Trazodone

1. About trazodone

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

It's used to treat depression, anxiety, 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.

2. Key facts

  • 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.

3. Who can and can't take trazodone

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.

4. How and when to take it

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.

5. Side effects

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.

Contact a doctor straight away 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

These are warning signs of a serious allergic reaction.

A serious allergic reaction is an emergency.

These aren't all the side effects of trazodone.

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

Information:

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

6. How to cope with side effects

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.

7. Pregnancy and breastfeeding

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 stop taking your medicine unless your doctor tells you to.

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

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 which treatment 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

8. Cautions with other medicines

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.

9. Common questions

Page last reviewed: 13/12/2018
Next review due: 13/12/2021