Side Effects Of Trazodone
A popular antidepressant, Trazodone, is a prescription drug used to treat major depression, anxiety, and insomnia. Its common side effects include drowsiness, dizziness, and prolonged penile erection. A word of caution for its safe usage is to not to mix it with alcohol, avoid it during pregnancy and lactation, and taper off the dosage gradually to avoid withdrawal effects.
Trazodone is a second generation antidepressant and a multifunctional drug. Multifunctional drugs have more than one therapeutic mechanism. Trazodone’s functions depend on the dosage, with low doses providing hypnotic actions and higher doses turning it into an antidepressant.1
Trazodone is one of the go-to drugs for treating major depressive disorder and is a schedule IV drug like Xanax and Valium. Its way of working and side-effects are very different from certain antidepressants whose use is now restricted owing to the severity of interactions with other drugs. Trazodone comes in both slow-release and fast-release formulations. Apart from depression, it has also been used in the treatment of OCD2, panic disorder3, erectile dysfunction4, diabetic neuropathy 5, and more.
What Are The Effects Of Trazodone?
Trazodone is mostly used for major depression, though it also has some antianxiety and hypnotic or sleep-inducing activities. Unlike a lot of other depressants, it does not cause sleep issues. It has also been found to be clinically useful in generalized anxiety disorder, agitation of patients with dementia and organic disorders, chronic pain disorders, alcohol and benzodiazepine dependence.6
Results from some short-term studies (4 to 6 weeks) in 320 elderly patients with major depression indicate that this drug works better than placebos. It has been observed to be effective as anti-depressants like amitriptyline, imipramine, fluoxetine, and mianserin in relieving depression symptoms. It has also been safely and successfully used in some patients with depression and pre-existing cardiovascular disease.
According to the Hamilton Depression Rating Scores, Trazodone showed a 39 to 64 percent efficacy in battling depression. In comparison to other antidepressants, other symptoms such as insomnia and anxiety showed early improvement with Trazodone therapy.
The drug is metabolized wonderfully in the body, with less than one percent of the dose excreted out through urine and stools. After ingestion on an empty stomach, single doses of 50 to 100 mg seem to be well absorbed from the GI tract. Thereafter, it is absorbed by the blood. Consuming Trazodone with food has a variable effect on the amount of drug absorbed.7
Trazodone is also useful for those struggling with alcohol deaddiction. It seems to soothe the symptoms of alcohol withdrawal like sleep disturbances and cravings.8
Can Trazodone Make One Sleep Better?
Sometimes insomnia can be a side effect of certain antidepressants and Trazodone helps with that. The drug is prescribed to many suffering from antidepressant-associated insomnia, thanks to its hypnotic effects. According to a study, 17 patients suffering from antidepressant-associated insomnia were given Trazodone or placebos. The group taking Trazodone experienced 67 percent improvement in sleep.9
However, the older set has better chances of enjoying a good night’s sleep with Trazodone. It has marked tranquilizing properties, which seem to work better in the elderly than in younger folk. A night-time dose of 150 mg significantly reduced the duration of rapid eye movement sleep and increased the duration of slow wave sleep in 9 elderly volunteers with insomnia.10
What Are The Side Effects Of Trazodone?
Unfortunately, a lot of adverse effects of Trazodone have also been reported. Here are some:
Dizziness And Drowsiness
The most common side effects are dizziness and drowsiness with 10 percent or more of users reporting it. The less common ones include dry mouth, insomnia, constipation, blurred vision, confusion, and nervousness. In those with cardiac complaints, cardiac arrhythmia is a possibility. Though the side effects often taper off during treatment, it helps to be watchful of them. Moreover, if skin rash is noticed, you need to consult your doctor without delay.11
Do Not Mix With Alcohol
The drug is generally safe even when patients have overdosed. The only time deaths have been reported in cases of overdose is when Trazodone was mixed with other agents or alcohol. So while you are on this drug, try to abstain from or minimize alcohol consumption. Long-term side effects of Trazodone include impaired alertness, more so in the elderly than in young individuals.12
Sexual Side Effects
Treatment with this medicine has been associated with the occurrence of prolonged penile erection (called priapism) that can be persistent and painful. In comparison to some other antidepressants like trimipramine, Trazodone significantly increased the total interval of nocturnal erectile activity, according to a study. These erections can often last up to or beyond four hours.13 If the erection lasts longer than six hours, it is a cause of great concern for men and may even require surgery in some cases.
