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What is Trazodone?

Trazodone is an FDA-approved prescription medication initially used to treat depression, though it has become more commonly administered as a sleep aid. In addition to treating major depressive disorder, anxiety disorders, and insomnia, it is sometimes used to treat alcohol dependence.

This medication works by acting on the brain and central nervous system (CNS), particularly affecting the neurotransmitter serotonin. This neurotransmitter is essential in helping brain cells communicate with each other. 

Serotonin levels affect behavior, including thoughts and mood, as well as sleep. Trazodone causes feelings of relaxation, tiredness, and sleepiness by blocking chemicals in the brain that interact with serotonin. This is why trazodone has been prescribed as a reliable sleep aid even though its initial intent was not sleep-related.

Trazodone may also help improve mood, stimulate appetite, and increase energy, in addition to decreasing anxiety and depression-related insomnia.

The medication is taken by mouth and is only available with a prescription. Due to its powerful sleep-aid properties, trazodone is often used and taken without doctors or healthcare professionals' consent.

Side Effects of Trazodone

Common side effects of trazodone include:

  • Tiredness
  • Dizziness
  • Fatigue
  • Nervousness
  • Dry mouth
  • Changes in weight
  • Confusion
  • Lack of coordination
  • Fatigue
  • Nausea
  • Headache
  • Constipation
  • Blurred vision

In addition to the common side effects listed above, there are more severe side effects of taking trazodone. Though they are rare, it is still essential to be aware of these adverse reactions.

Call for emergency medical assistance if any of the following symptoms occur after taking trazodone, as some of them could potentially be life-threatening:

  • Thoughts of suicide
  • Cardiac arrhythmias (changes in heart rhythm) 
  • Priapism
  • Hypotension (low blood pressure, which could lead to fainting)
  • Mania
  • Hyponatremia (blood sodium imbalance)
  • Weakness
  • Unsteadiness
  • Seizures

Taking trazodone can also lead to developing serotonin syndrome. This happens when an abundance of serotonin builds up in the body because it is unable to bind to the proper receptors. 

Serotonin syndrome can lead to severe reactions, though the chances of developing these are higher when taking other medications. 

Symptoms to watch for with serotonin syndrome include:

  • Hallucinations
  • Agitation
  • Dizziness
  • Seizures
  • Rapid heart rate
  • Increased body temperature
  • Headaches
  • Tremors
  • Problems with balance
  • Diarrhea
  • Nausea and vomiting
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What is the Proper Way to Take Trazodone?

Trazodone should only be taken with a prescription. It is commonly prescribed to treat anxiety and depression, or as a sleep aid on the advice of a doctor or licensed healthcare provider.

Although Trazodone is not addictive, it can still be misused based on the effects it provides. In comparison to commonly misused prescription narcotics, such as benzodiazepines or opioids, trazodone is much less harmful. 

However, this does not mean it cannot be harmful if not taken properly. This is especially true if you mix trazodone with other substances, particularly alcohol. 

What to Know About Mixing Trazodone and Alcohol

Mixing trazodone with alcohol can cause severe problems. It can increase the level of intoxication, leading to extreme drowsiness or even a possible overdose. Consuming these two substances in excessive amounts can also lead to death. 

Using trazodone and alcohol together for an extended period can cause physical dependence, resulting in withdrawal symptoms when stopping use of either substance.

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Side Effects of Mixing Trazodone and Alcohol

Mixing alcohol and trazodone can cause severe side effects that mainly affect the nervous system. 

These side effects are typically more pronounced than the common side effects that would be caused by taking either substance individually, and they can quickly become more serious. It is also much more common to develop side effects from mixing these substances. 

Common adverse effects that can occur from mixing trazodone and alcohol include:

  • Delayed reaction time
  • Compromised motor skills
  • Extreme drowsiness
  • Extreme dizziness
  • Loss of consciousness
  • Impaired decision making
  • Drastic mood swings
  • Increased depression or anxiety

Consequences of Mixing Trazodone and Alcohol

Mixing alcohol with any type of antidepressant medication, including trazodone, can be potentially fatal. Even if the consequences are not as severe as death, there is still a risk of developing CNS complications. This is because both alcohol and trazodone are CNS depressants.

Since the nervous system is responsible for so much of what the body does, from thinking to moving, negative impacts on the CNS can have serious consequences. 

