Dosage Of Trazodone For Sleep

Trazodone is a common antidepressant substance, but some doctors have begun to prescribe trazodone for sleep disorders off-label have seen success.

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What is Trazodone?

Trazodone is an antidepressant used to help treat major depressive disorder. This substance is in the class of antidepressants like serotonin receptor antagonists and reuptake inhibitors.1 Lately, medical professionals have begun prescribing trazodone for sleep.  

Brand Names

Trazodone is normally sold under the brand names Desyrel, Oleptro, and Desyrel Dividose.2 It is always sold as a tablet. 

Off-label

At times, a doctor will prescribe trazodone for off-label usage regarding anxiety and insomnia. It technically is not FDA-approved to treat those specific disorders, but it does help reduce some of the symptoms. Because of this fact, a doctor will sometimes prescribe the drug off-label so the patient can benefit from it.3  

What Is Trazodone Used to Treat?

Trazodone is primarily used to treat major depressive disorder. However, it has also been used to successfully treat anxiety, panic attacks, and insomnia.4   

Depression

Normally, a doctor will try out other antidepressants before switching to trazodone. This drug helps a person feel sleepy or tired. Doctors will prescribe it for someone before bed to treat issues like poor sleep, trouble concentrating, or depressed moods.

Anxiety

Because trazodone helps calm people down, it can be prescribed to help a person that struggles with anxiety. Trazodone inhibits two different kinds of serotonin receptors inside of the brain, which leads to an increase in the production of serotonin within the brain.6 

Insomnia

Insomnia is a sleep disorder where someone struggles with falling asleep. Because trazodone helps some feel sleepy and relaxed by blocking the chemicals that interact with serotonin in the brain, doctors may prescribe the drug for someone who struggles with insomnia. It can help the patient fall asleep easier or relax at night.7 

Is it Approved as a Sleep-aid?

Trazodone is not FDA approved to be used as a sleep aid. However, doctors normally prescribe it off-label to help those who may be struggling with sleep disorders.8  

Trazodone vs. Ambien

Trazodone and Ambien are used to treat different things. Trazodone is used to treat major depressive disorder. Ambien is used to treat insomnia and other sleep disorders.

Trazodone works by balancing the amount of serotonin inside of the brain while Ambien produces a calming effect by sedating the brain. Both can have similar effects by decreasing a person’s energy level. However, Ambien specifically helps a person fall asleep faster, while better sleep is simply a side effect of trazodone.9   

Off-label Use of Trazodone

Medical professionals will use trazodone off-label to treat anxiety and insomnia. Although the FDA has not approved the drug through clinical trials, trazodone has been used repeatedly to help patients struggling with these disorders when other methods are not working.  

Dosage for Sleep

When a doctor prescribes trazodone for sleep disorders like insomnia, they normally only prescribe between 25 mg and 100 mg. So far, research has shown that lower dosages tend to reduce any negative side effects of the drug, so most doctors try to stay as close to 25 mg as possible. 

Is it Safe?

Trazodone is a safe drug that is approved by the FDA to treat depression. It has gone through several clinical trials, deeming it as a safe substance, which is why doctors are willing to prescribe it off-label. 

Benefits

There are multiple benefits to using trazodone as a sleep aid. It is cheap compared to other drugs that specifically help insomnia, and it is not considered to be extremely addictive. Trazodone can help prevent mental decline and can be better for people with sleep apnea.10 Because of this aspect, doctors might be more willing to prescribe it over other medications like Xanax and Valium, which are also both more addictive. 

Side Effects of Trazodone

One of the reasons that doctors are sometimes hesitant to prescribe trazodone, especially in larger doses, is that it can cause major side effects. These effects can vary in severity and not all people will experience them. 

Long-term

Several different long-term effects can come into place when someone is using this substance. One of the major issues is thoughts of suicide, which tends to be more common in younger people.10 A person might also develop serotonin syndrome, which happens when someone has too much serotonin built up inside of their body. An individual could struggle with the following symptoms as well:10 

  • Changes in heart rhythm
  • Painful, long-lasting erections 
  • Hypotension 
  • Blurred vision 
  • Manic episodes 
  • A sodium imbalance within the bloodstream 
  • Withdrawal      

Short-term

In the short-term, trazodone use can cause significant effects, including not limited to:10 

  • Dizziness 
  • Sleepiness 
  • Nervousness 
  • Fatigue 
  • Dry or “cotton” mouth 
  • Drastic weight changes  

Interaction with Other Drugs

It is important to be careful with what substances an individual mixes trazodone with. Mixing different types of drugs can increase the side effects and possibly lead to fatality. 

Serious Effects

Mixing trazodone with prescription drugs that also raise serotonin levels can drastically increase a person’s risk of developing serotonin syndrome. In addition, if an individual mixes trazodone with other anti-depressants, it can drastically increase the drug’s side effects.

If someone mixes trazodone with stimulants or depressants, the different substances could cancel out each other’s side effects or create new ones, making it easier to suffer from overdose.11  

Minor Effects

One of the minor effects that could occur from mixing substances is severe drowsiness. If an individual mixes trazodone with dangerous substances such as marijuana, alcohol, and other sleep medicines, they will be at a higher risk of severe drowsiness not just at night but throughout the day.11   

Trazodone Dependence

Trazodone is currently considered a non-addictive drug. However, a person can still become dependent on this medication after taking it for long periods. Due to this dependence, someone can suffer from trazodone withdrawal once they stop taking the drug. Because of this aspect, a person should always talk to a health care professional before they quit using trazodone. 

Withdrawal Side Effects

There are multiple side effects of trazodone dependence and withdrawal. Normally, a patient will start to experience the following after going a period without the drug:12 

  • Dizziness/nausea
  • Suicidal thoughts or ideation 
  • Vertigo 
  • Difficulty concentrating or focusing 
  • Migraines 
  • Cold chills or other shock-like symptoms 
  • Depersonalization 
  • Irritability 

These trazodone withdrawal symptoms can vary from person to person.  

Risks of Trazodone Abuse

There are risks to using trazodone, especially over a long time. Normally, medical professionals will try to taper the dosage over time to avoid some of the long-lasting side effects such as:

  • Weight loss
  • Drowsiness 
  • Blurred vision 
  • Excessive sweating 
  • Swelling 
  • Dry or “cotton” mouth 
  • Diarrhea 
  • Sexual troubles  

Outlook

Normally, trazodone overdose is not life-threatening, but there is still is a risk involved in taking the drug. Trazodone overdose often leads to serotonin syndrome, which can have long-term effects. If you or a loved one starts to experience seizures, arrhythmia, unconsciousness, or a high fever, seek medical help immediately. Most symptoms of trazodone overdose include:12 

  • Vomiting
  • Changes in heartbeat 
  • Seizures 
  • Difficulty Breathing 

Trazodone is a prescription antidepressant that has the potential to treat anxiety and insomnia. Doctors might prescribe it off-label currently to treat those disorders because it is inexpensive and not addictive. If you have any questions about trazodone, speak to your primary care physician.     

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