Trazodone - Risks, Side Effects, Addiction, and Treatment

Is Trazodone Addictive?

According to the Drug Enforcement Administration, trazodone has no risk for drug abuse or addiction. However, it can lead to drug dependence.⁴

You may develop a mild physical dependence on Trazodone after regular use or abuse. This dependence becomes apparent when you stop taking the drug.

What is Trazodone?

Trazodone is a generic antidepressant prescription medication.¹

Trazodone is approved by the Food and Drug Administration (FDA) to treat depression and anxiety.⁴ However, healthcare providers may use the medication’s calming effects to treat people with:¹

• Insomnia
• Eating disorders
• Substance use disorders
• Post-traumatic stress disorder (PTSD)
• Some pain conditions like fibromyalgia
• Anxiety and other mood disorders

Although the drug is commonly used to treat insomnia, it isn’t FDA-approved for sleep disorders.⁴

How Does Trazodone Work?

Trazodone works by blocking serotonin, which is responsible for stimulation. This increases serotonin activity, causing you to feel good.¹

It also has important roles in other regulatory systems in the body, including:¹

• Maintaining body temperature
• Regulating the gastrointestinal system
• Maintaining cardiovascular function
• Functioning of the genitourinary system

Trazodone is part of a class of drugs called serotonin-antagonist-and-reuptake-inhibitor (SARI) or serotonin modulators, often confused with selective serotonin reuptake inhibitors (SSRIs).¹

SARIs reduce activity in the parts of the brain that causes depression and anxiety. 

Other Potential Uses of Trazodone

One study found that Trazodone is comparable in its anti-anxiety effects to diazepam (Valium).² Researchers are assessing whether the drug can help people with neurodegenerative disorders. 

These include:⁸

• Multiple Sclerosis (MS)
• Alzheimer’s Disease
• Parkinson’s Disease

A 2019 pilot study in people with Alzheimer’s Disease found that trazodone reduced symptoms of dementia. It also slowed cognitive decline.³

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Trazodone as a Sleep Aid

Because Trazodone can make you sleepy or tired, it has potential as a sleep aid. When used to help people sleep, the dosage of Trazodone is different from when it’s used for other conditions.⁶

When it’s prescribed for sleep disorders, Trazodone is typically given at the lower end of the dose range. Generally, that’s between 50-100 mg per day.⁶

Trazodone can make you sleepy because it affects chemicals in your brain associated with wakefulness.⁶ By blocking these chemicals, you’ll start to feel more tired.

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Side Effects of Trazodone

Because trazodone interrupts serotonin signaling, it can lead to several physiological consequences. Common side effects include:¹

Severe Side Effects of Trazodone Use

Trazodone may also cause more serious side effects. These include:¹

• Chest pain
• Shortness of breath
• Difficulty breathing
• Sexual dysfunction
• Fast or irregular heart rate or rhythm

Risks of Trazodone Abuse

Although Trazodone isn’t linked to addiction, it can still be abused. Trazodone abuse is linked to some risks, including: 

Suicidal Thoughts

The most severe risk of trazodone use is the risk of suicidal ideation. This risk is especially concerning among teenagers and young adults.¹

The risk for suicide is generally higher in those with untreated depression. However, it's essential to be aware of signs of suicidal ideation, especially in the first few months of taking it.

Serotonin Syndrome

Abusing Trazodone or mixing it with other drugs that reduce serotonin reuptake can trigger serotonin syndrome (SS). SS is a potentially life-threatening condition caused by excess serotonin levels in the brain and requires immediate medical treatment.⁵

Symptoms include:⁵

• Tremors
• Stiff muscles
• Excessive sweating
• Vomiting
• Diarrhea
• Irritation
• Hallucinations
• Seizures
• Death

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Trazodone Overdose Symptoms

Although it’s uncommon, you can overdose on Trazodone. The risk for overdose increases if you mix Trazodone with other substances, especially other CNS depressants.¹ 

Caution should also be practiced in those with severe liver and renal impairment. Symptoms of trazodone overdose include:¹

Severe Side Effects of a Trazodone Overdose

Trazodone overdose can also lead to more severe side effects.¹

These include:¹

• Serotonin syndrome: Presenting as a triad of mental status change, movement changes, and changes in vital signs
• Priapism: A painful erection that lasts for more than 4 hours
• Cardiac conduction abnormalities: Potentially deadly disorders of the electrical system controlling your heart rate and rhythm
• Severe hypotension: Low blood pressure

Who is at Risk When Taking Trazodone?

