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Trazodone for Sleep: What You Need to Know

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Trazodone is principally an antidepressant, but it is also widely used to treat insomnia and to promote healthy sleep patterns. It does this both by causing drowsiness and by balancing the level of serotonin in the brain.

THIS ARTICLE IS FOR INFORMATIONAL PURPOSES ONLY AND SHOULD NOT BE TAKEN AS MEDICAL ADVICE. ALWAYS FOLLOW THE DIRECTIONS GIVEN BY YOUR DOCTOR WHEN TAKING ANY MEDICATION.

How Can Trazodone Help Me?

Trazodone can help you to re-establish a normal sleep pattern. Often, sleep disturbances are due to an imbalance in a natural chemical which is found in the brain. Serotonin is an important neurotransmitter which not only regulates our sleep. It is also related to our moods, appetite, and digestion, as well as our memory, sexual function, and desire. Insomnia can take different forms, and if you are not getting enough quality sleep it can seriously affect your health and your ability to perform your normal daily tasks. Trazodone is non-addictive, and it is quite inexpensive, which make it a popular choice for doctors to prescribe.

Trouble Falling Asleep

Trazodone makes you feel drowsy, and when taken before going to bed it can help you to drop off to sleep. If you have trouble falling asleep, you should take your Trazodone about three hours before bedtime.

Trouble Staying Asleep

If you wake up frequently during the night Trazodone can help you to sleep through the entire night. If you fall asleep easily, but then wake up again later, you should take your Trazodone about a half an hour before retiring.

Brand and Generic Names

Chemical name -Trazodone hydrochloride(HCL)

Generic name- Trazodone

Brand names- Desyrel, Oleptro, Trittico, Molipaxin, Trazorel (among others)

Before Taking Trazodone

Before prescribing Trazodone, your doctor will ask you if you have any allergies and what other medications you are taking. This is to make sure that the Trazodone will not cause an allergic reaction or interact with the other drugs. He will also ask you about your personal medical history and that of your immediate family. You should tell him if you or a family member have ever suffered from any kind of mental illness, particularly bipolar disorder, or if you or they have attempted suicide or had suicidal thoughts. You must mention if you or they have heart, kidney, or liver disease, blood pressure problems or a history of glaucoma. Also, if you have a history of substance abuse.

As Trazodone can cause dizziness, drowsiness and blurred vision, your doctor will advise you not to drive or use machinery until these symptoms pass. If you smoke marijuana, you should tell your doctor, as smoking marijuana or drinking alcohol can increase the dizziness which is sometimes experienced when taking Trazodone.

Tell your doctor about all the drugs you take both those that are prescribed or bought over the counter and including herbal or natural remedies. Make a list so that you do omit any.

Before prescribing Trazodone, your doctor may want to run some tests to rule out physical causes of your insomnia. Heartburn, pain, hot flushes, and side effects of drugs are all common causes of sleep disturbances.

Allergy Information

Your doctor will ask you if you have any known allergies, and particularly if you are allergic to Nefazodone (Serzone).

Common Interactions

Trazodone can affect the way other drugs that you are taking can react, and the way it reacts can be affected by other drugs in your system. These interactions can be dangerous, so it is very important that you tell your doctor about all the medicines you take both regularly or occasionally, whether they have been prescribed by a doctor, or you buy them directly in the pharmacy, or in a health food store. Remember that if you buy a new medicine to treat even a common complaint, you should tell your pharmacist that you are taking Trazodone for sleep, to make sure there is no risk of an adverse interaction.

Interactions

The most commonly used medications which interact with Trazodone are digoxin and MAO inhibitors. Others are azole antifungals, HIV protease inhibitors, macrolide antibiotics, rifamycins, and, drugs used to treat seizures. The street drug Ecstasy or MDMA, the herb St John’s Wort, and some antidepressants also can cause interactions, as can antihistamines, muscles relaxants, and narcotic pain relievers, among others.

Adult Dosing

The adult dose of Trazodone for sleep is between 50-100 mg at bedtime. The tablet should be swallowed whole, and should not be crushed, snorted, or chewed. Eat a light snack before taking the tablet or take it with a meal. Frequently, you will be started on a low dose which your doctor may increase depending on your response to treatment. Be careful to follow the correct dosage and to take the tablet at the same time each night.

Black Box Warnings

A black box warning is a requirement of the FDA if reasonable evidence exists of a serious health hazard from using a drug. For Trazadone, the black box warning states that taking the drug can increase the chance of committing suicide. People aged less than 24 are at the greatest risk, and the risk of suicide increases when starting treatment, or changing the dosage.

Side Effects

Some people who take Trazadone may experience one or more side effects. Most of these are not serious. You may feel nausea and be sick or have diarrhea or sometimes constipation. You may experience drowsiness and tiredness or have blurred vision. Some people get headaches, muscle pain or a stuffy nose. Others feel dizzy or lightheaded, so remember to get up slowly from a sitting or lying posture, to reduce this. Occasionally weight changes can occur or a change in sexual interest or ability. Having an unpleasant taste in your mouth or having a dry mouth is quite common, and this can be relieved by sucking a hard sweet, or a piece of ice, chewing gum, or by drinking water. Most of these side effects will disappear after a period of using Trazodone, however, if any of them persist, or if they get worse, you should tell your doctor.

