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Trazodone Withdrawal Symptoms

Some persons may experience very little in the way of trazodone withdrawal symptoms during gradual cessation. Others may have more noticeable reactions, and some persons may suffer from protracted withdrawals that can last anywhere from 6 weeks to years if not properly treated.1,13

WARNING:  Abruptly stopping an antidepressant drug can often induce intense withdrawals that can last for a very long time, and may significantly increase the time required for complete recovery.

Commonly reported adverse trazodone withdrawal symptoms are similar to most other antidepressant drugs, and effects can range from mild to moderate to severe and protracted.

Trazodone withdrawal symptoms include:

  • Suicidality 3,8,12,13
  • Bipolar disorder11
  • Major depression11,13
  • Anxiety8,9,11,13
  • Mood swings, anger, irritability, crying spells, agitation8,10,11,13
  • Brain zaps, the sensation of electrical shock or jolts 13
  • Diaphoresis (excessive sweating) 9
  • Impaired concentration, brain fog 11,13
  • Impaired memory 11
  • Dizziness8,13
  • Nausea, vomiting, gastrointestinal symptoms, diarrhea 9,13
  • Insomnia, disturbed sleep, vivid dreams 8,9,10,11
  • Depersonalization9
  • Pathological gambling 11
  • Akathisia 13
  • Headaches8,13
  • Muscle aches, weakness13

Medical professionals often do not consider the ramifications of, or understand potential complications of trazodone withdrawal.

While trazodone is considered much safer than narcotic sedatives, still there are potential trazodone side effects and withdrawal complications3 that tend to get disregarded by prescribers.
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Trazodone Withdrawal is a Specialty at Alternative to Meds Center

Trazodone is a generic antidepressant (serotonin antagonist reuptake inhibitor, SARI) that is prescribed for depression and for numerous other off-label uses. It is particularly ironic that all antidepressants (including trazadone) carry a black box warning for risk of suicide.3,8,12,13

SARI drugs are thought to block serotonin from adhering to 5-HT2 receptors. After neurochemical expression, serotonin would normally be broken down and recycled. Blocking the reabsorption of neurochemicals causes them to remain out in the nerve synapse where they eventually degrade and become useless waste products. As with all antidepressant agents that are serotonergic, a deficit in vital levels of serotonin will often occur, leading to worsening depression. SARI drugs such as trazodone are also thought to alter or block dopamine, histamine, acetylcholine, norepinephrine, and other neurochemicals, and disrupt their normal distribution in the brain and along the system of nerve channels of the CNS.6

Before starting or stopping a drug such as trazodone it is recommended to adequately research and understand as much as possible in order to make an informed decision, and also to know when to seek medical help if taking any drug has been unable to help your symptoms the way you thought it would. Below is a body of information that may help to provide the most searched for answers about trazodone side effects, trazodone withdrawal symptoms, and other relevant data.


Testimonial
Trazodone Withdrawal
Success

At ATMC I was always supported. The staff was great at providing opportunities for me to work towards stability. What helped me here was always keeping a positive outlook and the constant encouragement and reminders to keep faith in myself.

-Jackie

What Is Trazodone Used For?

Trazodone is a generic drug prescribed for a number of conditions. Brand names are Desyrel and Oleptro (now discontinued). A time-release version is also manufactured called Desyrel Dividose.  First approved by the FDA in the treatment of major depressive disorder (MDD), it is often prescribed in the treatment of insomnia. Other uses include generalized anxiety disorder, bulimia, dementia, other CNS degeneration diseases such as Alzheimer’s, schizophrenia, chronic pain, diabetic neuropathy, fibromyalgia, headache, PTSD, sleep apnea, and is also used as a sedative for cocaine, benzodiazepine or alcohol withdrawal. Additionally, trazodone is prescribed off-label for pain syndromes, panic disorder, and OCD (obsessive-compulsive disorder).6,14

Note: There may be effective non-drug-based trazodone alternatives to be considered that your physician has not told you about. Please ask us about these.

Stopping Trazodone:  Important Info Regarding Discontinuing/Quitting Trazodone

Trazodone has a half-life of approximately 6 to 9 hours and trazodone withdrawal symptoms may begin quite soon, within a day or a day and a half of the last dose. These figures would be different if a time-release version of the drug was prescribed, such as Desyral Dividose time-release tablets.

