Trazodone is used to treat major depressive disorder.
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Trazodone is an antidepressant that belongs to a group of drugs called serotonin receptor antagonists and reuptake inhibitors (SARIs). While trazodone is not a true member of the selective serotonin reuptake inhibitors (SSRIs) class of antidepressants, it does still share many properties of the SSRIs.
It may help to improve your mood, appetite, and energy level as well as decrease anxiety and insomnia related to depression. Trazodone works by helping to restore the balance of a certain natural chemical (serotonin) in the brain.
Trazodone Hydrochloride is primarily approved for the treatment of major depressive disorder, but it is also widely used off-label for several other conditions due to its pharmacological effects.
Here are some of the common off-label uses:
1. Insomnia:
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- Primary Off-Label Use: Trazodone is frequently prescribed for insomnia, especially when it is associated with depression or anxiety. Its sedative properties make it effective for helping patients fall asleep and stay asleep.
2. Anxiety Disorders:
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- Trazodone can be used to manage generalized anxiety disorder (GAD), social anxiety disorder, and other anxiety-related conditions. It helps reduce anxiety symptoms by increasing serotonin levels in the brain.
3. Chronic Pain:
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- It is sometimes used as an adjunct treatment for chronic pain conditions, particularly when these are associated with sleep disturbances or depression. Trazodone may help improve sleep quality and pain perception.
4. PTSD (Post-Traumatic Stress Disorder):
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- Trazodone is used off-label to help manage symptoms of PTSD, particularly insomnia and nightmares. Its calming effects can be beneficial for patients with this condition.
5. Fibromyalgia:
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- Patients with fibromyalgia, a condition characterized by widespread pain, may benefit from trazodone’s sleep-improving properties, which can indirectly reduce pain perception.
6. Migraine Prophylaxis:
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- In some cases, trazodone is used off-label to help prevent migraines, particularly when they are associated with sleep disorders.
7. Alcohol Withdrawal:
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- Trazodone may be prescribed to help manage symptoms of alcohol withdrawal, such as anxiety, agitation, and insomnia, although this use is less common.
8. Agitation in Dementia:
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- In some cases, trazodone is used to manage agitation or behavioral disturbances in patients with dementia. However, this use requires careful monitoring due to the increased risk of falls and other side effects in elderly patients.
9. Panic Disorder:
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- Trazodone may be used off-label to treat panic disorder, often in combination with other medications.
10. Eating Disorders:
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- While not common, trazodone may be used as part of a treatment plan for eating disorders, particularly when these are associated with depression or anxiety.
How Does Trazodone Hydrochloride Work ?
Trazodone Hydrochloride is an antidepressant that works by influencing neurotransmitters in the brain, particularly serotonin. Its mechanism of action is complex and involves several processes that contribute to its therapeutic effects. Mechanism of Action of Trazodone Hydrochloride
Warnings
Trazodone Pregnancy and Breastfeeding Warnings
You should not use trazodone if you are allergic to it, or if you are being treated with methylene blue injection.
Do not use this medicine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, tranylcypromine and others.
Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using trazodone. Your family or other caregivers should also be alert to changes in your mood or symptoms.
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Do not give this medicine to anyone younger than 18 years old without the advice of a doctor. Trazodone is not approved for use in children.
Before taking this medicine
You should not use trazodone if you are allergic to it.
Do not use this medicine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine, and others.
After you stop taking trazodone, you must wait at least 14 days before you start taking an MAOI.
Tell your doctor if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson’s disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with trazodone could cause a serious condition called serotonin syndrome.
To make sure this medicine is safe for you, tell your doctor if you have ever had:
- liver or kidney disease;
- heart disease, or a recent heart attack;
- a bleeding or blood clotting disorder;
- seizures or epilepsy;
- narrow-angle glaucoma;
- long QT syndrome;
- drug addiction or suicidal thoughts; or
- bipolar disorder (manic depression).
Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.
Taking trazodone during pregnancy could harm the baby, but stopping the medicine may not be safe for you. Do not start or stop this medicine without asking your doctor.
If you are pregnant, your name may be listed on a pregnancy registry to track the effects of trazodone on the baby.
It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.
Trazodone is not approved for use by anyone younger than 18 years old.
How should I take trazodone?
Take trazodone exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.
Take trazodone after a meal or a snack.
It may take up to 2 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.
You should not stop using this medicine suddenly, or you could have unpleasant symptoms (such as dizziness, vomiting, agitation, sweating, confusion, numbness, tingling, or electric shock feelings). Ask your doctor how to safely stop using this medicine.
Store at room temperature away from moisture, heat, and light.
Dosing information
Trazodone Dosage Information
Usual Adult Dose for Depression:
Initial dose: 150 mg orally per day in divided doses; this may be increased by 50 mg orally per day every 3 to 4 days
Maximum dose:
-Inpatients: 600 mg/day
-Outpatients: 400 mg/day
Comments:
-Patients should be screened for a personal/family history of bipolar disorder, mania, or hypomania prior to initiating treatment.
-Patients should be monitored for withdrawal symptoms when discontinuing therapy.
-After an adequate response has been reached, dosage may be gradually reduced depending on therapeutic response.
-If drowsiness develops, a major portion of the daily dose may be administered at bedtime or a reduction of dosage may be necessary.
-This drug should be taken shortly after a meal or light snack.
Use: Treatment of major depressive disorder (MDD)
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can be fatal when trazodone is taken with alcohol, barbiturates such as phenobarbital, or sedatives such as diazepam (Valium).
Overdose symptoms may include extreme drowsiness, vomiting, penis erection that is painful or prolonged, fast or pounding heartbeat, seizure (black-out or convulsions), or breathing that slows or stops.
What to avoid
Do not drink alcohol. Dangerous side effects or death could occur.
Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, Advil, Aleve, Motrin, and others. Using an NSAID with trazodone may cause you to bruise or bleed easily.
Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.
Trazodone side effects
Get emergency medical help if you have signs of an allergic reaction to trazodone: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop taking trazodone and call your doctor at once if you have a penis erection that is painful or lasts 6 hours or longer. This is a medical emergency and could lead to a serious condition that must be corrected with surgery.
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have:
- fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness (like you might pass out);
- slow heartbeats;
- unusual thoughts or behavior;
- easy bruising, unusual bleeding; or
- low levels of sodium in the body – headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Common trazodone side effects may include:
- drowsiness, dizziness, tiredness;
- swelling;
- weight loss;
- blurred vision;
- diarrhea, constipation; or
- stuffy nose.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect trazodone?
Using trazodone with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.
Tell your doctor about all your current medicines. Many drugs can interact with trazodone, especially:
- any other antidepressants;
- phenytoin;
- St. John’s wort;
- tramadol;
- a diuretic or “water pill”;
- medicine to treat anxiety, mood disorders, or mental illness such as schizophrenia;
- a blood thinner – warfarin, Coumadin, Jantoven; or
- migraine headache medicine – sumatriptan, Imitrex, Maxalt, Treximet, and others.
This list is not complete and many other drugs may interact with trazodone. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.