Trazodone

TRAZODONE

Medicine Information

  • Clinical depression
  • Generalised anxiety disorder in adults
  • Mind: charity
  • Samaritans: charity for help or support
  • Trazodone: forums
  • Social anxiety (social phobia)
  • Antidepressants: videos of real stories
  • Anxiety support: forum
  • Depression UK: charity
  • Depression: forum
  • Depression: videos of real stories
  • Depression and anxiety: videos of real stories
  • Mental Health Foundation: charity

Trazodone is an antidepressant medicine that works to balance chemicals in the brain.

It’s used to treat depressionanxiety, or a combination of depression and anxiety.

It can help if you’re having problems like low mood, poor sleep and poor concentration.

Trazodone comes as tablets, capsules and liquid. It’s only available on prescription.

  • Doctors usually prescribe trazodone when other antidepressants haven’t worked or have caused side effects.
  • It can take 1 to 2 weeks before trazodone starts to work, but may be 4 to 6 weeks before you feel the full benefit.
  • Trazodone can make you feel sleepy. If you take it once a day, it’s best to take it in the evening or before you go to bed.
  • If you and your doctor decide to take you off trazodone, your doctor will probably recommend reducing your dose gradually to help prevent extra side effects.
  • Trazodone is also called by the brand name Molipaxin.

Trazodone can be taken by adults over 18 years of age for depression or anxiety, or both.

Check with your doctor before starting to take trazodone if you:

  • have had an allergic reaction to trazodone or any other medicines in the past
  • have had thoughts of self-harming or ending your life
  • have recently had a heart attack or have heart, kidney or liver problems
  • are taking sleeping tablets
  • have epilepsy or are having electroconvulsive treatment – trazodone may increase your risk of having a seizure
  • are pregnant, trying to become pregnant or breastfeeding
  • have the rare diseases porphyria (a blood disorder) or phaeochromocytoma (which affects the adrenal glands)

If you have diabetes, trazodone can make it more difficult to keep your blood sugar stable.

Monitor your blood sugar more often for the first few weeks of treatment with trazodone and adjust your diabetes treatment if necessary.

Speak to your doctor if your blood sugar levels are causing you concern.

Your doctor may advise you to take your dose of trazodone once a day.

If your dose is 300mg a day or less, your doctor will probably tell you to take it as a single dose at bedtime.

As trazodone can make you feel sleepy, taking it at bedtime may help if you’re having trouble sleeping.

If you have a larger dose, your doctor may suggest that you split it and take it twice a day.

You should take trazodone after food to reduce the chances of feeling sick.

HOW MUCH TO TAKE

For depression – the usual dose is 150mg daily. But in some cases your doctor may start you on a lower dose of 100mg to reduce the chance of side effects.

For anxiety – the usual dose is 75mg daily.

WILL MY DOSE GO UP OR DOWN?

Your dose may go up or down depending on how it affects you. Your doctor may prescribe up to 300mg a day for anxiety, or more for depression, if you need a stronger dose.

WHAT IF I FORGET TO TAKE IT?

If you forget to take a dose, don’t worry. Take it as soon as you remember, unless it’s almost time for your next dose. In this case, skip the missed dose and take your next dose as normal.

Never take a double dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you.

You could also ask your pharmacist for advice on other ways to help you remember to take your medicines.

WHAT IF I TAKE TOO MUCH?

The amount of trazodone that leads to an overdose varies from person to person.

CALL YOUR DOCTOR STRAIGHT AWAY IF YOU TAKE TOO MUCH TRAZODONE BY ACCIDENT:

You have taken too much trazodone by accident and experience symptoms such as:

  • being sick
  • feeling very sleepy
  • being confused
  • feeling dizzy or fainting
  • problems with your heart or breathing
  • fits (seizures)

If you need to go to A&E, do not drive yourself – get someone else to drive you or call for an ambulance.

Take the trazodone packet or leaflet inside it, plus any remaining medicine, with you.

Like all medicines, trazodone can cause side effects in some people, but many people have no side effects or only minor ones.

