Trazadone is an antidepressant medication mainly used to treat depression (major depressive disorder). Like all antidepressants, trazadone can have positive effects and negative side effects. Ongoing use of trazadone leads to dependence and potential withdrawal symptoms on quitting. These symptoms can be reduced by tapering off the medication gradually.

Read on to learn more about trazadone side effects and withdrawal and discover how to connect with compassionate care.

What Is Trazodone?

Trazodone is a medication primarily used to treat depression. It belongs to a class of drugs called SARIs (serotonin receptor antagonists and reuptake inhibitors)[1], which help improve mood by balancing certain chemicals in the brain.

Trazodone Uses

Trazodone is typically used [2] to treat depression and underlying associated symptoms such as insomnia, anxiety, loss of appetite, and more.

Common Dosages

Trazodone comes in different dosages that a person can take. Doctors usually start with a low Trazodone [3] dose and will slowly increase it. A common starting dose for adults is 150mg per day, which can be taken in smaller doses throughout the day.

Follow the doctor’s instructions closely and do not change the dose without talking to the doctor first.

Trazodone Side Effects

Trazodone can be helpful for treating depression and other conditions, but like all medications, it can also cause side effects. Knowing what these side effects are can help you understand what to expect and when to talk to your doctor.

Common Side Effects of Trazodone

Some side effects of trazodone are common and might happen to many people who take the medication. These side effects are usually mild and tend to go away after a few days or weeks. Common side effects include:

• Drowsiness: Many people feel very sleepy when they take trazodone. This is one reason why it is often used to help with sleep problems.

• Dizziness: You might feel lightheaded or unsteady when you stand up quickly.

• Dry mouth: Your mouth might feel dry, making it hard to talk or eat.

• Nausea: Some people feel sick to their stomach when they first start taking trazodone.

• Headaches: You might get more headaches than usual.

• Blurred vision: Things might look a bit fuzzy or unclear.

If these side effects are mild, they might go away on their own. But if they are bothersome or don’t go away, it’s a good idea to talk to your doctor.

What Are the Long-Term Side Effects of Trazodone?

Taking trazodone for a long time can lead to some side effects that you should be aware of. Long-term use means using the medication for several months or even years. Some long-term effects of trazadone include:

• Weight gain: Some people might gain weight over time when taking this medication.

• Memory problems: It might be harder to remember things.

• Heart issues: Trazodone can affect your heart, sometimes causing an irregular heartbeat [4].

• Hormonal changes: Long-term use can sometimes affect hormones, leading to issues like changes in menstrual cycles for women.

• Mood swings: You might experience changes in your mood, feeling very happy one moment and very sad the next.

• Tremors: Some people might develop shakes or tremors in their hands or other parts of the body.

If you notice any of these long-term side effects, discuss them with your doctor. They can help you manage these side effects or decide if you need to switch to a different medication.

Trazodone Female Side Effects

Women might experience some side effects of trazodone differently than men. Here are some side effects that are specific to women:

• Menstrual changes: Trazodone can sometimes cause changes in your menstrual cycle, making periods more irregular or heavier.

• Hormonal imbalance: It can affect hormones, leading to symptoms like hot flashes or changes in mood.

• Pregnancy and breastfeeding: If you are pregnant or breastfeeding, talk to your doctor before taking trazodone. It can affect the baby, so your doctor will need to decide if it’s safe for you to take.

It’s essential for women to talk to their doctors about any changes they notice while taking trazodone, especially if they are related to their menstrual cycle or overall hormonal health.

Trazodone Side Effects Sexually

Trazodone can also affect your sexual health. Both men and women might notice changes in their sexual desire or performance. Here are some common sexual side effects:

• Decreased libido: You might not feel as interested in sex as you usually do.

• Erectile dysfunction: Men might find it difficult to get or keep an erection.

• Delayed orgasm: Both men and women might take longer to reach orgasm.

• Painful erections: In rare cases, men might experience priapism, which is a painful, long-lasting erection. This needs immediate medical attention.

If you notice any changes in your sexual health while taking trazodone, don’t hesitate to talk to your doctor. They can help you manage these side effects or suggest different treatments.

If you experience any side effects while taking trazodone, there are some things you can do to help manage them:

• Stay hydrated: Drinking plenty of water can help with dry mouth and prevent dehydration.

• Take it at night: If trazodone makes you sleepy, taking it before bed can help you avoid feeling drowsy during the day.

• Eat small meals: If you feel nauseous, eating small, frequent meals might help.

