Section Contents:- Drowsiness, fatigue, lethargy, psychomotor retardation, lightheadedness, dizziness, difficulty in concentration, confusion, uncontrollable laughter, sex drive increase. (Trazodone is also known to cause a "hangover effect" in patients prescribed the drug as a sleep aid: the "Trazodone hangover" generally ceases with regular use after three or four days.)(More...)
- Priapism (including clitoral priapism in women), a painful condition in which the penis (or clitoris) remains in an erect position for a prolonged period, has been reported in patients receiving trazodone.(More...)
- The doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with trazodone.(More...)
- DESYREL (trazodone hydrochloride) is an antidepressant chemically unrelated to tricyclic, tetracyclic, or other known antidepressant agents.(More...)
- Trazodone may enhance the response to alcohol, barbiturates, and other CNS depressants.(More...)
- Sometimes trazodone must be taken for up to 4 weeks before you begin to feel better, although most people notice improvement within 2 weeks.(More...)
Drowsiness, fatigue, lethargy, psychomotor retardation, lightheadedness, dizziness, difficulty in concentration, confusion, uncontrollable laughter, sex drive increase. (Trazodone is also known to cause a "hangover effect" in patients prescribed the drug as a sleep aid: the "Trazodone hangover" generally ceases with regular use after three or four days.) [7] If the patient is under 18 years of age. (Trazodone use in youth may increase the possibility of suicidal thoughts or actions.)
[7] Trazodone has been associated with the occurrence of priapism. In approximately 33% of the cases reported, surgical intervention was required and, in a portion of these cases, permanent impairment of erectile function or impotence resulted. Male patients with prolonged or inappropriate erections should immediately discontinue the drug and consult their physician.
[7] Since trazodone may impair the mental and/or physical abilities required for performance of potentially hazardous tasks, such as operating an automobile or machinery, the patient should be cautioned not to engage in such activities while impaired.
[7] Trazodone was originally discovered and developed in Italy in the 1960s by Angelini research laboratories as a second-generation antidepressant. This agent was developed according to the mental pain hypothesis, which was postulated from studying patients and which proposes that clinical depression is associated with a decreased pain threshold.
[7] The possibility of suicide in depressed patients remains during treatment and until significant remission occurs. Therefore, the number of tablets prescribed at any one time should take into account this possibility, and patients with suicidal ideation should never have access to large quantities of trazodone.
[7] Depressed patients are therefore unlikely to successfully commit suicide with trazodone.
[7] Recent clinical studies in patients with pre-existing cardiac disease indicate that trazodone may be arrhythmogenic in some patients in that population.
[7] It is recommended that white blood cell and differential counts should be performed in patients who develop sore throat, fever, or other signs of infection or blood dyscrasia and trazodone should be discontinued if the white blood cell or absolute neutrophil count falls below normal.
[7] The mean blood elimination half-life is biphasic: the first phase's half-life is 3"6 hours, and the following phase's half-life is 5"9 hours. The drug is extensively metabolized with 3 or 4 major metabolites having been identified in man, some of which such as mCPP may contribute to the side effect profile of trazodone.
[7] Trazodone is well absorbed after oral administration with mean peak blood levels obtained at approximately 1 hour after ingestion.
[7] Trazodone is metabolised by CYP3A4, a liver enzyme ( PMID 9616194 ). Inhibition of this enzyme by various other substances may delay its degradation, leading to high blood levels of trazodone. CYP3A4 may be inhibited by many other medications, herbs, and foods, and as such, trazodone may interact with these substances.
[7] Because it is not known whether an interaction will occur between trazodone and MAO inhibitors, administration of trazodone should be initiated very cautiously with gradual increase in dosage as required, if an MAO inhibitor is given concomitantly or has been discontinued shortly before medication with trazodone is instituted.
[7] While trazodone is not a true member of the SSRI class of antidepressants, it does still share many properties of the SSRIs, especially the possibility of discontinuation syndrome if the medication is stopped too quickly.
[7] Trazodone is not a serotonin reuptake inhibitor; in contrast to the selective serotonin reuptake inhibitors such as fluoxetine (trade name Prozac), trazodone's antidepressant effects may be due to its antagonistic effects at 5-HT 2 receptors ( PMID 1365657 ).
