Trazodone: Interactions, Addiction, Withdrawal & Side Effects

Last Updated: October 25, 2022

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Trazodone is a prescription medication often used to treat depression, insomnia or alcohol dependence. While it is a non-controlled medication, there are sometimes questions about whether it can be habit-forming. This medication is generally safe and effective, but misuse and abuse can occur despite being a non-controlled medication under the Controlled Substances Act.

What Is Trazodone Used For?

Trazodone is a prescription antidepressant used to treat major depressive disorder (MDD) and, more commonly, insomnia or alcohol dependence. It is a selective serotonin reuptake inhibitor (SSRI), meaning it blocks serotonin in the brain from returning to the neuron. By doing this, serotonin stays in the synapse (the space between neurons) longer, where it can continue to activate neurons. More available serotonin can result in improved depression. One of the most common side effects of this medication is sedation, leading to its use for insomnia.

Trazodone Brand Name

Trazodone is available as a generic but is also marketed under these brand names:

  • Desyrel: an immediate-release tablet
  • Desyrel Dividose: an extended-release tablet
  • Oleptro: an extended-release formulation of trazodone tablets, which has been discontinued in the U.S. However, generics may be available.

Trazodone Dosage

Trazodone is available in the following doses: 50 mg, 100 mg, 150 mg and 300 mg. An extended-release formulation is available as 150 mg or 300 mg tablets. The initial prescribed dose for depression is generally 150 mg/day, divided into two or three doses throughout the day. The maximum recommended dose is 400 mg/day, although people in inpatient psychiatric treatment may receive up to 600 mg/day. Most other indications, including anxiety, insomnia, withdrawal or pain management, can range from 50 to 100 mg once daily. These would also be adjusted by 50 mg every few days by your healthcare professional until you reach the desired effect. 

Trazodone Side Effects

Commonly reported side effects of trazodone include: 

  • Blurred vision
  • Dizziness
  • Drowsiness
  • Dry mouth
  • Headache
  • Nausea and vomiting

Other more rare but serious side effects may include:

  • Confusion
  • Diarrhea 
  • Fainting 
  • Insomnia 
  • Involuntary muscle movements
  • Low blood pressure
  • Swelling 
  • Tachycardia (fast heart rate)

Trazodone Overdose

It is possible to overdose on trazodone which, rarely, can result in death. An overdose can happen when someone accidentally or purposefully takes too much trazodone or mixes it with other medications or alcohol. Some symptoms of trazodone overdose are: 

  • Difficulty or stopped breathing
  • Chest pain 
  • Irregular or slow heart rate
  • Low blood pressure
  • Dizziness 
  • Drowsiness 
  • Tremor 
  • Seizures
  • Coma 

If you suspect a trazodone overdose, call 911 right away. It may be helpful to take the prescription bottle to the hospital with you. There is no specific reversal agent for trazodone. However, vital signs will be monitored, and symptoms can be treated. 

Trazodone Interactions

Like most medications, trazodone has the potential for some significant drug interactions. It is important to always consult with your doctor or pharmacist to make sure trazodone is safe with any other medication you are taking. 

Trazodone and Alcohol

Both alcohol and trazodone are central nervous system depressants. Taking trazodone and alcohol together can have an additive effect and increase some side effects like dizziness, drowsiness or difficulty concentrating. Taking trazodone and alcohol together can also affect your judgment and ability to think clearly, so it is important to avoid or limit alcohol while on this medication. 

Combining trazodone with alcohol can also be counterproductive. This combination can make it more difficult to get quality sleep or worsen depression.

Trazodone and Benadryl 

Using Benadryl and trazodone together can result in increased side effects. These can include profound dizziness, confusion, difficulty concentrating and especially drowsiness. In certain populations, like the elderly, this combination can impair thinking, judgment and motor coordination.

Trazodone and Prozac

Taking Prozac with trazodone can result in a rare but serious condition called serotonin syndrome. Symptoms of serotonin syndrome can include

  • Confusion
  • Changes in blood pressure
  • Increased heart rate
  • Fever
  • Excessive sweating
  • Blurred vision
  • Tremor
  • Nausea and vomiting
  • Diarrhea
  • Seizures
  • Hallucinations

With severe cases of serotonin syndrome, coma or death have been reported. Always discuss all of your medications with your healthcare provider.

Trazodone and Xanax

Xanax and trazodone can each result in confusion, dizziness, drowsiness and difficulty concentrating on their own. Taking Xanax and trazodone together can amplify these side effects. Sometimes, these medications are taken on an “as needed” basis and may be less of a concern than if you take them daily. Always talk with your healthcare provider to determine the risks and benefits of any medications. 

Is Trazodone Addictive?

Trazodone is a non-controlled medication under the Controlled Substances Act; however, there is some debate about whether trazodone is addictive. In one study, trazodone was compared with two other sleep medications: triazolam (Halcion) and zolpidem (Ambien). Of the three medications studied, trazodone resulted in the lowest potential for abuse.

Still, trazodone is sometimes purchased on the street without a prescription. Concerning signs may be taking trazodone differently than prescribed or without a prescription. There may also be a concern that as tolerance to this drug develops, you may start using something else to try and get the same effect. 

Trazodone Withdrawal

As an antidepressant, trazodone withdrawal is medically called antidepressant discontinuation syndrome (ADS). Up to 20% of people experience ADS after abruptly discontinuing an antidepressant after more than six weeks. These symptoms are typically mild and last one to two weeks.

Trazodone withdrawal symptoms can vary from person to person or may not happen at all for some. To minimize the risk of withdrawal, trazodone should be discontinued slowly. Always discuss discontinuing trazodone with your healthcare provider to determine the safest way to stop taking it. 

Trazodone Withdrawal Symptoms

Trazodone withdrawal symptoms can vary depending on the dose you take and for how long. Always make sure to speak with your healthcare professional if you are considering stopping this medication to ensure you are doing so safely and effectively. Trazodone withdrawal symptoms can include

  • Agitation
  • Anxiety
  • Confusion
  • Dizziness
  • Headache
  • Trouble sleeping
  • Irritability

How Long Does Trazodone Stay in Your System?

Trazodone can stay in your system for varying times depending on which type of sample is tested. While trazodone is not routinely screened for on most drug tests, your doctor or employer can request a specific test to detect it. 

In general, trazodone can be detected in:

  • Urine for up to 26 days 
  • Blood for up to one to two days (based on the drug’s half-life)
  • Hair for up to 90 days
  • Not likely to be detected using a saliva test

Getting Help for Trazodone Addiction and Abuse

If you or a loved one are struggling with trazodone addiction or abuse, we are here to help. We provide comprehensive care, ranging from intensive inpatient programs to teletherapy from the comfort of your own home. Accredited by The Joint Commission, our facility’s focus on evidence-based, multidisciplinary care ensures you have licensed, professional addiction experts working for you.

If you or a loved one is struggling with trazodone use disorder, The Recovery Village Columbus can help. Contact our experts today to learn about our comprehensive rehab programs. We can help you get your life back.

See More: Trazodone Treatment 

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