Medication Guide
Trazodone (Desyrel) Side Effects and Uses
A plain-language guide to Trazodone, a Serotonin modulator (SARI) antidepressant. Learn how it helps, what it treats, how to take it and which side effects to know about.
Quick answer. Trazodone (Desyrel) is a Serotonin modulator (SARI) antidepressant. Common trazodone side effects include sleepiness or next-morning grogginess, dizziness or lightheadedness on standing, dry mouth and headache. The rare but serious ones, and when to get help, are listed under trazodone side effects below. Never stop or change your dose on your own.
How Trazodone Can Help You
Trazodone is a serotonin antagonist and reuptake inhibitor, or SARI. It was first approved for depression. Today it is most often used in small amounts as a gentle sleep aid. It can help people fall asleep and stay asleep. It is not a controlled substance.
At higher amounts, it works as a full antidepressant. Newer medicines are usually chosen first for that role.
For sleep, people often feel it the first night or within a few nights. For depression, improvement follows the usual timeline of four to eight weeks. Trazodone can be used nightly over the long term with your prescriber's follow-up. It also pairs well with daytime antidepressants that disturb sleep.
Uses for Trazodone
- Major depressive disorder
- Insomnia (off-label, a very common use)
- Depression with poor sleep
- Sleep problems linked to anxiety (off-label)
- Add-on to energizing antidepressants that disturb sleep (off-label)
- Nightmares and sleep problems in PTSD (off-label)
How to Take Trazodone
Your prescriber decides your dose. It is very different for sleep than for depression. For sleep, it is usually taken shortly before bedtime. The label says to take it after a meal or light snack. Leave time for a full night of sleep. If not, you may feel groggy in the morning.
If you miss a bedtime dose, skip it. Take the next one the following night. Do not take it in the middle of the night or double up. Do you take it every night for sleep? Then do not stop it suddenly. Check with your prescriber, who may suggest a short taper.
Trazodone Side Effects
Common Side Effects
- Sleepiness or next-morning grogginess
- Dizziness or lightheadedness on standing
- Dry mouth
- Headache
- Nausea
- Blurred vision
- Tiredness
- Constipation
Serious: Get Medical Help Promptly
- New or worse suicidal thoughts, mostly in people under 25 (boxed warning)
- Priapism, a painful erection that will not go away (a medical emergency)
- Fainting or a big drop in blood pressure on standing
- Heart rhythm changes, with a pounding heartbeat or fainting
- Serotonin syndrome when combined with other serotonin drugs
How Trazodone Works
Trazodone blocks certain serotonin receptors and also slows serotonin reuptake a little. It blocks histamine and some adrenaline receptors too. The histamine effect is the main reason it causes sleepiness.
The amount taken changes what it does. In small amounts, the sleepy effect stands out and the mood effect is small. In larger amounts, it acts as an antidepressant. Your prescriber explains which purpose it serves in your plan.
Before You Start Trazodone
Trazodone must never be taken with an MAOI antidepressant. Other drugs that raise serotonin add to the risk of serotonin syndrome. Some medicines can raise or lower trazodone levels. Examples are certain antifungals, HIV medicines and carbamazepine. Alcohol and other sedating drugs add to drowsiness.
Tell your prescriber about heart rhythm problems, low blood pressure and bleeding problems. Also share any history of bipolar disorder. Men with conditions such as sickle cell disease should ask about priapism risk. If you are thinking about harming yourself, call or text 988, or call 911. Learn about insomnia care by telehealth in California.
Is Trazodone Right for You?
Only a full evaluation with a prescriber can tell you if Trazodone fits your symptoms, history and goals. Harpal Singh, PMHNP-BC offers psychiatric evaluations and ongoing medication management by telehealth anywhere in California.
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Related Medication Guides
Other guides in the same group, written the same simple way. Being in one group does not mean you can swap one medicine for another.
- Sertraline (Zoloft), SSRI antidepressant
- Venlafaxine (Effexor XR), SNRI antidepressant
- Vilazodone (Viibryd), SSRI and serotonin partial agonist antidepressant
- Vortioxetine (Trintellix), Serotonin modulator antidepressant
- Amitriptyline (Elavil), Tricyclic antidepressant (TCA)
- Bupropion (Wellbutrin XL), Atypical antidepressant (norepinephrine-dopamine reuptake inhibitor)
FAQ
Questions About Trazodone
Is trazodone habit-forming like other sleep medications?
Trazodone is not a controlled substance and is not known to cause cravings. That sets it apart from benzodiazepines and sleep drugs such as zolpidem. This is a main reason prescribers use it for people who need ongoing help with sleep.
Why was I prescribed an antidepressant for sleep?
In small amounts, trazodone's sleepy effect stands out while its mood effect is small. That makes it work mainly as a sleep medicine. This off-label use is very common and well established.
What is priapism and how worried should I be?
Priapism is a long, painful erection that is not linked to sexual activity. It is rare, but it is a medical emergency. If an erection will not go away, get emergency care right away. Men with sickle cell disease or similar conditions should discuss this risk first.
Why do I feel dizzy when I stand up?
Trazodone can lower blood pressure for a moment when you change position, mostly at night. Get up slowly and sit on the edge of the bed first. If dizziness is strong or you fall, contact your prescriber.
Can I take trazodone with my antidepressant?
Often, yes. Trazodone at bedtime is commonly paired with an SSRI or SNRI taken in the morning. Because both affect serotonin, your prescriber confirms the pair is right for you and reviews the signs of serotonin syndrome.
How fast does trazodone work for sleep?
Many people feel sleepy within an hour or so and notice better sleep the first night or within a few nights. For depression, the effect takes four to eight weeks. Tell your prescriber if it does not help after a fair trial.
Can I drink alcohol with trazodone?
It is best not to. Alcohol adds to trazodone's sleepiness and dizziness, which raises the risk of falls. Alcohol also makes sleep worse later in the night.
Will I feel groggy the next day?
Some people do, mostly at first. Taking it early enough to allow a full night of sleep often helps. If grogginess lasts, tell your prescriber, who may change the plan.