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Trazodone is a drug used to treat depression, insomnia, and schizophrenia. It can also be used to control abnormal, uncontrollable movements that may be experienced as side effects of other medications, as well as for the management of alcohol dependence. Like all medicines, trazodone can cause side effects in some people, including drowsiness, dry mouth, blurred vision, low blood pressure, and allergic reactions. In rare cases, trazodone can also cause a life-threatening condition called serotonin syndrome, which is characterised by symptoms such as muscle spasms, twitching, stiffness, fever, sweating, and a racing heartbeat. If you experience any of these symptoms, it is important to seek medical help immediately.
| Characteristics | Values |
|---|---|
| Muscle spasms | Rare side effect |
| Muscle twitches | Common side effect |
| Muscle stiffness | Common side effect |
| Serotonin syndrome | Rare but potentially life-threatening side effect |
| QT prolongation | Rare side effect |
| Torsade de pointes | Rare side effect |
| Low blood pressure upon standing (orthostatic hypotension) | Less common side effect |
| Allergic reactions | Rare but serious side effect |
| Suicidal thoughts or actions | Risk is higher in children, teenagers, or young adults |
| Glaucoma | May increase pressure inside the eye and cause or worsen narrow-angle glaucoma |
| Low sodium levels (hyponatremia) | More likely to happen with older adults and those taking other medications that decrease sodium levels |
| Increased risk of bleeding | Rare risk, higher if taking other medications that have bleeding risks |
| Drowsiness | May cause drowsiness or sleepiness |
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What You'll Learn
Trazodone overdose
Trazodone is a prescription drug used to treat depression and anxiety. It can also be used to treat conditions such as insomnia, fibromyalgia, diabetic nerve pain, panic disorders, eating disorders, and agitation in people with dementia. Trazodone is a serotonin antagonist and reuptake inhibitor (SARI) that works by increasing serotonin activity in the brain.
- Dizziness
- Nausea
- Vomiting
- Diarrhea
- Low blood pressure (hypotension)
- QT prolongation (a heart rhythm issue that may cause chaotic or abnormal heartbeats)
- Serotonin syndrome, which can cause shivering, muscle rigidity, fever, and seizures
- Priapism, a persistent and painful erection that can last for more than four hours and cause permanent damage to the penis
If you suspect a trazodone overdose, call your doctor or seek guidance from a poison control center. If symptoms are severe, call 911 or go to the nearest emergency room immediately. Death from a trazodone overdose is rare, but it can occur, especially if large amounts of other CNS depressants have also been ingested.
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Serotonin syndrome
The syndrome typically occurs when an individual takes more than one medication that affects serotonin levels. It can also happen when someone starts taking a new serotonergic medication or increases the dosage of an existing one. Antidepressants, when combined with other serotonergic drugs, are often associated with serotonin syndrome. For example, taking an antidepressant with a migraine medication or an opioid pain medication can increase the risk of developing the syndrome. Additionally, certain illegal drugs, herbal products, and over-the-counter drugs that influence serotonin levels can also contribute to serotonin syndrome.
The symptoms of serotonin syndrome can vary from mild to severe. Mild symptoms may include shivering, diarrhoea, nausea, and muscle spasms or twitching. More severe symptoms can include high fever, seizures, muscle rigidity, confusion, disorientation, delirium, and even coma. In severe cases, serotonin syndrome can lead to unconsciousness and death if left untreated.
Trazodone, an antidepressant, has been associated with serotonin syndrome when taken alone or in combination with other medicines that affect serotonin levels. It is crucial to consult a healthcare professional if experiencing any symptoms indicative of serotonin syndrome, as immediate medical attention may be required.
While trazodone can increase the risk of serotonin syndrome, it exhibits a more prominent association with other side effects, such as drowsiness, increased suicidal thoughts or actions (especially in teenagers and young adults), and allergic reactions. It is important to carefully review potential side effects and consult a healthcare provider before taking trazodone or any other medication.
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Drug interactions
Trazodone can interact with several medications, and these interactions can cause different effects. Some drugs may interfere with how well trazodone works, while others may increase side effects. It is important to consult your doctor or pharmacist about any drug interactions that may affect you.
