Trazodone Addiction: Signs, Symptoms & Side Effects

Last Updated March 28, 2024

It’s no secret that anxiety and depression can be debilitating. Whether mild or severe, mood disorders can affect all aspects of life and make it difficult to carry out daily tasks. Fortunately, thanks to advances in psychotherapy and antidepressant medications like trazodone, there is hope and treatment for people with anxiety and depression.

However, despite these advancements, drugs like trazodone still pose risks for abuse and addiction. Individuals can become psychologically addicted to the medication because they find it difficult to function normally without it. Trazodone also comes with a few uncomfortable withdrawal effects once it’s been discontinued.

Before going into the treatment methods available for trazodone addiction, this article will outline what this medication is and what the long-term effects are.

What Is Trazodone?

Trazodone is a type of antidepressant medication that is used to treat depression, anxiety, sleep disorders, and alcohol dependence. Sold under the brand names Desyrel, Dividose, and Oleptro, trazodone is classed as a selective serotonin reuptake inhibitor (SSRI). Serotonin is responsible for regulating functions such as mood, sleep, and appetite; therefore, SSRIs make this neurotransmitter more readily available in the brain.

While trazodone is known primarily by its brand names, common street names for this drug include:

Trazo
Trazzy
Traz
Trazzer
Sleepeasy

How Does Trazodone Work?

As an SSRI, trazodone creates a greater abundance of serotonin in the body. The result of this increased serotonin is that it can improve energy levels, mood, sleep quality, and appetite, as well as decrease levels of fear, panic, and anxiety. This makes it an effective treatment for mood disorders, anxiety conditions, and sleep disorders.

Trazodone works by blocking the reabsorption of serotonin neurotransmitters by nerve cells and allowing more serotonin to be available in the brain and central nervous system. A higher abundance of serotonin is known to help stabilize moods, which is what makes this medication particularly effective for depression.

Risk Groups

While trazodone can be safely used in most cases, the Food and Drug Administration (FDA) has identified some high-risk groups that are not suited to SSRI medications due to potential health complications.

Children and Teens

Trazodone is currently only approved for children aged 6 to 17 if they have OCD. The reason is that people within this age group have demonstrated an increased risk of overdose and suicidal ideation.

Pregnant Women

In some studies, taking trazodone while pregnant carries an increased risk of hypertension and neonatal withdrawal. Therefore, women who are pregnant or intend to become pregnant are advised not to take this medication.

Individuals With Health Conditions

People with heart issues, glaucoma, or diabetes, are advised not to take trazodone. This is because SSRI medications can speed up heart rate, increase pressure on the eyes, and distort blood sugar levels.

Statistical Overview of Prevalence of Abuse

In 2018, trazodone was the 31st most prescribed medication in the U.S., with more than 22 million prescriptions.
The World Health Organization (WHO) estimates that depression affects around 350 million people worldwide.
According to some estimates, roughly 10% of Americans take or use antidepressants.
More than 60% of Americans are reported to take antidepressants for two years or longer.
The National Health and Nutrition Examination Survey reports that between 2015 – 2018, 13.2% of adults used antidepressants in the past 30 days.
In the same survey, antidepressant use was higher among women (17.7%) than men (8.4%).

The History of Trazodone

Trazodone was first synthesized in Italy in the 1960s by Angelini Research Laboratories. As a second-generation antidepressant, trazodone was developed according to the mental pain hypothesis, which suggests that major depression is linked with a decreased pain threshold.

While the drug showed promise in terms of blocking the reuptake of serotonin, trazodone developed a negative reputation due to its sedating properties and strange side effects. However, despite these downsides, trazodone was marketed and patented in countries around the world. In 1981, it became the first non-tricyclic or monoamine oxidase inhibitors (MAOI) antidepressant in the U.S. to be approved by the FDA.

Is Trazodone Addictive?

Antidepressants were originally designed to be a short-term treatment for mood disorders, taken for about 6 to 9 months. However, according to some estimates, over 15 million Americans in 2018 were taking antidepressants for at least five years. This extended use can lead to stronger addiction along with worsened withdrawal effects.

In physical terms, the brain becomes accustomed to the way antidepressants like trazodone alter serotonin levels in the brain, especially over the long term. When the brain chemistry is disrupted by discontinuing the drug, people can experience withdrawal effects such as rebound depression, suicidal thoughts, chills, fatigue, dizziness, and more. It is these uncomfortable withdrawal symptoms that can prompt people to continue the drug for many years.

Trazodone Addiction vs. Dependence

It’s worth noting that there is a difference between trazodone dependence and addiction. Dependence is a state of adaptation in the body that is caused by regular use of the drug. In this state, the individual isn’t mentally attached or obsessed with the drug. However, withdrawal symptoms can occur following abrupt discontinuation, and medical support may be required to help taper them off the drug.

