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.

Trazodone is used to treat major depressive disorder.

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.

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Trazodone, sold under many brand names, is an antidepressant medication, used to treat major depressive disorder, anxiety disorders, and insomnia. It is a phenylpiperazine compound of the serotonin antagonist and reuptake inhibitor (SARI) class. The medication is taken orally.

Common side effects include dry mouth, feeling faint, vomiting, and headache. More serious side effects may include suicide, mania, irregular heart rate, and pathologically prolonged erections. It is unclear if use during pregnancy or breastfeeding is safe. Trazodone also has sedating effects.

Trazodone was approved for medical use in the United States in 1981. It is available as a generic medication. In 2022, it was the eighteenth most commonly prescribed medication in the United States, with more than 27 million prescriptions

How it works

Trazodone is an antidepressant that may also be used to treat insomnia.
Experts aren’t sure exactly how trazodone works but suggest it improves the symptoms of depression by inhibiting the uptake of serotonin by nerves in the brain. This increases levels of serotonin in the nerve synapse (the space between two nerves).
Trazodone has a unique chemical structure and is unrelated to selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), or monoamine oxidase inhibitors (MAO inhibitors). It is structurally related to nefazodone. Trazodone and nefazodone belong to the class of drugs known as serotonin modulators. It may also be called a serotonin receptor antagonists and reuptake inhibitor (SARI).

How is trazodone supplied (dosage forms)?

Trazodone is available in the following dosage forms that are taken by mouth.

50 mg tablets
100 mg tablets
150 mg tablets
300 mg tablets

Trazodone Usages

Trazodone is an antidepressant primarily classified as a serotonin antagonist and reuptake inhibitor (SARI). It is FDA-approved for the following condition:

Major Depressive Disorder (MDD)
- Trazodone is used to treat depression by helping to improve mood, energy levels, and overall well-being. It works by balancing serotonin levels in the brain.

Off-Label Uses of Trazodone

Trazodone is widely prescribed for several off-label purposes, often taking advantage of its sedative properties. These include:

Insomnia
- Due to its sedative effects, trazodone is often used to help people with difficulty sleeping, especially when other medications or lifestyle changes are ineffective.
Anxiety Disorders
- It may be prescribed for generalized anxiety disorder (GAD) or other forms of anxiety to promote calmness and reduce stress.
Chronic Pain Management
- Trazodone can be used in conjunction with other therapies to help with pain syndromes, including fibromyalgia and chronic pain, by improving sleep and reducing associated depression.
Post-Traumatic Stress Disorder (PTSD)
- In some cases, trazodone is used to help manage the sleep disturbances and intrusive symptoms associated with PTSD.
Agitation in Dementia
- It may be prescribed to elderly patients to manage behavioral symptoms associated with dementia, such as agitation or aggression.
Panic Disorder
- Trazodone’s calming effects can also benefit those suffering from panic attacks or panic disorders.
Nightmares and Parasomnias
- It has been used to reduce the frequency and intensity of nightmares, particularly in individuals with PTSD.
Alcohol Dependence
- In certain cases, trazodone is prescribed to help with sleep and mood stabilization during alcohol withdrawal or recovery phases.
Restless Leg Syndrome (RLS)
- Though less common, it can help manage the symptoms of RLS by improving sleep quality.

Side Effects of Trazodone

Like all medicines, trazodone can cause side effects in some people, but many people have no side effects or only minor ones.

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.

Serious side effects

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

Call your doctor 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

What special precautions should I follow?

