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Trazodone For Insomnia

Caution Must Be Taken in Some Cases


Updated May 16, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

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The pharmaceutical drug trazodone is a commonly prescribed antidepressant that is also used as a hypnotic to initiate sleep.

Uses of Trazodone

Trazodone is an older drug that has been used to treat depression and severe anxiety for many years. Since it has sedative or hypnotic effects, meaning that it causes drowsiness, it is also helpful for treating insomnia or acute insomnia.

How Does Trazodone Work?

It is not known precisely how trazodone works. What is known is that it acts on neurotransmitters, which are chemical messengers within the brain. It allows a specific neurotransmitter called serotonin to build up in the spaces between nerve cells by blocking its uptake into the nearby cells.

Who Should Not Use Trazodone?

Trazodone should not be used in people who are recovering from a heart attack. It should also not be used by people under 25 years old, and the elderly should use the drug with caution. Trazodone should be avoided if you are pregnant or breastfeeding.

Trazodone may also not be appropriate for people who have psychiatric illnesses, including bipolar disease and schizophrenia, as well as in those at risk for suicide. Use trazodone with caution if you have heart or cerebrovascular disease, seizures, or kidney or liver problems.

Trazodone has the potential to interact with many other drugs, so your medications should be carefully reviewed by your health care provider before you start to take trazodone. No deaths or heart complications have been reported in people who are taking trazodone alone. Stopping the medication abruptly should be avoided.

What Are Common Side Effects?

There are many potential side effects of any drug. Although an individual would not be expected to experience most side effects -- and may indeed not have any of them - some that may commonly occur with trazodone include:

  • Sleepiness
  • Dizziness
  • Lightheadedness
  • Dry mouth
  • Headache
  • Blurred vision
  • Nausea or vomiting
  • Nervousness
  • Fatigue
  • Constipation
  • Palpitations
  • Rapid heart rate
  • Low blood pressure
  • Skin reactions, such as a rash
  • Confusion
  • Muscle pain
  • Weight changes
  • Diarrhea
  • Tremor (shakiness)
  • Difficulties with walking or coordination

What Are Potential Serious Reactions?

With the use of any drug, there are also risks of serious side effects. These occur more rarely. When using trazodone, these may include:

  • Priapism (persistent painful erection)
  • Orthostatic hypotension (low blood pressure when standing)
  • Abnormal heart rhythms
  • Hypertension (high blood pressure)
  • Fainting
  • Stroke
  • Heart attack
  • Extrapyramidal symptoms
  • Tardive dyskinesia
  • Hypomania/mania
  • Psychosis exacerbation
  • Worsening depression
  • Suicidal thoughts
  • Hallucinations
  • Seizures
  • Neutropenia (low white blood cell count)
  • Anemia
  • Hepatitis (liver inflammation)

What Safety Precautions and Monitoring Should Occur?

As noted above, certain people should use the medication with caution or not at all. It is important that you are monitored by your doctor as the medication is started or changes in the dose are made. In particular, symptoms of suicidality or unusual behavior changes should be watched for. If you experience any difficulties, you should be in close contact with your primary health provider.


"Trazodone." Epocrates Rx Pro. Version 2.90, 2009. Epocrates, Inc. San Mateo, California.

Katzung, B.G. Basic & Clinical Pharmacology. 9th edition, 2004. The McGraw-Hill Companies, Inc. New York.

Cooper, D.H. et al. The Washington Manual of Medical Therapeutics. 32nd edition, 2007. 14. Lippencott, Williams & Wilkins. New York.

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