Trazodone

Trazodone is an antidepressant. Trazodone is widely used by psychiatrists and family practice doctors. They typically prescribe this medicine for sleep and not depression.

Trazodone is effective for depression; however, Trazodone is an old drug and has an extensive side effect panel. Newer drugs are more commonly used for depression and sleep today.

For depression one may have to take up to 600mg of Trazodone for it to be effective. For sleep one will be prescribed 50mg up to 100mg.

I have seen Trazodone used for mood stabilization. The typical dose for mood is 50mg four times a day.

Precautions:

Trazodone has been associated with the occurrence of priapism. Sometimes surgical intervention is required. In a portion of these cases erectile dysfunction or impotence resulted. Male patients with prolonged erections should immediately stop the drug and consult their physician. If the condition persists for more than 24 hours, it then becomes advisable for the treating physician to consult a urologist to decide on a treatment plan for the problem. Trazodone can cause menstrual irregularities, retrograde ejaculation and inhibition of ejaculation too.

Trazodone can cause cardiac arrhythmias (inefficient heart beats) which can include isolated PVC’s (Premature ventricular contractions), ventricular couplets (Two PVC’s in a row), and short episodes (3 to 4 beats) of ventricular tachycardia, and artrial flutter. These ineffective beats will usually become worse and eventually will not support life. Patients with pre-existing cardiac disease should be closely monitored, particularly for cardiac arrhythmias. Or better yet, if you have a cardiac problem don’t use this medication at all. Trazodone is not recommended during the recovery phase of myocardial infarction. (Heart attack)

***As with any antidepressant a depressed person must be watched carefully until the depression lifts. The drug therapy can give a depressed/suicidal person the energy to carry out their suicide plan.Trazodone can cause you to become sleepy. Do not run heavy machinery until your body acclimates to the drug.

Trazodone may enhance the response to alcohol, barbiturates, and benzodiazepines; people should be cautioned accordingly. Increased Digoxin and Dilantin levels have been reported in people receiving Trazodone concurrently with either of these two drugs. Do not use Trazodone and MAO antidepressants together.

Trazodone may cause a person’s blood pressure to drop to serious levels. A person may faint due to this side effect. A person on Trazodone will need to change positions slowly.

Trazodone is not safe in pregnancy and is found in breast milk. Trazodone is not safe for the baby.

Trazodone can cause blood dyscrasias. This is a serious side effect. This can cause a person’s immune system to malfunction. The white blood cell count decreases and an infection can occur easily.

Trazodone can cause an increase prolactin secretion which has the potential to induce mammary neoplasms. (Cancer)

The most common adverse reactions encountered are drowsiness, nausea/vomiting, headache and dry mouth.Serious side effects include but not limited to:Drowsiness, fatigue, lethargy, light-headedness, dizziness, difficulty in concentration, confusion, impaired memory, disorientation, excitement, agitation, anxiety, tension, nervousness, restlessness, insomnia, nightmares, anger, hostility and rarely, hypomania, visual distortions, hallucinations, delusions and paranoia. Also, tremor, headache, ataxia (Unable to walk properly), akathisia (Unable to sit still), muscle stiffness, slurred speech, vertigo, tinnitus (ringing in the ears), tingling of extremities, weakness, grand mal seizures, and rarely, impaired speech, muscle twitching, numbness, and involuntary movements. Trazodone can cause blurred vision, double vision, nasal congestion, sweating, urinary retention, urinary frequency, and incontinence.

Trazodone is rather hard on the heart. As mentioned before Trazodone can cause missed beats, arterial irritation, and ventricular problems.

Any drug can cause GI problems. Trazodone is no different; it can cause nausea, vomiting, diarrhea, gastrointestinal discomfort, anorexia, or increased appetite.

An allergic reaction may cause skin rash, itching, swelling, and rarely, hemolytic anemia (damage to red blood cells), photosensitivity (A person can get a sunburn easily), and fever.

All medications come with side effects, both positive and negative. One must weigh the dangers to the benefits from the drug. In my 25 years of psychiatric nursing I noticed Trazodone did more good than bad. Always be aware of what you place in your body and why. Report adverse side effects immediately. If Trazodone does not work for you maybe another medicine will. Collaborate with your doctor for the best choice for you