Insomnia is more than not being able to get a good night's sleep. Having trouble falling asleep or staying asleep can affect every aspect of your life, from work and play to your health. If you're having trouble sleeping, your doctor may have discussed prescribing trazodone to help.
If you're thinking of taking trazodone (Desyrel, Molipaxin, Oleptro, Trazorel, and Trittico), here's important information for you to consider.
Trazodone is a prescription medication approved for use by the Food and Drug Administration (FDA) as an antidepressant.
This medicine works in multiple ways in your body. One of its actions is to regulate the neurotransmitter serotonin, which helps brain cells communicate with each other and influences many activities such as sleep, thoughts, mood, appetite, and behavior.
Even at lower doses, trazodone can cause you to feel relaxed, tired, and sleepy. It does this by blocking chemicals in the brain that interact with serotonin and other neurotransmitters, such as, 5-HT2A, alpha1 adrenergic receptors, and H1 histamine receptors.
This effect may be one of the main reasons trazodone works as a sleep aid.
FDA Warning about trazodoneLike many antidepressants, trazodone has been issued a 'Black Box Warning' by the FDA.
Taking trazodone has increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients. People taking this medication should be closely monitored for worsening symptoms and emergence of suicidal thoughts and behaviors. Trazodone is not approved for use in pediatric patients.
Though the FDA has approved trazodone for use as a treatment for depression in adults, for many years doctors have also prescribed it as a sleep aid.
The FDA approves medications to treat specific conditions based on clinical trials. When doctors prescribe the medicine for conditions other than what was approved by the FDA, it is known as off-label prescribing.
Off-label use of a medication is a widespread practice. Twenty percent of medications are prescribed off-label. Physicians can prescribe medications off-label based on their experience and judgment.
Trazodone is most often prescribed at doses between 25mg to 100mg as a sleep aid.
However, studies show lower dosages of trazodone are effective and may cause less daytime sleepiness and fewer side effects because the drug is short acting.
Experts recommend cognitive behavioral therapy and other behavioral modifications as the first treatment for insomnia and sleep problems.
If these treatment options are not effective for you, your doctor may prescribe trazodone for sleep. Your doctor may also prescribe it if other sleep medications, such as Xanax, Valium, Ativan, and others (short- to medium-acting benzodiazepine medications), haven't worked for you.
A few advantages of trazodone include:
Trazodone may cause some side effects, especially when first starting the medication.
This is not a complete list of side effects. Discuss concerns with your doctor or pharmacist if you feel you are experiencing side effects or have other worries about your medicine.
Some common side effects of trazodone include:
Although rare, trazodone can cause serious reactions. Call 911 or local emergency services if you are experiencing any life-threatening symptoms such as difficulty breathing.
According to the FDA, serious risks include:
There have been reports of overdose with trazodone use. These risks are higher with drinking alcohol, taking benzodiazepines, and other central nervous system depressant drugs that can slow your breathing and reactions.
Drug overdose can be fatal. If you suspect you have taken too much trazodone, call 911 or local emergency services and seek medical attention immediately.
symptoms of overdoseSymptoms of trazodone overdose include:
- drowsiness
- seizures
- vomiting
- heart rhythm changes
- respiratory arrest (stop breathing)
Trazodone is an older medication approved for use by the FDA in 1981 as an antidepressant. Although trazodone use for sleep is common, according to recent guidelines published by the American Academy of Sleep Medicine, trazodone should not be the first line of treatment for insomnia.
Given in lower doses, it may cause less daytime sleepiness or drowsiness. Trazodone is not addictive, and common side effects are dry mouth, drowsiness, dizziness, and lightheadedness.
Trazodone may offer benefits in certain conditions such as sleep apnea over other sleep aids.