Trazodone (Desyrel)

Basic Instructions

· Take 25mg at bedtime if necessary – (only take if after about ½ hour you are unable to fall asleep)

· Take with food

· If you wake in the middle of the night and have difficulty falling back asleep you can take another 25mg (max 50mg)

· Common side effects tend to go away within 1-2 weeks after starting or after each dose increase, as your body adjusts to the medicine

· Monitor your blood pressure before starting and twice a month thereafter.

Mayoclinic.org

Side effects and cautions

Most side effects may go away after the first few weeks of treatment, but talk to your doctor if any side effects are too troublesome for you.

Side effects of Trazodone may include, among others:

· Blurred vision

· Confusion

· Dizziness

· A feeling of dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

· Lightheadedness

· Sweating

· Unusual tiredness or weakness

· Dry Mouth (Use sugarless gum or candy, melt bits of ice in your mouth, or use a saliva substitute)

Taking your medication with food may reduce the risk of nausea. Also, as long as your medication doesn't keep you from sleeping, you can reduce the impact of nausea by taking it at bedtime.

Read the package insert for additional side effects, and talk to your doctor or pharmacist if you have questions.

Safety concerns

Here are some examples of safety issues to be considered with Trazodone:

· Antidepressants and pregnancy. Some antidepressants may harm your child if you take them during pregnancy or while you're breast-feeding. Paroxetine (Paxil, Pexeva) in particular appears to increase the risk of birth defects, including heart and lung problems. If you're taking an antidepressant and you're considering getting pregnant, talk to your doctor or mental health provider about the possible dangers. Don't stop taking your medication without contacting your doctor first.

· Drug interactions. When taking an antidepressant, be sure to tell your doctor about any other medications or dietary supplements you're taking. Some antidepressants can cause dangerous reactions when combined with certain medications or herbal remedies.

· Serotonin syndrome. Rarely, an SSRI can cause dangerously high levels of serotonin. This is known as serotonin syndrome. It occurs when two medications that raise serotonin are combined. These include other antidepressants, certain pain or headache medications, and the herbal supplement St. John's wort. Signs and symptoms of serotonin syndrome include anxiety, agitation, sweating, confusion, tremors, restlessness, lack of coordination and rapid heart rate. Seek immediate medical attention if you have any of these signs or symptoms.

· Changes in Heart Rhythm. Contact your doctor right away if you have any changes in your heart rhythm such as feeling dizzy or faint, or having a fast, pounding, or uneven heartbeat. These could be symptoms of a heart problem called QT prolongation.

· Difficulty concentrating and increased drowsiness. Make sure you know how you react to Trazadone before you drive, use machines, or do anything else that could be dangerous if you are not alert or well-coordinated.

· Postural Hypotension. This is a type of low blood pressure that happens when you stand up from sitting or lying down. It can make you feel dizzy or lightheaded, and maybe even faint. You will need to measure your blood pressure before starting this medicine and while you are using it. If you notice any change to your blood pressure since starting the medication, call your doctor right away. If you have questions about this, talk to your doctor. This is most common to happen the first week of therapy and with dose increases.

· Prior to Surgery. Before having any kind of surgery, dental treatment, or emergency treatment, tell the medical doctor or dentist in charge that you are using this medicine. Taking trazadone together with anesthetic medicines (numbing medicines) that are used during surgery, dental treatments, or emergency treatments may cause an increase in CNS depressant effects.

Suicide risk and antidepressants

Most antidepressants are generally safe, but the FDA requires that all antidepressants carry black box warnings, the strictest warnings for prescriptions. In some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed.

Anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior. If you or someone you know has suicidal thoughts when taking an antidepressant, immediately contact your doctor or get emergency help.

Keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood.

Stopping treatment

Stopping treatment abruptly or missing several doses can cause withdrawal-like symptoms. This is sometimes called discontinuation syndrome. Work with your doctor to gradually and safely decrease your dose.

Withdrawal-like symptoms can include:

· Nausea

· Anxiety

· Irritability

· Dizziness

· Lethargy

· Flu-like symptoms

· Difficulty sleeping

Finding the right antidepressant

Each person may react differently to a particular antidepressant and may be more susceptible to certain side effects. Because of this, one antidepressant may work better for you than another, or your doctor may prescribe a combination.

When choosing an antidepressant, your doctor will take into account your particular symptoms, what health problems you have, what other medications you take, what has worked for you in the past and what has worked for a close relative with depression.

Inherited traits play a role in how antidepressants affect you. In some cases, where available, results of special blood tests may offer clues about how your body may respond to a particular antidepressant. The study of how genes affect a person's response to drugs is called pharmacogenomics. However, other variables besides genetics can affect your response to medication.

Typically, it may take several weeks or longer before an antidepressant is fully effective and for initial side effects to ease up. You may need to try several dose adjustments or different antidepressants before you find the right one, but hang in there. With patience, you and your doctor can find a medication that works well for you.