Trazodone (Desyrel)

Ease symptoms of insomnia with trazodone

Trazodone is an antidepressant often prescribed to treat the symptoms of insomnia - a common sleep disorder that makes it difficult to sleep, stay asleep, or get good quality sleep.

Trazodone (Desyrel)
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Reviewed by Dr Roy Kedem, MD

Information last reviewed 03/26/21


What is trazodone?

Trazodone is an FDA-approved medication that can be used to relieve the symptoms of insomnia, a common sleep disorder that makes it difficult to sleep, stay asleep, or get good quality sleep. It is in a class of medications called SSRIs (selective serotonin reuptake inhibitors). Trazodone is available by prescription only. 

What is trazodone used for?

Although typically used to treat major depressive disorder (MDD), trazodone is also commonly used as an off-label treatment for insomnia. 

What does trazodone do?

Trazodone increases serotonin levels in the brain. Serotonin is a chemical that helps regulate sleep and mood. Increasing serotonin levels can therefore help you feel relaxed, tired, and sleepy. 

How long does trazodone last?

The effects of trazodone can last from 3-6 hours. It is fast-acting, and its sedative effects set in within 30 minutes of ingestion.

How long does trazodone stay in your system?

In healthy adults, trazodone will be out of your system in approximately one to three days. The dose and frequency of the medication taken, will affect how long the medication stays in your body.

Who should avoid taking trazodone

Trazodone should not be taken by individuals that are allergic to trazodone or any other ingredients in this medication or individuals with a history of QT prolongation or cardiac arrhythmias. It is also not recommended for individuals taking sildenafil or any other SSRIs or MAOIs. It is important to speak with your doctor about all medications you are taking to avoid dangerous interactions.

Does trazodone cause weight gain?

Trazodone, like many antidepressants, has the potential to cause weight gain. Researchers do not yet fully understand why this occurs, but they believe that the medication affects both appetite and metabolism. 


Active Ingredients

The active ingredient in trazodone is trazodone hydrochloride at a concentration of 50mg, 100mg, 150mg, or 300mg.

Inactive Ingredients

The inactive ingredients of trazodone may vary between generic brands of the medication. The branded version of trazodone is Desyrel and is manufactured by Pragma Pharmaceuticals. The 50mg and 100mg tablets contain the following inactive ingredients: corn starch, dibasic calcium phosphate, hypromellose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol, povidone, sodium starch glycolate, and triacetin.


Trazodone dosage

As a sleep aid, trazodone is most often prescribed at doses between 25mg to 100mg. Studies have shown that lower dosages of trazodone are effective and may cause less daytime drowsiness and side effects.

Side Effects

Trazodone side effects

Common side effects of trazodone include:

  • Feeling dizzy, tired, or weak
  • Constipation, diarrhea, vomiting, or upset stomach
  • Dry mouth
  • Headache
  • Feeling nervous
  • Shakiness
  • Muscle pain
  • Stuffy nose
  • Weight gain or loss

If any of these side effects persist or cause discomfort, talk to your physician.

Seek medical attention right away if you experience any of the following serious side effects:

  • Thoughts of suicide
  • Fast or abnormal heartbeat
  • Swelling
  • Feeling confused
  • Painful erection that lasts for more than 4 hours
  • Signs of serotonin syndrome: 
    • Agitation, change in balance, confusion, hallucinations, fever, fast or abnormal heartbeat, flushing, muscle twitching or stiffness, seizures, shivering or shaking, profuse sweating, severe diarrhea, upset stomach, vomiting, or very bad headache
  • Signs of an allergic reaction: 
    • Rash, hives, itching, red, swollen, blistered, or peeling skin with or without fever, wheezing, tightness in the chest or throat, trouble breathing, swallowing or talking, unusual hoarseness or swelling of the mouth, face, lips, tongue or throat
  • Signs of low sodium levels:
    • Headache, trouble focusing, memory problems, feeling confused, weakness, seizures or change in balance
  • Signs of bleeding:
    • Throwing up or coughing up blood, vomit that looks like coffee grounds, blood in the urine, black, red, or tarry stools, bleeding from the gums, abnormal vaginal bleeding, bruises without a cause or that get bigger, or bleeding you cannot stop
  • Signs of high or low blood pressure: 
    • Very bad headache or dizziness, passing out, or change in eyesight

Treatment Options

What are some prescription medications that treat insomnia?

Treatment Type How it works Efficacy for insomnia treatment
Hydroxyzine (Vistaril) Antihistamine Blocks the uptake of histamine and decreases the activity of the central nervous system Good for treatment of short-term insomnia (maximum of 4 months)
Zolpidem (Ambien) Sedative Activates GABA (a neurotransmitter) which slows down the central nervous system Good only for short-term insomnia because it can become habit-forming
Trazodone (Desyrel) SSRI Inhibits the reuptake of serotonin causing levels of serotonin to rise Good for the treatment of chronic insomnia because it is safe to take long-term
Diazepam (Valium) Benzodiazepine Activates GABA (a neurotransmitter) which slows down the central nervous system Good only for short-term insomnia because it can become habit-forming


Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.

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