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Trazodone 2018-09-11T16:54:10+00:00

Trazodone Uses, Dosage, Side Effects & Warnings

Trazodone is an antidepressant used in the treatment of depression, anxiety and insomnia. It is the most popular member of a class of medications called serotonin antagonist and reuptake inhibitors, or SARIs. Its effectiveness as an antidepressant is comparable to other medications in different antidepressant classes, such as the selective serotonin reuptake inhibitor Prozac or the selective norepinephrine reuptake inhibitor Cymbalta.

Despite its identity and effectiveness as an antidepressant, you are probably more familiar with trazodone as a medication to treat insomnia. With 26 million prescriptions filled in 2014 alone, it is the most commonly prescribed insomnia medication, and the second most common overall behind diphenhydramine (which is available over-the-counter in several types of preparations). Due to its unique effects on the body’s serotonin regulation system, the dosage of trazodone required to treat insomnia is much lower than the dose required to treat depression.

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Trazodone has two particularly common side effects: sedation and orthostatic hypotension, which is the inability of the body to maintain adequate blood pressure when changing positions. It is also infamous for the rare, but alarming, side effect of priapism, the presence of a penile erection lasting for several hours despite the lack of sexual arousal. Nevertheless, it is considered a safer alternative to benzodiazepines or other medications from the sedative/hypnotic class, like Ambien, to treat insomnia, as those medications are known to be habit-forming, and tolerance to them builds after just a few weeks of use.

While trazodone is not generally habit-forming, does not produce euphoria and does not create physical dependence, its sedative effect can lead to misuse. For some, trazodone’s sleep-inducing effect helps them avoid undesirable responsibilities. For others, trazodone is useful in reducing unwanted stimulant effects from other drugs.

Overdoses of trazodone do occur, though they are usually not fatal if trazodone is the only drug involved. When combined in overdose with central nervous system depressants, the fatality rate is considerably higher. Cardiac arrhythmias, or disturbances to the heart’s normal beating pattern, and severely low blood pressure are significant potential outcomes of a trazodone overdose.

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Have you been prescribed trazodone? What does your relationship with it look like? Transformations Treatment Center can help you better understand your connection to your medication and offer healthy alternatives if that connection has been harmful.

How Trazodone Works Within Your Body

Like many antidepressants, the primary target for the action of trazodone is serotonin, which is a nerve cell messenger widely distributed throughout your body. Serotonin in the brain is, among other functions, responsible for the regulation of mood and anxiety levels, and your body has many different control levers for it. Trazodone blocks nerve cell receptors from binding up serotonin using a few of these levers. Trazodone also blocks nerve cells from absorbing serotonin out of the area that two or more nerve cells use to communicate. The effect is to create higher levels of serotonin for nerve cell communication, which in turn leads to better mood and reduced anxiety. This effect, combined with trazodone’s mild antihistamine effect and reversal of the “fight-or-flight” response system, is why trazodone is so effective at treating insomnia.

How to Identify Problematic Trazodone Use

While problematic trazodone usage does not produce many physical signs and symptoms, certain indicators are helpful for you or your family and friends to identify it.Taking more trazodone than what is prescribed, without your provider’s permission, strongly suggests problem use. Similarly, non-prescribed ingestion of a medication like trazodone points to problem use. The refusal or inability to stop taking trazodone despite suffering negative consequences from its use is a clear indicator that a problem is present; this is a hallmark symptom of addiction, no matter the substance.

Other signs and symptoms of trazodone misuse might include:

  • Visible over-sedation
  • Unsuccessful attempts to cut down usage
  • Taking trazodone with alcohol or other drugs

How to Treat Trazodone Misuse

Many antidepressants, including trazodone, are thought to remodel the brain’s serotonin regulation system. In these cases, it is often best to begin treatment with medical detoxification to avoid withdrawal symptoms from abruptly removing medications that act on serotonin. Especially in cases where more trazodone is being taken than prescribed, it will be important to monitor vital signs and to safely taper off of the medication.

When the problematic use of trazodone is identified, the main choice of psychotherapy is cognitive behavioral therapy (CBT). The primary goal of CBT is to show you how to change unhealthy behaviors by re-examining and challenging the thought processes that lead to them. CBT is a mainstay of the treatment of addictive disorders, and a specialized form of it has been adapted and utilized to treat insomnia without the use of medications. Participation in a 12-step program will ensure that you receive support, develop new skills and establish accountability with others. Motivational interviewing may also be used in treatment.

At Transformations Treatment Center, we will help you face the problematic use of trazodone in a nonjudgmental, non-confrontational way. Our professional staff is highly trained in the best evidence-based practice, and we will create a comprehensive program to meet your specific needs. Contact us today to discuss your options for treatment.

Continue Reading: Effects, Signs & Symptoms
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Trazodone
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