Trazodone
Trazodone is an antidepressant medicine. Trazodone is used for Major depressive disorder (MDD), Depression and anxiety and Off‑label uses.
Also called: Raldesy (United States) · Molipaxin (United Kingdom)
Pronunciation: Not available.
- Generic name
- trazodone hydrochloride
- Drug class
- Antidepressant (serotonin reuptake inhibitor and 5-HT2 receptor antagonist)
- Form
- Tablets, capsules, or liquid depending on country and product
- Route
- Oral
- Legal status
- Prescription-only medicine
Availability and supply rules vary by country
Trade names by country: United States · United Kingdom · Canada
Australia: · Full directory
What trazodone hydrochloride is and how it works
Trazodone is an antidepressant medicine. In the United States, it is FDA-approved for the treatment of major depressive disorder (MDD) in adults. In the UK, NHS information describes its use for depression and anxiety. It is thought to work by increasing serotonin activity in the brain. It is sometimes used off-label for insomnia or other conditions, but those uses are not FDA-approved and no standard insomnia dose is set by the manufacturer. (1) (2) (3)
Trazodone requires a prescription. A clinician must confirm the diagnosis, appropriateness, and dosing plan. It is not approved for use in children or adolescents. Use for any off-label purpose must be directed by a prescriber.
Mechanism of action: how trazodone hydrochloride works
Trazodone is a serotonin reuptake inhibitor and 5‑HT2 receptor antagonist, thought to enhance serotonergic activity in the CNS. It is metabolised by CYP3A4 to an active metabolite (m‑chlorophenylpiperazine), is 89‑95% protein bound, and less than 1% is excreted unchanged in urine. Peak plasma levels occur about 1 hour after dosing on an empty stomach or 2 hours with food. (1) (3)
What is Trazodone hydrochloride used for?
Major depressive disorder (MDD)
Trazodone is approved in the United States for the treatment of major depressive disorder in adults. It controls depression but does not cure it; full benefit may take 2 weeks or longer. The US label gives a starting dose of 150 mg/day in divided doses, increased by 50 mg/day every 3–4 days, with outpatient maximum usually 400 mg/day and inpatient maximum up to 600 mg/day. (1) (2)
Depression and anxiety (UK)
UK NHS information states that trazodone is used to treat depression and anxiety. In the US, anxiety is not an FDA-approved indication; MedlinePlus lists it as an off-label use. No numeric UK dose is provided in the current sources; prescribing must follow local guidance. (3) (2)
Off‑label uses
Healthcare professionals sometimes prescribe trazodone off-label for insomnia, schizophrenia, anxiety (in the US), abnormal involuntary movements caused by other medicines, and alcohol dependence. None of these uses are FDA-approved, and the drug manufacturer gives no insomnia dose. Any off‑label use must be determined by a prescriber; do not self‑start or self‑adjust. (2)
Before taking trazodone hydrochloride
Do not take / not appropriate for
- Do not take trazodone if you are taking, or have stopped within the last 14 days, a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, linezolid, intravenous methylene blue, phenelzine, selegiline, or tranylcypromine, because of the increased risk of serotonin syndrome. (all indications) (1) (2)
- Do not take trazodone after a severe hypersensitivity reaction to trazodone or any of its ingredients unless the responsible specialist determines otherwise under the exact local label. (all products) (1) (3)
- Trazodone is not approved for use in children or adolescents; safety and effectiveness in paediatric patients have not been established. (all indications) (1)
Tell your clinician about
- Any personal or family history of bipolar disorder, mania, or hypomania.
- A history of suicide attempts, self‑harm, or current suicidal thoughts.
- Heart problems, including long QT syndrome, past heart attack, or irregular heartbeat.
- Liver or kidney disease, overactive thyroid, epilepsy, or glaucoma.
- Bleeding disorders, stomach ulcers, or use of aspirin, NSAIDs, warfarin, or other blood‑thinning medicines.
- Any condition that raises the risk of priapism, such as sickle cell anaemia, multiple myeloma, leukaemia, or Peyronie's disease.
- Pregnancy, plans for pregnancy, or breastfeeding; also tell the prescriber about any herbal products (especially St John's wort) or frequent alcohol use.
