image by: PIxorize

HWN Suggests

Should You Take Trazodone for Insomnia?

Though trazodone is rarely used to treat depression alone anymore, it’s widely prescribed off-label at lower doses for treating insomnia. One reason could be because that unlike other insomnia drugs, including Ambien, trazodone isn’t classified by the FDA as a controlled substance (PDF) because there’s little risk of it causing dependency and abuse. As a result, doctors can prescribe trazodone without a limit on how many pills a patient can receive. And perhaps because trazodone is unlikely to cause dependence, the high levels of prescribing suggests that many physicians may believe trazodone is safer than other frequently prescribed sleep medications. But there are no studies that confirm…

read full article

Featured

 Trazodone: The Forgotten Antidepressant

Trazodone is an effective antidepressant whose tolerability is greatly improved with nightly dosing, even in instant-release form. Its novel mechanism of action is a promising avenue for treatment-resistant patients, and its lack of weight gain and sexual side effects is a welcome advantage for others. Daytime somnolence, orthostasis, and drug interactions make it a second- or third-line option.

Articles of Interest

Is Trazodone Effective and Safe for Treating Insomnia?

Trazodone should not be used to treat insomnia. Trazodone decreases the number of nightly awakenings and may slightly improve subjective sleep quality, but it does not significantly improve total sleep time, sleep efficiency (the ratio of time sleeping to time in bed), sleep latency, or waking time after sleep onset.

Mechanism of Action of Trazodone: a Multifunctional Drug

Multifunctional drugs are those with more than one therapeutic mechanism. Trazodone is a multifunctional drug with dose-dependent pharmacologic actions. That is, it has hypnotic actions at low doses due to blockade of 5-HT2A receptors, as well as H1 histamine receptors and α1 adrenergic receptors. Higher doses recruit the blockade of the serotonin transporter (SERT) and turn trazodone into an antidepressant.

Mirtazapine (Remeron®) vs. Trazodone (Desyrel®) Antidepressants for Sleep: How Do They Compare?

Both mirtazapine and trazodone work to increase serotonin levels in the brain and have proven effective for insomnia. Some studies have shown mirtazapine was better tolerated than trazodone by users. Trazodone does have more side effects than mirtazapine, particularly muscle pain and shaking that can make it uncomfortable for some users.

Rediscovering Trazodone for the Treatment of Major Depressive Disorder

Trazodone is a triazolopyridine derivative that belongs to the class of serotonin receptor antagonists and reuptake inhibitors (SARIs). The drug is approved and marketed in several countries worldwide for the treatment of major depressive disorder (MDD) in adult patients. In clinical studies, trazodone has demonstrated comparable antidepressant activity to other drug classes, including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs) and serotonin–noradrenaline (norepinephrine) reuptake inhibitors (SNRIs).

Should Trazodone Be First-Line Therapy for Insomnia? A Clinical Suitability Appraisal

Trazodone is one of the most commonly used prescription medications for insomnia; however, some recent clinical guidelines do not recommend its use for treating insomnia. This clinical appraisal critically reviews the scientific literature on trazodone as a first-line treatment for insomnia, with the focus statement “Trazodone should never be used as a first-line medication for insomnia.”

Side Effects of Trazodone to Be Aware of

The most prominent Trazodone side effect is drowsiness. In fact, the drug is often used off-label to treat insomnia.

Trazodone Antidepressant Review

Trazodone is an atypical antidepressant drug used to treat depression. Side effects of the drug include orthostatic hypotension, sedation, and priapism.

Trazodone for Insomnia: A Systematic Review

The findings in this review show that trazodone is a generally safe therapeutic that has been repeatedly validated as an efficacious treatment for insomnia, particularly for patients with comorbid depression. Trazodone has been effective for insomnia across many different populations. While it is not currently a drug indicated for insomnia, it is among the most common off-label choices for treating insomnia. This review article has found that trazodone can be an effective option when treating insomnia with little to no risk in most cases.

Resources

PharmGKB

Trazodone is a triazolopyridine derivative primarily indicated as an antidepressant, but has also nonspecific sedating properties. Trazodone acts as both a weak serotonin reuptake inhibitor and as an antagonist at serotonin receptor 2A and serotonin receptor...

StatPearls

Trazodone is a medication used in the management and treatment of major depressive disorder. This drug is in the serotonin-antagonist-and-reuptake-inhibitor class of medications; it can be used as a component of combination therapy with other drugs or psychotherapies or as monotherapy for treating depression. Trazodone is an antidepressant that inhibits serotonin transporter and serotonin type 2 receptors; it is a triazolopyridine derivative.