Trazodone

Brand names of trazodone

  • Alti-Trazodone
  • Apo-Trazodone
  • Desyrel
  • Desyrel Dividose
  • Novo-Trazodone
  • Nu-Trazodone
  • PMS-Trazodone
  • Trazorel
  • Trialodine

Trazodone is an antidepressant, taken orally, that affects neurotransmitters, which are like chemical messengers within the brain used by various nerves to communicate with or stimulate each other. Acetylcholine, dopamine, norepinephrine and serotonin are among major neurotransmitters in our brain. It is widely believed in psychiatric circles that depression is caused by an imbalance among these neurotransmitters.

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Although the precise mechanism of trazodone's action is not known, it is thought that it inhibits excessive serotonin uptake by some nerves of the brain which leaves more serotonin for the stimulation of other nerves. Besides, trazodone is also thought to directly increase serotonin's action.

Trazodone is chemically not related to the SSRIs or selective serotonin reuptake inhibitors, the TCAs or tricyclic antidepressants, or the MAO, or monoamine oxidase inhibitors. Instead, it is chemically closely related to nefazodone (Serzone) and shares many of its actions.

Trazodone received the FDA's approval in 1982.

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Prior to taking trazodone let your health care provider know

  • About your drug allergies, including that to trazodone.
  • About all prescription or non prescription medicines, vitamin, mineral or other nutritional supplements, and herbal products you are currently taking or are going to take. Don't forget to mention any medicines for allergies, colds, and coughs if you are taking, or going to take them. It is also important to inform your doctor about all medicines for anxiety, mental illness, irregular heartbeat or heart pain, and medicines for high blood pressure you take. Any medicines taking for seizures should also be reported to your health care provider.
  • You should know that trazodone may increase the action of antihypertensive medicines causing extremely low blood pressure. Mixing some phenothiazines with trazodone may also cause extremely low blood pressure.
  • About your medical history, especially diseases like cancer, heart attack, irregular heartbeat, high blood pressure, low count of white blood cells, HIV infection and AIDS. Also inform your doctor if you are undergoing electroshock therapy, a procedure to treat a few mental illnesses by administering mild electric shocks to the brain.
  • About your pregnancy state; whether you are already pregnant or are going to be pregnant shortly, or are breastfeeding babies. If pregnancy occurs while you are on trazodone, immediately inform your doctor.
  • In case you are to undergo any surgical procedure, including dental, tell the surgeon or the dentist that you are on trazodone.
  • Trazodone may cause drowsiness and impair judgment. So, don't do anything that requires you to be awake and alert, like driving a car or operating machinery, until you have seen how you are affected by it. If drowsiness creates problems in work, ask your doctor if you can take part of the dose at bedtime.
  • Trazodone may also cause lightheadedness, dizziness and fainting while getting up from a lying position too quickly. So, get out of bed carefully; first rest your feet on the floor firmly and then slowly stand up.
  • Alcohol can aggravate the side effects of trazodone. If you are on trazodone and want to take alcoholic beverages, ask your doctor how you can do that safely. Avoid if the doctor advises against it.
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Usage

Trazodone is used to treat major depression with all attendant symptoms. It can be taken with SSRIs, or selective serotonin reuptake inhibitors like fluoxetine, paroxetine and sertraline, when these medicines may be causing insomnia, that is trouble sleeping.

Trazodone may also be given as a stand-alone drug for insomnia or trouble in falling asleep. It may sometimes be given as a sedative to people suffering from panic and anxiety. In combination with some other drugs, it may also be used in the treatment of agoraphobia, aggressive behaviour and cocaine withdrawal symptoms.

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How to use trazodone

Trazodone is taken orally, once or twice every day after meals or some snacks, unless directed otherwise by your doctor. Follow the directions on your prescription very carefully. In addition, get the Medication Guide from your pharmacist when you start treatment and every time you get refills. Read it carefully and follow the instructions. If you find anything ambiguous, clarify it with your doctor or the pharmacist.

If the medicine causes drowsiness and you are taking only one dose daily, you can take it before going to bed. If you are taking two doses daily, you can take at least one of them before going to bed. You can also consult your doctor to schedule the doses properly.

The doctor would prescribe dosage on the basis of severity of your condition and your response to treatment. In order to minimize the possibilities of side effects, the treatment may be started with low doses which would increase gradually. Therefore, take the medication exactly in the way prescribed; don't take in larger doses, or more frequently than prescribed. It won't improve your condition any faster, but will certainly increase the risk of serious side effects.

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Take the medicine regularly, at about the same time every day, for the full duration prescribed, even if you start feeling well. Never stop the medication unless advised so by the doctor. If you do that you may again fall into depression or whatever condition you were suffering from, apart from experiencing withdrawal symptoms like headache, nausea and tiredness.

The medicine may take two to four weeks to show its full effects. So, be patient. However, if the condition persists even after four weeks, or worsens any time, talk about it to your doctor.

How trazodone works

Trazodone helps in maintaining serotonin balance in the brain, possibly by inhibiting excessive serotonin uptake by some nerves and thus making it available to other nerves. Serotonin, a chemical found in brain, is profoundly linked to mental states like moods and emotions.

Side effects

Serious
Common
Less common

Possible interactions

Herbal medicines or minerals
Caution should be exercised while taking St. John's wort with trazodone, because of its possible connection with the serotonin syndrome.
Ginseng's mechanism of action may partly be like an MAO inhibitor; therefore it should not be combined with trazodone.
It would be better to avoid ma huang, yohimbe and Indian snakeroot also while taking trazodone.
Alcohol
Alcohol's intoxicating effects and depressant action on brain functioning may be markedly increased by trazodone. Caution is advised in using it.

Discontinuation

Trazodone should not be abruptly stopped. Discontinuation should follow gradual reduction of dose as advised by the doctor.

Storage instructions

Keep the medicine in its original container, tightly closed, and away from children and pets. Store at room temperature, away from light, heat and moisture (not near fireplace or in the bathroom). Dispose the unused medicines in the proper manner as advised by the pharmacist or the local waste disposal company personnel. Don't flush it down the toilet, nor pour it into a drain.

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