up to 600mg of trazodone can be administered daily. Trazodone should not be used by persons under 18 years of age.
FDA Black Box Warning
Trazodone comes with a boxed warning from the FDA. Boxed warnings are aimed to alert both patients and their doctors about the potentially dangerous effect of certain medications. Like many antidepressants, there is a minimal but not entirely insignificant risk of suicidal ideations when using trazodone.
According to the FDA, trazodone has the potential to cause an “increase in suicidal thoughts or actions.” This risk is more notable among children and young adults and higher when treatment is first initiated or related to a dosage change.
If you notice abrupt changes in mood, behaviors, thoughts, or feelings when using trazodone, you are urged to contact your healthcare provider immediately.
Side Effects of Trazodone
Common side effects of trazodone may include the following:
- Blurry vision
- Nausea and vomiting
- Stuffy nose
- Swelling (edema)
- Weight loss
These effects should subside within a week or so. If they persist or become more severe, you should speak with a health provider.
Taking trazodone can also trigger some more severe side effects. Please seek immediate medical assistance for yourself or another person who is experiencing the following:
Adverse Mood/Behavioral Changes
- Suicidal thoughts or behaviors
- Aggression, anger, or violence
- Acting on dangerous impulses
- Anxiety (new or worsening)
- Unusual changes in behavior
- Depression (new or worsening)
- Irritability (new or worsening)
- Panic attacks
Serotonin syndrome is a severe, possibly life-threatening disorder caused by excessive amounts of serotonin in the brain. Using too much of an antidepressant or with other serotonin-boosting agents can lead to its development. When this occurs, emergency medical assistance is required.
- Accelerated heart rate
- Impaired cognition
- Nausea or vomiting
- Impaired coordination
- Tight, stiff muscles
- Blurred vision
- Bruising and bleeding
- Eye pain
- Irregular or rapid heartbeat
- Low blood pressure
- Swelling or redness of the eye
Drugs That May Interact with Trazodone
MAOIs (monoamine oxidase inhibitors) should not be used by those taking trazodone. They include prescription drugs such as isocarboxazid, phenelzine, selegiline, and tranylcypromine. Using MAOIs within two weeks of taking trazodone increases can an individual’s risk of developing serotonin syndrome. Other drugs that may also intensify the effects of trazodone include the following:
Antidepressants – Other medications (specifically SSRIs such as citalopram and paroxetine) can increase the risk of serotonin syndrome developing when used in combination with trazodone.
CNS depressants – Other central nervous system (CNS) depressants, such as benzodiazepines or barbiturates, can increase the response to other depressants, such as trazodone.
Digoxin – Taking trazodone concurrently with digoxin can boost digoxin levels in the body to unsafe levels.
NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) – The risk of bleeding is increased when using trazodone and NSAIDs (e.g., ibuprofen) or aspirin in combination.
Warfarin – If you’re taking a blood-thinning agent such as warfarin, your risk of bleeding increases if you’re also using trazodone simultaneously.
Trazodone Overdose Risk
Overdosing on trazodone is possible in theory but is very rare and unlikely. Almost without exception, trazodone overdose occurs when a patient has been legitimately prescribed the drug. Since trazodone doesn’t produce a high, it is considered to have little to no recreational value. All that’s achieved by using more of the drug is an increase in the drug’s ability to cause drowsiness.
Moreover, while an overdose on opioids typically occurs due to tolerance or a person trying to achieve a more intense high, trazodone overdoses are most often accidental. However, some severely depressed patients have been reported to use trazodone in excessive amounts in an attempt to relieve their symptoms. This approach is not likely to work and may instead lead to an overdose.
How Much Trazodone it Takes to Overdose
When trazodone is used to treat depressive symptoms, the standard daily dose is 150mg. This amount can be gradually increased to 600mg if required in a clinical setting. Smaller quantities are used to treat insomnia, up to a maximum of 75mg. Consumption of more than 600mg in 24 hours is considered to be an overdose.
There is scant data regarding the specific dosage that can potentially induce a lethal overdose. Most fatalities linked to trazodone result from the antidepressant being used in conjunction with other substances, particularly other CNS depressants.
For example, alcohol use should be avoided when a person is taking trazodone because the two substances are both depressants and can amplify each other’s effects.
Trazodone Overdose Symptoms
A trazodone overdose is marked by a range of potentially life-threatening symptoms linked to specific areas of the body, including the following:
Lungs and Airway – Difficulty breathing or respiratory arrest can occur as a result of trazodone overdose. This is due to profound CNS depression, leading to a failure of the lungs to expand and contract as they should.
Heart and Blood Vessels – Chest pain and an irregular heartbeat (arrhythmia) can both occur place during trazodone overdose. Blood levels can also fall so low that lightheadedness and fainting are possible. Heart rate may also decrease dramatically to dangerously low levels.
The CMS and the Brain
The medical benefits that a person may receive from using trazodone are related to the way in which the medication directly impacts the CNS and brain. As such, mental and physical symptoms associated with brain function are possible and may include the following:
- Chronic headaches
- Impaired coordination
Getting Help for Drug Dependence and Addiction
Just Believe Recovery center offers customized, integrated addiction treatment programs designed to address all aspects of a person’s health and well-being. Our programs feature several evidence-based services and activities vital for the process of recovery, including psychotherapy, counseling, group support, art and music therapy, aftercare planning, and more.