Trazodone for Sleep: Uses, Benefits, and Side Effects

Chronic insomnia, a common sleep disorder, is estimated to affect approximately 33% of adults, according to the results of one study. In addition to causing frustrating feelings of exhaustion, insomnia can also have serious health consequences, as getting enough sleep is vital for optimal health.

Although there are a number of prescription medications available to help with sleep problems, the use of trazodone for sleep has a number of benefits compared to other drugs.

What is Trazodone?

Trazodone is a generic drug that is sometimes sold under the brand name Desyrel. The medication belongs to a class of medications called atypical antidepressants.

Despite their name, atypically antidepressants like trazodone can treat a wide range of mental health conditions, including anxiety and depression. Trazodone was first introduced to the U.S. market under the brand name Desyrel in 1981, and the medication has been studied extensively and used for the treatment of millions of people over the past 40 years.

Can trazodone be used to treat insomnia?

Although trazodone is primarily used for the treatment of clinical depression and anxiety, it can also be used for the treatment of insomnia. In fact, trazodone offers many benefits compared to the use of other prescription medications for insomnia.

Insomnia

Trazodone is commonly prescribed off-label for the treatment of insomnia in those who have difficulty falling asleep.

Although trazodone was not originally intended for use as a sleep aid, the sedative effect and feelings of relaxation and sleepiness it provides make it an ideal sleep aid.

While most prescription sleep aids, such as Ambien and Lunesta, are controlled substances with a high potential for abuse, trazodone is not a controlled substance and has a much lower chance of abuse. Additionally, trazodone is also a generic medication, which makes it affordable for most patients even without health insurance.

Because it is not a controlled substance, patients do not have to consult with a doctor on a regular basis for prescriptions, and a healthcare provider can provide more than a 30 day supply of medication at once.

People who take trazodone for sleep typically begin to feel the effects of the medication in about 30 minutes.

Clinical Depression / Major Depressive Disorder

Trazodone is also commonly used for the treatment of clinical depression.

Clinical depression, also known as major depressive disorder, is one of the most common types of depression. Clinical depression causes physical, mental, and emotional symptoms that persist for a period of at least two weeks and are severe enough to interfere with daily activities on most days. Although the feelings of intense and persistent sadness must last for a minimum of two weeks, many people experience symptoms for much longer.

Anxiety

Trazodone is also commonly used for the treatment of anxiety. There are many different types of anxiety, but among the most common is generalized anxiety disorder (GAD).

Trazodone is not used for feelings of occasional anxiety, which are common, but it may be used when the feelings become extreme, interfere with a person’s quality of life, or last for more than six months, indicating an anxiety disorder.

People with GAD experience chronic anxiety that is generally not provoked by any specific situation or fear.

What dose of trazodone should I take for sleep?

Trazodone is typically available in strengths of 50 mg, 100 mg, 150 mg, and 300 mg. The amount a patient is prescribed will vary depending on the condition being treated, with patients generally taking doses of between 150 mg and 400 mg per day for the treatment of major depressive disorder on an outpatient basis.

When trazodone is used for sleep, the dose is typically much lower. Most patients who use trazodone for sleep are prescribed a dose of between 25 mg and 100 mg, although studies show that even lower doses can be effective. Lower doses may also result in fewer side effects, including daytime sleepiness. In order to avoid side effects, patients should take the lowest possible dose that is effective in helping them sleep.

Trazodone use does carry with it the potential for withdrawal symptoms if the medication is discontinued abruptly, particularly when used for a period of six weeks or more.

When taken at the low doses prescribed for sleep, withdrawal is rare, but it is possible. Patients should not change their dose of trazodone or stop using the medication without advice from their healthcare provider.

Symptoms of withdrawal include:

Dizziness
Vomiting
Sweating
Numbness
Agitation
Confusion
Tingling
Feelings of electric shock

What Are the Side Effects of Trazodone?

Most side effects that are associated with the use of trazodone for sleep, depression, anxiety, or another condition are considered mild if present at all.

Side effects associated with trazodone include:

Blurred vision
Vomiting
Swelling
Disorientation
Drowsiness
Fatigue
Nausea
Sedation
Anxiety
Anemia
Nasal congestion
Increased appetite
Insomnia
Fainting
Weight change
Decreased libido
Headache
Constipation
Confusion
Double vision
Urinary retention
Dizziness
Dry mouth
Tremors
Ejaculation disorder
Painful erection
Lack of coordination
Feeling faint or dizzy when standing
Lightheadedness
Hair loss
Acne
Vertigo

Are Any Drug Interactions Associated with Trazodone?

Trazodone does interact with a number of different drugs. The majority of these interactions are moderate to mild, but some can be severe.

Medications known to interact with trazodone include, but are not limited to:

Arsenic trioxide
Pentamidine
Pimozide
Disopyramide
Ibutilide
Isocarboxazid
Saquinavir
Cisapride
Eliglustat
Indapamide
Terfenadine
Astemizole
Sotalol
Tranylcypromine
Phenelzine
Procainamide
Phenytoin

What risks are associated with trazodone use?

Whether you take trazodone for sleep or for the treatment of depression, anxiety, or another condition, there are some risks associated with trazodone use. The FDA lists the following risks associated with trazodone, and you should seek medical advice or medical attention if these symptoms become apparent:

Thoughts of suicide, especially in young adults and children
Serotonin syndrome, a dangerous condition that occurs when too much serotonin builds up in the body, causing potentially serious reactions. Taking antidepressant medications like fluoxetine while also taking trazodone can increase your risk of experiencing serotonin syndrome. Symptoms of serotonin syndrome include:
- Hallucinations
- Increased heart rate
- Headaches
- Dizziness
- Agitation
- Seizures
- Rigidity
- Nausea
- Diarrhea
- Increased body temperature
- Muscle tremor
- Trouble with balance
- Vomiting
Cardiac arrhythmia, particularly in people who already have heart problems
Hypotension, or sudden low blood pressure when moving from sitting to standing
Increased risk of bleeding, particularly in patients taking blood thinners
Priapism, an erection lasting longer than four hours
Mania
Blurred vision
Hyponatremia, a dangerous sodium imbalance that can cause the following symptoms:
- Headache
- Confusion
- Unsteadiness
- Weakness
- Seizures

Are there any warnings associated with trazodone?

People who take certain types of drugs known to cause dangerous interactions with trazodone, including monoamine oxidase inhibitors (MAO inhibitors/MAOIs) such as isocarboxazid, linezolid, rasagiline, methylene blue injection, phenelzine, selegiline, and tranylcypromine, and people taking blood thinners should not take trazodone. People who are allergic to trazodone or nefazodone should not use trazodone for sleep.

Depending on your medical history, you may need to be extra careful when taking trazodone for sleep. Be sure to give your doctor a complete medical history, especially including any personal or family history examples of:

Allergic reactions to any drugs or supplements
Narrow-angle glaucoma
Drug addiction
Heart disease or recent heart attack
Seizures or epilepsy
Suicidal thoughts
Liver or kidney disease
Bleeding or blood clotting disorder
Bipolar disorder
Long QT syndrome

Although serious side effects from taking this medication are rare, they are more likely to occur in older adults, particularly bleeding and loss of coordination. In order to prevent issues associated with serious side effects, patients who use trazodone for sleep should ensure that they have plenty of time to sleep each night and let their body process the medication.

Summary

Trazodone can be effectively used for sleep in addition to clinical depression and anxiety disorders. Trazodone is less likely to be addictive than other medications used for sleep, such as Ambien, so it is an excellent choice for some people.

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