When mental health issues build up, you might feel like you’ve exhausted every option available to help you feel better. Perhaps you’ve made lifestyle changes, opened up to a medical professional, or even tried medication. But what happens when a certain medication doesn’t help your symptoms, or creates side effects that outweigh its benefits?
Medications affect everyone differently. For instance, SSRIs and SNRIs are the “go-to” treatments for conditions like depression, but sometimes, they’re either not strong enough for some people or cause too many uncomfortable side effects. This is when an atypical medication like Trazodone may enter the equation.
Trazodone works differently from other medications, so it may provide relief for people who haven’t tolerated previous forms of treatment well. Yet Trazodone comes with its own operating method, so its effects can vary from person to person.
A healthcare provider can discuss whether Trazodone could be a good fit for your or a loved one’s needs. This page covers:
- What Trazodone is and how it works.
- What Trazodone is used for.
- How long it takes for Trazodone to work.
- Possible Trazodone side effects.
- How to stop Trazodone safely.
- Answers to frequently asked questions about Trazodone.
- Where to find professional mental health and medication support.
What Is Trazodone?
Trazodone (also known under the brand name “Desyrel”) is an antidepressant that is sometimes prescribed to treat major depression. It’s Food and Drug Administration (FDA) approved for depression, but also can be used off-label for a variety of other conditions, including:[1]
- Insomnia.
- Anxiety.
- Schizophrenia.
- Alzheimer disease.
- Fibromyalgia.
- Post-traumatic stress disorder (PTSD).
Off-label prescribing isn’t something to be concerned about. Healthcare providers often turn to non-approved medications for treating a condition when other treatments haven’t worked or there are no available options. It’s perfectly legal, and will be explained by a provider if Trazodone is prescribed for a condition it’s not FDA-approved for.
Having said as much, a provider likely won’t resort to Trazodone as a first-line treatment. Instead, they’ll initially attempt to treat symptoms with the antidepressants that tend to be better tolerated: selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs).
If these first-line medications don’t produce benefits, or if someone doesn’t respond well to their side effects, a provider may consider treatment with Trazodone. Trazodone works differently from more “classic” antidepressants, meaning its benefits and side effects can also vary. The following section goes into how Trazodone works in more detail.
How Trazodone Works
Like other antidepressants, Trazodone works by targeting the levels of chemicals in the brain responsible for mood, called “neurotransmitters.” However, Trazodone also differs in core ways from the classic antidepressants. To be specific, Trazodone is a “triazolopyridine serotonin receptor antagonist and reuptake inhibitor” (SARI).[1]
Let’s face it; Trazodone’s clinical group name is a mouthful. So let’s break down what it means into simpler terms.
Like SSRIs, Trazodone prevents the reabsorption of the “happy hormone,” serotonin. This means that there’s more of the chemical available in the brain to carry messages from cell to cell, helping people feel more alert and positive.
However, Trazodone also blocks other chemical receptors in the brain. This effect tends to boost mood, quality of sleep, and focus. In fact, Trazodone has been shown to be as effective in treating depression as SSRIs, SNRIs, and tricyclics. Plus, it also tends to be well-tolerated by the majority of people.[2]
However, due to some long-term Trazodone risks, it tends not to be the first-line option for prescribers. We’ll discuss these side effects and risks later in this article.
What Is Trazodone Used For?
As mentioned, Trazodone is FDA-approved for treating depression, either as a standalone treatment or in combination with other medications. However, Trazodone is also prescribed off-label for a variety of other mental and physical conditions, including anxiety, schizophrenia, and uncontrollable tremors.
The following information discusses how Trazodone can be used for various conditions.
Trazodone for Depression
Depression can be debilitating for someone’s life, as it causes persistent hopelessness, sadness, and loss of interest. Recent research has demonstrated how Trazodone benefits the symptoms of depression, including feelings of:[3]
- Anxiety.
- Insomnia.
- Agitation.
- Thought disturbances.
- Physical pains.
- Suicidal thoughts.
Moreover, Trazodone tends to be as effective as other antidepressants and is well-tolerated, making it a valuable option for those who haven’t responded well to other medications.
Trazodone for Sleep
Insomnia is when someone struggles to fall or stay asleep, or when they wake up too early – leading to constant fatigue and low mood.