• Get up slowly: To avoid dizziness, try standing up slowly and holding onto something stable if you feel unsteady.

• Stay active: Light exercise can help improve your mood and reduce some side effects like weight gain.

Always talk to your doctor before making any changes to how you take your medication. They can give you the best advice on how to manage side effects and ensure that trazodone is safe for you.

Contact your doctor if you experience any of the following:

• Severe side effects: If you have serious side effects like chest pain, difficulty breathing, or severe dizziness, seek medical help right away.

• Allergic reactions: Symptoms like swelling, rash, or difficulty breathing can be signs of an allergic reaction.

• Mental health changes: If you feel more depressed, anxious, or have thoughts of harming yourself, contact your doctor immediately.

• Long-term side effects: If you notice any long-term side effects, such as heart issues or hormonal changes, discuss them with your doctor. 

6 Trazodone Interactions to Be Cautious Of

Consult with your doctor before taking other medication in addition to trazodone, since it can
react poorly with other medications or substances [5]. It is recommended to avoid taking trazodone
with medications like buspirone, fentanyl, lithium, tryptophan, tramadol, and sumatriptan.

1. Interactions With Other Medications that Boost Serotonin

Because trazodone is a serotonin modulator, it regulates and raises serotonin levels in the brain. When trazodone is mixed with other medications that boost serotonin, it could result in serotonin syndrome, which causes sweating, tremors, a fast heartbeat, agitation, and more.  Be cautious of other medications that influence serotonin levels, such as SSRIs, SNRIs, tricyclic antidepressants,  St. John’s wort, triptans, and monoamine oxidase inhib itors. If you have any questions, it’s best to consult your doctor.

2. Medications That Increase Risk of Bleeding

If you’re taking any blood thinners, combining them with trazodone might increase the risk of bleeding. Blood thinners to avoid when taking trazodone include rivaroxaban, apixaban, dabigatran, and Plavix. Symptoms that trazodone is reacting with other blood thinners include unexplained bruising, random nosebleeds, and blood in urine or gums.

3. Medications That Affect How Trazodone Is Metabolized

Some medications may interfere with trazodone’s metabolization process, making it ineffective or leading to an increased risk of side effects. These medications are known as CYP3A4 inhibitors and CYP3A4 inducers. Inhibitors block the enzyme that helps break down trazodone, which can potentially lead to higher trazodone levers and cause increased side effects. Inducers increase the activity of the enzyme that metabolizes trazodone, which can lead to lower trazodone levels and make it ineffective.

4. Medications That Change Heart Rhythm

Trazodone may cause changes in heart rhythm, as listed in its side effects. This risk increases when it is taken with other medications that may have the same side effect, like Pacerone, Betapace, or Geodon. Trazodone should also not be taken if you have a pre-existing heart condition that leads to arrhythmias, such as long QT syndrome.

5. Sedative Substances

Trazodone is known to cause sleepiness and other sedative effects. When combined with other medications or substances—such as alcohol—that do the same thing, it can lead to slower brain activity and exacerbate sedation effects, resulting in shallow breathing, forgetfulness, trouble coordinating, excessive sleepiness, or confusion.

6. Phenytoin & Digoxin

Phenytoin, an anti-seizure medication, and digoxin, a medication that helps control heart rate, are known as “narrow therapeutic index” medications. Medications under this classification mean that the margins between a safe dose and a toxic dose are very small. Trazodone may elevate the levels of these medications, which can create toxic doses.

Trazodone Withdrawal

When you stop taking trazodone, especially if you’ve been using it for a long time or at a high dose, you might experience withdrawal. Withdrawal happens because your body has become dependent on the medication [6], and it needs time to adjust when you stop taking it.

Trazodone Withdrawal Symptoms

Withdrawal from trazodone can cause a range of symptoms. These symptoms can be uncomfortable but knowing what they are can help you prepare and get the right help. Common side effects of antidepressant withdrawal include:

• Anxiety: You might feel nervous or worried.

• Irritability: Little things might make you angry or upset.

• Insomnia: You might have trouble sleeping or staying asleep.

• Dizziness: You could feel lightheaded or unsteady.

• Nausea: Your stomach might feel upset, and you might feel like vomiting.

• Headaches: You could get more headaches than usual.

• Sweating: You might sweat more than usual, even if you’re not hot.

• Tiredness: You might feel tired and have low energy.

These symptoms can vary in how strong they are. Some people might only have mild symptoms, while others might find them more difficult to manage.