- Any other medicines, including antidepressants, antifungals, epilepsy drugs, sleeping pills, erythromycin, levodopa, or warfarin.
Trazodone hydrochloride dosage and how to take it
- Take trazodone by mouth with a meal or light snack, usually two or more times a day as directed by the prescriber.
- Swallow tablets whole or break them in half along the score line if needed. Do not chew or crush.
- Take it at the same time(s) every day. If drowsiness occurs, the prescriber may recommend taking the larger portion of the daily dose at bedtime.
- Do not take more or less than prescribed, and do not alter the dose or stop taking it without the prescriber's advice.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3)
Missed dose
Take the missed dose as soon as you remember. If it is almost time for the next scheduled dose, skip the missed dose and continue your regular schedule. Do not take a double dose to make up for a missed one.
Overdose
If you think you have taken too much trazodone, call emergency services or a poison control centre immediately. In the US, call 1‑800‑222‑1222. In the UK, call NHS 111. If the person has collapsed, had a seizure, is having trouble breathing, or cannot be woken, call 999 or 911. Overdose can cause severe drowsiness, vomiting, priapism, respiratory arrest, seizures, and heart rhythm changes including QT prolongation. Deaths have occurred when trazodone was taken with alcohol or other central nervous system depressants. There is no specific antidote; treatment is supportive. Bring the medicine packaging and remaining tablets to the emergency department if told to do so by a healthcare provider. (1) (2) (3)
Trazodone hydrochloride side effects
Side effects vary between individuals. Drowsiness is very common. Some effects are serious and need urgent medical attention.
Drowsiness and fatigue
What to notice: Feeling unusually sleepy, tired, or sluggish.
What to do: Avoid driving or operating machinery until you know how the medicine affects you. If severe, tell the prescriber—they may adjust the dosing schedule. (1) (2) (3)
Gastrointestinal upset
What to notice: Diarrhoea, nausea, constipation, or changes in appetite or weight.
What to do: Report persistent or severe symptoms to the prescribing team. (1) (2) (3)
Headache, muscle pain, dry mouth, or nasal congestion
What to notice: Mild to moderate headache, muscle aches, a dry mouth, or a stuffy nose.
What to do: Often temporary. Discuss with the prescriber if they become troublesome. (1) (3)
Blurred vision or swelling
What to notice: Blurred vision, or swelling of the hands, feet, or legs.
What to do: Tell the prescribing team if these occur; they may need to rule out other causes. (1) (2)
Sexual difficulties
What to notice: Changes in sexual desire or function in males or females.
What to do: Discuss with the prescriber; do not stop the medicine abruptly by yourself. (2)
Priapism (prolonged erection)
What to notice: An erection lasting more than 6 hours, painful or not, in males.
What to do: Seek immediate medical attention. Priapism can cause permanent damage. (1) (2) (3)
Serotonin syndrome
What to notice: Fever, sweating, confusion, severe muscle stiffness or twitching, agitation, hallucinations, loss of coordination, nausea, vomiting, or diarrhoea.
What to do: Seek emergency care. Tell the clinicians what you are taking; they will decide whether treatment should be continued or adjusted. (1) (2)
Irregular heartbeat, fainting, or chest pain
What to notice: Fast, pounding, or irregular heartbeat; dizziness; light‑headedness; fainting; or chest pain.
What to do: Contact the prescriber or seek urgent care. These could indicate QT prolongation or other cardiac effects. (1) (2)
Abnormal bleeding or bruising
What to notice: Unexplained bruising, nosebleeds, or bleeding that is heavier than usual.
What to do: Inform the prescriber promptly, especially if you also take anticoagulants or antiplatelet medicines. (1) (2)
Angle‑closure glaucoma
What to notice: Eye pain, vision changes such as seeing coloured rings around lights, or eye redness/swelling.
Serious warnings
Suicidal thoughts and behaviour — emergency
Symptoms: Worsening depression, new or increased suicidal thoughts or actions, especially at the start of treatment or after a dose change.
Action: If these symptoms appear, call a healthcare professional or emergency services immediately. Do not change the dose by yourself. Close monitoring is required for all antidepressant‑treated patients. (1) (3)
Serotonin syndrome — emergency
Symptoms: Fever, agitation, hallucinations, rapid heartbeat, overactive reflexes, severe muscle twitching, stiffness, loss of coordination, nausea, vomiting, or diarrhoea.
