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Taking Trazodone for Sleep—An In-Depth Guide

Taking Trazodone for Sleep—An In-Depth Guide

If you’re struggling with sleeplessness, you’re not alone. Statistics show that approximately 50–70 million adults in the U.S. are grappling with insomnia. The good news is that with expert guidance, sleep medication can provide relief from sleepless nights.

For instance, your doctor may recommend trazodone—an antidepressant that can be helpful in treating insomnia, especially when taken in lower doses. Learn about this drug’s mechanism of action, onset, effects, and guidelines for safe usage in this trazodone for sleep guide.

What Is Trazodone for Sleep?

Trazodone is an antidepressant belonging to the class of medicines known as serotonin modulators. It was approved for sale in the U.S. in 1981 and is primarily used in treating major depressive disorders.

Trazodone’s active component is trazodone hydrochloride, which shares several properties with serotonin reuptake inhibitors. This drug also balances the levels of natural chemicals that affect the sleep-wake cycle, such as:

  • Serotonin
  • Acetylcholine
  • Dopamine
  • Noradrenaline
  • Histamine

Because of that, trazodone can exert sedative effects when administered in lower doses. Sleep medicine specialists typically prescribe this drug off-label to patients grappling with insomnia, especially in the short term.

How Does Trazodone Help You Sleep?

Trazodone can affect several hormones and neurotransmitters in the body. When administered, this medicine blocks the chemicals in the brain that interact with three specific neurotransmitters:

  1. 5-HT2A
  2. H1 histamine receptors
  3. Alpha1 adrenergic receptors

The medicine raises serotonin and noradrenaline levels in the central nervous system, making you feel better. This action induces a state of relaxation and drowsiness, promoting sleep.

Trazodone for Sleep—Dosage

Source: keli Santos

Trazodone comes in three forms:

  1. Tablet
  2. Capsule
  3. Liquid

Check out a detailed breakdown of the available doses for each form in the table below:


Available doses

Tablet (regular and extended-release)

  1. 50 mg

  2. 100 mg

  3. 150 mg–regular and extended-release

  4. 300 mg–extended-release only


  1. 50 mg

  2. 100 mg


  1. 10 mg

  2. 20 mg

The regular tablet form is the most common way to take trazodone for insomnia, but your doctor may prescribe extended-release tablets or capsules depending on your medical history and sleep issues. The typical starting dose for adults with insomnia is 25mg, but this can be increased up to 100 mg as needed.

The dosage is generally lower for people over 65, individuals with other medical conditions, and patients taking other drugs to reduce the risk of unwanted reactions. You should only take the prescribed dose and follow your doctor’s instructions to minimize the risk of overdosing or experiencing the drug’s side effects.

How To Take Trazodone for Sleep?

The appropriate way to take trazodone for sleeplessness depends on the specific type of sleep problem you have. If you have sleep-onset insomnia, you should take this medicine 1–2 hours before bedtime.

If you have sleep maintenance insomnia, take this drug at least 30 minutes before going to bed.

In both cases, you should allocate seven hours of sleep for trazodone to work effectively. The drug will wear off during that time, reducing the risk of next-day drowsiness.

If you feel lightheaded after waking up, you should avoid activities that require intense focus, such as driving and operating heavy machinery, until the feeling subsides.

How Long Does It Take for Trazodone To Work for Sleep?

Trazodone typically kicks in within 30 minutes. Food delays the onset of this medicine, so you should expect it to start working after 1–2 hours if you take it with a meal. The drug reaches peak concentration in the blood about 1–2 hours after administration, and the effects typically last 5–9 hours.

This information is general—the onset and duration of trazodone effects will vary depending on your medical history and other substances you may be taking alongside this medicine.

How Long Does Trazodone Stay in Your System?

Source: RDNE Stock project

How long trazodone stays in your system can vary depending on several factors, including:

  • Age
  • Metabolism
  • Health history
  • Weight
  • The amount of the drug taken
  • How long you’ve been using the drug

This medicine has a half-life of around 5–13 hours. Half-life is the period the body needs to metabolize 50% of a substance ingested at a specific time. On average, your body eliminates trazodone after 5.5 half-lives, so it takes 2–3 days for this drug to leave your system.

Who Can Take Trazodone?

Trazodone can be taken by most adults (18+) grappling with major depressive disorders. Due to its sedative properties, it can help individuals struggling with insomnia or anxiety.

Some studies suggest that trazodone can be effective in managing the symptoms of post-traumatic stress disorder (PTSD) and Alzheimer's disease, so patients with these conditions can also use this medicine under the guidance of their healthcare providers.

How Can You Get Trazodone?

Trazodone is only available with your doctor’s prescription. While the drug isn’t listed in the DEA’s schedule of controlled substances, it can interact with certain substances and medical conditions, making it unsuitable for some patients.