Withdrawal Timeline

The timeline for withdrawal can be different for everyone. It depends on how long you’ve been taking trazodone, the dose you were taking, and your overall health. Here’s a general idea of what to expect:

• First few days: Withdrawal symptoms usually start within a few days of stopping trazodone. You might begin to feel anxious, irritable, and have trouble sleeping.

• First week: Symptoms can get stronger during the first week. This is when you might feel the most uncomfortable. It’s common to feel dizzy, have headaches, and feel very tired.

• Second week: By the second week, some symptoms might start to get better. You might still feel anxious and have trouble sleeping, but the physical symptoms like dizziness and nausea often start to improve.

• After two weeks: Most withdrawal symptoms should start to fade after a couple of weeks. However, some people might have lingering symptoms, especially trouble sleeping or feeling anxious.

Talk to your doctor before stopping trazodone. They can help you plan to taper off the medication slowly [7], which can make withdrawal symptoms less severe. Tapering means gradually reducing your dose instead of stopping all at once. This helps your body adjust more smoothly and can make the process more comfortable.

Stopping Trazodone: How to Wean Off Trazodone

Your doctor will help you create a plan to lower your dose gradually instead of abruptly stopping the medication. This helps your body get used to having less of the antidepressant and makes withdrawal easier to handle.

How to Sleep After Stopping Trazodone

When you stop taking trazodone, you might have trouble sleeping, especially if you have been relying on the long term use of trazodone for sleep. Here are some tips to help you sleep better:

• Keep a routine: Go to bed and wake up at similar times every day, even on weekends.

• Relax before bed: Spend the last hour before getting into bed doing something relaxing, like reading a book or taking a warm bath.

• Avoid screens: Stay away from phones, tablets, and computers before bed. The light from screens can keep you awake.

• Stay active: Get some exercise during the day, but not too close to bedtime.

• Limit caffeine: Avoid drinks with caffeine, like coffee or soda, especially in the afternoon and evening.

• Create a comfortable space: Make sure your bedroom is quiet, dark, and cool.

If you still have trouble sleeping, talk to your doctor. They might have more ideas or be able to give you a different medication to help with sleep for a short time.

A Trazodone Taper Schedule

A taper schedule helps you slowly reduce your trazodone dose. Here’s an example of what a taper schedule might look like:

• Week 1: Reduce your dose by a small amount, like 25mg less each day.

• Week 2: Continue taking the lower dose if you feel okay. If you have too many withdrawal symptoms, stay at the current dose a bit longer.

• Week 3: Reduce the dose by another 25mg.

• Week 4: Keep lowering the dose every week until you are no longer taking the medication.

Remember, this is just an example. Your doctor will create a taper schedule that’s right for you, based on how long you’ve been taking trazodone and your current dose. Always follow your doctor’s advice and never change your dose without talking to them first.

Trazodone | FAQs

Is trazodone memory loss real?

Yes, trazodone can cause memory problems in some people, especially with long-term use.

What happens if you miss a trazodone dose?

If you miss a dose of trazodone, take it as soon as you remember unless it’s almost time for your next dose. Do not double up to make up for the missed dose.

What is the trazodone half-life?

The half-life of trazodone is about 5 to 9 hours, which means it takes this long for half of the drug to leave your body. All of the medication is gone from the body after five or six half-lives.

Does trazodone cause brain fog?

Trazodone can cause brain fog or make it hard to concentrate for some people.

Can I take trazodone for alcohol withdrawal?

Trazodone is not typically used for alcohol withdrawal. It’s best to talk to your doctor for proper treatment if you need help detoxing from alcohol.

Is trazodone addictive?

Trazodone is not considered addictive, but it can lead to dependence if misused.

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Sources

[1] https://www.ncbi.nlm.nih.gov/books/NBK470560/

[2] https://www.gratitudelodge.com/the-complete-guide-to-understanding-trazodone/

[3] https://www.gratitudelodge.com/the-complete-guide-to-understanding-trazodone/

[4]https://jamanetwork.com/journals/jamapsychiatry/article-abstract/493561

[5] https://www.mayoclinic.org/drugs-supplements/trazodone-oral-route/precautions/drg-20061280#:~:text=Do%20not%20use%20trazodone%20with,Relpax%C2%AE%2C%20Zomig%C2%AE

[6]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8583742/

[7] https://connect.mayoclinic.org/discussion/withdrawal-from-trazodone-need-hope/