Trazodone

Trazodone is approved for depression. Lower doses are often used off-label for insomnia, but a sleep dose may not adequately treat depression. The expected benefit and risks should match the reason for use.

It blocks selected serotonin receptors and inhibits serotonin reuptake. Histamine and alpha-1 effects contribute to drowsiness and low blood pressure.

Sleep, energy, or appetite may change before mood improves. Benefit usually builds over several weeks; some conditions need a longer trial at a useful dose.

Track the symptoms you are treating and how you manage daily activities. Keep follow-up appointments. Schedule an earlier appointment if your mood gets worse.

• Take immediate-release trazodone shortly after a meal or light snack.
• Follow the prescribed timing and any instructions for splitting scored tablets.
• If you miss a dose, take it when you remember unless it is almost time for the next dose. Then skip it. Do not double a dose.
• Consult with your provider before reducing or stopping regular treatment.

• Drowsiness or morning grogginess
• Dizziness or low blood pressure
• Dry mouth, nausea, or constipation
• Headache

Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.

Antidepressants can increase suicidal thoughts in people under 25. Watch for changes in mood or behavior at any age, especially when starting treatment or changing a dose.

Tell your provider about emotional numbness, unusual agitation, or a reduced need for sleep with increased energy. These changes may call for a treatment adjustment.

Report palpitations, falls, unusual bleeding, or confusion. QT prolongation and low sodium are relevant risks in susceptible people.

For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.

Discuss any history of mania or bipolar disorder, seizures, heart disease, glaucoma, and kidney or liver problems.

Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.

Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.

Do not combine with MAOIs. Other serotonergic drugs can cause serotonin syndrome.

CYP3A inhibitors can raise levels. QT-prolonging medicines, alcohol, sedatives, and blood-pressure medicines add important risks.

A regular dose time and refill reminder can help prevent missed doses.

Bring a few specific observations to appointments: sleep, motivation, anxiety, and activities that have become easier or harder.

Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.