Trazodone

Trazodone

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SARI Can Be Addictive Some Weight Gain Risk
Sedating: Yes Driving: Avoid QT risk: Moderate Akathisia: Low Metabolic: Low Prolactin: Low t½: 7 h Tmax: 1.5 h

The antidepressant that accidentally became a sleep med. Trazodone is technically an SARI (serotonin antagonist/reuptake inhibitor), but in the UK it’s mostly prescribed at low doses for insomnia. At higher doses it can treat depression, but side effects (sedation, dizziness, priapism in rare cases) mean it’s rarely a first choice. For sleep, though, it’s still widely used, especially in psychiatry wards.

🩺 Main Uses

Depression; insomnia (off‑label).

🧪 The Science & Facts

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Half‑life (t½)

7 h

How long the drug hangs around. Longer half‑life = slower changes.

Time to Peak (Tmax)

1.5 h

Roughly when you feel the main effect after a dose.

What it hits (receptors)

Primary:

5-HT2A (antagonist)SERT (inhibitor (weak))H1 (antagonist)alpha1 (antagonist)

Priapism (rare), orthostasis, and next‑day grogginess are key risks.

How your body processes it (metabolism)

Substrate: CYP3A4

Caution with strong 3A4 inhibitors/inducers.

⚠️ Warnings

  • Drowsiness lasts into the next day
  • Can cause dizziness when standing up
  • Rare risk of priapism (read up on it) but basically an intense erection for hours that can be very dangerous, despite how fun it may sound
  • Avoid mixing with sedatives or alcohol
  • Not meant for long-term depression alone

⏬ Taper & Withdrawal

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If you’re reducing

If used nightly, taper to limit rebound insomnia.

Possible withdrawal

Insomnia, anxiety, flu‑like symptoms (usually mild).

Info here is educational, not medical advice. Always taper with prescriber support if possible.

🧠 Trusted External Sources Last reviewed 22 Aug 2025, 21:33 by Connor O’Driscoll

🔗 Interaction Checker

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⚠️ Black Box Warning

Antidepressants: ↑ suicidal thoughts/behaviours in under‑25s.

This is a plain‑English summary of headline safety warnings. Talk to a clinician before changing any medication.