When an individual is addicted to trazodone, though, it is considered a primary, chronic disease that is characterized by cravings, compulsive use, and continued use despite the negative consequences. People who have an addiction are largely unable to function without the drug and will go to extreme lengths to keep using it.

Who Abuses Trazodone?

Like most antidepressants, individuals who are prescribed trazodone by their doctor can be at risk of abusing it. This risk increases among individuals who abuse drugs for non-medical purposes or who regularly take multiple medications at once.

Whether due to non-supervised prescription drug-taking or deliberate misuse for recreational purposes, combining trazodone with substances like alcohol, stimulants, or other illicit drugs can lead to dangerous consequences. Therefore, individuals with a history of substance abuse or medication misuse should be taking trazodone under careful supervision.

Methods of Use

Trazodone is taken orally in tablet form and is available in dosages ranging from 25 mg to 300 mg. An average dose typically starts at 150 mg per day and can then be increased in 50 mg increments where needed. The pills are often white with different shapes denoting the dosages:

50 mg tablet: white, round, compressed tablet. Contains “PLIVA 433” on one side, with a score on the other side.
100 mg tablet: white, round, compressed tablet. Contains “PLIVA 434” on one side, with a score on the other side.
150 mg tablet: white, oval, beveled-edge tablet. Contains “PLIVA” bisect “441” and a score on one side, with “50” engraved in three scored sections on the other side.

For patients who take trazodone for sleep, the effects are typically felt within 30 minutes, depending on the dose. Patients who are taking it as an antidepressant may not experience any noticeable symptoms for 1 to 2 weeks — possibly up to 4 weeks.

Physical and Neurological Effects of Trazodone

Like other SSRIs, trazodone affects brain chemicals that regulate mood, energy, and sleep. This drug is also not typically abused on its own to get high. Some of the effects that a person may experience while taking trazodone include:

Increased energy
Improved appetite
Better quality sleep
Improved mood
Reduced anxieties and fears

Potential Side Effects

There is also the potential for a range of uncomfortable (and sometimes severe) side effects with trazodone, especially during the first few weeks while the body adjusts. The most common effects include:

Blurred vision
Drowsiness, dizziness, or tiredness
Sweating
Swelling
Weight loss
Stuffy nose

Less common side effects include:

Dry mouth
Diarrhea or constipation
Sexual dysfunction
Priapism (painful and persistent erection of the penis or the clitoris)
Cardiac arrhythmia

Serious side effects require immediate medical attention and include:

Skin rashes
Fast or pounding heartbeat
Shortness of breath
Sudden dizziness (feeling like passing out)
Slow heart rate
Easy bruising or unusual bleeding
Chest pain
Seizures
Low sodium levels in the body

Suicide

One of the most serious potential side effects of trazodone is that it can produce suicidal thoughts in children and young adults. A black box warning has been issued from the FDA for trazodone for this very reason. Therefore, if you are taking trazodone, it’s important that you are doing so under medical supervision so that doctors can monitor you for any sudden changes in mood or behavior.

Common Trazodone Combinations

While trazodone is not often used to get high, some people mix this medication with other substances either by accident or deliberately. In some cases, these combinations can be dangerous or fatal. Some of the most common combinations include:

Alcohol

Alcohol is the most common substance that is combined with drugs. Due to the widespread availability of alcohol and its role in our social lives, it can easily be mixed with medications and other substances. However, it can be dangerous to drink alcohol when taking antidepressants like trazodone.

The reason is that alcohol and trazodone both cause sedation, and combining them can cause increased levels of intoxication. A person may experience a worsening of symptoms or side effects such as dizziness or extreme drowsiness.

Also, when a person is drinking, they may not realize how intoxicated they are, which means they can accidentally take too much of either substance. Trazodone can also enhance the effects of alcohol and lead to other secondary effects such as accidents and falls.

Alcohol is also a depressant and can worsen anxiety or depression, leading to an increased risk of suicidal thoughts. Therefore, if you are taking trazodone to help with these conditions, it is best to avoid alcohol.

Cocaine

Cocaine is another substance that is dangerous to mix with medications like trazodone. While it may seem harmless because these drugs perform different functions, cocaine causes the brain to release serotonin, while trazodone allows more of this neurotransmitter to be available.

Therefore, combining these two substances can quickly result in an over-abundance of serotonin, leading to a dangerous condition known as “serotonin syndrome”. In this state, the brain and body receive more serotonin than they can handle.

Cannabis

Like alcohol, cannabis can enhance the sedating effects of trazodone. It can also increase other side effects such as dizziness, confusion, drowsiness, and difficulty concentrating. Elderly people who mix cannabis and trazodone may also experience thinking and judgment impairment, as well as a loss of motor coordination. Cannabis can also worsen or enhance anxiety, which is dangerous for people who are taking trazodone for anxiety issues.

