Experiences with
Trazodone

Trazodone is an antidepressant medicine. It's used to treat depression, anxiety, or a combination of depression and anxiety.

Trazodone works by increasing your levels of serotonin and noradrenaline so you feel better.

It can help if you're having problems like low mood, not sleeping (insomnia) and poor concentration.

Trazodone comes as tablets, capsules and liquid that you swallow. It's only available on prescription.

Who can take trazodone

Most adults aged 18 years and over can take trazodone.

Who may not be able to take trazodone

Trazodone is not suitable for some people. To make sure it's safe for you, check with your doctor before starting to take it if you:

have ever had an allergic reaction to trazodone or any other medicine
have ever had thoughts of self-harming or ending your life
have recently had a heart attack or have heart, kidney or liver problems
have epilepsy or are having electroconvulsive treatment – trazodone may increase your risk of having a seizure
are pregnant, trying to get pregnant or breastfeeding
have porphyria, a rare disorder
have phaeochromocytoma, a condition that affects the adrenal glands

Dosage and strength

Trazodone tablets come as 50mg, 100mg and 150mg strengths. Capsules come as 50mg and 100mg strengths. The liquid has either 10mg or 20mg of trazodone in every 1ml.

For depression, the usual dose is 150mg daily. But in some cases your doctor may start you on a lower dose of 100mg to reduce the chance of side effects.

For anxiety, the usual dose is 75mg daily.

Your dose may go up or down depending on how it affects you. Your doctor may prescribe up to 300mg a day for anxiety, or more for depression, if you need a stronger dose.

How to take it

Your doctor may advise you to take your dose of trazodone once a day. If you have a larger dose, your doctor may suggest that you split it and take it twice a day.

If your dose is 300mg a day or less, your doctor will probably tell you to take it as a single dose at bedtime. As trazodone can make you feel sleepy, taking it at bedtime may help if you're having trouble sleeping.

Take trazodone after food to reduce the chances of feeling sick.

How long to take it for

If you have only had 1 episode of depression, you'll need to take trazodone for at least 6 months after you feel better.

Stopping before that time can make depression come back.

If you have had depression more than once, your doctor may recommend carrying on with trazodone for longer.

If you forget to take it

If you forget to take a dose, take it as soon as you remember, unless it's almost time for your next dose. In this case, skip the missed dose and take your next dose at the usual time.

Never take 2 doses to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicines.

If you take too much

Taking too much trazodone can cause symptoms including:

being sick
feeling very sleepy
being confused
feeling dizzy or fainting
problems with your heart or breathing
a fit or seizure

The amount of trazodone that leads to an overdose varies from person to person.

you take more than your prescribed dose of trazodone and have any symptoms

Go to 111.nhs.uk or call 111

you have a seizure or fit

Find your nearest A&E

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the trazodone packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Once you have been feeling better for 6 months or more, your doctor may suggest that you stop taking trazodone.

Your doctor will probably recommend reducing your dose gradually over several weeks, or longer if you have been taking trazodone for a long time.

This is to help prevent any withdrawal side effects you might get as a reaction to coming off the medicine. These can include:

feeling dizzy
feeling sick
numbness or tingling in the hands or feet
trouble sleeping
feeling agitated or anxious
headaches
shaking

Do not stop taking trazodone suddenly, or without talking to your doctor.

Common side effects

Some of the common side effects of trazodone will gradually get better as your body gets used to it. There are things you can do to help cope with them:

Take trazodone in the evening and try to cut down the amount of alcohol you drink. If you take trazodone twice a day, talk to your doctor. Feeling sleepy should become less of a problem after a few days as your body gets used to the medicine. Do not drive, ride a bike or use tools or machinery if you're feeling sleepy or tired.

Make sure you rest and drink plenty of fluids. Try not to drink too much alcohol. Talk to your doctor if the headaches last longer than a week or are severe.

