Trazodone (e.g., Oleptro, Desyrel) is an antidepressant approved by the Food and Drug Administration (FDA) to treat the symptoms of depression. Trazodone is often used in conjunction with other medications. It has many potential therapeutic uses for several conditions commonly experienced in conjunction with major depression, as well as off-label usage to induce sleep in those who have insomnia.
Combining trazodone with alcohol can amplify a person’s level of intoxication because both substances have sedating effects. Doing so can result in extreme drowsiness and increase the risk of overdose if either is consumed excessively. Chronic use of these substances can also result in dependence and withdrawal symptoms when a person attempts to discontinue use.
What Is Trazodone?
Trazodone is a SARI (serotonin receptor antagonist and reuptake inhibitor) antidepressant medication. The drug is believed to increase the feel-good neurochemical serotonin in the central nervous system (CNS). By stimulating serotonin activity throughout the brain, certain types of antidepressants are believed to reduce major depressive disorder symptoms.
Trazodone is also commonly used off-label to treat a range of conditions, such as anxiety, insomnia, Alzheimer’s disease, substance use disorder, schizophrenia, bulimia, and fibromyalgia.
Side effects of trazodone can include:
- Dry mouth
- Impaired coordination
- Blurred vision
Less common but severe side effects may include the following:
- Suicidal ideations
- Increased bleeding risk, especially when used with NSAIDs
- Irregular heart rhythm and increased risk of sudden death
- Low blood sodium levels
- Painful, long-lasting erections
- Cognitive impairment
- Motor impairment
- Serotonin syndrome
Serotonin syndrome occurs when an individual has too much serotonin in their system, usually because of a medication or a combination of medications. Anyone experiencing severe side effects should contact their health provider as soon as possible.
What Is Alcohol?
Alcohol’s legal status in the U.S. makes it one of the most commonly abused substances. According to SAMHSA (Substance Abuse and Mental Health Services Administration), an estimated 14.5 million persons aged 12 and older had an alcohol use disorder in 2017.
Alcohol is a CNS depressant that acts on numerous neural targets and several neurochemical systems. However, it is believed that its intoxicating abilities are primarily achieved by decreasing the effects of brain chemicals that stimulate or excite the brain and increasing the effects of chemicals that inhibit activity and induce feelings of calm and sedation.
Effects of alcohol include the following:
- Diminished reaction time
- Blurry vision
- Slurred speech
- Impaired coordination
- Decreased alertness
- Decreased inhibitions
- Impaired judgment
- Poor decision-making
The Potential for Trazodone Abuse
When used as directed, antidepressants such as trazodone are not associated with a rewarding, euphoric high like many other prescription drugs of abuse. Moreover, it’s potential for misuse is relatively minor compared to other mood-altering medication, such as opioids or benzodiazepines.
Therefore, antidepressants like trazodone are not considered to be significant drugs of abuse. In fact, research on trazodone has so far found no indication that users are more likely to engage in drug-seeking behavior. For example, a 2014 review of antidepressant abuse studies found no published cases that provided evidence of any excessive trazodone abuse.
While polysubstance abuse (the abuse of multiple substances) can occur related to trazodone use, most individuals who take antidepressants do not misuse them. Trazodone overdoses are uncommon but can occur, primarily if other contraindicated substances are used in combination.
The Effects of Combining Trazodone With Alcohol
Drinking alcohol while taking trazodone is risky. Trazodone may compound some of alcohol’s effects, leading to critical levels of intoxication, overdose, and death. The combination can also induce extreme drowsiness, which can cause accidents and falls. Furthermore, alcohol has been known to exacerbate anxiety and depression.
Long-term use of alcohol and trazodone can also lead to chemical dependence and withdrawal effects. Trazodone withdrawal symptoms can include agitation, anxiety, and sleep disturbances. Instead of quitting abruptly or “cold turkey,” persons taking this medication are strongly advised to undergo a tapering or weaning schedule under a health provider’s supervision.
Acute alcohol withdrawal syndrome, on the other hand, can be even more severe and result in symptoms such as the following:
- Increased body temperature
- Increased heart rate
If left unaddressed, alcohol withdrawal also has the potential to lead to a life-threatening condition known as delirium tremens (DTs). If this condition manifests, the individual may experience extreme agitation, confusion, hallucinations, and seizures. DTs is a medical emergency and has the potential to cause severe health complications and death.
Individuals who have become dependent on alcohol often need to undergo medical detox in which they are monitored around-the-clock by health providers. Detox can be conducted either as part of a standalone program or at the start of long-term rehab. Medical detox programs are typically staffed with several healthcare professionals who monitor the individual’s recovery 24/7 during the withdrawal process and deliver therapeutic interventions, such as medication when needed.
Alcohol is not the only substance that has the potential to interact with trazodone adversely. Other drugs that may be risky to use in conjunction with trazodone include the following:
- Monoamine oxidase inhibitors (e.g., Marplan, Nardil), which can increase the risk of serotonin syndrome
- CNS depressants (e.g., opioids, benzodiazepines, and barbiturates), which can increase drowsiness and increase the risk of serotonin syndrome
- CYP3A4 enzyme inhibitors (e.g., clarithromycin, ketoconazole), which can cause trazodone toxicity to be more likely to occur
- CYP3A4 inducers (e.g., carbamazepine), which may decrease the effectiveness of standard trazodone doses.
- Digoxin or phenytoin, which can lead to increased serum levels of both medications and toxicity
- Warfarin (e.g., Coumadin), which along with concurrent trazodone use can lead to impaired blood clotting
- Serotonergic medications (e.g., SSRIs such as Zoloft, Paxil) which can increase the risk of serotonin syndrome
- Non-steroidal anti-inflammatory drugs (NSAIDs), anticoagulants, or aspirin, which can increase the risk of bleeding
Whenever a person is prescribed a trazodone-containing product, they should talk to their doctor and make sure that he or she has a complete list of their prescription medications. A health provider should be able to determine the potential for any interactions with trazodone and adjust medications accordingly, if necessary.
Getting Treatment for Addiction
If you are using trazodone and alcohol together despite the risks involved, you may have what is known as polysubstance use disorder. This condition is characterized by the use or abuse of multiple substances despite the adverse consequences that result.
Just Believe Recovery is a state-of-the-art addiction treatment center that offers comprehensive programs intended to treat all aspects of a person’s health and wellness, including substance disorders and co-occurring mental health conditions. We are well-equipped to treat polysubstance abuse and address the underlying factors contributing to a person’s need to use drugs or alcohol.
Therapeutic services we offer include, but are not limited to, the following:
- Individual/family counseling
- 12-step group support
- Substance abuse education
- Health and wellness education
- Relapse prevention
- Mindfulness meditation
- Art therapy
- Music therapy
- Aftercare planning