Trazodone (Deseryl, Molipaxin, Trittico, Thombran, Trialodine)
Trazodone is a tetracyclic antidepressant with sedative and antianxiety actions. It has been in use in the US since 1982.
The Bottom Line: What You Really Need to Know
- Trazodone (Trade Names: Deseryl) is an antidepressant with many other uses.
- The usual dose depends on what it is being taken for and can range from 150-600 mg/day.
- Trazodone interacts with many medications. Make sure your doctor and pharmacist know about all of the medications you take, including over-the-counter medications, herbal remedies, homeopathic remedies, vitamins, supplements and medications you only take occasionally.
- It will probably be a week or two before you notice any difference in the way you feel.
- Don't stop taking trazodone suddenly; the dose must be tapered gradually or you may experience withdrawal symptoms.
- Most people have a few mild side effects, like dry mouth or nightmares, when they start taking trazodone. They usually go away with time.
- If you experience dizziness when you stand up abruptly, sit up slowly first, then stand slowly. If you have dizziness at other times or if you faint, notify your doctor.
- Let your doctor know if you experience fever, chills, aching and flu-like symptoms after you start taking trazodone.
- Notify your physician if you have any allergic-type reactions, such as rash, hives or facial swelling.
- Notify your physician immediately if you experience chest pain after you start taking trazodone.
- Notify your physician if you have an erection of the penis or clitoris that lasts a long time.
- Do not eat grapefruit or drink grapefruit juice while you are taking trazodone.
- Have a friend or family member check in with you every day for the first few weeks you take trazodone. Ask him or her to help monitor your condition for
- Worsening depression
- Restlessness, irritability, agitation, hostility or aggression
- Unusual thoughts or thoughts of suicide
- Report any serious or unusual side effects to your doctor.
- Women who are trying to get pregnant or are pregnant or nursing should not take trazodone.
Trazodone has various approved and unapproved uses in different parts of the world. Its primary use is as an antidepressant. It is also used to treat:
- Alcohol addiction
- Panic attacks
- Cocaine withdrawal
- Diabetic peripheral neuropathy
- Obsessive compulsive disorder
It is also used to augment other antidepressants (some SSRI's).
Dosage and instructions
The usual dose of trazodone is 150-600 mg/day. Treatment usually starts with 150 mg/day in one or more doses and is increased slowly until the desired effect is achieved. The dose can be increased at 3-4 day intervals, but the full effect of the medication may not be felt for 2 weeks or longer.
Higher doses are sometimes necessary and the maximum recommended daily dose is 600 mg. If doses over 300 mg/day are necessary, the patient should be hospitalized until a stable dose has been reached.
Trazodone is usually taken in the evening to take advantage of its sedative effects. It should be taken after a meal or snack to avoid dizziness.
Elderly people usually need smaller doses.
The usual dose of trazodone for treating insomnia is 25-75 mg at bedtime.
How trazodone works
Trazodone is not chemically similar to any other antidepressants except nefazodone. It is a tetracyclic serotonin modulator. It does inhibit serotonin reuptake, but has an even greater effect on blocking serotonin receptor sites. Serotonin is believed to affect mood and anxiety; increasing serotonin at nerve endings seems to help depression.
There are some serious side effects that can occur with trazodone. Notify your doctor immediately if any of the following occur:
- Suicidal thoughts or behaviors
- Dizziness and fainting
- Fever, chills, aching and flu-like symptoms
- Allergic reaction-rash, hives, shortness of breath, wheezing, swelling of face, etc.
- Chest pain
- Erection of the penis or clitoris that lasts more than 4 hours (priapism). This can be extremely painful and serious and may require surgery. It can lead to permanent loss of sexual function.
Other side effects that can occur include:
- Difficulty urinating
- Dry mouth
- Loss of appetite, upset stomach, stomach cramps, diarrhea, constipation
- Muscle aches
- Lack of coordination
- Blurred vision
- Weight changes
- Inability to concentrate, forgetfulness, confusion
- Tired, red, itchy eyes
- Runny nose and congestion
- Ringing in the ears
- Slow movements
- Changes in sex drive-either an increase or a decrease
- Uncontrollable, inappropriate laughter
- Twitches and tremors
Most minor side effects disappear after you've been taking trazodone for a while.
Grapefruit and grapefruit juice can interact with trazodone and should be avoided while you are taking it.
Medications that are known to interact with trazodone are:
- Antiviral medications
- Antifungal medications
- Seizure medications
- Blood thinners
- Monamine oxidase inhibiting (MAOI) antidepressants. Trazodone may have a serious interaction with MAOIs that results in high blood pressure, high fever, rapid heart rate, muscle rigidity and seizures. The two medications should not be taken within two weeks of each other.
Trazodone should not be stopped suddenly because you can experience unpleasant side effects of discontinuation syndrome. The dose needs to be tapered slowly before you stop taking it.
Warnings, precautions and contraindications
Suicide risk: Antidepressants increase the risk of suicide, especially early in treatment. It's important to closely monitor anyone who is beginning to take an antidepressant. Weekly physician visits and daily observation by family and friends are needed. Any change in mood, thought or behavior should be reported immediately to the physician. They can include:
- Thoughts of harming self or others
- Paranoid thoughts
- Hallucinations or delusions
- Anxiety, nervousness, agitation, excessive restlessness
- Hostility or aggression
Seizures: Trazodone can cause complex partial seizures in people who have a seizure disorder.
Heart problems: Trazodone can cause serious heart dysrhythmias in people who have heart problems.
Liver disease: There have been rare reports of liver damage with trazodone.
Pregnancy and lactation: There is no information on the use of trazodone in pregnancy. In general, it is wisest to avoid antidepressants during pregnancy. Trazodone is excreted in human milk, so you should not breast feed if you are taking trazodone.blog comments powered by Disqus