[7] Trazodone is often used in conjunction with selective serotonin reuptake inhibitor, like fluoxetine and has been noted to help with the anxiety that can result from beginning treatment with an SSRI anti-depressant.
[7] Trazodone is often used instead of tricyclic antidepressants because it is very rarely lethal in overdose.
[7] Trazodone has less prominent anticholinergic (dry mouth, constipation, tachycardia ) and adrenolytic (hypotension, male sexual problems) side effects than most tricyclic antidepressants.
[7] Trazodone is chemically and pharmacologically distinct from tricyclic antidepressants and tetracyclic antidepressants (for a review, see PMID: 8019056 ). Lacking the fused ring structures typical of these compounds, trazodone is a triazolopyridine derivative.
[7] Overdosage of trazodone may cause an increase in incidence or severity of any of the reported adverse reactions, e.g. excessive sedation.
[7] Trazodone (trade names Desyrel, Molipaxin, Trittico, Thombran, Trialodine Trazorel ) is a psychoactive compound with sedative, anxiolytic, and antidepressant properties.
[7] Trazodone is not recommended for use during the initial recovery phase of myocardial infarction.
[7] Approximately 70"75% of C 14 -labelled trazodone was found to be excreted in the urine within 72 hours ( PMID 1037253 ).
[7] Drinking grapefruit juice is discouraged in patients taking trazodone. One glass of grapefruit juice occasionally is not likely to have this effect on most people, but drinking large amounts, or drinking it regularly is proven to affect trazodone's clearance.
[7] Elevated prolactin concentrations have been observed in patients taking trazodone ( PMID 7673654 ).
[7] 
Priapism (including clitoral priapism in women), a painful condition in which the penis (or clitoris) remains in an erect position for a prolonged period, has been reported in patients receiving trazodone. [1] If a patient is switched from trazodone to an MAO inhibitor, at least one week should be allowed after stopping trazodone before the MAO inhibitor is begun.
[1] Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of trazodone or any other antidepressant in a child or adolescent must balance this risk with the clinical need.
[1] Studies in animals have demonstrated effects on the developing fetus. Trazodone should only be used during pregnancy if the physician feels that its benefits outweigh its potential risks.
[1] PRESCRIBED FOR: Trazodone is primarily used for the treatment of depression. It is sometimes prescribed as a sedative, and it also is used in combination with other drugs for the treatment of panic attacks, aggressive behavior, agoraphobia, and cocaine withdrawal.
[1] Drugs in the MAO-inhibitor class include isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane). Such combinations may lead to confusion, high blood pressure and tremor. This same type of interaction may occur when trazodone is used with selegiline (Eldepryl).
[1] DRUG INTERACTIONS: All antidepressants that increase concentrations of serotonin in the brain, including trazodone, should not be taken with MAO-inhibitors.
[1] DRUG CLASS AND MECHANISM: Trazodone is an oral antidepressant drug that affects the chemical messengers (neurotransmitters) within the brain that nerves use to communicate with (stimulate) each other.
[1] Ketoconazole (Nizoral), ritonavir (Norvir), and indinavir (Crixivan) inhibit the breakdown of trazodone leading to increased blood levels of trazodone and potential side effects.
[1] SIDE EFFECTS: The most common side effects associated with trazodone are nausea, dizziness, insomnia, agitation, tiredness, dry mouth, constipation, lightheadedness, headache, low blood pressure, blurred vision, and confusion.
[1] Although the exact mechanism of action of trazodone is unknown, it probably improves symptoms of depression by inhibiting the uptake of serotonin by nerves in the brain. This results in more serotonin to stimulate other nerves.
[1] Trazodone should be taken after a meal or light snack to reduce the risk of dizziness.
[1] Trazodone is chemically unrelated to the selective serotonin reuptake inhibitors (SSRIs), the tricyclic antidepressants (TCAs) or the monoamine oxidase inhibitors (MAO inhibitors). It is chemically related to nefazodone (Serzone) and shares its actions.
[1] NURSING MOTHERS: Trazodone is secreted in breast milk. Therefore, caution should be used in prescribing trazodone to women who are breastfeeding.
[1] Trazodone is given in one or more daily doses, sometimes with the largest dose at night.
