Trazodone is an antidepressant that drug manufacturers developed to treat depression. Trazodone may also help treat 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 reuptake inhibitors (SSRIs). These drugs act by blocking the absorption of serotonin in the brain.

SSRIs are the most common antidepressants that doctors prescribe.

However, according to a review of studies, 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 review mentioned above,trazodone in low doses is generally safe and effective for treating insomnia, although, currently, the FDA only approve 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 these sleep disorders.

If a person is having trouble sleeping due to depression, they may require a higher dose of trazodone. If this is the case, a person increases their risk of developing side effects from the medication due to the higher dose.

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 people use them 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 normal process that happens with many medications.

Trazodone treats depression and may help a person fall asleep. Some additional benefits include:

  • 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 on their doctor’s recommendations.
  • Generic forms are available, so it can be cheaper than some other medications doctors may prescribe for sleep.

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

If a person notices side effects, they should talk to 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 should seek emergency medical attention and 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 have given trazodone a black box warning. This is the most severe warning the FDA can issue for a drug, regarding the risk for depression and suicidal behaviors.

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 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.

Click here for more links and local resources.

Doses will vary between brands and a person’s prescriptions. For example, the FDA indicate the following doses for Desyrel, for treating depression:

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

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 using trazodone, they should gradually reduce their dosage. They should follow their doctor’s recommendation of how to 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 dosage trazodone for these conditions.

The 2017 review of studies, however, shows the doses of trazodone that people commonly use for treating sleep disorders in clinical studies were between 25–150 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 list includes:

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

A person should talk to their doctor about all supplements and medications they are taking prior to starting trazodone.

They should also let their doctor know if they start taking additional medications or supplements when they are using trazodone.

The original use of trazodone was to treat depression. However, in addition to treating sleep disorders, doctors have also used trazodone to treat conditions such as unipolar depression or 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 Ambien. In addition, there are several over-the-counter (OTC) sleep aids, such as melatonin that a person may try to fall asleep.

Some people may find success with supplements to help them relax. Before taking any OTC sleep aids, including supplements, a person should talk to their doctor about their sleeping issues.

A doctor may be able to recommend additional treatments or help 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 adequate exercise, 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, drug regulators have not approved it for treating sleep disorders.

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

A person should talk to their doctor about their sleeping issues and discuss all the options to make sure they are taking the best medication for their needs.