Trazodone  is a medication prescribed by your healthcare provider, selected based on current evidence-based guidelines to best address specific mental health conditions. While effective, it's important to understand that all medications come with potential side effects. As a patient or caregiver, being informed about these risks and benefits is crucial. Equally essential is knowing how to monitor for side effects, and understanding the strategies to reduce their occurrence or manage them effectively. This guide aims to empower you with this knowledge, ensuring a well-informed approach to your or your child's treatment.

What is Trazodone?

Trazodone is an antidepressant by classification and works increasing levels of serotonin in the brain.

When is Trazodone prescribed to Children & Adolescents?

• Insomnia: It can help improve sleep quality without the risk of dependency. 
• It is effective in treating Depression & Anxiety but generally not prescribed due to very high doses required, which can lead to significant side-effects. 

What is the Dose of  Trazodone?

• The dose typically ranges from 25 to 200 mg for insomnia and 100mg to 600 mg for treatment of depression & Anxiety.
• Food delays absorption of trazodone for one to two hours, so it’s best taken at least 1-2 hours after dinner when used for insomnia. 

Medication Guidelines: What you need to know

• Combining Trazodone with certain medications can lead to a dangerous condition called Serotonin Syndrome, caused by excessive serotonin levels in the body. Symptoms include anxiety, agitation, confusion, sweating, rapid heartbeat, high blood pressure, fever, stomach problems, tremors, muscle stiffness, spasms, and heightened reflexes. Over-the-counter agents and supplements such as Dextromethorphan (DXM), St. John's Wort, certain cough and cold medications, over-the-counter migraine medications, 5-HTP, and L-tryptophan can also interact with Trazodone to induce serotonin syndrome. It's vital to consult your primary care provider or psychiatrist before starting any new prescription or over-the-counter medication.
  
  
• Abruptly stopping this medication at higher doses can lead to a discontinuation syndrome, which may cause symptoms like dizziness, chills, lightheadedness, fatigue, headache, muscle aches, nausea, diarrhea, restlessness, irritability and tingling.

What can be the possible

side-effects from the medication?

Serious but Rare Side-Effects

Risk of Increased Suicidal Thoughts with Antidepressants

 

Antidepressant medications can sometimes lead to increased suicidal thoughts or actions, particularly in children, teenagers, and young adults during the early stages of treatment. Research indicates a small but notable elevation in the risk of suicidal thoughts and behaviors among these groups, although these do not typically extend to actual suicide deaths. The current evidence is not definitive in establishing a clear link between antidepressants and these increased risks.

Risk-Benefit Analysis:

Despite these concerns, the advantages of treating depression significantly outweigh the potential risks. It's crucial, however, to vigilantly monitor for this side effect.

Monitoring Guidelines:

Pay careful attention to any shifts in mood, behavior, thoughts, or feelings. This is particularly critical when starting a new antidepressant or adjusting the dosage. Watch for any sudden changes, as these can be indicative of increased risks and may require immediate action.

By closely observing and reporting these changes, the effectiveness and safety of the treatment can be maximized, ensuring the best possible outcome for the patient.

• Switching into Mania (An extreme increase in activity and talking): Antidepressants, when used independently, can induce manic episodes in individuals with bipolar disorder. Furthermore, some instances of bipolar disorder manifest initially as major depressive episodes. It's crucial to communicate your child's psychiatric history and any family history of bipolar disorder to your provider. This information ensures that the provider is vigilant about the potential risk of this side effect.

• QT interval prolongation: Higher doses can cause increase in the QT interval, a measure of time in the heart's electrical cycle. This prolongation can potentially lead to a life-threatening heart rhythm disorder known as torsade de pointes. While the increase in QT interval with trazodone is typically minor and not a concern on its own, it can be significant if you have other heart-related risks. Additionally, it should not be used with other drugs that prolong the QT interval. 

• Priapism: Although rare, there have been reports of painful erections lasting 6 hours or longer associated with Trazodone use. If you experience this symptom, seek immediate medical attention at the nearest emergency room, as it requires urgent intervention. If left untreated, priapism can potentially result in permanent erectile dysfunction.

• Increased Bruising & Bleeding Risk: Fluoxetine may slightly elevate the risk of bleeding, though severe clinical incidents are uncommon. However, this risk increases when fluoxetine is taken alongside medications such as antiplatelet agents, anticoagulants, and NSAIDs, all of which also carry bleeding risks. To mitigate potential interactions between medications, ensure that all healthcare providers are aware of your medication list. This promotes your safety and well-being.

To learn more about this medication please visit MedlinePlus, a official US government website, part of National Library of Medicine and managed by National Institute of Health by clicking HERE