Trazodone For Sleep—Can It Be Abused?

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

April 18, 2019

Trazodone is a prescription antidepressant drug, formerly sold under the brand names Desyrel and Oleptro in the United States.

It is effective as a sleep medication and is used more frequently today for insomnia than for depression. It may also be prescribed to treat anxiety. Though abuse of trazodone is uncommon, some people do misuse it.

Using Trazodone For Sleep

Trazodone part of a drug class called serotonin antagonist and reuptake inhibitors (SARIs) and is specifically known as a serotonin modulator.

This means it disrupts the brain’s regulation of serotonin, a chemical that produces relaxation and a positive mood. Trazodone prevents receptors in the brain from reabsorbing serotonin, allowing an excess of the chemical to be available.

This helps people who are clinically depressed to feel happier and provides relief for those who have trouble falling asleep or staying asleep at night. Unfortunately, these calming effects are what make trazodone a candidate for abuse.

How Is Trazodone Abused?

Doctors typically prescribe trazodone in low doses for insomnia. People who abuse trazodone take it more often or in higher doses than prescribed, take it without a prescription, or take it in ways that are not intended, in order to feel more immediate or intense effects.

Most people abuse trazodone orally, but some crush the pills and snort (insufflate) them. Since trazodone is water-soluble, snorting allows it to be absorbed directly into the bloodstream through nasal blood vessels.

This may cause trazodone to take effect more quickly but is dangerous because it can have unexpected results.

Side Effects Of Trazodone Abuse

Even if a person takes trazodone according to their doctor’s guidelines, they may experience mild to severe side effects. Abusing the drug increases the chances of an adverse reaction.

Possible side effects of trazodone use and abuse are:

• nausea or vomiting
• diarrhea or constipation
• weakness or fatigue
• dizziness
• confusion
• muscle pain or tremors
• numbness (arms, legs, hands, or feet)
• chest pain
• shortness of breath
• a persistent, painful erection
• loss of consciousness
• irregular heart rate
• bruising or bleeding
• seizures

Risks Of Trazodone Abuse

Taking trazodone for sleep in high doses—even at the dose recommended for clinical depression—can cause increased suicidal thoughts and actions in people age 24 and younger.

Too much trazodone can also elevate serotonin to unsafe levels, causing serotonin syndrome, a dangerous condition that can be deadly if untreated.

Symptoms of serotonin syndrome include:

• restlessness
• confusion
• rapid or irregular heartbeat
• high blood pressure
• sweating or shivering
• muscle stiffness
• diarrhea
• headaches
• seizures
• unconsciousness

Though overdosing on trazodone alone is unlikely, it is possible. Common trazodone overdose symptoms are vomiting and drowsiness, while more serious symptoms may be:

• seizures
• rapid heart rate
• difficulty breathing
• a painful, lasting erection (priapism)

Trazodone also increases the effects of central nervous system depressants like alcohol, opioids, and benzodiazepines. Taking trazodone at the same time as these substances can result in severe respiratory depression or death.

Treatment For Trazodone Abuse

Treatment for trazodone abuse may begin with a medically supervised detox program. During detox, medical professionals monitor a person and help to ease withdrawal symptoms that can occur if someone stops taking trazodone suddenly. This may involve tapering the dosage to avoid drastic effects.

After safely ridding their body of trazodone, an individual can enter a treatment program. Many people benefit from inpatient care, which provides a safe, focused environment where people work together toward recovery.

Individualized treatment plans explore the causes and effects of substance abuse and addiction in each person’s life, dealing with the root of the issue to prevent relapse.

Many inpatient programs also treat co-occurring disorders like depression, anxiety, and insomnia. Treatment may include relaxation, coping techniques, exercise, nutrition, and medication management if needed.