Generic Name: Trazodone Hydrochloride
Brand Names: Oleptro, Trazodone-D
Drug Class: SARI (Serotonin antagonist and reuptake inhibitors), Anti-depressant, Sedative, Anxiolytic
Similar Class Drugs: Lorpiprazole, Nefazodone
Available Dosage Form: Oral extended-release tablet
What is Trazodone?
Trazodone is used for the treatment of major depressive disorder in adults with insomnia as the predominant symptom.2 It antagonizes the action of serotonin receptors and inhibits the reuptake of serotonin from the synaptic cleft. The simultaneous inhibition of the receptors and SERT transporter prevents the side effects (anxiety, insomnia, and sexual impairment) which are usually seen with most second-generation antidepressants.2
It has clinical efficacy similar to that of TCAs, SNRIs, and SSRIs. A distinguishing feature of Trazodone is its broad-spectrum action on several types of receptors. This property affects the neurotransmission of histamine, adrenaline, cholines, and dopamine.
Its off-label use include:1
– Alcohol cessation
– Anxiety
– Alzheimer’s
– Dementia
– Schizophrenia
– Fibromyalgia
– Bulimia nervosa
– Anorexia nervosa
– Post-traumatic disorder (PTSD)
How to use Trazodone?
– The minimum dosage of Trazodone is 150 mg/day.
– Do not take the total dosage at once and take the dosage in increments throughout the day.
– Your doctor is going to prescribe tablets of 50mg or 100mg dosages.
– Break the tablets along the score line if your doctor asks you to. Swallow the broken half or the whole tablet if prescribed.
– Approved maximum dosage of Trazodone is 400mg. Exceeding the amount of dosage will increase the risk of adverse effects.
– Tablets have to be taken with a meal or snack to prevent stomach upset.
– The drug might cause drowsiness, and therefore it is best to take it at bedtime.
– Your doctor is going to taper the dosages at the end of treatment.
What are the side effects of Trazodone?
Common side effects experienced with Trazodone involve:
– Headache
– Dizziness
– Dry mouth
– Excessive sedation
– Orthostatic hypotension
– Priapism
Adverse effects noted with the medication:1
– Exacerbation of panic symptoms in PTSD patients1
– Cardiovascular effects
– Suicidal ideation in children and adolescents
– Visual hallucinations
Conditions that need extra precaution before Trazodone prescription:
– Pregnancy and lactation
– Sickle cell anemia
– Cancer
– Autonomic dysfunction
– Hypercoagulability
Inform your doctor about your conditions, medication history, and allergens to prevent potential adverse effects.
Who should not use Trazodone?
– Hypersensitive patients
– Ongoing treatment with MAOIs, methylene blue, linezolid, and other drugs that interact with Trazodone
– Compromised liver or kidney function
References
- Shin JJ, Saadabadi A. Trazodone. [Updated 2021 May 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470560/
- Cuomo A, Ballerini A, Bruni AC, Decina P, Di Sciascio G, Fiorentini A, Scaglione F, Vampini C, Fagiolini A. Clinical guidance for the use of trazodone in major depressive disorder and concomitant conditions: pharmacology and clinical practice. Riv Psichiatr. 2019 Jul-Aug;54(4):137-149. doi: 10.1708/3202.31796. PMID: 31379379.