Pregnancy And Lactation
While antidepressants like Trazodone are relatively safe, its use can be avoided during pregnancy and lactation. In a study that observed 147 women on phenylpiperazine (of which Trazodone is one) antidepressants in the first trimester or during the entire course of pregnancy, there were 121 (82.4 percent) live births, 20 (13.6 percent) spontaneous abortions, and 6 (4 percent) therapeutic abortions. Of the live births, there were 2 (1.6 percent) major malformations. Results concluded that phenylpiperazine antidepressants like Trazodone increase the rate of major malformations only by one to three percent.14
As far as lactation is concerned, study results show that small doses (50mg) of Trazodone lead to a minuscule excretion of the drug in breast milk. However, larger doses mean a greater exposure for the baby.15
What Are Some Common Trazodone Withdrawal Effects?
You may experience some withdrawal symptoms if you suddenly stop the medication–especially if your dose was large. These include blurred vision or vision disturbances, gastrointestinal symptoms, lethargy, insomnia, anxiety, agitation, irritability, and migraines. That is why it is best to consult your doctor and leave the medication as advised.
Medical practitioners recommend that Trazodone be tapered off gradually at a very slow rate to avoid withdrawal symptoms.16
Like many other medications, Trazodone too comes with some side effects. If you must take the medicine, stay alert and report any noticeable changes in you to the doctor without delay.
References [ + ]
|1.||↑||Stahl, Stephen M. “SM: Mechanism of action of trazodone: a multifunctional drug.” In CNS Spectr.|
|2.||↑||Pigott, Teresa A., F. R. A. N. C. I. N. E. L’HEUREUX, Cheryl S. Rubenstein, Suzanne E. Bernstein, James L. Hill, and Dennis L. Murphy. “A Double-Blind, Placebo Controlled Study of Trazodone: in Patients with Obsessive-Compulsive Disorder.” Journal of clinical psychopharmacology 12, no. 3 (1992): 156-162.|
|3.||↑||Mavissakalian, Matig, James Perel, Kathleen Bowler, and Robert Dealy. “Trazodone in the treatment of panic disorder and agoraphobia with panic attacks.” Am J Psychiatry 144, no. 6 (1987): 785-7.|
|4.||↑||Fink, H. A., R. MacDonald, I. R. Rutks, and T. J. Wilt. “Trazodone for erectile dysfunction: A systematic review and meta‐analysis.” BJU international 92, no. 4 (2003): 441-446.|
|5.||↑||Khurana, R. C. “Treatment of painful diabetic neuropathy with trazodone.” Jama 250, no. 11 (1983): 1392-1392.|
|6.||↑||Frecska, E. “Trazodone–its multifunctional mechanism of action and clinical use.” Neuropsychopharmacologia Hungarica: a Magyar Pszichofarmakologiai Egyesulet lapja= official journal of the Hungarian Association of Psychopharmacology 12, no. 4 (2010): 477-482.|
|7, 10.||↑||Haria, Malini, Andrew Fitton, and Donna McTavish. “Trazodone.” Drugs & aging 4, no. 4 (1994): 331-355.|
|8.||↑||Borras, L., Philippe de Timary, E-L. Constant, P. Huguelet, and A. Eytan. “Successful treatment of alcohol withdrawal with trazodone.” Pharmacopsychiatry 39, no. 06 (2006): 232-232.|
|9.||↑||Zornberg, Gwen, and Michel Rosenthal. “Trazodone for antidepressant-associated insomnia.” Am J Psychiatry 151 (1994): 1069-1072.|
|12.||↑||Haria, Malini, Andrew Fitton, and Donna McTavish. “Trazodone.” Drugs & aging 4, no. 4 (1994): 331-355.|
|13.||↑||Saenz, de Tejada I., J. C. Ware, R. Blanco, J. T. Pittard, P. W. Nadig, K. M. Azadzoi, R. J. Krane, and I. Goldstein. “Pathophysiology of prolonged penile erection associated with trazodone use.” The Journal of urology 145, no. 1 (1991): 60-64.|
|14.||↑||Einarson, A., L. Bonari, S. Voyer-Lavigne, A. Addis, D. Matsui, Y. Johnson, and G. Koren. “A multicentre prospective controlled study to determine the safety of trazodone and nefazodone use during pregnancy.” Canadian journal of psychiatry. Revue canadienne de psychiatrie 48, no. 2 (2003): 106.|
|15.||↑||Verbeeck, R. K., S. G. Ross, and E. A. McKenna. “Excretion of trazodone in breast milk.” British journal of clinical pharmacology 22, no. 3 (1986): 367-370.|
|16.||↑||Otani, K., O. Tanaka, S. Kaneko, M. Ishida, N. Yasui, and Y. Fukushima. “Mechanisms of the development of trazodone withdrawal symptoms.” International clinical psychopharmacology 9, no. 2 (1994): 131.|