Evidence suggests that Trazodone is an effective treatment for insomnia, as it can be used to treat insomnia that occurs by itself or alongside other mental health issues, such as depression. Plus, when low-dose Trazodone is used, there’s a limited risk of side effects.[4]
Aside from these conditions for which Trazodone is commonly prescribed, it may also be suitable for a variety of off-label issues. Your provider can talk to you about the suitability of Trazodone for your needs.
How Long Does It Take for Trazodone to Work?
When depressive symptoms are weighing on your day-to-day life, it’s normal to wonder, How long does Trazodone take to work?
It’s important to recognize that Trazodone isn’t a short-acting medication, so its effects don’t kick in overnight. Plus, while some people might notice benefits after the one to two-week point, others might have to wait until roughly 6 weeks to see the full effects. We all respond to medications in unique ways, so it’s tough to put a specific timeline on when Trazodone will start to work for you.[5]
However, like many antidepressants, the initial signs Trazodone is working can be subtle. Yet keeping an eye out for them can prevent someone from becoming discouraged during the early stages of treatment.
Signs Trazodone Is Working:
- Better sleep
- Increased energy
- Appetite shifts
- Boosts in concentration and focus
- Reduced anxiety
- Fewer depressive symptoms
- Feeling more like “yourself”
If, after the adjustment period, you don’t notice signs Trazodone is working, reach out to your provider. They may talk to you about the option of increasing your dose or trying out a different medication.
What Are Potential Trazodone Side Effects?
As Trazodone is an antidepressant, it comes with the risk of certain side effects. However, as Trazodone works differently from other medications, it may cause fewer side effects in someone who previously didn’t respond well to other drugs.
Nevertheless, it can create certain effects, especially early in treatment. Not everyone will experience the following effects, but those who do will likely find that they ease after a couple of weeks.
Common Trazodone Side Effects:[6]
- Stomach issues, such as nausea and vomiting
- Diarrhoea and constipation
- Weight and appetite changes
- Fatigue
- Agitation and nervousness
- Dizziness
- Nightmares
- Tremors
- Dry mouth
- Aches and pains
- Flu-like symptoms
- Eye irritation
- Skin rash
- Sexual dysfunction
As mentioned, these common symptoms should ease after the period of adjustment. However, if they become uncomfortable or persist, contact your provider. Also, Trazodone comes with certain more serious, but rare risks. It’s important to be aware of these prior to starting treatment.
Serious Trazodone Side Effects and Risks:[6]
- Irregular or pounding heartbeat
- Chest pain
- Fainting
- Loss of consciousness
- Fever
- Sweating
- Lack of coordination
- Hallucinations
- Shortness of breath
- Nose bleeds
- Red or purple dots on skin, or unusual bruising
- Concentration or memory issues
- Weakness
- Painful and persistent erections in males
- Seizures
If you encounter any of these side effects, it’s important to seek medical assistance as soon as possible. Prior to treatment, your provider will talk to you about these risks, including how Trazodone might not be suitable in older people due to the increased risk of side effects.
Stopping Trazodone Safely
If Trazodone is creating more side effects than benefits for you, or if you feel like your symptoms no longer require medication, you may want to come off the drug. This may lead to the question, “How can I stop taking Trazodone safely?”
If you want to come off Trazodone, the answer to this question is “slowly.” Trazodone alters the chemicals in the brain, so stopping it suddenly could cause Trazodone withdrawal symptoms or a relapse of mental health issues. In fact, evidence suggests that Trazodone may need to be reduced even more slowly than other medications due to how it can have a rebound effect on the brain.[7]
Trazodone withdrawal symptoms include excessive perspiration, sleep difficulties, and irritability. To prevent these issues and continue on the path to long-term recovery, talk to your provider about creating a tapering plan that takes your dosage and length of time on Trazodone into account.
Get Depression Treatment at Mission Connection
If Trazodone is already part of your treatment plan, or if it’s currently being considered for your needs, Mission Connection is here to provide you with continued support, care, and guidance.
Medication for mental health is often a process of trial and error, with many ups and downs along the way. While Trazodone can offer relief from symptoms, it can also come with difficult-to-manage side effects – and works best in combination with therapy.
At Mission Connection, we offer personalized outpatient treatment tailored to your unique needs. Our expert clinical team provides medication management in conjunction with a range of other evidence-based mental health treatment approaches.
In addition to outpatient care at our locations in California, Virginia, and Washington, we also offer more intensive levels of care, such as a partial hospitalization program (PHP) or an intensive outpatient program (IOP). We treat a variety of mental health conditions and are in-network with most major insurance providers.