[1] After stopping an MAO inhibitor, two weeks should elapse before starting trazodone. Increased blood concentrations of digoxin and phenytoin (Dilantin) have been reported in persons taking trazodone due to a decrease in the metabolism (break-down and elimination) of these drugs by trazodone. Carbamazepine (Tegretol) may decrease blood levels of trazodone by increasing its elimination from the body.
[1] You may need to take trazodone for several weeks or months to control your depression symptoms. To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis.
[4] Trazodone is used to treat depression. Trazodone may also be used for purposes other than those listed in this medication guide.
[4] Trazodone is an tetracyclic antidepressant medication. It is thought to increase the activity of one of the brain chemicals (serotonin) which may become unbalanced and cause depression. It may also be used for relief of anxiety disorders (eg, sleeplessness, tension) and chronic pain.
[4] Trazodone works best if you take it after a meal or a snack. Call your doctor at once if you have any new or worsening symptoms 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.
[4] Trazodone may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
[4] Do not give trazodone to anyone younger than 18 years old without the advice of a doctor. Take this medication exactly as it was prescribed for you.
[4] Trazodone is available with a prescription under the brand name Desyrel. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.
[4] You may not be able to take trazodone, or you may require special monitoring during treatment if you are taking any of the medicines listed above. Drugs other than those listed here may also interact with trazodone.
[4] Do not take extra medicine to make up the missed dose. An overdose of trazodone can be fatal when it is taken with alcohol, barbiturates such as phenobarbital, or sedatives such as diazepam (Valium).
[4] If you have any of these conditions, you may not be able to use trazodone, or you may need dosage adjustments or special tests during treatment.
[4] Trazodone can cause side effects that may impair your thinking or reactions.
[4] Trazodone works best if you take it after a meal or a snack. You may need to take this medicine at bedtime, because trazodone can cause drowsiness.
[4] If you need to have any type of surgery, tell the surgeon ahead of time that you are using trazodone.
[4] Before taking trazodone, tell your doctor if you are allergic to any drugs, or if you have bipolar disorder (manic depression), schizophrenia or other psychiatric illness, a history of drug abuse or suicidal thoughts, or if you have recently had a heart attack.
[4] The doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with trazodone. [2] Children younger than 18 years of age should not normally take trazodone, but in some cases, a doctor may decide that trazodone is the best medication to treat a child's condition.
[2] Trazodone is also sometimes used to control abnormal, uncontrollable movements that may be experienced as side effects of other medications. Talk to your doctor about the possible risks of using this medication for your condition. This medication may be prescribed for other uses.
[2] Trazodone may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
[2] Alcohol can make the side effects from trazodone worse. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. Talk to your doctor about drinking grapefruit juice while taking this medicine.
[2] Trazodone is also sometimes used to treat schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions); anxiety (excessive worry); and alcohol abuse.
[2] Trazodone is in a class of medications called serotonin modulators. It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.
[2] You should know that your mental health may change in unexpected ways when you take trazodone or other antidepressants even if you are an adult over age 24.
[2] Your doctor may start you on a low dose of trazodone and gradually increase your dose, not more than once every 3 to 4 days.
[2] Trazodone may cause painful, long lasting erections in males. In some cases emergency and/or surgical treatment has been required and, in some of these cases, permanent damage has occurred.
[2] Trazodone comes as a tablet to take by mouth. It is usually taken with a meal or light snack two or more times a day.
[2] To help you remember to take trazodone, take it around the same times every day.
[2] Trazodone controls depression, but does not cure it. It may take 2 weeks or longer before you feel the full benefit of trazodone.
[2] If you become pregnant while taking trazodone, call your doctor. Do not drive a car or operate machinery until you know how this medication affects you.
[2] Your healthcare provider will want to see you often while you are taking trazodone, especially at the beginning of your treatment.
[2] DESYREL (trazodone hydrochloride) is an antidepressant chemically unrelated to tricyclic, tetracyclic, or other known antidepressant agents. [8] Read the Medication Guide and Patient Information Leaflet provided by your pharmacist before you start using trazodone and each time you get a refill.
[9] Trazodone works by helping to restore the balance of a certain natural chemical (serotonin) in the brain.
[9] Trazodone may enhance the response to alcohol, barbiturates, and other CNS depressants. Increased serum digoxin and phenytoin levels have been reported to occur in patients receiving trazodone concurrently with either of those 2 drugs.
