Sleepless nights can be a significant challenge, affecting our daily routine, relationships, and overall well-being. When insomnia takes hold, you may find yourself on a winding path of trial and error—from experimenting with natural remedies to taking over-the-counter medications. While these methods may help, visiting your healthcare provider is the best course of action in such cases.
Your doctor may recommend various drugs, including trazodone, to help you sleep better. Even though this medicine is an antidepressant, healthcare providers prescribe it off-label to patients with insomnia.
But does trazodone improve sleep quality, and is it safe? We’ll explain this drug’s mechanism of action, efficacy for sleep, and alternatives to consider in this concise guide.
What Is Trazodone?
Trazodone is an antidepressant. Its active component is trazodone hydrochloride, classified as a serotonin receptor antagonist and reuptake inhibitor (SARI). This medicine was approved for use in the U.S. in 1981 and is primarily prescribed to patients with major depressive disorders, anxiety disorders, or a combination of both.
Since the drug affects serotonin levels, it’s also used in the short-term treatment of insomnia.
This medicine comes in tablet, capsule, and liquid forms and is available in six doses:
- 10 mg
- 20 mg
- 50 mg
- 100 mg
- 150 mg
- 300 mg
Check out basic facts about this medication in the table below:
Trazodone doesn’t carry the risk of addiction and isn’t categorized as a controlled substance, according to the DEA. Despite that, you should take it strictly as prescribed by your healthcare professional to avoid potential unwanted reactions and psychological dependence.
How Does Trazodone Work?
Trazodone works by blocking the reabsorption of serotonin in the brain. Its action increases the levels of serotonin in the nerve synapse. Increased serotonin levels enhance the chemical messages that regulate mood and mental well-being, helping alleviate the symptoms of depression.
Serotonin is also a precursor to melatonin, a hormone directly involved in sleep regulation. This hormone is produced in response to darkness and suppressed by light, helping regulate your body’s internal clock by signaling when it’s time to sleep. By increasing melatonin levels, serotonin provides a calming effect, inducing drowsiness and sleep.
How Do You Take Trazodone for Sleep?
You should take trazodone for sleep as instructed by your doctor. Healthcare providers typically recommend a starting dose of 25 mg tablets, but this may increase to 100 mg depending on the severity of your sleep problems.
The timing also varies with the type of insomnia. Patients with sleep-onset issues may be instructed to take this medicine 1–2 hours before bedtime. If you have sleep maintenance insomnia, your doctor may recommend taking trazodone at least 30 minutes before going to bed.
Either way, you should set aside at least seven hours of sleep to let the sedative effects kick in and wear off naturally.
Does Trazodone Work for Sleep?
Source: KATRIN BOLOVTSOVA
Tradozone’s effectiveness for sleep varies between patients due to several factors, including:
- Medical history
- Lifestyle
- Specific insomnia type
- Environmental conditions
According to various clinical studies, trazodone is effective in treating both primary and secondary insomnia. Some of the ways this medication improves sleep include:
- Shortening the time it takes to fall asleep
- Improving total sleep time
- Reducing the number of awakenings at night
- Enhancing overall sleep quality
The benefits are more pronounced when this drug is taken in lower doses, so you should stick to the prescribed dose to make the most out of this medicine.
Even though trazodone can help with insomnia, it’s not a cure-all. Sleeplessness can result from several complex factors, which medication alone may not address all. You should use this medicine as part of a comprehensive treatment plan that includes meaningful lifestyle changes and cognitive behavioral therapy for insomnia (CBT-i) best practices.
Visiting a sleep medicine specialist should be your first step toward addressing sleep problems. The biggest obstacle to this approach is that only 1% of doctors in the U.S. are trained in sleep medicine, while more than a third of the adult population experience occasional or chronic sleeplessness. Due to the long waiting times, getting an appointment with an expert can be challenging.
The exciting news is that expert guidance is only a click away with telemedicine platforms like Kick.
Kick—Sleep Science at Your Fingertips
Source: SHVETS production
Designed by Dr. Alex Dimitriu, a Stanford sleep expert, Kick’s sleep program combines the practices of cognitive behavioral therapy for insomnia (CBT-i) with the effectiveness of gentle sleep medications like trazodone. Instead of a one-size-fits-all approach, our doctors tailor the treatment to your lifestyle, medical history, and specific sleep issues.
When you join the program, our expert will:
- Prescribe two trial medications—You’ll rotate the drugs to reduce the risk of dependence and find an effective solution quickly
- Schedule regular consultations—They’ll check in with you online and offer valuable tips on good sleep hygiene
- Adjust the treatment if necessary—If the initial plan doesn’t provide relief within the first two weeks, our expert will adjust the dosage or recommend other drugs
If our specialist decides you’re not the best candidate for the program, you won’t pay for the initial consultation as per our Doctor Guarantee.