Before prescribing this medication, your doctor will evaluate your medical history and the medications you’ve been taking to determine whether it’s safe for you.

Is Trazodone Effective for Sleep?

According to clinical studies, trazodone is effective in treating sleep disorders 95.5% of the time. This drug can be prescribed to both depressed and non-depressed patients grappling with secondary insomnia.

Since insomnia is a complex condition, the most effective treatment should combine gentle medications with healthy sleep hygiene for lasting relief. A sleep medicine specialist can design a safe and effective plan tailored to your health history and sleep problems. However, considering the shortage of sleep specialists in the U.S., getting an appointment with an expert can be challenging and time-consuming.

The excellent news is that telemedicine clinics can help you consult sleep experts almost instantly. Kick, an online performance medicine clinic, has a groundbreaking sleep program that connects you with sleep doctors from the comfort of your home.

Source: SHVETS Production 

Kick—Instant Relief for Occasional Sleeplessness

Kick’s sleep program entails a personalized approach, ensuring your treatment is tailored to your medical history and underlying factors contributing to your sleeplessness. Our program combines cognitive behavioral therapy for insomnia (CBT-i) and gentle prescription medications, helping you get lasting results. Our medications include:

  1. Trazodone
  2. Cyclobenzaprine
  3. Doxepin
  4. Gabapentin
  5. Ramelteon
  6. Hydroxyzine

The drugs are fast-acting, providing instant relief from sleeplessness. Your doctor will prescribe two trial medications you’ll take during the first two weeks and rotate them to reduce the risk of dependence.

If the initial approach doesn’t yield satisfying results, your doctor will adjust the treatment. Our expert will also offer tips on good sleep hygiene, helping you address any behavioral and environmental factors contributing to your sleeplessness.

How Kick Works

To get started with Kick, follow these three easy steps:

  1. Go to our signup page to start your 15-minute sleep visit
  2. Fill out the intake form to help us understand your health and sleep history
  3. Choose between home delivery and local pharmacy pickup for receiving your medication

If our team decides Kick isn’t the best solution for your sleep issue, you won’t pay for the initial consultation, according to our Doctor Guarantee. Our unique approach has proven effective, as evidenced by numerous positive reviews on Trustpilot. Join our program today and experience the benefits first-hand!

Source: Ketut Subiyanto

Is Trazodone for Sleep Addictive?

There’s little information to claim that trazodone carries the risk of physical addiction. According to a study on the abuse potential of Ambien, Halcion, and trazodone in humans, trazodone has the least potential for abuse. Psychological addiction can’t be ruled out—some patients may develop dependence, especially after taking this medicine for a long time.

Signs of trazodone dependence may include:

  • An urge to take the drug more frequently
  • Inability to stop taking the medication after treatment discontinuation
  • Unusual dreams or thoughts
  • Irregular sleep patterns
  • Out-of-character behavior
  • Neglect of personal or professional responsibilities
  • Noticeable mood swings

Patients who experience the signs of trazodone dependence should seek immediate medical attention.

What Are the Side Effects of Trazodone?

Source: Vika Glitter

Although trazodone is generally safe, it carries the risk of side effects. Most unwanted reactions occur when patients don’t stick to the recommended dosage.

Common Side Effects of Trazodone

The common side effects of trazodone may include:

  • Dry mouth—Drinking plenty of fluids, chewing sugar-free gum, or using a saliva substitute can alleviate this problem
  • Muscle or bone pain—Over-the-counter pain relievers can help. You should inform your doctor if the pain persists
  • Trouble sleeping—Contact your healthcare provider if trazodone causes sleep disturbances. They may adjust your dose or timing of taking the medication
  • Trouble with remembering—Report memory issues to your healthcare provider immediately
  • Unpleasant taste—Drink plenty of water or chew gum to alleviate this effect

These reactions are typically mild and may subside as your body adjusts to the drug. Inform your healthcare provider if the side effects you experience are severe or persistent.

Rare Side Effects of Trazodone

The less common but concerning undesirable reactions to trazodone include:

  • Confusion about identity, place, and time—This can be a sign of delirium or other neurological conditions
  • Dizziness or drowsiness—This can be a sign of an overdose or not sleeping for the recommended duration after taking the drug
  • Lightheadedness—Getting up slowly from sitting or lying positions can alleviate this effect
  • Fatigue—You should sleep for at least seven hours and maintain a balanced diet to prevent this effect
  • Difficulty breathing—This could indicate an underlying heart or lung condition
  • Swelling—This could be a sign of an allergic reaction or other concerning conditions

The lists above aren’t exhaustive, so you should inform your doctor immediately if you experience any undesirable reactions to this medicine.

Who Shouldn’t Use Trazodone?