Some of the common side effects of trazodone will gradually improve as your body gets used to it.

COMMON SIDE EFFECTS

Tell your doctor if these side effects bother you or don’t go away:

  • feeling sleepy or tired
  • headaches
  • feeling sick
  • constipation (difficulty pooing)
  • a dry mouth

SERIOUS SIDE EFFECTS

Serious side effects are rare and happen in less than 1 in 1,000 people.

Go to A&E immediately if you have:

  • a long-lasting and painful erection that lasts longer than 4 hours – this may happen even when you’re not having sex
  • a fast, slow or abnormal heartbeat
  • a seizure

Speak to your doctor straight away if you get:

  • yellow skin, or the whites of your eyes turn yellow
  • thoughts of self-harming or ending your life
  • bad constipation or you’re unable to pee and it’s causing severe stomach pain
  • more bruising than usual
  • more infections than usual, such as a sore throat or skin infections

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to trazodone.

CALL 999 OR GO TO A&E IF:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you’re wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These aren’t all the side effects of trazodone.

For a full list, see the leaflet inside your medicines packet.

You can report any suspected side effect to the UK safety scheme.

What to do about:

  • feeling sleepy or tired – take trazodone in the evening and cut down the amount of alcohol you drink. If you take trazodone twice a day, talk to your doctor. Feeling sleepy should become less of a problem after a few days as your body gets used to the medicine. In the meantime, do not drive or use tools or machinery if you’re feeling this way.
  • headaches – make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Talk to your doctor if the headaches last longer than a week or are severe.
  • feeling sick – try taking trazodone with or after food to see if that helps. It’s best to avoid rich or spicy food while you’re taking this medicine.
  • constipation – eat more high-fibre foods, such as fresh fruit and vegetables and cereals. Try to drink several glasses of water or another non-alcoholic liquid every day. If you can, it may also help to do some exercise. Watch a short video on how to treat constipation.
  • a dry mouth – chew sugar-free gum or sugar-free sweets.

It’s important for you and your baby that you stay well during your pregnancy.

If you become pregnant while taking trazodone, speak to your doctor. Do not stoptaking your medicine unless your doctor tells you to.

Trazodone has been linked to a very small increased risk of problems for your unbornbaby.

But if your depression isn’t treated during pregnancy, this can also increase the chance of problems.

You may need to take trazodone during pregnancy if you need it to remain well.

Your doctor can explain the risks and the benefits, and will help you decide whichtreatment is best for you and your baby.

For more information about how trazodone can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPS) website.

BREASTFEEDING AND TRAZODONE

If your doctor or health visitor says your baby is healthy, trazodone can be used during breastfeeding.

Trazodone passes into breast milk in very small amounts, and hasn’t been linked with any side effects.

It’s important to continue taking trazodone to keep you well. Breastfeeding will also benefit both you and your baby.

If you notice that your baby isn’t feeding as well as usual, seems unusually sleepy, or you have any other concerns about your baby, talk to your health visitor or doctor as soon as possible.

TELL YOUR DOCTOR IF YOU’RE:

  • trying to get pregnant
  • pregnant
  • breastfeeding

Many medicines and trazodone can interfere with each other and increase the chances of you having side effects.

Tell your doctor if you’re taking these medicines before you start trazodone:

  • tranylcypromine, phenelzine and isocarboxazid (for depression), or selegiline (for Parkinson’s disease) – tell your doctor if you have taken any of these medicines within the last 2 weeks
  • antidepressants, such as amitriptyline or fluoxetine
  • antifungal medicines, such as ketoconazole and itraconazole
  • medicines for seizures, such as carbamazepine or phenytoin
  • medicines for high blood pressure, such as clonidine
  • sleeping pills, tranquilisers or other sedatives
  • digoxin, a heart medicine
  • erythromycin, an antibiotic
  • levodopa, used to treat Parkinson’s disease
  • ritonavir, used to treat HIV infections
  • warfarin, a blood thinner

MIXING TRAZODONE WITH HERBAL REMEDIES AND SUPPLEMENTS

Do not take St John’s wort, the herbal remedy for depression, while you’re being treated with trazodone as this will increase your risk of side effects.

