Desyrel (Trazodone)

Trazodone is primarily used for the treatment of depression; however, it is sometimes prescribed as a sedative, and it also is used in combination with other drugs for the treatment of psychiatric conditions other than depression and cocaine withdrawal.

For the treatment of depression, the dose for adults is 150-600 mg per day. The initial starting dose usually is 150 mg per day. Trazodone is given in one or more daily doses, sometimes with the largest dose at night. As with all antidepressants, it may take several weeks for the full effects of treatment to be seen. Doses often are adjusted slowly upwards to find the optimal dose. Elderly patients and debilitated persons may need lower doses. Trazodone should be taken after a meal or light snack to reduce the risk of dizziness. Food also increases the amount of drug absorbed into the body.

Trazodone is an oral antidepressant drug that affects the chemical messengers (neurotransmitters) within the brain that nerves use to communicate with (stimulate) each other. The major neurotransmitters are acetylcholine, norepinephrine, dopamine and serotonin. Many experts believe that an imbalance among the different neurotransmitters is the cause of depression. Although the exact mechanism of action of trazodone is unknown, it probably improves symptoms of depression by inhibiting the uptake of serotonin by nerves in the brain. This results in more serotonin to stimulate other nerves. Trazodone also may increase directly the action of serotonin. Trazodone is chemically unrelated to the serotonin reuptake inhibitors (SSRIs), the tricyclic antidepressants (TCAs) or the monoamine oxidase inhibitors (MAO inhibitors). It is chemically related to nefazodone (Serzone) and shares its actions. Trazodone was approved by the Food and Drug Administration in 1982.

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take only the next one as directed. Do not take a double dose of this medication.

Store at room temperature, 15-30 degrees C (59-86 degrees F)

Use caution when driving, operating machinery, or performing other hazardous activities. Trazodone may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Dizziness may be more likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking trazodone. There are no adequate studies of trazodone in pregnant women. Studies in animals have demonstrated effects on the developing fetus. Trazodone should only be used during pregnancy if the physician feels that its benefits outweigh its potential risks. Trazodone is secreted in breast milk. Therefore, caution should be used in prescribing trazodone to women who are breast- feeding.

The most commonly noted side effects associated with trazodone are nausea, dizziness, insomnia, agitation, tiredness, dry mouth, constipation, lightheadedness, headache, low blood pressure, blurred vision, and confusion. Priapism (including clitoral priapism in women), a painful condition in which the penis (or clitoris) remains in an erect position, has been reported in patients receiving trazodone. Priapism occasionally results in permanent impairment of erectile function or impotence. Patients should be warned of the possibility of priapism and told to discontinue the drug at once and consult with their physician if this reaction occurs. Trazodone also may affect ejaculation, orgasm and libido.

If you experience any of the following serious side effects, stop taking trazodone and seek emergency medical attention or contact your doctor immediately: an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); a prolonged (4 hours or longer), painful, or inappropriate erection; or an irregular heartbeat or chest pains. Other, less serious side effects may be more likely to occur. Continue to take trazodone and talk to your doctor if you experience dizziness or drowsiness; headache; insomnia or vivid dreams; dry mouth, upset stomach, nausea, or vomiting; diarrhea or constipation; tremors (shaking); or blurred vision. Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.