Trazodone (Desyrel®)

Trazodone (Desyrel® and generic forms) belongs to a group of medications called “antidepressants”, but is used more commonly to treat sleep disorders.

What is this medication used for?

Health Canada has not approved trazodone for use by children or adolescents.

When potential benefits outweigh risks, trazodone may be prescribed “off-label” for treatment of sleep disorders (insomnia), depression, anxiety disorders and aggressive behaviour in children and adolescents. Learn more about off-label medication use: http://bit.ly/KMH-off-label-use

Tell your doctor or pharmacist if you:

Have allergies or bad reactions to a medication
Take (or plan to take) other prescription or non-prescription medications, including natural medicines. Some medications interact with zopiclone. Your doctor may adjust medication doses or monitor for side effects
Have a history of heart, kidney or liver disease, seizures, breast cancer, sickle cell anemia, multiple myeloma or leukemia
Have a history of depression, any other psychiatric condition, thoughts of self-harm
Miss a menstrual period, are pregnant, breast-feeding or planning a pregnancy
Use alcohol or drugs. Taking trazodone together with certain substances may cause a bad reaction. Learn more at www.DrugCocktails.ca

When will the medication start to work?

Trazodone is usually prescribed to be taken on an ‘as needed’ basis, but it is sometimes taken regularly. You should start to feel sleepy within 30-60 minutes of taking trazodone.

Talk with your doctor if you feel that trazodone has not been helpful or if side effects are too bothersome. Your doctor may recommend switching you to a different medication.

This medication is not addictive. Do not stop taking it before talking to your doctor.

How do I take this medication?

When used for treatment of sleep disorders, a low dose is taken once daily at bedtime. Usually, you will start with a low dose of trazodone and may slowly increase this dose over several days or weeks, based on how you tolerate it. It is important to follow the dosing schedule as given by your doctor. Your doctor will determine the dose of trazodone that works best for you based on your symptoms and your response to this medication. Do not take more than the recommended dosage before talking to your doctor.

Trazodone is available in tablets that are taken by mouth. If necessary, tablets may be broken in half, but they should not be crushed or chewed.

Possible common or serious side effects:

Side effects may be more common when first starting a medication or after a dose increase. Talk to your doctor, nurse or pharmacist if any side effect concerns you.

Dizziness, drowsiness, poor coordination or headache
Blurred vision or dry mouth
Nausea, vomiting, stomach ache or constipation
Shakiness (tremors) or muscle aches

Contact your doctor immediately if you experience:

Change in mood to an unusual state of excitement, irritability or happiness
Hallucinations (hearing or seeing things that are not there)
Irregular heart beat
Skin rash, itchy skin or hives
Thoughts of hurting yourself, suicide, increased hostility or worsening symptoms
Prolonged (more than four hours), inappropriate and/or painful erection of the penis

What precautions should my doctor and I be aware of when taking this medication?

Before starting trazodone, try making small changes to sleep habits to see if you have a need for medication. For example, good sleep habits include:
- avoiding caffeine and other substances that can disrupt sleep (alcohol, nicotine, cannabis)
- sticking to a regular sleep/wake schedule (avoid sleeping in or taking naps
- powering down devices early in the evening and avoiding stimulating activities, large meals or exposure to bright lights before bedtime
- keeping the bedroom only for sleep, free of distractions
Many medications may interact with trazodone, including other sleep-aides, anti-anxiety medications, antidepressants, mood stabilizers, monoamine oxidase inhibitors and several others. If you are (or begin) taking any other prescription, over-the-counter medication, natural health product or supplement, check with your doctor or pharmacist to see if they are safe to use.
While taking this medication, if you feel dizzy, drowsy or slowed down in the morning, do not drive a car or operate heavy machinery. Alcohol could make this worse. Try to avoid alcohol while taking trazodone.

What special instructions should I follow while using this medication?

Keep all appointments with your doctor.
Tell your doctor about your sleep pattern. Your doctor will monitor your sleep disorder and your response to this medication.
Do not allow anyone else to use your medication.

What should I do if I forget to take a dose of this medication?

If you take trazodone regularly and forget to take it, skip the missed dose and take your next dose at its regularly scheduled time the next day. DO NOT double your next dose to try to ‘catch up’.

How do I store this medication?

Keep this medication in the original container, stored at room temperature away from moisture and heat and protected from light. Keep this medication out of reach and sight of children.

How does this medication work?

Trazodone affects levels of the brain chemical serotonin and the actions of the brain chemical histamine. By enhancing the action of these brain chemicals, trazodone helps you fall asleep faster and increases total sleep duration. It also improves symptoms of depression. Trazodone may improve insomnia by shortening the time it takes for you to fall asleep, decreasing the number of times you wake up during the night, and increasing your total sleep duration.

How well does the medication work in children and adolescents?

In adults, short-term trazodone use improves sleep quality better than placebo (an inactive pill). Trazodone is rarely used for treatment of depression in children and adolescents, and studies are limited for treatment of sleep disorders.

Trazodone is sometimes prescribed when other treatments are ineffective or not well-tolerated. Trazodone may be helpful for improving sleep in people with symptoms of depression or other emotional and behavioural problems such as anxiety, aggression or irritability.

How long should I take the medication for?

Most people who have sleep disorders take trazodone occasionally on an ‘as-needed’ basis, while others may take it regularly for as long as sleep problems continue. This can range from several weeks to several months. Your doctor will discuss the benefits and risks of taking trazodone with you. At this time, you can also discuss how long you might need to take this medication.

Do not increase, decrease, or stop taking this medication without discussing it with your doctor. If you stop taking trazodone suddenly, it is possible that you may experience worsened sleep.