Before taking Trazodone, talk to your doctor about your medical history and anything you recently stopped taking. This includes any:¹

• Prescription medications
• OTC drugs
• Herbal supplements

Talk to your doctor if you’re pregnant or breastfeeding. You should also inform them if you or your family has a history of:¹

• Bipolar disorder
• Liver disease
• Heart disease
• Heart attacks
• Suicide attempts

Trazodone Interactions

Trazodone can interact with other serotonergic drugs and dangerously increase serotonin levels. Because of this, you shouldn’t mix Trazodone with:^1,7

• Triptans
• Tricyclic antidepressants
• Fentanyl
• St. John’s Wort
• MDMA/ecstasy

Additionally, trazodone interacts with hundreds of other drugs, which include:^1,7

• MAO Inhibitors
• Antifungals
• HIV protease inhibitors
• Macrolide antibiotics
• Seizure medications
• Rifamycins
• Drugs that cause drowsiness, such as alcohol and marijuana

Symptoms of Trazodone Abuse

Although Trazodone isn’t a habit-forming drug, it can still be abused. If you’ve become physically dependent on the drug, you might continue to use it without a doctor’s prescription, leading to drug abuse.

Signs of Trazodone abuse include:

• Short-term physical side effects (dizziness, nausea, blurred vision, etc.)
• Frequent or repeated Trazodone use
• Combining Trazodone with other drugs and alcohol
• Illegally obtaining Trazodone
• Spending more time using or getting Trazodone
• Performance issues at work or school
• Disregarding social obligations and relationships to abuse Trazodone
• Continued use despite negative health consequences
• Developing a tolerance to the drug
• Developing withdrawal symptoms

If you or someone you know is abusing Trazodone, consider seeking treatment. Substance use disorder (SUD) is a condition that requires immediate medical attention at a treatment center.

Symptoms of Trazodone Withdrawal

When you stop using Trazodone, you may feel antidepressant discontinuation syndrome (ADS). This happens because your body is reacting to a short-term drug deficiency.

Your body will typically correct this on its own, leading to uncomfortable withdrawal symptoms. Trazodone withdrawal symptoms include:²

Twenty percent of people who stop taking antidepressants may experience ADS.² These symptoms typically last for a few days. In rare cases, you may experience symptoms for 2 to 3 weeks.²

Experiencing withdrawals from Trazodone does not always mean a person is addicted, but it does indicate a physical dependency on the medication.

How to Avoid Trazodone Withdrawal Symptoms

Talk to your doctor if you want to prevent or reduce ADS symptoms. Together you can develop a dosing schedule to taper off the drug gradually.²

Tapering means reducing the dose over several days. This allows your brain to become accustomed to working without the drug.

Trazodone Abuse Treatment

If you have a physical dependence on Trazodone, consider seeking substance abuse treatment. Substance abuse is a medical emergency and requires professional care and treatment.

Fortunately, there are various treatment options available to help you recover. Talk to your doctor regarding the right treatment program for your needs.

Available treatment options include:

• Medical detox: Medically supervised detox used to avoid harmful withdrawal symptoms
• Inpatient treatment: Treatment that involves checking yourself into a rehab facility for 24-hour medical supervision 
• Outpatient treatment: A treatment plan where you are freely allowed to leave the rehab facility
• Cognitive behavioral therapy: A short-term therapy technique explores the link between thought patterns and addiction
• Dual diagnosis treatment: A treatment program that addresses co-occurring mental health conditions alongside addiction
• Support groups: Organizations like Narcotics Anonymous (NA) provide a much-needed community to help maintain sobriety after treatment

Types of Trazodone Pills

Trazodone pills come in various forms. It's prescribed based on the strength and duration of the depression, along with other factors.

The pills and dosages available are:⁴

• Trazodone 50 mg
• Trazodone 100 mg
• Trazodone 150 mg
• Trazodone 300 mg

Summary

Trazodone is a commonly prescribed antidepressant that's generally well-tolerated and not addictive. It is often prescribed to treat depression, but doctors may use it to help with sleep, stress, anxiety, and pain.

Although Trazodone isn’t addictive, it can be abused. You may develop a physical dependence and experience antidepressant discontinuation syndrome when you stop using it.

Clinical trials are being conducted to determine whether trazodone can help people with neuropathic pain and sleep apnea. The trials also assess whether the drug can improve memory in people with depression.

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