IMPORTANT

Tell your doctor or pharmacist if you’re taking any other medicines, including herbal remedies, vitamins or supplements.

Serotonin and noradrenaline are chemicals in the brain that help improve your mood. When your levels are low, you can get depressed.

Trazodone helps increase your levels of serotonin and noradrenaline so you feel better.

In the first few days trazodone may make you feel sleepy.

Antidepressants like trazodone help to jump start your mood so you feel better.

You may notice that you sleep better and get on with people more easily because you’re less anxious.

You’ll hopefully take in your stride little things that used to worry you.

Trazodone won’t change your personality or make you feel euphorically happy. It’ll simply help you feel like yourself again.

At the moment, there’s no evidence that trazodone protects against dementia.

But it’s sometimes used to treat some symptoms of dementia, like irritability and agitation.

There are steps you can take that may reduce your risk of dementia.

If you’re worried about getting dementia or Alzheimer’s disease, or have a family history of these conditions, speak to your doctor.

Trazodone can make you feel more or less hungry than usual, so you may lose or gain weight when you start taking it.

If you start to have problems with your weight while taking trazodone, talk to your doctor or pharmacist.

Trazodone does not affect any type of contraception, including the combined pill or emergency contraception.

There’s no firm evidence to suggest that taking trazodone will reduce fertility in either men or women.

But speak to a pharmacist or doctor if you’re trying to get pregnant. They may want to review your treatment.

Trazodone can cause problems with ejaculation. Some people say it gives them a higher sex drive, others say it makes it lower.

Rarely, men may get a painful erection that lasts a long time that isn’t to do with sexual activity.

If you experience a long-lasting and painful erection that lasts longer than 4 hours, go to A&E straight away.

Trazodone may make you feel sleepy or less alert. Do not drive, cycle, or use tools or machinery until you know how this medicine affects you.

You can drink alcohol while taking trazodone, but it may make you feel sleepy.

It might be best to stop drinking alcohol until you see how the medicine makes you feel.

You can eat and drink normally while taking trazodone.

Cannabis with trazodone can give you a fast heartbeat. Cannabis can also make drowsiness worse with citalopram, especially in people who have just started taking it.

Methadone can increase the risk of side effects in people taking sertraline.

It can be potentially dangerous to take trazodone with:

  • stimulants like MDMA (ecstasy) or cocaine
  • hallucinogens like LSD
  • novel psychoactive substances (which used to be known as legal highs) like mephedrone

Don’t expect to feel better overnight. Trazodone can take 1 to 2 weeks to start to work, and it can be 4 to 6 weeks before you feel the full benefit. Give the medicine at least 6 weeks to work.

Some people feel worse during the first few weeks of treatment before they begin to feel better.

In this time some people occasionally have thoughts of harming themselves or ending their lives.

If this happens to you, it’s very important to speak to a doctor about it immediately.

If you need additional help, you can also contact the Samaritans.

If you have only had 1 episode of depression, you’ll need to take trazodone for at least 6 months after you feel better.

Stopping before that time can make depression come back.

If you have had depression more than once, your doctor may recommend carrying on with trazodone for much longer.

Yes, trazodone is safe to take for a long time. There don’t seem to be any lasting harmful effects from taking it for many months, or even years.

Some people need to take trazodone long term to treat depression or anxiety that keeps coming back.

If you need it and don’t get side effects, there’s no reason to worry about taking trazodone for a long time.

If you have only had 1 episode of depression, you’ll need to take trazodone for at least 6 months after you feel better.

Stopping before that time can make depression come back.

If you have had depression more than once, your doctor may recommend carrying on with trazodone for much longer.

If you have only had 1 episode of depression, you’ll need to take trazodone for at least 6 months after you feel better.

Stopping before that time can make depression come back.

If you have had depression more than once, your doctor may recommend carrying on with trazodone for much longer.