It is thought that abrupt trazodone withdrawal, as in stopping all at once can cause a rebound effect in certain neurotransmitters. This is common, especially if the natural precursors for these neurotransmitters are not being supported during trazodone withdrawal, for example, with targeted nutrition. In any case, slow and gradual trazodone withdrawal is indicated as the best overall method.1,8

Certain factors may influence how intense withdrawal can be for an individual, such as how long the drug was taken, the general health of the individual, and how high the dosage was. Taking trazodone for long periods of time may result in trazodone addiction or dependence and requires medical oversight for a safe and more comfortable experience. Protracted withdrawal symptoms are those that emerge and linger 6 weeks or more after discontinuation, and can last months, or even years. Medical research has been slow to report on protracted withdrawals. For too long, antidepressant withdrawal symptoms were regarded as new or re-emerging mental illness, incorrectly. The evidence is now overwhelmingly clear that antidepressant withdrawals are actual, and not re-emerging or newly emerging mental illness. This understanding is crucial for the proper handling and resolution of antidepressant withdrawal phenomena.13

Always consult your prescribing physician or other competent medical practitioners before stopping trazodone or any antidepressant drug so you receive the best care possible.

Trazodone Side Effects

Trazodone side effects are similar to other antidepressants. These trazodone side effects may be mild to moderate or severe, in which case, medical attention may be required. Trazodone side effects can include mild to moderate to severe reactions.

Trazodone side effects include:

    • Seizures18
    • Serotonin syndrome 3,12,14
    • Impaired cognitive function, impaired motor controls 3,12,16
    • Increased depression 3,12
    • Fatigue14,17
    • Suicidal thoughts & behavior 3,12,14,17
    • Cardiac arrhythmia, QT prolongation, torsades, other cardiac risks 3,12,14,17
    • Panic attacks,panic symptoms6
    • Mania, hypomania 3,7,12
    • Hyponatremia 3,12,14
    • Akathisia3,12
    • Dry mouth14
    • Blurred vision 3,12
    • Dry mouth 3,12,17
    • Dizziness or lightheadedness14,17
    • Drowsiness, tiredness, fatigue 3,12,14,17
    • Headache14,17
    • Anxiety, agitation, hostility, nervousness, irritability, aggression 3,12,14,15,17
    • Nausea, vomiting3,12
    • Constipation, diarrhea3,12
    • Priapism (a persistent painful erection)3,12,14,17
    • Visual hallucinations14
    • Abnormal bleeding3,12

Some of these side effects may require immediate medical attention such as severe allergic rash, seizures, cardiovascular events, or any severe reaction.


Trazodone FAQs

The following section addresses some of the most commonly asked questions and searches for information about trazodone.

Is Trazodone a Sleeping Pill?

Trazodone is classed as a SARI type of antidepressant. The letters stand for Serotonin Antagonist Reuptake Inhibitor. SARI drugs also block adrenergic receptors. Trazodone could also be classed as a hypnotic/anxiolytic (similar to a benzodiazepine) and is sometimes prescribed off-label for insomnia or other sleep issues, such as nightmares. Trazodone was not specifically designed (or licensed) as a sleeping pill but it has become one of the most frequently (off-label) prescribed drugs for insomnia, because of the drug’s “knock-out” effect. Alternatives to trazodone are becoming more widely available for sleep disturbances, which could be considered where prescription drugs are not the best of all options.2, 4, 5

Is Trazodone a Narcotic?

Technically, a narcotic is any drug that affects mood, induces sleep, or numbs pain or other unwanted sensations. The word narcotic comes from the Greek “narko,” which means to numb pain. In a legal sense, the word narcotic most often refers to an illegal psychoactive substance. In medical usage, the word has come to generally refer to opioids such as heroin or morphine. While there are similarities in effect between trazodone and narcotics, legally there is a distinct difference because trazodone is an uncontrolled substance in the US, and is not illegal to possess when it is a prescribed medication.

How Does Trazodone Work in the Body/Brain?

The mechanism of action of trazodone is thought to involve preventing serotonin and likely other neurotransmitters from binding to the receptors that these would normally bind to, connect with, or be attracted to. No drug can create neurotransmitters such as serotonin, or norepinephrine, or dopamine. Drugs can only interfere with how they travel or are prevented from traveling along the neuron pathways of the brain and central nervous system.

As an example, when serotonin becomes trapped in the synaptic regions, this is linked to a euphoric lift in mood. Any such trazodone side effects are artificial, and temporary until the serotonin breaks down, metabolizes, (becomes inert), and is cleared.

Does Trazodone Show up on Drug Tests?