Try taking trazodone with or after food to see if that helps. It's best to avoid rich or spicy food while you're taking this medicine.

Eat more high-fibre foods, such as fresh fruit and vegetables and cereals. Try to drink several glasses of water every day. If you can, it may also help to do some exercise.

Try sugar-free gum or sugar-free sweets.

Tell your doctor if this advice does not help or the side effects do not go away.

Serious side effects

Serious side effects are rare and happen in less than 1 in 1,000 people.

Call your doctor or call 111 now if:

the whites of your eyes turn yellow, or your skin turns yellow although this may be less obvious on brown or black skin – this can be a sign of liver problems
you have difficulty pooing (constipation) or you're unable to pee
you are bruising more easily than usual or have unexplained bruising
you get more infections than usual, such as a sore throat or skin infections
you have a fast, slow or abnormal heartbeat

a long-lasting and painful erection that lasts longer than 2 hours – this may happen even when you're not having sex
a seizure or fit
thoughts of self-harming or ending your life

Find your nearest A&E

Meds - serious side effects A&E safety messaging

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to trazodone.

Meds New IA (H4) - serious allergic reaction

Trazodone can cause problems with ejaculation. Some people say it gives them a higher sex drive, others say it makes it lower.

Other side effects

These are not all the side effects of trazodone. For a full list, see the leaflet inside your medicines packet.

Trazodone and pregnancy

It's important that depression and anxiety are well treated during pregnancy as these can affect both you and your baby's wellbeing. Depression and anxiety can sometimes get worse during pregnancy, and after your baby is born.

Talk to your doctor if you become pregnant while taking trazodone. They will help you weigh up the risks and benefits so you can decide on the best treatment for you and your baby.

Do not stop taking your medicine unless your doctor tells you to. You may need to continue to take trazodone during pregnancy to stay well.

Trazodone and breastfeeding

If your doctor or health visitor says your baby is healthy, you can take trazodone while breastfeeding.

Trazodone passes into breast milk in very small amounts, and has not been linked with any side effects in breastfed babies.

It's important to continue taking trazodone to keep you well. Breastfeeding will also benefit both you and your baby.

Although other medicines might be preferred while you're breastfeeding, it's important you take the medicine that works for you. If you are breastfeeding or planning to breastfeed, talk to your doctor or pharmacist to help you decide what is best for you.

If you notice that your baby is not feeding as well as usual, or seems unusually sleepy or irritable, or you have any other concerns about your baby, talk to your health visitor, midwife, pharmacist or doctor as soon as possible.

Trazodone and fertility

There's no clear evidence to suggest that taking trazodone reduces fertility in either men or women.

But speak to a pharmacist or doctor if you're trying to get pregnant. They may want to review your treatment.

Meds New IA (H2) - Pregnancy non-urgent care card

Cautions with other medicines

Many medicines can affect the way trazodone works, and trazodone can do the same to other medicines. Both can increase the chances of you having side effects.

Tell your doctor if you're taking any of these medicines before you start trazodone:

tranylcypromine, phenelzine or isocarboxazid (for depression), or selegiline (for Parkinson's disease) if you have taken any of these medicines within the last 2 weeks
antidepressants, such as amitriptyline or fluoxetine
antifungal medicines, such as ketoconazole or itraconazole
epilepsy medicines, such as carbamazepine or phenytoin
medicines for high blood pressure, such as clonidine
sleeping pills, tranquilisers or other sedatives
digoxin, a heart medicine
erythromycin, an antibiotic
levodopa, used to treat Parkinson's disease
ritonavir, used to treat HIV infections
warfarin, used to prevent blood clots

Mixing trazodone with herbal remedies and supplements

Do not take St John's wort, the herbal remedy for depression, while you're being treated with trazodone as this will increase your risk of side effects.

There's not enough information to say that other herbal remedies and supplements are safe to take with trazodone. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Meds New IA (H2) - Cautions with other medicines alert