Trazodone
Also known as: Desyrel, Trazonil, Trazalon
Important: This is informational content only. Always consult Dr. Ambrish Singal or your psychiatrist before starting, stopping, or changing any medication.
What is Trazodone?
Trazodone is a multifunctional antidepressant primarily used at low doses for insomnia due to its strong sedative effects. At higher doses, it functions as an antidepressant.
How It Works
Blocks serotonin 5-HT2A receptors, inhibits serotonin reuptake, and blocks histamine H1 and alpha-1 adrenergic receptors. The 5-HT2A blockade improves sleep architecture without suppressing REM sleep.
Uses
How This Drug Starts Working
Effects typically begin within 1-4 weeks depending on the condition being treated. Full therapeutic effect usually takes 4-8 weeks.
Week-by-Week Timeline
Week 1: Medication reaching therapeutic blood levels. Some initial side effects may appear as body adjusts.
Week 2-3: Initial therapeutic effects beginning. Side effects often settling.
Week 4-6: Significant therapeutic benefit in most patients.
Week 8+: Full effect established. Treatment response can be properly assessed.
What Changes First?
Physical symptoms (sleep, appetite, energy) typically improve before emotional and cognitive symptoms. Others may notice improvement before you feel it yourself.
Why Does It Take Time?
Psychiatric medications work by gradually rebalancing brain chemistry and neural circuits. Unlike pain medications that block a sensation, these drugs help your brain rebuild healthy patterns — which requires time.
Complete Dosage Guide
How to Take
Take exactly as prescribed by your doctor. Maintain consistent timing each day.
Starting Dose
Your doctor will determine the appropriate starting dose based on your condition, age, weight, and other factors.
Dose Increases
Dose adjustments are made gradually based on your response and side effects. Follow your doctor's instructions for any changes.
Maximum Dose
Your doctor will not exceed safe maximum doses. Never take more than prescribed.
When to Take
Take at the same time daily for best results. Ask your doctor whether morning or evening is better for your specific medication.
If You Miss a Dose
If you miss a dose, take it as soon as you remember unless close to your next dose. Never double up. Contact your doctor if you miss multiple doses.
Food & Drink
Ask your doctor or pharmacist about specific food interactions for your medication.
How Long to Take
Duration of treatment varies by condition. Never stop medication without discussing with your doctor first — some medications require gradual tapering.
Dosage by Age Group
adult
Insomnia: 25-100mg at bedtime. Depression: Start 150mg/day, increase to 300-600mg/day in divided doses.
child
Not commonly used in children. Off-label: 25-50mg for sleep.
elderly
Start 25mg at bedtime. Titrate slowly. Increased sensitivity.
Special Populations
Pregnancy
Category C. Limited data. Use only if clearly needed.
Kidney Conditions
Use with caution. No specific adjustment.
Liver Conditions
Use with caution in hepatic impairment.
Side Effects
Common
- Drowsiness
- Dizziness
- Dry mouth
- Nausea
- Headache
- Blurred vision
Serious
- Priapism (painful prolonged erection - rare but serious)
- Orthostatic hypotension
- Cardiac arrhythmias
- Serotonin syndrome
- Suicidal ideation
What You Should Know
Overdose Risks
Less dangerous than TCAs. May cause sedation, hypotension, and in rare cases, cardiac arrhythmias. Priapism risk exists even in overdose.
Safe Discontinuation
Taper over 1-2 weeks. Abrupt discontinuation may cause rebound insomnia, anxiety, and irritability.