Yes, trazodone can show up on drug tests, however, it is unlikely to be screened for in the multipanel drug tests that are commonly used, for example, in the workplace.

Is Trazodone a Benzo (Benzodiazepine)?

No. Benzodiazepine drugs are thought to influence the transmitters called GABA. Trazodone is thought to affect other natural brain chemicals (serotonin and others). However, both drugs share similar properties in how they affect a person, for instance, drowsiness. Benzodiazepine drugs are recommended for only very short-term use, according to FDA and other regulatory guidelines. Trazodone is often prescribed for much longer periods of time. Trazodone is often used as a benzodiazepine alternative and can be used as a bridge medication to help people get off of benzodiazepines.

Can Trazodone Cause Serotonin Syndrome?

Yes, any agent which causes too much of a build-up of active serotonin in the central nervous system can induce “serotonin syndrome.” 3 This reaction is considered potentially life-threatening and medical intervention is required, without delay19,20. Usually one of the first treatments is to withdraw the drug. This is the one exception where stopping trazodone abruptly, is recommended as to do so can be life-saving in this case. Some symptoms of serotonin syndrome to watch for include:

  • Sudden fever
  • Seizure
  • Coma
  • Loss of consciousness
  • Rash
  • Hives
  • Itching
  • Difficulty breathing
  • Agitation
  • Delirium
  • Pressured speech
  • Significant drop and dramatic swings in blood pressure
  • Fainting
  • Agitation
  • Diarrhea
  • Mental confusion
  • Muscle rigidity
  • Sweating, hyperthermia (99.9° F+ or 37.7°C +)
  • Twitching muscles
  • Tremors
  • Shivering
  • Tachycardia (elevated heart rate)
  • Respiratory failure
  • Renal failure
  • Blod clotting
  • Hyperactive bowel sounds

Treatment for Trazodone Addiction and Abuse?

The treatment for long term trazodone addiction or dependence may be beneficial where the withdrawal symptoms are intense and difficult to endure. Although the drug is promoted as not habit-forming, the actuality is that once the body becomes accustomed to the presence of the drug over time, there is the potential for a reaction when the drug is withdrawn. Whether this is called dependence or addiction, trazodone withdrawal help must be gradual.

There are many trazodone withdrawal treatment protocols that can lessen the severity of symptoms and accelerate the normalization process after trazodone addiction or dependence may have developed.

Alternative to Meds Center has refined the trazodone withdrawal treatment process using slow and safe tapering methods in the inpatient program. Each client is helped by preparing an individualized inpatient program consisting of many steps. For instance laboratory testing is used to assess accumulations of toxins and other factors that could need to be addressed. Neurotoxic substances could include heavy metals, pesticide exposures, chemicals and cleaners from work or industrial uses as well as food additives and other toxins that get built up and stored in the fatty tissues. The process of purging accumulated neurotoxic load, supplemented by corrective nutritional therapy, therapeutic massage, Reiki, Equine therapy, and many other adjunctive therapies makes Alternative to Meds a leader in the field of recovery from psychiatric prescription drugs. The root causes of mental health symptoms are investigated and resolved using natural therapies. Drug tapering using alternatives that are drug-free is foundational to healing after drug use.

An important overall step in recovery from antidepressants is rebalancing neurochemistry naturally, to alleviate or eliminate the original symptoms that led to prescribing antidepressant medication in the first place. Exacting series of steps are completed during our programs to provide the best in trazodone withdrawal help.

The process of stopping trazodone can be surprisingly mild and easy to tolerate using such safe and gradual tapering protocols. Please feel free to ask us for more information on the processes that are used in the Alternative to Meds Center trazodone withdrawal program.

1 (800) 301-3753 for Trazodone Withdrawal Help

1. Otani K, Tanaka O, Kaneko S, Ishida M, Yasui N, Fukushima Y, “Mechanisms of the development of trazodone withdrawal symptoms.”  International Clinical Pharmacology Journal [Internet] 1994 Summer [cited 2020 Jul 20]

2. Jarema M, Dudek D, Landowski J, Heitzman J, Rabe-Jablonska J, Rybakowski J, “Trazodon — the antidepressant: mechanism of action and its position in the treatment of depression.” Polish Journal of Psychiatry [Internet] 2011 Jul-Aug [cited 2020 Jul 20]

3. FDA trazodone label, “Highlights of Prescribing Information“, [Internet] Revised 2017 Jun [cited 2020 Aug 14]

4. Jaffer KY, Chang T, Vanle B, Dang J, Steiner A, Loera N, et al., “Trazodone for Insomnia: A Systematic Review.” Innovations in Clinical Neuroscience [Internet] 2017 Jul-Aug [cited 2020 Aug 14]

