Trazodone

What is trazodone?

Trazodone is a prescription only antidepressant medicine. It is in a class of medications known as serotonin modulators and it is licensed for the treatment of depression and anxiety.

What is trazodone used for?

Trazodone is licensed for the treatment of depression and anxiety. It may also help with sleep problems such as insomnia, and poor concentration[1]

How does trazodone work?

Trazodone works by increasing the brain’s natural level of serotonin – a chemical messenger that helps regulate things like mood, emotions and sleep. The mechanism of action of trazadone is not fully understood, but it includes blocking the reuptake of serotonin which stops existing serotonin from being broken down and recycled. In turn, this helps improve general mood and can have a soothing or calming effect[1].

Who can take trazodone?

Trazodone can be suitable for most adults over the age of 18 years old. However, it may not be appropriate:

• If you have ever had an allergic reaction to trazadone

• If you have recently had a heart attack

• If you are a heavy drinker or if you regularly take sleeping tablets

• If you are pregnant or breastfeeding, or trying to conceive

• If you have liver, kidney, or heart problems

• If you have any of the following conditions: epilepsy, hyperthyroidism, glaucoma, an enlarged prostate, or urinary retention (issues with passing water)

• If you have a history of schizophrenia, bipolar disorder, self-harm, or suicidal thoughts

• If you are taking monoamine oxidase inhibitors (MAOIs) or other antidepressants

Please tell your doctor or pharmacist about any conditions you may have before starting trazadone, and always follow the instructions in the Patient Information Leaflet[2].

How do you take trazodone?

Trazadone is usually taken once a day at bedtime, as it can make you feel sleepy. If you are taking a higher dose your doctor may advise you to split the dose and take it twice a day. Taking trazadone after food can reduce the chances of feeling nauseous. Swallow the tablets whole with a drink of water and do not crush or chew them[1].

What is the typical dosage of trazodone?

The dose you are prescribed may vary depending on your condition. It may also change over time depending on how you respond to the medicine[1].

Trazodone comes in 50mg, 100mg, and 150mg tablets, 50mg and 100mg capsules, and 10mg/ml and 20mg/ml in liquid form[1]. If you are prescribed the liquid form, it is important to use the measuring spoon or oral syringe provided with the medication to ensure you are taking the correct dose. Kitchen teaspoons are not reliable and may lead to incorrect dosing.

Standard doses are:

• Treatment of depression in adults: 150mg to 300mg daily, increased up to 600mg in daily divided dose as needed

• Treatment of depression in elderly patients: initially 100mg daily, increased up to 600mg in daily divided doses as needed

• Treatment of anxiety: 75mg daily, increased up to 300mg daily as needed.

Always follow the dosage on the label or as prescribed by your doctor or pharmacist[2].

Can you stop taking trazodone suddenly?

You should not stop this medication suddenly unless your doctor tells you to. If you are considering stopping the medication speak to your doctor first, especially if you have been taking it for a long time, to reduce your dose gradually. Stopping abruptly can cause withdrawal symptoms, such as anxiety, nausea, sickness, numbness or tingling in your limbs, headaches, shaking, problems sleeping, irritability, or dizziness[1].

What should you do if you take too much trazodone?

Taking too much trazodone can be dangerous. If an overdose occurs, symptoms may include:

• Extreme drowsiness

• An irregular or racing heartbeat

• Nausea and vomiting

• Confusion

• Dizziness or fainting

• Seizures

• Difficulty breathing

It’s crucial to call 111 if you think you or someone else has taken more than the prescribed dose of trazadone, even without any symptoms present. Call 999 or go to A&E immediately if you or someone else may have overdosed[1].

What should you do if you forget a dose of trazodone?

If you forget to take trazodone then remember within a few hours, take the missed dose as soon as possible. However, if it is nearly time for your next dose, skip the missed one and carry on as usual. It’s important not to take two doses of trazodone at the same time to make up for a missed dose as this could cause unwanted side effects[1].

What medicines should you avoid while taking trazodone?

You should inform your doctor or pharmacist if you are taking any of the following medications or if you have taken them in the last two weeks[1]:

• MAOIs (Mono Amine Oxidase Inhibitors) such as tranylcypromine, phenelzine, isocarboxazid, or selegiline

• Other antidepressant medications

• Sleeping tablets and antihistamines, as these can increase drowsiness

• Medication used for high blood pressure (e.g. clonidine) or heart disease (e.g. digoxin)

• Blood thinners such as warfarin, as this may affect the time your blood takes to clot

• Some medication used for Parkinson’s disease, antiepileptic medication, antifungal medication, antiviral medication, and some antibiotics

• St John’s Wort (a herbal medicine used for depression)

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of trazodone?

Some of the most common and less serious side effects of trazodone include[1]:

• Drowsiness

• Constipation

• A dry mouth

• Headaches

• Nausea

If you experience side effects, report them to your doctor or pharmacist. You can also report side effects via the MHRA Yellow Card scheme.

Serious but rare side effects include:

• An irregular heartbeat, restlessness, confusion, shaking, hallucinations – these may be signs of Serotonin syndrome

• Numbness, tingling, or burning sensations

• Shortness of breath, a raised temperature, and difficulty walking could all be signs of Neuroleptic Malignant Syndrome

• Yellowing of the eyes or skin as these may suggest a problem with your liver

• Severe stomach pain and bloating with or without vomiting and constipation

• Bruising more easily than usual or getting more infections than usual

If you notice any of these, contact your doctor or call NHS 111 as soon as possible.

You must call 999 or go to A&E if you experience any for the following:

• A serious allergic reaction to trazadone, which can present as a severe rash, swelling of the face and throat, and difficulty breathing

• A painful and prolonged erection that will not go away (priapism)

• Thoughts of self-harm

• Fits (seizures)

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2].

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice.

Frequently asked questions about trazodone

Is trazodone addictive?

Trazodone is not considered addictive. However, stopping trazodone suddenly can lead to withdrawal symptoms such as difficulty sleeping, low mood, and excessive sweating. If you are considering stopping trazadone you should discuss it with your doctor first to reduce the dose gradually and safely.[1].

How long does trazodone take to work?

Trazodone usually begins to help within 1 to 2 weeks,but it can take 4 to 6 weeks to feel the full benefit. You may feel worse in the first few weeks of treatment before starting to see an improvement in your symptoms[1].

Can I drink alcohol while taking trazodone?

It is best to avoid alcohol while taking trazodone. This is because it can increase drowsiness and make side effects worse[1].

Can I drive or operate machinery while taking trazodone?

Trazodone can cause drowsiness. As such, it’s best not to drive or use heavy machinery until you know how the medicine affects you[1].

Can I take trazodone long-term?

Yes, trazodone can be taken long-term if it continues to help and does not cause serious side effects. Your doctor or pharmacist will review your treatment regularly and may suggest other doses or treatments if the results are not as desired[1].

For the official NHS guide to trazodone, visit their website.