Before taking trazodone,

tell your doctor and pharmacist if you are allergic to trazodone or any other medications.
tell your doctor or pharmacist if you are taking the following medications or stopped taking them within the past two weeks: monoamine oxidase (MAO) inhibitor, such as isocarboxazid (Marplan), linezolid, methylene blue, phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate). Your doctor will probably tell you that you should not take trazodone. If you stop taking trazodone, your doctor will tell you that you should wait at least 14 days before you start to take an MAO inhibitor.
some medications should not be taken with trazodone. Other medications may cause dosing changes or extra monitoring when taken with trazodone. Make sure you have discussed any medications you are currently taking or plan to take before starting trazodone with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking trazodone, please get the advice of your doctor or pharmacist.
the following nonprescription or herbal products may interact with trazodone: St. John’s wort; tryptophan; aspirin and other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve). Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking trazodone. Do not start any of these medications while taking trazodone without discussing with your healthcare provider.
tell your doctor if you or anyone in your family has or has ever had long QT syndrome (a rare heart problem that may cause irregular heartbeat, fainting, or sudden death), if you have ever had a heart attack, or if you have a low level of sodium in your blood. Also tell your doctor if you drink or have ever drunk large amounts of alcohol, or if you have or have ever had high blood pressure; bleeding problems; sickle cell anemia (a disease of the red blood cells); multiple myeloma (cancer of the plasma cells); leukemia (cancer of the white blood cells); cavernosal fibrosis or Peyronie’s disease (conditions that affects the shape of the penis such as angulation); or heart, liver, or kidney disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking trazodone, call your doctor.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking trazodone.
you should know that trazodone may make you drowsy and affect your judgment, thinking, and movements. Do not drive a car or operate machinery until you know how this medication affects you.
ask your doctor about the safe use of alcoholic beverages while you are taking trazodone. Alcohol can make the side effects from trazodone worse.
you should know that trazodone may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
you should know that trazodone may cause angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Talk to your doctor about having an eye examination before you start taking this medication. If you have nausea, eye pain, changes in vision, such as seeing colored rings around lights, and swelling or redness in or around the eye, call your doctor or get emergency medical treatment right away.

What special dietary instructions should I follow?

Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What should I tell my healthcare provider before using trazodone?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if trazodone is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

Heart conditions, including a family history of QT prolongation (a rare dangerous heart rhythm problem)
History of heart attack
Bipolar disorder or mania
Liver or kidney problems
Glaucoma
Bleeding problems
Low sodium levels
Peyronie’s disease
Sickle cell anemia, multiple myeloma, leukemia, or other serious medical conditions

Pregnancy. It is not known if or how trazodone could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take trazodone while you are pregnant or trying to get pregnant.

Breastfeeding. Trazodone may pass into your breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take trazodone while breastfeeding.

Does trazodone interact with foods or drinks?

There are no known interactions between trazodone and foods or drinks.

Do not drink alcohol while taking trazodone. The risk of dizziness or sleepiness may be increased if you drink alcohol while taking trazodone.

Does trazodone interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using trazodone.

A monoamine oxidase inhibitor (MAOI) within the past 2 weeks, which is a medicine usually used for depression or Parkinson’s disease
A selective serotonin reuptake inhibitor (SSRI) or a serotonin norepinephrine reuptake inhibitor (SNRI), which are medicines commonly used for anxiety or depression
A tricyclic antidepressant, such as amitriptyline or nortriptyline, even if it is not used for depression
An antipsychotic, which is a medicine for certain mental health conditions
A type of medicine called a triptan, such as sumatriptan (Imitrex and others), eletriptan (Relpax), and others, which are used to treat migraine headaches
Lithium, which is a medicine for certain mental health conditions
Buspirone (Buspar), which is a medicine for anxiety
Opioid pain medicines, including tramadol or fentanyl
A non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which are contained in many prescription and OTC products for pain, swelling, and fever
A medicine that affects bleeding, such as aspirin, warfarin (Coumadin, Jantoven), rivaroxaban, dabigatran, or clopidogrel
Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
A barbiturate, such as phenobarbital, butalbital, or primidone which is a medicine that may be used to treat insomnia, migraines, or seizures
Medicines that can cause QT prolongation, which is a dangerous heart rhythm problem, including amiodarone or sotalol
A medicine for high blood pressure, such as lisinopril or losartan
A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
St. John’s Wort or tryptophan