Occasionally severe side effects can occur, and if you experience any of the following conditions you should visit your doctor. If you have tremors or shaking, hear ringing in your ears or have nightmares. Also, if you have pains in your stomach, feel a shortness of breath, or have signs of an infection such as a high temperature or a persistent sore throat. Also, if you see blood in your urine or have trouble urinating.

Very serious side effects are uncommon, but if you experience any of the following symptoms you should seek medical help immediately. If you have pain in your left arm, jaw, or chest, have an irregular or fast heartbeat, experience seizures or fainting. Also, if you have pain in your eyes or they are swollen or red, if your pupils are wide, or if you have changes in your vision like seeing rainbows around the lights in the night time.

Trazadone for Sleep

Rarely a serious condition called serotonin toxicity can occur and you should immediately see your doctor if you have severe dizziness, loss of coordination, hallucinations, muscle twitching, nausea, vomiting or diarrhea, or if you feel extreme agitation.

Very occasionally, men can experience a serious condition called priapism where the penis remains erect for more than four hours and causes pain. If this happens, do not take another dose of Trazodone and seek medical attention.

Allergic reactions to Trazodone are uncommon, but you should seek medical attention if you experience itching and a rash, and swelling, particularly if this is in the throat, tongue, or face. Also, if you have trouble breathing or feel very dizzy.

If at any time during treatment you feel aggressive, irritable, extremely worried, have a panic attack, get abnormally excited, act without thinking beforehand, or have suicidal thoughts, you should contact your doctor.

Older people are more susceptible to suffer from dizziness, drowsiness and abnormal heart rhythms and they should be carefully monitored.

How Should I Take Trazodone for Sleep?

Trazodone should be taken orally, that is by mouth. When taking Trazodone for sleep it is normal to be prescribed just one tablet a day. Take it a short while before you go to bed with a light snack. If you have trouble falling asleep, you should take it about three hours before bedtime. If you have trouble sleeping throughout the night, you should take it about 30-minutes before retiring.

Try to take it at the same time every night and only take the prescribed amount. It can take between two and four weeks before you will feel the full benefit of taking Trazodone. So, be patient and do not be tempted to increase the dosage as this will not make the drug work any faster or more effectively and it could be dangerous.

If, after a month of taking Trazodone, you do not find an improvement in your sleeping, or your condition has got worse, you should see your doctor. Do not stop taking this medicine unless your doctor tells you to. Stopping suddenly can make you feel anxious and agitated and will further disturb your sleep.

What Do I Do If I Miss a Dose?

If you forget to take a dose of Trazodone at the correct time take it as soon as you remember. However, if you go to bed and sleep, do not take the missed dose in the morning or take a double dose in the evening. Simply skip the dose and resume taking it as prescribed from then on.

What Happens If I Overdose?

Overdosing is caused by taking more than the prescribed dose at the correct times. It can cause irregular, slow, or rapid heartbeat, unusual dizziness, drowsiness, vomiting, difficulty in breathing, seizures, and a prolonged and painful penile erection in men. If you experience serious symptoms such as breathing difficulties or passing out, you should call 911 immediately. For other symptoms, you should call your local poison control center at 1-800-222-1222.

Efficacy Concerns

Short-term studies have shown that Trazodone can improve sleep after two weeks of treatment, but investigation into the long-term effects have not been performed. After six weeks of treatment, it is unclear as to how safe it is, or how well it works for treating chronic insomnia. Also, there is no established effective dosage for treating sleep problems, although lower dosages are generally given for this use.

In 2017, the treatment guidelines published by the American Academy of Sleep Medicine felt that due to so little research they could not recommend Trazodone for the treatment of chronic insomnia. However, data compiled recently has shown that people with insomnia have generally enjoyed an improvement in their condition while taking Trazodone.

As Trazodone is not classed as a controlled substance by the FDA as it has a very small risk of abuse or causing dependency, doctors can prescribe an unlimited number of pills to a patient. For this reason, many doctors believe that it is safer than many other sleep medications, but this is not backed up by scientific research as yet.

The FDA approved Trazodone for use as an antidepressant in 1981, but it has never been legally approved as a treatment for insomnia.

Pregnancy

Trazodone should not be taken during pregnancy as it can harm the fetus and cause abnormal development. Be sure to tell your doctor if there is any chance that you are pregnant. It is unclear if Trazodone passes into the breast milk, but if you are breastfeeding a child you should inform your doctor.

Other Uses

Trazodone is not often used for the treatment of depression any more as more effective anti-depressants have been developed which have fewer side effects and have better success rates.

Typical Uses

Depression, anxiety, and schizophrenia.

Off-label uses

Insomnia in low doses.

Trazodone has been shown to be effective over the short term for both primary and secondary insomnia, in people both with and without depression. Although daytime sedation and some motor impairment can be experienced, side-effects are generally slight. Due to its low cost, and that it is not addictive, Trazodone remains a frequent off-label choice for treating insomnia and other sleep disturbances.

Resources

  1. https://www.webmd.com/drugs/2/drug-11188-89/trazodone-oral/trazodone-oral/details
  2. https://www.consumerreports.org/insomnia/trazodone-for-insomnia-should-you-take/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842888/
  4. https://pubchem.ncbi.nlm.nih.gov/compound/Trazodone_hydrochloride#section=Computed-Properties
  5. https://www.everydayhealth.com/drugs/trazodone

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