Trazodone is FDA approved for the treatment of:

• Major depressive disorder (MDD) or depression

• Insomnia—commonly used in lower doses for sleep problems (off-label)

Trazodone is the generic equivalent of Desyrel®.

By law, a generic drug must be the same as its brand name counterpart in terms of active ingredient, dosage, safety, effectiveness, strength, stability, and quality. A generic may, however, differ in its inactive ingredients (i.e. flavoring, fillers, and preservatives).

Trazodone (Desyrel®) does come with serious warnings. These include:

• Worsening depression; increased risk of suicidal thoughts or actions in young adults*

• Serotonin syndrome—a rare, but potentially life-threatening condition that occurs when the serotonin levels in the brain are too high

• Cardiac arrhythmias—problems with your heart rate or heart rhythm

• Low blood pressure when standing after sitting or lying down (orthostatic hypotension); fainting

• Increased chance of bleeding, especially if you’re taking a blood thinner

• Prolonged, painful erections (priapism)

• Manic episodes or hypomania in patients with bipolar disorder

• Impaired judgment, thinking, and motor skills

• Glaucoma

If any of the above concern you, speak with your doctor or pharmacist about your perceived risk and other treatment options that exist.

*This warning is a boxed warning. A boxed warning is the most serious type of medication warning assigned by the FDA.

Trazodone is a serotonin receptor antagonists and reuptake inhibitor, or SARI. How trazodone works isn’t fully understood, but it’s known to block the brain’s quick absorption of serotonin, a “feed good” chemical in your brain. The end result? An increased level of serotonin in your brain, which is thought to improve mood. It also affects other neurotransmitters, which differentiates it from other antidepressants.

The most common side effects of trazodone include:

• Edema (or swelling)

• Blurred vision

• Syncope (or fainting)

• Drowsiness, tiredness

• Fatigue, lightheadedness

• Diarrhea

• Nasal congestion

• Weight loss

• Constipation, dry mouth

• Trouble sleeping

Side effects may improve over time as your body adjusts to the medicine. This list doesn’t represent all possible side effects (or serious side effects) of trazodone. If you’re experiencing any ongoing, bothersome side effect(s), tell your healthcare provider or seek medical attention right away.

If you’d like to learn more, speak with your doctor or pharmacist. The Food and Drug Administration (FDA) also has a helpful medication guide for trazodone here.

Trazodone can interact with some medicines and supplements. It’s always recommended to give both your doctor and pharmacy an updated list of everything you’re taking, so drug interactions can be identified.

Some medicines and supplements trazodone can interact with include:

• Monoamine oxidase inhibitors (MAOIs): selegiline, phenelzine, linezolid, methylene blue, tranylcypromine, isocarboxazid

• • SSRIs (selective serotonin reuptake inhibitors): citalopram, sertraline, fluoxetine, paroxetine

• SNRIs (serotonin and norepinephrine reuptake inhibitors): desvenlafaxine, venlafaxine, duloxetine, milnacipran

• Tricyclic antidepressants: amitriptyline, doxepin, imipramine, nortriptyline

• Opioids: fentanyl, tramadol, morphine, codeine

• St. John’s Wort

• Lithium

• Anti-platelets and anti-coagulants: rivaroxaban, clopidogrel, warfarin

• Certain anti-infective drugs: erythromycin, itraconazole, rifampin, ketoconazole, ritonavir

• Alcohol

• Seizure medicines: carbamazepine, phenytoin

• Drugs that act on the central nervous system (CNS)

This list doesn’t represent all the drugs that may not be safe to take with trazodone. If you’re unsure whether a certain prescription drug or supplement can be taken with trazodone, seek medical advice from your doctor or pharmacist. The FDA also has a helpful medication guide for trazodone here.

If you accidentally miss your dose of trazodone, take the dose as soon as you remember. If it’s almost time for your next dose (within 2 hours), skip the missed dose and take your next dose at the usual time. Don't take 2 doses at the same time or extra doses.

Trazodone can be taken with or without food. If the drug causes stomach upset or dizziness, try taking your dose with a meal or light snack. Make sure to keep food intake with trazodone consistent, as food can change the amount of medicine your body absorbs.

During pregnancy: Studies suggest trazodone can be a safe options during pregnancy, but more research is needed.

While breastfeeding: Similarly, data on trazodone while breastfeeding is limited. ******Research suggests that small amounts of trazodone can enter breast milk, but in levels not expected to cause side effects in nursing infants.

It’s important to treat mental health conditions (and other medical conditions) when pregnant or nursing, as untreated depression, anxiety, or other conditions can harm both you and baby. Always let your provider know if you’re pregnant or breastfeeding, so you can discuss the risks and benefits of starting or continuing trazodone. Always let your provider know if you’re pregnant or breastfeeding, so you can discuss the benefits and risks of starting or continuing trazodone.

It’s recommended to avoid or limit the use of alcohol when taking trazodone. Alcohol can intensify the side effects of trazodone, including dizziness and sleepiness.