Action: Seek immediate emergency care. Do not start or stop any medicine without the supervising clinician's direction. (1)
Priapism — emergency
Symptoms: A prolonged, painful (or painless) erection lasting more than 6 hours.
Action: Go to the emergency department immediately. Priapism can permanently damage tissues if not treated. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Monoamine oxidase inhibitors (MAOIs) | Combined use can cause serious, sometimes fatal, serotonin syndrome. | At least 14 days must separate stopping an MAOI and starting trazodone, and at least 14 days after stopping trazodone before starting an MAOI. Never combine them. (1) (2) |
| Other serotonergic drugs (e.g., SSRIs, SNRIs, triptans, fentanyl, lithium, tramadol, St John's wort) | Increases the risk of serotonin syndrome. | Tell the prescriber about all medicines and supplements. Do not use St John's wort. (1) (3) |
| Central nervous system depressants (alcohol, benzodiazepines, opioids, sleep aids) | Enhanced drowsiness, slowed breathing, and impaired coordination; deaths have occurred with alcohol and sedatives. | Avoid alcohol. Use other CNS depressants only as directed by the prescriber; they may need dose adjustment. (1) (2) (3) |
| Drugs affecting QT interval (e.g., some antiarrhythmics, antipsychotics, antibiotics) | May additively prolong QT interval and raise the risk of serious arrhythmia. | The prescriber must review the full medicine list and may perform ECG monitoring. (1) |
| CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir) and inducers (e.g., carbamazepine, phenytoin) | Inhibitors can raise trazodone levels; inducers can lower them. | The prescriber may need to adjust the trazodone dose; do not change it yourself. (1) (3) |
| Blood‑thinning medicines (warfarin, NSAIDs, aspirin, antiplatelet drugs) | Trazodone can increase the risk of bleeding. | Tell the prescriber if you bruise or bleed easily. Monitoring of clotting times may be needed. (1) (2) |
| Digoxin or phenytoin | Trazodone may alter blood levels of these medicines. | The prescriber will monitor drug levels and adjust therapy as needed. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Children and adolescents
Safety and effectiveness have not been established in paediatric patients. Trazodone is not approved for use in children or adolescents. The boxed warning on suicidal thoughts applies to all antidepressant‑treated patients; paediatric patients are especially at risk. (1)
Pregnancy
Published studies over decades have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal/fetal outcomes, but available studies cannot definitively rule out risk and have methodological limitations. Untreated depression during pregnancy can lead to relapse. Decisions about continuing or stopping trazodone in pregnancy should be made with the prescriber, weighing the individual risks and benefits. A US National Pregnancy Registry for Antidepressants is available (1‑844‑405‑6185). In the UK, the NHS advises using the lowest effective dose and discussing possible hospital birth monitoring. More information can be found at medicinesinpregnancy.org (Bumps). (1) (3)
Breastfeeding
Trazodone transfers into human milk. Limited postmarketing data have not identified adverse effects on breastfed infants. The prescriber will weigh the benefits of breastfeeding against the mother's clinical need for trazodone and the potential for infant side effects. Seek advice from the prescriber if the baby shows unusual drowsiness or poor feeding. (1) (3)
Older adults
Clinical experience in geriatric patients is limited. Trazodone should be used with caution because of increased sensitivity to side effects such as drowsiness, low blood pressure, and heart rhythm changes. (1)
Kidney or liver problems
Trazodone has not been studied in patients with renal or hepatic impairment. The medicine should be used with caution, and prescribers will consider the individual's clinical status. No universal dose adjustment is available. (1)
Monitoring
Before starting
- Screen for personal or family history of bipolar disorder, mania, or hypomania.
- Assess suicide risk, cardiac history (including long QT syndrome), bleeding risk, and presence of priapism risk factors.
- Review all current medicines and supplements, especially MAOIs, serotonergic drugs, anticoagulants, and drugs that prolong the QTc interval.
- Consider an eye examination if the patient is at risk for angle‑closure glaucoma.
During treatment
- Monitor for clinical worsening, emergence of suicidal thoughts or behaviours, or unusual changes in behaviour, particularly at the start of treatment and after dose changes.