Monoamine Oxidase Inhibitors (MAOIs)
MAOIs, such as isocarboxazid, phenelzine, tranylcypromine, selelgiline, and linezolid, should not be taken with trazodone or within 14 days of taking them. Combining MAOIs with trazodone increases the risk of serotonin syndrome.
Central Nervous System (CNS) Depressants
CNS depressants, including pentobarbital and secobarbital, opioid medication, sleeping pills, muscle relaxers, and antihistamines, can increase the effects of trazodone, making individuals more drowsy or less alert.
Warfarin and Other Blood Thinners
Combining trazodone with warfarin or other blood thinners, such as apixaban or rivaroxaban, can increase the risk of bleeding.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and Aspirin
Taking trazodone with NSAIDs or aspirin, such as ibuprofen, naproxen, or Advil, may increase the risk of bruising or bleeding.
Stimulant Medicine
Inform your doctor if you are taking stimulant medicine, as an interaction with trazodone could lead to serotonin syndrome.
Herbal Products
Some herbal products, such as St. John's wort and tryptophan, may interact with trazodone.
Antidepressants and Mental Health Medications
Certain antidepressants and mental health medications can increase the risk of serotonin syndrome when combined with trazodone.
Migraine Medications
Combining trazodone with some migraine medications, such as triptans (e.g., sumatriptan) and opioids (e.g., tramadol or fentanyl), may increase the risk of serotonin syndrome.
It is important to discuss any medications, including prescription drugs, over-the-counter medicines, vitamins, and supplements, with your healthcare provider before taking trazodone.
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Allergic reactions
Trazodone may cause severe allergic reactions, which can be life-threatening. Stop using trazodone and seek immediate medical attention if you experience any of the following symptoms:
- Swelling of the lips, mouth, throat, or tongue
- Difficulty breathing, including wheezing, choking, or gasping for air
- Tightness in the throat or difficulty swallowing
- Skin, tongue, or lips turning blue, grey, or pale
- Sudden confusion, drowsiness, or dizziness
- In children, symptoms may include limpness, floppiness, or difficulty focusing
- A rash that is swollen, raised, itchy, blistered, or peeling
Trazodone may also cause a serious condition called serotonin syndrome, which can be life-threatening. Symptoms of serotonin syndrome include anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, hallucinations, and changes in heart rhythm. Serotonin syndrome can occur when trazodone is taken alone or in combination with other medications that affect serotonin levels.
It is important to discuss your health history and any allergies you may have with your doctor before taking trazodone. Your doctor will determine if trazodone is suitable for you and prescribe it accordingly.
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Suicidal thoughts
Trazodone is an antidepressant prescription drug used to treat depression and, off-label, to treat insomnia. It is one of the most widely prescribed sleep aids in the US.
Trazodone may cause an increase in suicidal thoughts or actions, especially at the beginning of treatment and during dosage changes. This risk is higher in children, teenagers, and young adults up to 24 years of age. It is also higher for those with depression or another mental illness, and those with bipolar disorder, mania, or a family history of these conditions.
In a 2019 observational safety study, researchers found that veterans taking trazodone attempted suicide at a rate 1.5 times higher than those taking zolpidem (Ambien). However, the study did not prove causation, and there was no mention of completed suicides.
If you or someone you know is experiencing suicidal thoughts or actions while taking trazodone, it is important to seek medical attention immediately. Do not stop taking trazodone or change your dose without guidance from a healthcare professional.
It is important to carefully consider the benefits and risks of taking trazodone and to discuss any concerns with a healthcare team.
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Frequently asked questions
Trazodone is a drug used to treat depression, insomnia, schizophrenia, and anxiety. It is also used to control abnormal, uncontrollable movements that may be experienced as side effects of other medications and for the management of alcohol dependence.
Muscle spasms are a rare side effect of taking Trazodone. However, if you experience muscle spasms, twitching, or stiffness, contact your doctor right away as these may be symptoms of a serious condition called serotonin syndrome.
Common side effects of Trazodone include drowsiness, dry mouth, nausea, vomiting, diarrhea, low blood pressure, dizziness, and lightheadedness. More severe side effects include allergic reactions, suicidal thoughts or actions, painful erections, increased risk of bleeding, and angle-closure glaucoma.
If you experience any side effects from taking Trazodone, contact your doctor or healthcare provider right away. Do not stop taking Trazodone without first checking with your doctor as this can cause withdrawal symptoms.
