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Trazodone is an antidepressant that was originally developed for use in treating major depressive disorder and symptoms of depression. Nowadays, it is perhaps most widely used off-label for managing insomnia (both depression-related and otherwise). Trazodone was approved by the U.S. Food and Drug Administration (FDA) in 1981 under the brand name Desyrel and is now available as a generic medication produced by several leading drug companies. Currently the extended-release tablet form, Oleptro, is the only remaining brand name version of trazodone. 

Trazodone is an atypical antidepressant that does not fit into the standard antidepressant classes (e.g., SSRIs, SNRIs, MAOIs, tricyclic antidepressants, etc.). Rather, trazodone is generally categorized according to its mechanism of action, which is as a serotonin receptor (5HT2a) antagonist and reuptake inhibitor, or SARI. These drugs work by moderating levels of serotonin in the brain and increasing its availability in the CNS (central nervous system). Like many antidepressants, trazodone has been issued a Black Box Warning by the FDA and is required to clearly display a warning label indicating the possibility of increased suicidal thoughts and behaviors when taken by some individuals under the age of 25. 

Trazodone Long Term Side Effects

While trazodone is generally safe and effective when used as directed for its intended purpose, as is true with taking any type of medication there are associated risks and possible adverse effects. Possible side effects of trazodone could include, but are not limited to the following examples:

  • Serotonin syndrome
  • Confusion
  • Tremors
  • Hyponatremia (decreased serum sodium levels) and associated symptoms such as headache, concentration problems, memory problems, confusion, weakness, unsteadiness, increased fall risk, etc.
  • Gastrointestinal upset
  • Heart rate and rhythm abnormalities
  • Fainting
  • Hypotension
  • Coordination problems 
  • Angle-closure glaucoma
  • Blurred vision

Prolonged use of trazodone could lead to the following effects, provided by the Journal of Sleep Research:

  • Equilibrium disruption
  • Short-term memory dysfunctions
  • Verbal learning issues
  • Next-day memory performance problems
  • Difficulties with arm muscle endurance

The sudden discontinuation of trazodone that had been used to alleviate insomnia may cause withdrawal symptoms such as anxiety, irritability, depression, and mild flu-like symptoms. These side effects can be largely eliminated by slowly tapering off and using less trazodone over time. There are several contributing factors (e.g., the individual’s health history, the presence of any additional mental health ailments, substance abuse issues, genetics, etc.) that will play a role in the long-term effects caused by trazodone. 

Further Information and Support

Navigating the challenges that arise from living with mental illness, struggling with substance abuse, and/ or addiction can not only be all consuming but are often impossible to effectively handle without proper support. If you are concerned for yourself or a loved one regarding mental illness, substance abuse, and/ or addiction we recommend reaching out for help as soon as possible. Bear in mind that you do not have to be on this journey alone. At Upwell Advisors, we offer unique, customized concierge therapeutic services to provide our clients with unparalleled support throughout every step of the recovery process. 

If left untreated, substance abuse, addiction, and/ or mental illness can result in long lasting and potentially life-threatening consequences. The earlier you seek support, the sooner you and your loved ones can return to leading happy, healthy, and fulfilling lives. Please do not hesitate to reach out for guidance. We welcome the opportunity to discuss how we might best be able to help you or your loved one in the recovery process.

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