- Watch for signs of serotonin syndrome, QT prolongation, orthostatic hypotension, bleeding, hyponatraemia, and priapism.
- Re‑evaluate the continued need for treatment and reassess the dose periodically.
- Do not infer treatment failure or dose adjustment from any single symptom without consulting the prescriber.
Storage
Keep trazodone in the original container, tightly closed, and out of reach of children. Store at room temperature away from light, excess heat, and moisture (do not store in the bathroom). Dispose of unused medicine through a take‑back programme; do not flush down the toilet.
Professional information
Clinician‑facing context only. Use the current local indication, dosing information, and background disease guideline. Off‑label uses are not FDA‑approved and require prescriber‑level evidence evaluation.
United States
Indication: Major depressive disorder (adults)
Dose summary: Starting dose: 150 mg/day orally in divided doses. Increase by 50 mg/day every 3 to 4 days. Outpatient maximum usually 400 mg/day; inpatient maximum up to 600 mg/day, both in divided doses. Take shortly after a meal or light snack. Drowsiness may require giving the major portion of the daily dose at bedtime. Tablets may be broken along the score line. When discontinuing, gradual dose reduction is recommended.
Renal context: Not studied in renal or hepatic impairment; use with caution. No universal dose adjustment is available. (1)
United Kingdom
Indication: Depression and anxiety
Dose summary: UK NHS information provides no numeric dose. Prescribing and dose titration must follow the current SmPC or local guidance. Forms include tablets, capsules, and liquid. Dose may be adjusted after a week or more.
Renal context: Not studied in renal or hepatic impairment; use with caution. No universal dose adjustment is available. (3)
Hepatic guidance
Use local product information and specialist judgement; this page does not provide impairment‑specific dosing.
Overdose note
Medication errors require product identification, dose reconstruction, monitoring for serotonin syndrome, QT prolongation and priapism, and poison‑centre or specialist consultation. No specific antidote exists. (1) (3)
Frequently asked questions
Can trazodone be used for sleep?
Trazodone is sometimes prescribed off‑label for insomnia, but it is not FDA‑approved for this purpose and the manufacturer provides no insomnia dose. Any use for sleep must be set by a prescriber; never self‑start or adjust the dose. (2)
What should I do if I miss a dose?
Take it as soon as you remember. If it is nearly time for the next dose, skip the missed one and continue your regular schedule. Do not double the dose. (2) (3)
Can I drink alcohol while taking trazodone?
It is best to avoid alcohol. Alcohol can increase the sedative effects and raise the risk of serious side effects and overdose. (2) (3)
What if I want to stop taking trazodone?
Do not stop suddenly. Withdrawal symptoms can include dizziness, nausea, headache, confusion, sleep problems, and anxiety. Your prescriber will create a gradual dose‑reduction plan. (1) (2)
How long does trazodone stay in the system?
The current research pass did not retrieve a numeric elimination half‑life; therefore this page cannot answer that question. A follow‑up source pass is needed before the page provides a time estimate.
What is the mechanism of action of trazodone hydrochloride?
Trazodone is a serotonin reuptake inhibitor and 5‑HT2 receptor antagonist, thought to enhance serotonergic activity in the CNS. It is metabolised by CYP3A4 to an active metabolite (m‑chlorophenylpiperazine), is 89‑95% protein bound, and less than 1% is excreted unchanged in urine. Peak plasma levels occur about 1 hour after dosing on an empty stomach or 2 hours with food. (1) (3)
References
- TRAZODONE HYDROCHLORIDE tablet — prescribing informationU.S. National Library of Medicine (DailyMed) · United States · dated 2026-07-14 · accessed 2026-10-12 · source 1
- Trazodone: MedlinePlus Drug InformationMedlinePlus, U.S. National Library of Medicine · United States · accessed 2026-10-09 · source 2
- Trazodone: an antidepressant medicineNational Health Service (UK) · United Kingdom · accessed 2026-10-09 · source 3
Brand names by country
Single-ingredient trazodone hydrochloride names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Raldesysolution · 10 mg/mL · validus pharmaceuticals llcregulator source
United Kingdom
- Molipaxinreference source
Canada
- TRAZODONE-150 Dregulator source
- APO-TRAZODONE Dregulator source