Is Trazodone Addictive? Know the Pros & Cons


Although becoming addicted to Trazodone is not very common, it does still happen. Trazodone is commonly prescribed for depression, anxiety, and more recently to treat insomnia due to the drowsiness associated with it. However, the calming effects of prescription medication have led to a certain amount of abuse and the need for rehabilitation for those who are abusing it. 

What Is Trazodone?

Trazodone is a prescription medication that has been around for a very long time. The primary use of this medication is as an antidepressant. In certain cases, a doctor may prescribe it to treat anxiety. More recently, thanks to the drowsiness (a side effect) it causes, doctors have started using it to treat insomnia. For those who are recovering from alcohol or drug dependency, trazodone is the most commonly prescribed sleep aid.
Trazodone sold under brand names Desyrel, Desyrel Dividose, Oleptro, Trazodone D, is a serotonin reuptake inhibitor and an antagonist. It works by blocking the serotonin receptors in your brain. In turn, this prevents the neurons in your brain from reabsorbing serotonin. Because the reabsorption does not occur, your brain ends with an increased amount of serotonin.
Serotonin is a neurotransmitter (helps to transmit messages from one part of your brain to another). The amount of serotonin can have an effect on mood (antidepressant), appetite, sexual desires and function, memory, learning, certain types of social behavior (proper control of the amount of serotonin has been found to help those who are diagnosed as bipolar), and sleep.
abstract photo of pills in a container

How Is Trazodone Prescribed?

Trazodone is prescribed in pill form. Common dosages are usually:

  • 50 mg
  • 100 mg
  • 150 mg
  • 300 mg

There are also extended release pills available in:

  • 150 mg
  • 300 mg

Trazodone can be used in children aged 6 years and up, by adults, and geriatrics. 

Common Dosages 

In children, it is most commonly used as an antidepressant in very small doses. 

  • Children aged 6-12 can be given 1.2 to 2mg per kg in divided dosages of no more than 6mg/kg/day split into doses every 8 hours. 
  • Children over the age can be given 25 to 50 mg per day and increased to 100 to 150 mg divided into doses every 8 hours. 

For adults, trazodone is prescribed for depression in the following doses:

  • Initial 150mg split into doses every 8 to 12 hours. 
  • Every 3 to 7 days the dose can be increased by 50mg.
  • For outpatient treatment, the maximum daily dose should not exceed 400mg per day.
  • For inpatient treatment, the maximum daily dose should not exceed 600mg per day. 
  • Extended-release version (Oleptro) – may take 150mg by mouth at bedtime. The dose can be increased in 75mg increments every three days, but must not exceed 375mg per day.  

For seniors, trazodone is prescribed for depression in the following doses:

  • Immediate release version – 25 to 50mg by mouth at bedtime. The dose can be increased by 25 to 50mg for inpatients every three days. For outpatient treatment, the increase is on a weekly basis. In both cases, the maximum dosage should not exceed 75 to 150mg per day. 
  • Extended-release version – may take 150mg by mouth at bedtime. The dose can be increased in 75mg increments every three days, but must not exceed 375mg per day. 

man in winter taking a solitary walk down the street

When used to treat insomnia in adults:

  • 50 to 100mg daily 

Trazodone can be used to treat aggression:

  • Initial dosage: 50mg every 12 hours. 
  • Maintenance dosage: 75 to 400mg per day split into doses every 6 to 12 hours. 

Trazodone can also be used to assist with withdrawal from alcohol and cocaine:

  • Alcohol – 100 to 60mg in split doses. 
  • Cocaine – 150 to 200mg once daily. 

Doctors may also prescribe trazodone for migraine prevention (not to be taken when suffering a migraine, there are other medications for that such as sumatriptan). The dose is 100mg daily. 

Common Side Effects Associated with Trazodone

The list of common side effects caused by this prescription medication includes:

  • Dizziness
  • Nausea or vomiting
  • Muscle pain
  • Sexual dysfunction
  • Confusion or memory issues
  • Dry mouth
  • Headaches
  • Digestive issues
  • Numbness or tingling
  • Sweating

This is only a partial list, but these are the most common side effects. The best way to find out all possible side effects is to talk to a doctor or pharmacist. Keep in mind that each person will react to this medication differently.
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Severe Side Effects Associated with the abuse of Trazodone

When a person becomes addicted to trazodone, there is an elevated risk of severe side effects, including: 

  • Difficulty breathing
  • Drowsiness
  • Vomiting 
  • Seizures 

If at any point the person starts ignoring any of these side effects and continues to use this medication, this should be considered a sign of possible addiction. At this point, professional addiction treatment is advised. 