[6] Hypotension, including orthostatic hypotension and syncope, has been reported to occur in patients receiving trazodone.
[6] Trazodone may cause hypotension including orthostatic hypotension and syncope; caution is required if it is given to patients receiving antihypertensive drugs and an adjustment in the dose of the antihypertensive medication may be required.
[6] Trazodone has been associated with the occurrence of priapism. In approximately 1/3 of the cases reported, surgical intervention was required and, in a portion of these cases, permanent impairment of erectile function or impotence resulted. Male patients with prolonged or inappropriate erections should immediately discontinue the drug and consult their physician.
[6] Trazodone is not recommended for use during the initial recovery phase of myocardial infarction. Caution should be used when administering trazodone to patients with cardiac disease, and such patients should be closely monitored, since antidepressant drugs (including trazodone) have been associated with the occurrence of cardiac arrhythmias.
[6] Trazodone belongs to the group of medicines known as antidepressants or "mood elevators." It is used to relieve mental depression and depression that sometimes occurs with anxiety
anxiety.
[6] Peak plasma levels occur approximately one hour after dosing when trazodone HCl is taken on an empty stomach or two hours after dosing when taken with food. For those patients who responded to trazodone HCl in clinical trials, one-third of the inpatients and one-third of the outpatients had a significant therapeutic response by the end of the first week of treatment.
[6] Symptomatic relief may be seen during the first week, with optimal antidepressant effects typically evident within two weeks. Twenty-five percent of those who respond to trazodone require more than two weeks (up to four weeks) of drug administration.
[6] Death from overdose has occurred in patients ingesting trazodone and other drugs concurrently (namely, alcohol; alcohol + chloral hydrate + diazepam; amobarbital; chlordiazepoxide; or meprobamate).
[6] Trazodone should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Trazodone and/or its metabolites have been found in the milk of lactating rats, suggesting that the drug may be secreted in human milk.
[6] As with all antidepressants, the use of trazodone should be based on the consideration of the physician that the expected benefits of therapy outweigh potential risk factors.
[6] The most severe reactions reported to have occurred with overdose of trazodone alone have been priapism, respiratory arrest, seizures, and EKG changes.
[6] Concomitant administration of antihypertensive therapy with trazodone may require a reduction in the dose of the antihypertensive drug.
[6] Due to the absence of clinical experience, if MAO inhibitors are discontinued shortly before or are to be given concomitantly with trazodone, therapy should be initiated cautiously with gradual increase in dosage until optimum response is achieved.
[6] Little is known about the interaction between trazodone and general anesthetics; therefore, prior to elective surgery, trazodone should be discontinued for as long as clinically feasible. It is not known whether interactions will occur between monoamine oxidase (MAO) inhibitors and trazodone.
[6] Interference with Cognitive or Motor Performance: Trazodone may cause drowsiness, dizziness, or lightheadedness. Using this medicine alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to this medicine.
[6] Trazodone may enhance the response to alcohol, barbiturates, and other CNS depressants.
[6] Desyrel Dividose: Each orange rectangular-shaped, trisected and bisected tablet contains: Trazodone hydrochloride 150 mg.
[6] In animals, trazodone HCl selectively inhibits serotonin uptake by brain synaptosomes and potentiates the behavioral changes induced by the serotonin precursor, 5-hydroxytryptophan.
[6] Caution should be exercised when trazodone is administered to a nursing woman.
[6] Sometimes trazodone must be taken for up to 4 weeks before you begin to feel better, although most people notice improvement within 2 weeks. The dose of this medicine will be different for different patients.
[3] Trazodone may cause some people to be agitated, irritable or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you or your caregiver notice any of these adverse effects, tell your doctor right away. This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness).
[3] Trazodone must be used with caution in children with depression. Studies have shown occurrences of children thinking about suicide or attempting suicide in clinical trials for this medicine.
[3] Drowsiness, dizziness, confusion, vision problems, dryness of mouth, and constipation may be more likely to occur in the elderly, who are usually more sensitive to the effects of trazodone.
[3] Take trazodone only as directed by your doctor, to benefit your condition as much as possible.
[3] Taking trazodone together with medicines that are used during surgery or dental or emergency treatments may increase the CNS depressant effects.
[3] 