While trazodone is recommended for adults with various conditions, it isn’t the right choice for everyone. Some of the categories of patients who shouldn’t use this medication include:

Individuals Who Shouldn’t Use Trazodone


Patients with a history of suicidal thoughts

Studies show that this drug carries the risk of suicidal thoughts or actions, especially in younger patients and seniors

Individuals who recently had a heart attack

Trazodone can exacerbate cardiovascular complications, making it harder to recover from a heart attack

People with epilepsy

This medication lowers the anticonvulsant action of epilepsy treatment, especially with electroconvulsive methods

Patients with porphyria

Trazodone can potentially exacerbate the symptoms of porphyria

Those who have a pheochromocytoma

This drug can interfere with the treatment of a pheochromocytoma

Patients with liver problems

In rare cases, this medication may contribute to liver issues

Those with kidney problems

This drug can accumulate in the kidneys, contributing to an overdose

Individuals with long QT syndrome

Trazodone carries the risk of irregular heart rhythm and may increase QT prolongation

People with low sodium levels

This medication can lower sodium levels, leading to concerning complications

Healthcare providers only prescribe trazodone to individuals with the conditions above if the benefits outweigh the risks. In that case, the dose is typically lower, and the patient is monitored regularly to reduce the chances of unwanted reactions.

Which Medications Interact With Trazodone?

If you’re taking other medications, you should inform your healthcare provider before starting trazodone. Your doctor will assess the potential for interactions and recommend the appropriate dose and timing to ensure all drugs are safe and effective.

Check out some medications that interact with trazodone in the table below:

Medication Category

Interaction With Trazodone


Anti-HIV drugs

Some anti-HIV drugs can raise trazodone levels in the blood, increasing the risk of an overdose

Your doctor may prescribe lower doses or recommend taking the drugs at different times of day

Antiseizure medication

Trazodone can reduce the potency of some antiseizure drugs, enhancing the risk of convulsions

Consult your doctor for personalized guidelines


Antihistamines can enhance unwanted reactions like dizziness and drowsiness

Dosage adjustment may be necessary

Blood pressure medication

Trazodone can contribute to low blood pressure

Consult your doctor for potential interactions

Heart medication

Trazodone can raise the risk of irregular heart rhythm

You shouldn’t mix trazodone with heart medication

Herbal supplements

St. John’s wort and melatonin can enhance the drug’s sedative effects

You shouldn’t take these supplements and trazodone at the same time

Infection medications

Potential for interaction is low, but risks can’t be disregarded

Consult your healthcare provider before mixing trazodone with antibiotics

Muscle relaxants

Some muscle relaxants can raise the risk of serotonin syndrome

Consult your healthcare provider before combining these drugs

Opioids and CNS depressants

Trazodone can contribute to the CNS depressant effects

You shouldn’t mix these drugs without your doctor’s guidance

Sleep or anxiety medications

Trazodone can raise the risk of sedation and drowsiness

Consult your doctor before mixing these medications

Non-steroidal anti-inflammatory drugs (NSAIDs)

NSAIDs can raise the risk of bruising or bleeding

Talk to your healthcare provider for personalized advice

Blood thinners

Blood thinners can increase the risk of bleeding

You shouldn’t take these medications at the same time

Medications that increase serotonin levels

The combination can raise the risk of serotonin syndrome

Dosage adjustment may be necessary

CYP3A4 inhibitors and inducers

CYP3A4 inhibitors and inducers can affect trazodone levels in the body, raising the risk of improper dosing

Consult your doctor for more details

Therapeutic index medications

These medications can have their levels increased when taken with trazodone

Your doctor may monitor serum levels and adjust the dosage if necessary

What Are the Alternatives to Trazodone?

If your doctor decides that the risk of using trazodone is too high based on your health history and sleep problems, they may recommend the following alternatives:

Trazodone Alternative

Typical Application for Sleep Issues

Treatment Duration


Treating sleep problems stemming from anxiety, depression, or mood disorders

Can be used both in the short and long term, depending on the patient’s health history 


Treating sleep disorders exacerbated by symptoms of allergic reactions

Up to two weeks


Short-term treatment of sleep-onset insomnia

Six weeks maximum


Short-term treatment of insomnia

13 weeks maximum


Treating sleep issues due to severe pain

May vary from a day to several weeks, depending on your health history


Treating sleep problems due to anxiety, depression, or major depressive disorder

Can be used in the long term under continuous guidance and monitoring by a healthcare provider


Treating sleeplessness due to convulsions and seizures

Consult your healthcare provider for specific information


Treating sleep issues stemming from mental disorders

Up to eight weeks


Treating sleeplessness caused by anxiety or depression

4–8 weeks maximum


Short-term treatment of insomnia

Two weeks maximum


Short–term treatment of sleep-onset and sleep maintenance insomnia

3–4 months maximum


Short-term treatment of sleeplessness

3–4 months maximum


Treating sleeplessness related to muscle injury or pain

Three weeks maximum

The list above isn’t comprehensive, so you should discuss the potential alternatives with your doctor.

Featured image source: Natalie Bond