Trazodone is an antidepressant with fewer side effects than other SSRIs, and a sleep aid with less risk of dependence.

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What is Trazodone?

Trazodone is a drug prescribed primarily as an antidepressant, although it can be used to treat other conditions. It is a psychoactive compound, meaning it acts on the body’s nervous system and alters brain function, which results in temporary changes to mood, behavior, perception and consciousness. Trazodone is sold under several brand names, including Desyrel, Trittico, Trialodine, Molipaxin, Thombran, and Trazorel.

Trazodone acts as a selective serotonin uptake inhibitor (SSRI) by inhibiting the reuptake of serotonin in the brain. It also causes changes in the 5-HT presynaptic receptor adrenoreceptors, and this is thought to be the main contributing factor to its antidepressant properties. While it can be called an SSRI, it differs from other SSRIs in that it becomes active in the body during the first week of use. It also differs from tricyclic antidepressants in that it has a lower incidence of common side effects such as constipation, dry mouth, and male sexual dysfunction. Trazodone was originally developed in Italy in the 1960s. The Food and Drug Administration (FDA) approved it for use as an antidepressant in the United States in 1981. Since that time, it has been approved for other uses as well.

In addition to its antidepressant qualities, trazodone also has sedative and anxiolytic (anti-anxiety) properties. Because the FDA has only approved trazodone for use as an antidepressant, any other conditions it may be prescribed for are considered “off-label” uses. Doctors often prescribe trazodone for chronic insomnia, insomnia resulting from fibromyalgia, and as a general sleep aid. Trazodone is considered a better choice as a long-term sleep aid because it carries a reduced risk of dependency that is common to other sleep aids currently on the market.

Several other uses for trazodone are currently being investigated, including panic disorder, obsessive-compulsive disorder, schizophrenia, diabetic neuropathy and alcohol withdrawal.

Because trazodone is metabolized by the liver, patients taking the drug should avoid alcohol. The most notable food-drug interaction is with grapefruit juice. Substances in the juice can inhibit the liver enzyme that metabolizes the drug, causing the level of trazodone in the blood to rise too high and become toxic. While one glass of the juice probably won’t cause any problems, it’s best for anyone taking trazodone to avoid it.

There are other precautions as well. As with many antidepressants, the incidence of suicidal thoughts and actions can be increased by taking trazodone. Patients taking trazodone should not stop taking the drug abruptly, even when prescribed as a sleep aid in the smallest dose of 25 milligrams. Abruptly ceasing treatment can increase the possibility of suicidal thoughts or actions, and can bring about other adverse reactions such as a depressed mood or emotional instability.

The most common side effects of trazodone are dry mouth, headache and nausea. The patient may also experience drowsiness, dizziness, difficulty concentrating, or increased sex drive. Other more serious side effects have been reported, to include seizures, impaired speech, involuntary muscle twitching, tachycardia and hypotension. Before taking trazodone, it is advisable to thoroughly read the accompanying literature that lists all known possible side effects and drug interactions, and to discuss any concerns with your doctor. Patients should only take—or stop taking—trazodone under a doctor’s supervision, and should notify their doctor immediately if they experience any suicidal thoughts while taking the drug, or after stopping it.

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