Potential Drug Interactions 

Any time you add a new prescription medication to those already being taken, there is the potential for drug interaction. Before taking trazodone, you need to talk to your doctor about your medical history and that of your family. In particular, you need to let your doctor know if there is a history of:

  • Bipolar disorder
  • Liver disease
  • Heart disease 
  • Other heart conditions 
  • If you have had a heart attack 
  • Suicide Attempts

According to the PDR (Physicians Desk Reference book), there are 

  • Minor reactions to 137 drugs 
  • Moderate interactions to 415 drugs
  • Serious interactions to 124 drugs

This is only a glimpse of the many potential risks associated with taking trazodone. The best thing you can do is talk to your doctor. Let them know about all the medications you are currently taking and your health history. 

More About the Risks of Abusing Trazodone

While the above listings are common and severe side effects associated with trazodone abuse, there are other risks you should be aware of. Starting with the fact that trazodone is considered a “Black Box” medication. The black box warning indicates there is an increased risk of suicidal thoughts in children and adults under the age of 25 in this particular case.
It is possible for depression levels to increase rather than decrease and anyone taking it should be monitored closely.
young man looking out his window in distress
While rare, it is possible for a person to develop serotonin syndrome in which there are excessive levels of serotonin building up in the brain. When co-administered with MAO inhibitors, there is an increased of serotonin syndrome

This can lead to a range of problems including:

  • Anxiety 
  • Agitation
  • Confusion 
  • Sweating
  • Tremors 
  • Restlessness
  • Rapid heartbeat
  • Lack of Coordination 
  • Low blood pressure 

About Trazodone Addiction 

Although the number of people reported as being addicted to trazodone is relatively small, there are those who choose to use it recreationally. Trazodone is not used by anyone looking for a euphoric high, instead, they use it for its sedative effects and in certain cases the level of cognitive impairment it causes.
One of the reasons trazodone is used to treat anxiety is the speed with which it helps the person recover from their anxiety attack. However, like many other prescription antidepressant medications, over time a person’s tolerance level will increase. This leads to the need for higher doses to be effective.
Like many other antidepressant medications, there is always the potential for misuse and abuse of trazodone. Taking it in conjunction with other drugs or alcohol increases the risk of serious health risks. Abusing it in this way can amplify the known side effects, increase any current health risks, and in certain instances become life-threatening.  For anyone who is dealing with co-occurring disorders, the dangers to their physical and mental health can prove to be increasingly challenging to overcome. 

What Types of Treatment are Recommended for Trazodone Addiction?

man on phone in Calfornia
Like any drug that affects brain chemistry, simply cutting off the supply of trazodone to the brain can lead to unpleasant side effects. The “withdrawal” symptoms are very different from those associated with drug or alcohol withdrawal. When withdrawing from an antidepressant, these symptoms are just as real, and the withdrawal process should be done under medical supervision. In most cases, the doctor will slowly reduce the dosage until the person has transitioned away from the drug. Doing this helps to minimize the intensity of any side effects associated with withdrawal. 

Symptoms of Trazodone Withdrawal

  • Agitation
  • Anxiety
  • Confusion
  • Depression
  • Dizziness
  • Extreme irritability
  • Headaches 

Steps to a Successful Recovery

The first step is to determine the person’s level of addition along with any other co-occurring physical or mental health disorders they might be dealing with. After this, a complete detoxification and rehabilitation plan can be developed.
The treating doctor will be able to prescribe medications that can help reduce the severity of the withdrawal symptoms. Doing this will make the process more comfortable for the person undergoing rehabilitation.
After completing a rehabilitation program, the person may need to undergo therapy sessions and join in one of the many 12-step programs such as NA (Narcotics Anonymous) where they will learn the skills needed to return to a productive and successful life free of their trazodone addiction.
If you or a loved one needs help, call us at 949-625-4019.

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