Trazodone: All You Need To Know

One of the downsides of trazodone compared to other types of antidepressants, like selective serotonin reuptake inhibitors, is its dosing regimen . Trazodone must in fact be taken several times a day.

Trazodone is an antidepressant medicine. More specifically,  it belongs to the family of second generation tricyclic antidepressants. As the name suggests, it is very effective in treating depression.

However, trazodone is also indicated for the treatment of other conditions such as insomnia and certain anxiety disorders. It can be given as monotherapy or in combination with other drugs, as directed by the doctor.

It can also be used as a complementary therapy for certain psychiatric disorders, such as manias, Tourette’s syndrome or schizophrenia, although its effectiveness in treating the latter is still being studied.

Ultimately,  anxiolytic, sedative and hypnotic properties have been attributed to this tricyclic antidepressant. Trazodone was first synthesized in 1966 in Italy and was approved by the FDA in 1982.

How does trazodone work on the body?

In addition to being a second generation tricyclic antidepressant, as we have mentioned,  trazodone is classified as an antidepressant which has a dual action  in the body to achieve their therapeutic goal.

Thus,  it exhibits an agonist action on serotonin 5-HT2a receptors  and, at the same time, inhibits the reuptake of this neurotransmitter which plays an important role in depressive clinical settings.

Nevertheless,  the mechanism of this drug is not yet known with certainty  because some authors suggest that the main mechanism of action of trazodone is established presynaptically and involves a serotonin transporter.

Also,  trazodone has no effect on cholinergic receptors,  unlike many antidepressants. It therefore does not trigger the side effects associated with the activation of this type of receptor.

Recommended doses and dosage

One of the disadvantages of trazodone compared to other types of antidepressants, such as selective serotonin reuptake inhibitors, is its dosing regimen. It must indeed be taken several times a day. SSRIs only require a daily intake to trigger their antidepressant action.

This disadvantage is however offset by its price, which is lower than that of SSRIs. Usually,  an initial dose of 150 mg per day is prescribed  and then gradually increased as directed by the doctor.

Side effects of trazodone

Trazodone, like all medicines on the market,  can cause a series of side effects  which are important when you start treatment with this medicine.

Thus,  the most common adverse reactions  with trazodone treatment are:

• Drowsiness:  It is very important not to take this medicine if you are going to operate dangerous machinery or drive a vehicle.
• Dizziness.
• Nausea.
• Headache.

Liver toxicity has also been  reported  in clinical trials with this drug, when administered to patients for prolonged periods of time.

In addition,  there have also been cases of tardive dystonia and late sensory syndrome,  in addition to hyponatremia (low sodium levels) and seizures when a patient overdoses.

Adverse reactions are surely caused by the high doses used when administering this drug. Therefore,  more studies are needed to try to reduce the doses in long-term administrations,  achieving good clinical efficacy and reducing side effects.

Serotonin syndrome

This disorder  occurs when drugs that increase serotonin levels, such as trazodone (tricyclic antidepressants) or other antidepressants, are given in high doses. This syndrome is extremely dangerous because it can lead to the death of the patient. It is therefore essential not to self-medicate or to take a higher dose than that indicated by the doctor.

Serotonin syndrome  is characterized by a series of symptoms such as:

• Changes in mental state:  confusion or agitation.
• Diarrhea.
• Chills.
• Fever.
• Lack of coordination of movements.

These side effects are due to a pharmacodynamic interaction,  which is the result of common actions on the neurotransmission system and competitive pharmacokinetic interactions of cytochrome isoenzymes. In this way, the plasma levels of antidepressants increase dramatically.

Conclusion

Trazodone is a drug that belongs to the family of tricyclic antidepressants. One should be careful with this type of medication and with self-medication. Misuse of trazodone can lead to the death of the person involved. Therefore, always follow your doctor’s directions.