Alcohol itself can cause depression and decrease the effectiveness of trazodone (if the goal of taking it is to treat depression). Mixing trazodone and alcohol can also lead to suicidal thoughts and actions.

Is Mixing Trazodone and Alcohol Deadly?

Yes, mixing trazodone and alcohol can be deadly. However, it is much less likely to be fatal compared to mixing alcohol with other medications, such as benzodiazepines and opioids. 

While it is possible to overdose on trazodone or alcohol individually, the risk is much higher when taken together. This risk is further increased if other CNS depressants are also taken with trazodone or alcohol.

Any drug overdose can be fatal. Call for emergency assistance and seek immediate medical attention if you suspect a trazodone overdose is occurring.

Symptoms of Trazodone and Alcohol Overdose

The symptoms of trazodone and alcohol overdose are similar to overdosing on either individually. These include:

  • Drowsiness
  • Seizures
  • Vomiting
  • Irregular heart rhythm
  • Slowed or stopped breathing

While trazodone and alcohol should never be actively combined, trazodone is helpful for treating alcohol withdrawal symptoms. In fact, it tends to be a safer, less addictive option than other alcohol addiction treatment options such as benzodiazepines.

Treatment for Trazodone and Alcohol Addiction 

Treatment for trazodone and alcohol misuse should be done simultaneously. Given the strain that consumption of both drugs puts on the central nervous system, treatment should be multifaceted and tailored to each person. 

Additionally, it should always be completed under a medical professional’s supervision. Physical alcohol dependence is often treated with medical detox followed by group therapy, such as a 12-step program or another form of psychological counseling. 

Ironically, trazodone is one of the drugs used to treat alcohol withdrawal symptoms, so it might be the case that someone suffering from alcohol and trazodone addiction would stay on trazodone while dealing with alcohol withdrawal symptoms. However, this should be decided by licensed healthcare professionals, not the patient. 

Treatment for trazodone addiction itself is typically less intense as it is a less physically addictive substance than alcohol.   

Regardless of which substance is being used, the behavioral and emotional aspects of addiction are typically best treated with behavioral therapies, group therapies, and individual counseling sessions. 

These treatments address the psychological issues underlying addiction. They also tend to help improve coping mechanisms and overall mental health, which can lead to higher chances of a successful recovery. 

There are many treatment options available if you or a loved one is struggling with trazodone and alcohol addiction. Speak to a medical or healthcare professional to find help.

Resources

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Shin JJ, Saadabadi A. Trazodone. [Updated 2020 May 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470560/

Jaffer, K. Y., Chang, T., Vanle, B., Dang, J., Steiner, A. J., Loera, N., Abdelmesseh, M., Danovitch, I., & Ishak, W. W. (2017). Trazodone for Insomnia: A Systematic Review. Innovations in clinical neuroscience, 14(7-8), 24–34. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842888/

Bryant SG, Ereshefsky L. Antidepressant properties of trazodone. Clin Pharm. 1982 Sep-Oct;1(5):406-17. PMID: 6764164 https://pubmed.ncbi.nlm.nih.gov/6764164/

Generali, J. A., & Cada, D. J. (2015). Trazodone: Insomnia (Adults). Hospital pharmacy, 50(5), 367–369. https://doi.org/10.1310/hpj5005-367

Haria M, Fitton A, McTavish D. Trazodone. A review of its pharmacology, therapeutic use in depression and therapeutic potential in other disorders. Drugs Aging. 1994 Apr;4(4):331-55. doi: 10.2165/00002512-199404040-00006. PMID: 8019056. https://pubmed.ncbi.nlm.nih.gov/8019056/

Roth, A. J., McCall, W. V., & Liguori, A. (2011). Cognitive, psychomotor and polysomnographic effects of trazodone in primary insomniacs. Journal of sleep research, 20(4), 552–558. https://doi.org/10.1111/j.1365-2869.2011.00928.x 

Borras L, de Timary P, Constant EL, Huguelet P, Eytan A. Successful treatment of alcohol withdrawal with trazodone. Pharmacopsychiatry. 2006 Nov;39(6):232. doi: 10.1055/s-2006-951385. PMID: 17124647. https://pubmed.ncbi.nlm.nih.gov/17124647/

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