Negative Health Consequences

Using trazodone for a long period can damage a person’s physical and mental health over time. Some of the potential issues include:

Short-term memory problems
Issues with verbal learning
A disruption to a person’s equilibrium or balance
Muscle endurance problems

Serotonin Syndrome

Another potential health consequence of antidepressants like trazodone is the risk of serotonin syndrome. If patients are taking more than one antidepressant or other drugs that encourage serotonin production, this can lead to an over-abundance of this neurochemical.

Clinical symptoms of serotonin syndrome can be seen within two hours—or up to 24 hours—after taking a higher dose or adding another serotonin-related drug. Symptoms of serotonin syndrome consist of:

Tremors
Muscle aches
Sweating
Anxiety
Confusion
Tachycardia
Delirium
Hallucinations
Seizures
Renal failure
Vomiting
Seizures
Fever
Diarrhea
Coma
Death

Overdose

Another risk associated with trazodone use is a potential overdose. Key signs and symptoms of an overdose include:

Agitation or restlessness
Twitching muscles
Confusion
Rapid heart rate and high blood pressure
Diarrhea
Shivering and goosebumps

Signs & Symptoms of Trazodone Addiction

Trazodone can be physically and psychologically addicting, especially if it is used for sustained periods. Some of the signs of trazodone addiction also apply to other prescription drug dependencies, and they include:

Finding ways to get trazodone without a prescription.
Taking more trazodone than is prescribed.
Using trazodone in ways that are not consistent with prescribed use (e.g., snorting it or combining it with other drugs).
Spending enormous amounts of time attempting to acquire trazodone, either illegally or by prescription.
Continuing to use trazodone even after experiencing negative consequences (e.g., loss of job, relationships ending, failing classes).
Neglecting other areas of life such as work, school, social life, and family.
Ongoing health issues due to trazodone use.
Engaging in risky or dangerous behavior.
Using trazodone for other reasons than its intended use (e.g., to get high by combining it with other drugs or as a crutch to get through daily life).
Showing signs of tolerance and withdrawal symptoms when not taking trazodone. This can include increased anxiety, depression, nausea, dizziness, etc.

Other Abuse Signs

Aside from the signs above, there are other behaviors to watch out for if you suspect someone has a trazodone addiction.

“Doctor Shopping”

One of the most common signs of addiction or abuse with prescription drugs is “doctor shopping.” Because doctors only prescribe a set amount of trazodone at one time, people who are addicted will resort to finding multiple doctors to obtain more than one prescription. Doctor shopping is often a more extreme sign of addiction as the person is at the stage where they are not only consuming more than prescribed, but they’re also taking desperate measures to acquire it. As part of this activity, individuals will even travel great distances to different pharmacies to remain undetected.

Mood Swings

Because trazodone influences moods, some people may experience mood swings if they’re abusing the drug. This is especially the case if they’re taking multiple drugs and medications at once (poly-drug use). If you or someone you know is experiencing frequent mood swings and you know that they regularly use trazodone, it can be a sign of addiction.

Financial Problems

Like many addictions, excessive use of a substance or behavior can eventually lead to financial problems. Individuals may go into debt because they are buying so many trazodone prescriptions at once. This can lead to issues such as struggling to pay rent and bills. Also, long-term drug use may cause a person to lose their jobs or get kicked out of school, resulting in a downward spiral of substance abuse and financial problems.

Resources

If you or a loved one are struggling with trazodone abuse or addiction, you are not alone. Treatment and support are readily available. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment.

You can also find a list of treatment centers near you on our website to help get you on the path to recovery.

Key Sources

Centers for Disease Control and Prevention (CDC). (2020). Antidepressant Use Among Adults: United States, 2015-2018. https://www.cdc.gov/nchs/products/databriefs/db377.htm.

Drugs.com. (n.d.). Trazodone. https://www.drugs.com/pro/trazodone.html.

Edlund, M. (2017). Is Trazodone the New Brain Wonder Drug? https://www.psychologytoday.com/us/blog/the-power-rest/201704/is-trazodone-the-new-brain-wonder-drug.

Help.org. (n.d.). Trazodone Addiction, Abuse, and Symptoms. https://www.help.org/trazodone-addiction.

Medical Disclaimer

At RehabAid.com, we are dedicated to helping people recover from problematic substance use and associated mental health disorders. If you or a loved one are struggling with addiction to drugs or alcohol, you are not alone. Information on treatment and support options is readily available through the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357. To further assist you along the path to recovery, the treatment center locator on our website allows you to easily find rehabilitation programs and services in your local area.

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