Trazodone

💊 What is Trazodone used for?

• •Major depressive disorder (MDD) in adults
• •The label says trazodone is not approved for use in pediatric (child) patients.

How it works

The label describes trazodone as a selective serotonin reuptake inhibitor and a 5HT2 receptor antagonist. The label does not explain this in more detail.

How it is usually taken

• •The label says to take trazodone exactly as your healthcare provider tells you.
• •The tablets should be taken shortly after a meal or light snack.
• •The tablet can be swallowed whole, or it can be broken in half along the score line. The label says not to chew or crush it.
• •The label says the dose is usually raised slowly over time, based on how you respond and how well you tolerate it.
• •If drowsiness is a problem, the label says a larger part of the daily amount may be taken at bedtime, or the dose may be lowered.
• •When treatment is stopped, the label says the dose is usually lowered gradually. Never stop an antidepressant without first talking to your healthcare provider.

Comes as

• •Scored tablets in 50 mg, 100 mg, 150 mg, and 300 mg strengths

⚠️ Trazodone side effects

🛑 Who should not take Trazodone, and who should be careful

The label says not to take it if

• 🚨You take a monoamine oxidase inhibitor (MAOI), including linezolid or intravenous methylene blue.
• 🚨You have stopped an MAOI within the last 2 weeks.
• 🚨The label says you should not take an MAOI within 2 weeks of stopping trazodone, and you should not start trazodone within 2 weeks of stopping an MAOI, unless your healthcare provider directs otherwise.

Tell your doctor before taking it if

• •Tell your healthcare provider about all of your medical conditions, including heart problems or a family history of QT prolongation, a past heart attack, bipolar disorder, liver or kidney problems, and other serious medical conditions.
• •Tell your provider if you have a personal or family history of bipolar disorder (also called manic-depressive illness) or of suicidal thoughts or actions.
• •Tell your provider if you are pregnant, plan to become pregnant, are breastfeeding, or plan to breastfeed.
• •Tell your provider about all medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Keep a list and show it to your provider and pharmacist.
• •The label says trazodone can impair judgment, thinking, and motor skills. Use caution when operating machinery.
• •The label warns to avoid use in people with untreated narrow angles in the eye (angle-closure glaucoma).

🔀 Trazodone with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Alcohol, barbiturates, and other CNS depressants: trazodone may enhance their effects. Overdose deaths have occurred when trazodone was taken with other CNS depressants, including alcohol.
• •MAOIs (such as isocarboxazid, moclobemide, phenelzine, selegiline, and tranylcypromine): this combination is contraindicated.
• •Other serotonergic drugs (such as triptans, other antidepressants, SNRIs, SSRIs, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John's Wort): these can increase the risk of serotonin syndrome.
• •Aspirin, NSAIDs, other antiplatelet drugs, and anticoagulants such as warfarin, rivaroxaban, dabigatran, and clopidogrel: these may increase the risk of bleeding. For warfarin, the label says the INR should be monitored when trazodone is started or stopped.
• •Strong CYP3A4 inhibitors or inducers: the label says the trazodone dose may need to be reduced or increased.
• •Digoxin or phenytoin: the label says levels may need monitoring.
• •Drugs that also prolong the QT interval: the label says to avoid these.
• •Diuretics: listed in the patient information as medicines to tell your provider about.

Alcohol and food

The label says trazodone may enhance the effects of alcohol, so the two together can add to drowsiness and other effects. Take the tablets shortly after a meal or light snack.

🤰 Trazodone in pregnancy and breastfeeding

Pregnancy

The label says published studies in pregnant women have not found drug-associated risks of major birth defects, miscarriage, or other adverse outcomes. Animal studies at higher doses showed effects on the fetus. The label says it is not known if trazodone will harm an unborn baby, so talk with your healthcare provider about the risks. A pregnancy registry for antidepressants is available at 1-844-405-6185.

Breastfeeding

The label says trazodone passes into breast milk. Talk with your healthcare provider about the best way to feed your baby while taking it. The label notes that the benefits of breastfeeding and the mother's need for treatment should both be considered.

🗓️ Storage, missed doses and taking too much

Storage

The label does not say.

If a dose is missed

The label does not say.

If too much is taken

The label says death from overdose has occurred when trazodone was taken with other CNS depressants, including alcohol. The most severe reactions reported with trazodone overdose alone include priapism, respiratory arrest, seizures, and ECG changes such as QT prolongation, and syndrome of inappropriate antidiuretic hormone secretion (SIADH). The most frequently reported reactions are drowsiness and vomiting. The label says there is no specific antidote. Get emergency medical help right away if an overdose is suspected.

🗒️ Questions to ask about Trazodone

• Is trazodone the right choice for my depression, and what are my other treatment options?
• How should I watch for changes in mood, behavior, or suicidal thoughts while I take this medicine?
• Does my heart history or family history affect whether this medicine is a good fit for me?
• Which of my current medicines, supplements, or over-the-counter products could interact with trazodone?
• What should I do if I feel very drowsy or dizzy during the day?
• How will my dose be lowered if I need to stop, and what symptoms should I watch for?

❓ Trazodone: frequently asked questions