Trazodone is an antidepressant that drug manufacturers developed to treat depression. Doctors may also recommend Trazodone for sleep disorders, such as insomnia.

A person who has trouble sleeping may decide to talk to their doctor about the possibility of taking trazodone. However, trazodone may not be good for everyone and can have unwanted side effects.

Keep reading for more information on using trazodone to aid sleep.

Trazodone is an antidepressant that the Food and Drug Administration (FDA) approved to treat depression in the United States.

It belongs to a class of drugs called selective serotonin antagonists and reuptake inhibitors (SARIs). These drugs act by blocking the absorption of serotonin and other neurotransmitters in the brain.

Selective serotonin reuptake inhibitors (SSRIs) are the most common antidepressants that doctors prescribe.

However, according to a review of studies published in 2017, some researchers suggest that the off-label use of trazodone to treat sleep disorders now surpasses its use as an antidepressant.

Trazodone can help certain people to fall asleep. However, similarly to other medications, it may work better for some people than for others.

According to the 2017 research review mentioned above,trazodone in low doses is generally safe and effective for treating insomnia. It’s important to note that currently, the FDA has only approved trazodone for treating depression.

Doctors generally consider trazodone safe in small doses for sleep disorders such as insomnia. But it may not be as effective as medications such as Ambien for treating these sleep disorders.

If a person is having trouble sleeping due to depression, they may require a higher dose of trazodone. If a doctor determines that a person needs a higher dose to effectively treat insomnia, they will also let them know that their risk of developing side effects from the medication increases.

Doctors do not consider trazodone to be habit-forming, meaning a person is not likely to become addicted to it. However, trazodone and other SSRIs may still cause physical dependence when they are prescribed long term.

This type of dependence occurs when a person becomes used to the drug being in their system. As a result, they may experience withdrawal when the drug is no longer there.

Physical dependence is a process that can happen with many medications. If a person is concerned about physical dependence, they can discuss their questions with a healthcare professional.

Trazodone treats depression and may help a person fall asleep. The following are some additional benefits.

  • It has fewer side effects than many sleep aids, such as Ambien.
  • It is not habit forming, but a person will need to gradually reduce higher doses under a doctor’s recommendation and supervision.

Trazodone can cause a variety of side effects in certain individuals. Some potential side effects include:

If a person notices side effects, it is important that they talk with their doctor who may adjust their dose or recommend a different medication.

In addition, a person may experience more serious or life threatening side effects. If these occur, a person needs emergency medical attention, and it is advised that they discuss discontinuing the medication with their doctor.

Some serious side effects include:

  • cardiac arrhythmia
  • cognitive and motor impairment
  • serotonin syndrome
  • activation of mania, particularly in people with bipolar disorder
  • orthostatic hypotension and fainting
  • increased risk of bleeding
  • seizures
  • thoughts of self-harming
  • prolonged and painful erections
  • allergic reactions to the drug

It is also worth noting that the FDA has given trazodone a boxed warning regarding the risk of depression and suicidal behavior. A boxed warning is the most severe warning the FDA can issue for a drug.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Doses will vary between brands and a person’s prescription. For example, the FDA indicates the following doses for Desyrel when prescribed to treat depression:

  • Starting dose is 150 milligrams (mg) divided into 2 doses daily.
  • Dose may increase by 50 mg per day every 3–4 days.
  • The maximum dose is 400 mg per day in divided daily doses.

A person should take tablets or pills whole or cut in half. They should also take trazodone with a light meal or snack.

If a person is going to discontinue taking trazodone, they should follow their doctor’s recommendations on how to gradually reduce their dosage as they wean themselves off the medication.

Since the FDA has not approved trazodone for treating sleep disorders, there is no official guidance from the manufacturer or the FDA on trazodone dosages for these conditions.

However, the previously mentioned 2017 review of studies shows the doses of trazodone that people commonly take for treating sleep disorders in clinical studies were between 25 and 150 mg taken once at bedtime.

Certain supplements that affect serotonin levels may increase the chances that a person will develop serotonin syndrome.

Potential drug interactions with trazodone that the FDA lists include:

  • benzodiazepines
  • clarithromycin
  • carbamazepine
  • digoxin
  • phenytoin
  • warfarin

It is important that a person talks with their doctor about all supplements and medications they are taking prior to starting trazodone.

It is also important that they update their doctor about any additional medications or supplements they start taking while using trazodone.

Trazodone was initially only prescribed to treat depression. However, doctors now also prescribe trazodone to treat sleep disorders and other mental health conditions such as anxiety disorders.

There are other potential steps a person can take to help improve their sleep quality.

For those looking for alternate medication, doctors may prescribe a Z-drug such as zolpidem (Ambien), eszopiclone (Lunesta), or zaleplon (Sonata). These medications are effective but may also lead to dependency and unfavorable side effects over time.

Z-drugs can also increase the risk of falls and fractures in older people, so trazodone may be a preferred solution for them.

Orexin antagonists belong to a newer drug class for treating insomnia. They work by blocking the orexin receptor, reducing the orexin system’s wakefulness-promoting effects and leading to longer sleep periods.

Examples of orexin antagonists include suvorexant (Belsomra), lemborexant (Dayvigo), and daridorexant (Quviviq).

In addition, there are several over-the-counter (OTC) sleep aids such as melatonin that a person may try to help fall asleep.

Some people may find supplements beneficial in helping them relax. Before taking any OTC sleep aids, including supplements, it is advised that a person talk with a doctor about their sleeping issues.

A doctor may be able to recommend additional treatments or provide treatment advice to address any underlying condition that may exist. They will also be able to identify any potential interactions that may occur with existing medication usage.

A person may find that getting adequate physical activity, eating a healthful diet, and reducing stress can all help improve sleep quality.

Click here to find out more about improving sleep quality.

For some people, trazodone may be a safe and effective sleep aid. However, the FDA has not approved it for treating sleep disorders.

Typically, lower doses of trazodone do not cause side effects, but the risk rises as the dosage increases.

A helpful first step a person can take is talking with their doctor about their sleeping issues. Together, they can discuss all the treatment options to make sure they are selecting the best medication for their needs.