To find out more about our in-person, virtual telehealth, or hybrid program that combines in-person and virtual care, call us at 866-833-1822. You can also learn more about how to get started with treatment services online.
Trazodone FAQ
Trazodone is an atypical antidepressant, so it doesn’t follow the same operating method as other medications. Plus, information about it isn’t as readily available online as it is for other antidepressants. To help clarify whether this drug is the right choice for your needs or not, we provide responses to some frequently asked questions below.
Can Trazodone cause nightmares?
The information around whether Trazodone can cause nightmares is mixed. On the one hand, Trazodone is sometimes prescribed for nightmares associated with PTSD and depression. Yet, nightmares can also be a side effect of Trazodone. In fact, a Trazodone review shows that over 58% of people who take Trazodone experience nightmares.[8] It appears that if nightmares are a symptom of a mental health condition, Trazodone may help to get these under control. However, they may cause them in people without this issue.
Which is right for me? Trazodone vs Mirtazapine
When it comes to Trazodone vs mirtazapine, the best choice for your needs will come down to the outcomes of a thorough evaluation by a provider. For instance, they’ll decide based on your symptoms, response to previous medications, and mental health condition.
In general, studies have shown that people tend to respond to and tolerate mirtazapine better than Trazodone.[9] However, the side effects of both drugs vary, with weight gain being more common with mirtazapine than Trazodone. Ultimately, your condition and response to side effects will determine which medication is the best fit for you.
Is there a link between Trazodone and weight changes?
While many antidepressants are linked to weight gain, evidence suggests that Trazodone may be associated with weight loss due to appetite changes.[10] This loss should be minimal, and your appetite may settle after the adjustment period. However, if weight loss becomes concerning, it may be a good idea to talk to your provider.
Does Trazodone cause morning grogginess?
Although Trazodone is not a sleep medication, it can cause drowsiness, so some people find that taking it at night helps them sleep. However, these effects do risk spilling into the next day, creating a link between Trazodone and morning grogginess. If this daytime drowsiness persists, your doctor may recommend lowering your dose so that the effects wear off before you wake up.
Is Trazodone habit-forming?
Trazodone is not typically considered with substance misuse, but some people may experience withdrawal symptoms – especially when they stop taking it abruptly. These effects can be uncomfortable, suggesting that the body has formed a physical reliance on the drug to operate functionally. For this reason, tapering off Trazodone under professional supervision is always recommended.
References
- Shin, J. J., & Saadabadi, A. (2024). Trazodone. StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470560/
- Fagiolini, A. et al. (2023). Role of trazodone in treatment of major depressive disorder: an update. Annals of General Psychiatry, 22, 32. https://doi.org/10.1186/s12991-023-00465-y
- Berardelli, I. et al. (2024). Rethinking the role of trazodone in the different depressive dimensions. Expert Review of Neurotherapeutics, 24(7), 619–632. https://doi.org/10.1080/14737175.2024.2363843
- Jaffer, K. Y. et al. (2017). Trazodone for insomnia: a systematic review. Innovations in Clinical Neuroscience, 14(7-8), 24. https://pmc.ncbi.nlm.nih.gov/articles/PMC5842888/
- Drugs.com. (2024, August 22). How long does it take for trazodone to work? https://www.drugs.com/medical-answers/long-Trazodone-work-3561224/
- National Library of Medicine. (n.d.). Trazodone: drug information. MedlinePlus. https://medlineplus.gov/druginfo/meds/a681038.html#side-effects
- Otani, K. et al. (1994). Mechanisms of the development of trazodone withdrawal symptoms. International Clinical Psychopharmacology, 9(2), 131–133. https://doi.org/10.1097/00004850-199400920-00011
- Drugs.com. (n.d.). Trazodone and nightmares: what users say. https://www.drugs.com/comments/Trazodone/sfx-nightmares.html
- van Moffaert, M. et al. (1995). Mirtazapine is more effective than trazodone: a double-blind controlled study in hospitalized patients with major depression. International Clinical Psychopharmacology, 10(1), 3–9. https://pubmed.ncbi.nlm.nih.gov/7622801/
- Hecht Orzack, M. et al. (1986). Weight changes in antidepressants: a comparison of amitriptyline and trazodone. Neuropsychobiology, 15(Suppl. 1), 28–30. https://doi.org/10.1159/000118237