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 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:

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.

Side Effects

There are some serious side effects that can occur with trazodone. Notify your doctor immediately if any of the following occur:

Other side effects that can occur include:

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:


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:

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.

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