Trazodone HCl (Desyrel)
- Generic Name: Trazodone hydrochloride
- Brand Names: Desyrel, Trazonil, Oleptro
- Therapeutic Class: Antidepressant, Phenylpiperazine derivative
What is Trazodone used for?
- Depression. Some people can not tolerate high doses of trazodone necessary to treat depression because of sedation and drowsiness, especially during the daytime.
- Short-term treatment for anxiety when mild sedative is needed.
- Trazodone is the most common off-label prescription
for insomnia and sleep difficulties because it
is sedating, quite safe, easy to titrate, and inexpensive.
- Agitation and irritability in elderly persons with dementia.
- Management of benzodiazepine/alcohol withdrawal4.
Serious drug interactions
- Antifungals (e.g., itraconazole, ketoconazole), CYP3A4 inhibitors: substantially increased plasma trazodone concentration
- Serotonergic agents (e.g. SSRIs, SNRIs), tryptophan, St. John’s wort: potential for serotonin syndrome.
- Antihypertensive agents: possible additive hypotensive effect.
- Warfarin: increased or decreased prothrombin time.
There is evidence, that trazodone can be safely used together with
However, excessive sedation is possible.
Trazodone and benzodiazepines, e.g. alprazolam (Xanax), clonazepam (Klonopin): According to the prescribing information, concomitant use of trazodone with benzodiazepines is not contraindicated. However, a caution would be needed if both medications are taken together. Such combination can increase the risk of central nervous system depression. Consult with a doctor before taking both.
Taking trazodone with food reduces peak plasma concentrations, slows the rate of absorption, and increases the extent of absorption.
Grapefruit/grapefruit juice does not interfere with trazodone.
Does Trazodone show up in a panel drug test?
Most standard screening panels won't test for trazodone. It is not a controlled substance.
However, the metabolite of trazodone meta-chlorophenylpiperazine (hallucinogenic drug) can cause false-positive test results on urine drug screens for
Trazodone in NOT a benzodiazepine. It is unlikely to show up as a false-positive on a drug screen for benzodiazepams.
How long does it take for Trazodone to get out of the system?
Trazodone elimination half-life is 5-9 hours. So the drug should leave your system in 2 to 3 days.
- 1. Baron JM, Griggs DA, Nixon AL, Long WH, Flood JG. The trazodone metabolite meta-chlorophenylpiperazine
can cause false-positive urine amphetamine immunoassay results. J Anal Toxicol. 2011 Jul;35(6):364-8.
- 2. Prapotnik M, Waschgler R, König P, Moll W, Conca A. Int J Clin Pharmacol Ther. 2004 Feb;42(2):120-4.
- 3. Logan BK, Costantino AG, Rieders EF, Sanders D. Trazodone, meta-chlorophenylpiperazine (an hallucinogenic drug and trazodone metabolite), and the hallucinogen trifluoromethylphenylpiperazine cross-react with the EMIT®II ecstasy immunoassay in urine. J Anal Toxicol. 2010 Nov;34(9):587-9.
- 4. Rickels K, DeMartinis N, Rynn M, Mandos L. Pharmacologic strategies for discontinuing benzodiazepine treatment. J Clin Psychopharmacol. 1999 Dec.
- 5. OLEPTRO (trazodone hydrochloride) PDF
- 6. Einarson A, Bonari L, Voyer-Lavigne S, Addis A, Matsui D, Johnson Y, Koren G. A multicentre prospective controlled study to determine the safety of trazodone and nefazodone use during pregnancy. Can J Psychiatry. 2003 Mar;48(2):106-10. PubMed
Last updated: February, 2015
Advanced Consumer Info
- Pregnancy Category: C. Trazodone does not increase the rates of major malformations above the baseline rate of 1-3%6.
- Breastfeeding: Trazodone levels in the breast milk are low and would not be expected to cause any adverse effects in breastfed infants, especially if the baby is older than 2 months or when doses of 100 mg or less are used at bedtime for sleep.
- Elimination half-life:5-9 hours
- Mechanism of action: Trazodone is a triazolopyridine derivative, chemically and pharmacologically distinct from other antidepressants. Trazodone’s most potent binding property is 5-HT2A antagonism. It also blocks 5-HT2C receptors to a lesser extent. Its ability to block serotonin transporters is 100 fold less potent than its ability to block 5-HT2A receptors.
- Reasons to choose Trazodone:
- 1. Reasonable sleep aid for patients at risk for benzodiazepine abuse. Trazodone has no potential for addiction.
- 2. Trazodone may be useful for depressed persons with anxiety and insomnia.
- 3. Trazodone is generally safe, it is not a controlled substance, and vast generic availability makes it less costly than "Z" drugs.
- 4. Trazodone can intensify erections and sometimes is used to prolong erectile time and turgidity in men with erectile disorder.