Kick’s innovative sleep program has earned many thumbs-ups on Trustpilot, demonstrating its safety and effectiveness in helping our customers get restorative sleep.
Getting Started With Kick
To benefit from Kick’s acclaimed sleep program, follow these simple steps:
- Visit our signup page to start your brief consultation
- Fill us in on your medical history and sleep problems
- Enter your delivery address and payment information
The sleep visit takes only 15 minutes, and you can choose between the convenience of home delivery or local pharmacy pickup for receiving your medication. Join Kick today and skip the long queues of patients waiting to get the much-needed appointment with a sleep expert.
Source: KATRIN BOLOVTSOVA
Will You Be Tired in the Morning After Taking Trazodone?
Trazodone can cause daytime tiredness, especially when taken in higher doses or combined with other medications. This side effect is generally manageable and may subside as your body adapts to the medicine.
If you feel tired in the morning after using trazodone, consult your healthcare provider to adjust the treatment. Your doctor will determine whether this unwanted reaction is due to trazodone or its interaction with other medications and advise you accordingly.
Side Effects of Trazodone
Besides daytime tiredness, trazodone carries the risk of other side effects, as the table below shows:
This list isn’t exhaustive, so you should consult your doctor for more information. To avoid the risk of unwanted reactions, you should take only the prescribed dose. Patients who experience these side effects should inform their doctors immediately.
What’s More Effective as a Sleep Aid—Trazodone or Nortriptyline?
Nortriptyline is a tricyclic antidepressant that can be prescribed off-label to treat insomnia. It inhibits the reuptake of norepinephrine and serotonin, which improves mood and promotes sleep.
While both trazodone and nortriptyline are effective as sleep aids, the results vary among patients. You should consult a sleep expert to determine which medication would be more safe and effective for your case. To avoid unwanted reactions, don’t mix these drugs without your doctor’s guidance.
Eszopiclone vs. Trazodone—Which Offers Better Sleep?
Eszopiclone (brand name Lunesta) is generally considered a stronger sleep aid than trazodone. While trazodone is an antidepressant, eszopiclone is a non-benzodiazepine sedative-hypnotic.
Which one would work better in your case depends on your medical history. You can only use eszopiclone for a maximum of two weeks, so this medicine may not be effective if your sleep issues persist beyond this period. Meanwhile, you can use trazodone for up to one month.
Which Is Safer for Sleep, Trazodone or Benadryl?
Both trazodone and Benadryl are generally safe for sleep, but their safety and effectiveness can vary among patients.
Individuals who should approach these drugs with caution include:
- Persons under 18
- People with heart disease
- Patients with glaucoma
- Women who are pregnant, breastfeeding, or planning to get pregnant
- People who are allergic to these drugs or their ingredients
- Patients taking MAO inhibitors
- Elderly patients with a history of accidental falls and injuries
- Individuals with a history of substance abuse, suicidal thoughts, or other mental health conditions
This list isn’t exhaustive. You should tell your doctor about all medical conditions you have or procedures you underwent recently so they can recommend safe and effective treatment for you.
Does Trazodone Cause Sleepwalking?
There’s little information to claim that trazodone causes sleepwalking, but the risks can’t be disregarded. According to the FDA, certain prescription sleep drugs carry the risk of this side effect.
If you experience sleepwalking or other unusual behavior while on trazodone, inform your healthcare provider so they can adjust your treatment.
Why Is Trazodone Not Helping Me Sleep Anymore?
On average, most patients begin to feel the positive effects of trazodone 1–2 weeks after starting the treatment. In rare cases, it may take up to six weeks to feel the effects.
If you’ve been taking trazodone and it’s not helping you sleep anymore, you should contact your healthcare provider. Your doctor will determine the specific cause and recommend the appropriate steps to take.
Some of the reasons trazodone may not help with sleep after using it for a while are:
- You’ve been using the drug for a while and developed tolerance
- The dosage you’ve been taking is low
- You have other underlying conditions that this medication can’t treat
If you experience sleeplessness after discontinuing this medicine, you should inform your healthcare provider immediately.
Source: Jep Gambardella
Trazodone Alternatives To Consider
If your doctor decides you’re not the best candidate for trazodone, they may recommend the following alternatives:
- Ambien
- Belsomra
- Cyclobenzaprine
- Hydroxyzine
- Tramadol
- Benadryl
- Mirtazapine
- Gabapentin
- Seroquel
- Doxepin
- Doxylamine
- Xanax
- Ativan
- Valium
- Propranolol
- Zoloft
These alternatives can interact with certain substances and medical conditions, so you should first discuss what their potential side effects are and how to prevent them with your healthcare provider.
Featured image source: KATRIN BOLOVTSOVA
