medicinal drugs Trazodone is a commonly used antidepressant and is sometimes used to help with insomnia. It has been used as a sleep aid for decades. Its use for insomnia is considered off-label, meaning it has not been officially approved for this condition. But how does it work and who should use it?
This article discusses how trazodone is used and how it works. It also includes side effects, precautions to take, who to avoid, and when to consult a doctor.
Trazodone is an older drug that has been used for many years to treat depression and severe anxiety. Since it has a sedative or hypnotic effect, which means it causes drowsiness, it is also helpful in the treatment of insomnia or acute insomnia.
Acute insomnia is short-term and may last for days or weeks. Insomnia is long-term or chronic, occurring at least three nights a week for three months or more.
Trizadone acts on neurotransmitters, which are chemical messengers in the brain. It allows a specific neurotransmitter called serotonin to build up in the spaces between nerve cells by preventing it from entering nearby cells. This increases serotonin in the brain, which helps improve mood.
Trazodone also appears to act on another neurotransmitter, histamine. Your immune system releases histamine to help your body fight foreign substances. In the brain, they also help you stay alert and awake.
Trazodone can make you drowsy by blocking these histamines. This is similar to the effect of another common antihistamine, benadrine (diphenhydramine). Trazodone also appeared to improve slow-wave or deep sleep in one study.
The American Academy of Sleep Medicine does not currently recommend the use of trazodone for the treatment of insomnia. This suggests that the potential risks and harms outweigh the benefits.
Their position is based in part on research showing that it takes only about 10 minutes to fall asleep with trazodone. In addition, the time spent awake at night decreased by only eight minutes on average.
Trizadone can treat depression, but it can also make you drowsy, which may help with insomnia. It works by blocking histamine in the brain that keeps you awake. However, the American Academy of Sleep Medicine does not recommend its use.
Precautions and contraindications
In some cases, you may want to avoid trazodone for insomnia.
Trazodone should not be used in people recovering from a heart attack. People under the age of 25 should not use it, and the elderly should use it with caution. Trazodone should be avoided if you are pregnant or breastfeeding.
Trazodone may also not be suitable for people with mental illnesses, including bipolar disorder and schizophrenia. People at risk of suicide should not use it. Talk to your doctor if you have heart disease, cerebrovascular disease (affecting blood flow in the brain), seizures, or kidney or liver problems.
Trazodone has the potential to interact with many other drugs. Before you start taking trazodone, your healthcare provider should review your medication carefully. There were no reports of death or heart complications in people taking trazodone alone.
You should not stop taking the medicine suddenly. Instead, it may need to be reduced slowly under the supervision of a healthcare provider.
Before taking trazodone, make sure your healthcare provider understands your medical condition and the medicines you take. Trazodone may not be safe in some cases. This includes whether you have heart disease, are under the age of 25, are pregnant or breastfeeding, or are at risk of suicide.
You may experience side effects from trazodone. Some of these are common, while others are rare but can be serious.
These possible side effects include the following.
You may or may not have any side effects while taking trazodone. When reported, some of the most common side effects included:
- dry mouth
- blurred vision
- nausea or vomiting
- heart rate too fast
- low blood pressure
- skin reactions, such as rashes
- Muscle pain
- weight change
- tremor (shaking)
- Difficulty walking or coordinating
With any drug, there is also a risk of serious side effects. When using trazodone, it may include:
- Priapism (permanent painful erection)
- Orthostatic hypotension (low blood pressure when standing)
- abnormal heart rhythm
- high blood pressure (high blood pressure)
- heart attack
- Extrapyramidal symptoms (motor and coordination problems)
- tardive dyskinesia (uncontrollable facial movements)
- Hypomania (high mood and increased energy) or mania (high mood, high energy and possible delusions)
- Worsening psychosis (loss of touch with reality, experiencing delusions and hallucinations)
- Depression worsens
- suicidal thoughts
- Neutropenia (low white blood cell count)
- Hepatitis (inflammation of the liver)
- Syndrome of Inappropriate Antidiuretic Hormone (SIADH, a disorder in which the body retains too much water)
Please consult your doctor
As mentioned above, some people should use the drug with caution or not at all. Your doctor will need to monitor you when you start or change your dose. In particular, you should watch for any symptoms of suicide or unusual behavioral changes.
If you experience any difficulties, you should stay in close contact with your primary care provider. If insomnia persists, consider treatment with cognitive behavioral therapy for insomnia (CBTI), which includes professional guidance on healthy sleep behaviors.
You can start a conversation with your healthcare provider using the healthcare provider discussion guide below.
Trazodone, an antidepressant, can also cause drowsiness. Because of its sedative properties, it is sometimes used to treat insomnia, both short-term and long-term.
Trazodone may have a sedative effect because it blocks histamine in the body. Histamine in the brain usually keeps you alert.
Trazodone may not be safe for some people, especially those with heart disease, mental illness, or who are pregnant or breastfeeding. It should also not be used by people under the age of 25 or the elderly.
Talk to your doctor about possible side effects and whether it is safe for you to take trazodone.
If you have insomnia and are considering medications such as trazodone, schedule an evaluation by a board-certified sleep specialist.
Sleep disorders, including sleep apnea, often make it difficult to fall asleep throughout the night. Treating this condition may resolve your insomnia problems.
Additionally, conditions such as sleep apnea can have long-term health effects if left untreated or masked by medication. Getting proper treatment can help improve symptoms while avoiding unnecessary or potentially harmful medications.
Frequently Asked Questions
How does trazodone treat insomnia?
Trozadone promotes sleep in several different ways. It is a tired antidepressant. It increases serotonin levels to improve your mood and acts as an antihistamine similar to benadrine, making you drowsy.
Is trazodone a sleeping pill?
Not official, but it’s often prescribed off-label to treat insomnia. Trazodone, an older-generation antidepressant, was approved by the FDA in 1981 for the treatment of anxiety and depression. Drowsiness is a side effect of trazodone. When prescribed as an antidepressant, it should be taken at bedtime.
How long does it take for trazodone to fall asleep?
Trazodone works fairly quickly as a sleep aid, usually taking about 30 minutes to make you drowsy. Most people who take trazodone for sleep find that it helps them fall asleep and stay asleep throughout the night.
Will trazodone make me sleepy in the morning?
Possibly, especially if you start taking it for the first time or take it too late at night. The sleep-promoting effects of trazodone can last from five to nine hours, depending on the individual. You should not drive or operate heavy machinery until you understand how trazodone affects you.