Trazodone belongs to the group of antidepressants used in depressive syndromes with sleep disorders and anxiety. How should I dose trazodone correctly? Are there any contraindications to the use of trazodone?
Trazodone - action, indication for use
Trazodone belongs to the group of antidepressants used in depressive syndromes with sleep disorders and anxiety. It blocks both serotonin 5HT2A and 5HT2C receptors, histamine H1 and α1 adrenergic receptors. At higher doses, it also inhibits the serotonin reuptake transporter. Trazodone is used in the treatment of depressive disorders, anxiety disorders, sleep disorders, and is also used in addiction therapy.
Trazodone - dosage
The dosage depends on the indication for use and the individual patient's response to the treatment.
- treatment of depressive syndromes
Treatment is started with a dose of 50 mg and increased to 100 mg after 2-3 days. On day 4, the patient can take a dose of 150 mg. In the absence of a response to treatment, the dose can be increased to 300 mg. Doses higher up to 600 mg are used rarely and only in hospitalized patients under close medical supervision.
- anxiety disorders
According to medical studies, it is possible to use doses of 150-300 mg in the treatment of anxiety disorders, but it will not be effective in the case of anxiety disorders with anxiety attacks and in obsessive-compulsive disorders.
- behavioral disorders in people with dementia
Trazodone is also used to reduce irritability and anxiety in people with dementia. It is particularly effective in combating verbal aggression and oppositional behavior.
It is administered in doses of 50-250 mg, but the maximum single dose should not exceed 100 mg.
- sleep disorder treatment
Trazodone is used not only in the treatment of insomnia caused by depression, but also in the treatment of insomnia, which is an undesirable effect of its therapy. It has a positive effect on the amount of sleep, and at the same time improves its structure (extends slow-wave sleep and normalizes the duration of the REM phase). In combination therapy with other antidepressants, the dose is 100 mgbedtime. It seems to be a safe alternative to other sleeping pills because it is not addictive and there is a lower risk of daytime sleepiness.
- alcohol consumption control
In doses of 75-300 mg, trazodone reduces the need to drink alcohol, improves sleep quality, reduces anxiety and helps to maintain abstinence.
Trazodone - contraindications, side effects
Trazodone is considered a safe and well-tolerated drug. There are also no side effects associated with discontinuation of treatment.
Its main side effects are:
- sleepiness, orthostatic pressure drops (in this case they often occur at the beginning of treatment, later the body adapts),
- dizziness, gastrointestinal upset, dry mouth.
You may experience an increase in appetite, but if used for a short period of time, trazodone should not cause you to gain weight.
Compared to other antidepressants, it does not affect sexual function, and in some cases when added to, for example, SSRI drugs, it may even reduce sexual dysfunction.
Special caution should be exercised in people with hepatic insufficiency, as trazodone is extensively metabolized in the liver and may be hepatotoxic. Treatment must be discontinued immediately if jaundice occurs.
Trazodone should not be used in children under 18 years of age, in people after acute myocardial infarction, and in patients under the influence of alcohol or sleeping pills.
Caution should be exercised when using trazodone in pregnant people. If it is used until delivery, newborns should be monitored for signs of withdrawal. Breastfeeding is not contraindicated, but it is best to check with your doctor to determine the benefits of breastfeeding and trazodone treatment.
Trazodone - interactions
Interaction with trazodone:
- tricyclic antidepressants (TCAs), fluoxetine, MAO inhibitors - risk of serotonin syndrome
- carbamazepine - reduces the concentration of trazodone
- drugs prolonging the QT interval - risk of arrhythmias