5. Mendelson W, “A review of the evidence for the safety of trazodone in insomnia.” Journal of Clinical Psychiatry [Internet] 2005 Apr [cited 2020 Aug 14]

6. Shin JJ, Saadabadi A. Trazodone. [Updated 2020 May 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.Available from: https://www.ncbi.nlm.nih.gov/books/NBK470560/ [cited 2021 July 10]

7. Knobler HY, Itzchaky S, Emanuel D, Mester R, Maizel S. Trazodone-induced mania. Br J Psychiatry. 1986 Dec;149:787-9. doi: 10.1192/bjp.149.6.787. PMID: 3790881. [cited 2021 July 10]

8. Henssler J, Heinz A, Brandt L, Bschor T. Antidepressant Withdrawal and Rebound Phenomena. Dtsch Arztebl Int. 2019 May 17;116(20):355-361. doi: 10.3238/arztebl.2019.0355. PMID: 31288917; PMCID: PMC6637660. [cited 2021 July 10]

9. Montalbetti D, Zis A, “Cholinergic Rebound Following Trazodone Withdrawal.” Journal of Psychopharmacology Feb 88 Vol 8 Issue 1 P.73 [online] [cited 2021 July 10]

10. Lejoyeux M, Adès J. Antidepressant discontinuation: a review of the literature. J Clin Psychiatry. 1997;58 Suppl 7:11-5; discussion 16. PMID: 9219488. [cited 2021 July 10]

11. Lerner A, Klein M, “Dependence, withdrawal, and rebound of CNS drugs – an update.” Oxford Academic Journal: Brain Communications Vol 1 Issue 1 2019 [cited 2021 July 10]

12. FDA label Oleptro (trazodone hydrochloride) extended release tablets [Feb 2010] [cited 2021 July 10]

13. Hengartner MP, Schulthess L, Sorensen A, Framer A. Protracted withdrawal syndrome after stopping antidepressants: a descriptive quantitative analysis of consumer narratives from a large internet forum. Ther Adv Psychopharmacol. 2020;10:2045125320980573. Published 2020 Dec 24. doi:10.1177/2045125320980573  [cited 2021 July 10]

14. Bossini L, Coluccia A, Casolaro I, Benbow J, Amodeo G, De Giorgi R, Fagiolini A. Off-Label Trazodone Prescription: Evidence, Benefits and Risks. Curr Pharm Des. 2015;21(23):3343-51. doi: 10.2174/1381612821666150619092236. PMID: 26088119. [cited 2021 July 10]

15. Schwasinger-Schmidt TE, Macaluso M. Other Antidepressants. Handb Exp Pharmacol. 2019;250:325-355. doi: 10.1007/164_2018_167. PMID: 30194544. [cited 2021 July 10]

16. Gonçalo AMG, Vieira-Coelho MA. The effects of trazodone on human cognition: a systematic review. Eur J Clin Pharmacol. 2021 Jun 7:1–15. doi: 10.1007/s00228-021-03161-6. Epub ahead of print. PMID: 34097124; PMCID: PMC8182348. [cited 2021 July 10]

17. Fagiolini A, Comandini A, Catena Dell’Osso M, Kasper S. Rediscovering trazodone for the treatment of major depressive disorder. CNS Drugs. 2012 Dec;26(12):1033-49. doi: 10.1007/s40263-012-0010-5. Erratum in: CNS Drugs. 2013 Aug;27(8):677. PMID: 23192413; PMCID: PMC3693429. [cited 2021 July 10]

18. Lefkowitz D, Kilgo G, Lee S. Seizures and Trazodone Therapy. Arch Gen Psychiatry. 1985;42(5):523. doi:10.1001/archpsyc.1985.01790280105012 [cited 2021 July 10]

19. Volpi-Abadie J, Kaye AM, Kaye AD. Serotonin syndrome. Ochsner J. 2013;13(4):533-540. [cited 2021 July 10]

20. Bijl D. The serotonin syndrome. Neth J Med. 2004 Oct;62(9):309-13. PMID: 15635814. [cited 2021 July 10]

Originally Published Sep 13, 2018 by Diane Ridaeus


This content has been reviewed and approved by a licensed physician.

Dr. John Motl, M.D.

Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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Trazodone Withdrawal Symptoms, (Oleptro, Desyrel Dividose) Side Effects, Treatment Help
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Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.

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