Overview Of Trazodone

Trazodone is a prescription antidepressant that belongs to a class of medicines known as serotonin modulators. This medication has been on the market since 1981 and is approved for the treatment of major depressive disorder in adults. Doctors also frequently prescribe it 'off-label' for insomnia and anxiety. Before prescribing trazodone, doctors will need to know if the patient has a history of mental health issues, heart disease, cancer, anemia, or liver or kidney issues. The patient should also inform their healthcare provider about any personal or family history of suicidal thoughts or actions.

How It Works

Serotonin modulators like trazodone work by moderating the level of serotonin in the brain. Specifically, the medications block the reuptake of serotonin while also modulating one or more of the brain's serotonin receptors. Scientists have identified at least fifteen different serotonin receptor subtypes, and they believe serotonin modulators may be more beneficial than selective serotonin reuptake inhibitors for certain patients with depression. This is because some serotonin receptors only play a minor role in the regulation of the patient's mood. Additionally, many serotonin modulators target a serotonin receptor known as 5-HT3. This receptor regulates the gastrointestinal tract, nausea, and vomiting, and patients who take serotonin modulators may experience fewer gastrointestinal side effects.

Trazodone Uses And Benefits

Trazodone is used primarily as a treatment for major depression. In addition to this approved use, physicians may consider prescribing trazodone for the treatment of insomnia and other sleep issues. In a 2014 study, researchers found the medication to be particularly effective for the treatment of nighttime sleep disturbances in patients with Alzheimer's disease. The medication might be used off-label to treat bulimia, fibromyalgia, schizophrenia, chronic pain, and diabetic neuropathy as well. It is often beneficial for patients with anxiety disorders, and doctors may also prescribe trazodone off-label to ease the symptoms of central nervous system degenerative diseases. It can reduce uncontrolled movements that develop as a side effect of other medicines, and some patients take it during recovery from alcohol or benzodiazepine dependence.

Potential Side Effects

Headaches, dry mouth, constipation, confusion, and blurry vision are some of the most common side effects associated with trazodone. Patients who use the medication frequently report ringing in the ears, dizziness, fatigue, weight loss, and loss of appetite as well. Nausea and vomiting could develop, and some individuals may notice sensations of numbness, burning, or tingling. Serious side effects such as chest pain, seizures, heart rhythm changes, fainting, and breathing difficulties have occurred. Patients might have panic attacks or notice unusual bleeding or bruising. If these side effects occur, the patient should seek urgent medical care.

Patients should also seek emergency care if they experience suicidal thoughts or worsening depression. In rare cases, individuals using trazodone have reported auditory hallucinations. Patients should be closely monitored for mood changes while taking this drug, and they should mention any side effects to their physician. If side effects are bothersome, reducing the dose could make the drug more tolerable.

Precautions to Remember

Trazodone may not be safe for patients with epilepsy, long QT syndrome, narrow-angle glaucoma, bleeding disorders, or heart disease. Before taking this medicine, patients should let their doctor know about any history of heart attacks, liver disease, kidney disease, bipolar disorder, substance use, or suicidal thoughts. Patients who are pregnant should discuss the risks and benefits of trazodone use with their physician. They may be placed on a pregnancy registry to monitor the pregnancy and the impact of trazodone on the newborn baby. Researchers do not know if trazodone passes into breastmilk, and patients who are breastfeeding should discuss this with their doctor.

Trazodone should be taken with food, and it can be taken with a meal or a snack. The medication needs to be stored away from light, moisture, and heat. It usually takes around two weeks of treatment with trazodone for patients to begin to notice an improvement in their symptoms. Taking this medicine with alcohol could be fatal, and the medicine can slow down an individual's reaction time. Patients should not drive or operate heavy machinery until they understand how the medicine impacts them. To reduce the risk of dizziness, it is advisable to get up slowly from a sitting or lying position. If the patient misses a dose of trazodone, the missed dose can be taken as soon as it is remembered. However, the missed dose should be skipped if it is almost time for the next one, and the patient should never take two doses at once. Patients who want to discontinue trazodone should speak with their doctor about tapering the dose to avoid withdrawal symptoms.

Potential Medication Interactions

Due to the risk of serotonin syndrome, trazodone should not be taken with monoamine oxidase inhibitors like selegiline. Patients who have been using monoamine oxidase inhibitors will need to wait at least two weeks after stopping this treatment before they can safely begin taking trazodone. Taking trazodone with nonsteroidal anti-inflammatories such as naproxen or ibuprofen could increase the risk of bleeding, and using trazodone with central nervous system depressants could increase the likelihood of experiencing side effects. Combining trazodone with digoxin, St. John's wort, other antidepressants, or phenytoin could cause the patient to have more side effects from these drugs.

Phenytoin and carbamazepine can make trazodone less effective, and patients who use these medicines may need to take higher doses of trazodone to counteract this. Medication interactions are also possible between trazodone and tramadol, diuretics, blood thinners, and medications used to treat migraines, anxiety, and mood disorders. Patients should always let their doctor know about all of the medications they use, including prescription medicines, over-the-counter drugs, vitamins, minerals, and herbal supplements.