Trazodone for anxiety: Dosage and usage

trazadone for anxiety
Medically reviewed by Dr. Mandy Liedeman

Key Takeaways

  • Trazodone is prescribed for depression and anxiety.
  • Trazodone may cause side effects like drowsiness, weight gain, and, in rare cases, more serious issues such as serotonin syndrome or angle-closure glaucoma.
  • Trazodone may take one to two weeks to start working. Full therapeutic effects are experienced after 4-6 weeks of treatment.

Overview

Trazodone is recommended for the treatment of anxiety. It is prescribed to treat depression, anxiety, or a combination of depression and anxiety.

It is an anti-depressant medication that falls under the sub-class selective serotonin reuptake inhibitor and antagonist (SARI). This medicine prevents the body from absorbing serotonin by obstructing histamine and alpha-1-adrenergic receptors. 

Trazodone takes about a week to two weeks to start working. After 4 to 6 weeks of treatment, you will feel the full effects of the therapy. This blog covers the effects and uses of Trazodone.

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How and when to take Trazodone for anxiety?

Your doctor will provide you with the best guidance to take Trazodone for anxiety. However, here are some guidelines that you can follow:

  • You can administer Trazodone orally by swallowing pills with a full glass of water.
  • To reduce the chances of dizziness and postural hypotension, take Trazodone with food.
  • To keep your blood concentration of Trazodone constant, take it at the same time every day.
  • Initially, it may take 1 to 2 weeks for Trazodone to show effectiveness.
  • Trazodone may take up to four to six weeks for its full anxiety-relieving effects to kick in.
  • Before discontinuing or altering the dosage of Trazodone, consult your physician.
  • Because of the potential for harmful side effects, you should never suddenly stop taking Trazodone without first talking to your doctor.

Is Trazodone approved for use for anxiety?

The use of Trazodone for anxiety is often considered off-label. Regulatory authorities do not specifically approve Trazodone as a first-line treatment for anxiety. It is primarily prescribed as an antidepressant to manage major depressive disorder. 

However, in certain cases where other medications for anxiety have not been effective or have caused side effects, doctors may prescribe Trazodone to address anxiety symptoms.

Does Trazodone cause sleepiness?

Yes, Trazodone can cause sleepiness. That is why it is often given as a single dose at bedtime. This sedative effect can help people with anxiety by promoting a good night’s sleep.

If you have taken Trazodone during the day, you should be careful about engaging in tasks requiring full concentration, such as driving. The sedative effects of Trazodone might cause sleepiness, impaired vision, brain fog, lightheadedness, and even slurred speech.

How does Trazodone help to alleviate depression?

Trazodone reduces depressive symptoms by blocking particular receptors in our bodies. These processes change the brain’s neurotransmitter concentrations, and an individual’s mood improves.

Inhibiting serotonin reuptake

One neurotransmitter in the brain that controls mood is serotonin. Trazodone works primarily by inhibiting serotonin reuptake. Trazodone improves mood and alleviates depressive symptoms by increasing serotonin levels.

Blocking histamine receptors

Another sedative effect of Trazodone is through the inhibition of histamine receptors. In this way, Trazodone aids in the treatment of sleep disorders and insomnia caused by anxiety and depression.

Blocking Alpha-1 adrenergic receptors

Trazodone inhibits alpha-1-adrenergic receptors, which may contribute to its anti-inflammatory properties and the lowering of blood pressure as well.

Effecting other neurotransmitters

Trazodone alleviates depression by increasing serotonin levels and modulating other neurotransmitters, such as dopamine and noradrenaline. These effects collectively contribute to mood stabilization and the overall antidepressant effect of trazodone.

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Can you take Trazodone during pregnancy for anxiety?

Yes, if your doctor prescribes Trazodone for depression or anxiety during pregnancy, you can take it. There is no evidence that Trazodone use is linked to miscarriage, birth abnormalities, stillbirth, premature birth, or low childbirth weight. 

Discuss with your doctor if you are planning to get pregnant. This ensures that potential benefits and risks are thoroughly explored. If you were already taking Trazodone for anxiety and are pregnant, your doctor might not change your medication. If Trazodone is taken in the last few weeks of pregnancy, newborns may experience short-term withdrawal symptoms.

What risks are associated with taking Trazodone to treat depression?

The associated risks are not common but can occur in some cases. The following are a few potential dangers associated with Trazodone:

Increased suicidal thoughts

Trazodone can make people feel more depressed and even anxious. There is a higher risk to children, teens, and young adults in some cases. This risk is especially notable during the initial months of treatment or dosage adjustments. Hence, keeping in touch with your doctor is essential.

Serotonin syndrome risk

Combining Trazodone with certain medications, such as Sertraline or Citalopram, can increase the risk of serotonin syndrome. This serious condition is marked by agitation, confusion, dizziness, and rapid heart rate.

Angle-Closure Glaucoma

Trazodone use may lead to angle-closure glaucoma, a severe eye condition. If not promptly treated, this condition can result in permanent vision loss.

Weight gain and drowsiness

Side effects may include weight gain and drowsiness.

Initial worsening of anxiety and depression

Some individuals may experience heightened depression or anxiety initially. This occurs as the body adjusts to new chemical levels.

Physical dependence

Prolonged use of Trazodone use can cause physical dependence. This condition requires medical assistance to manage symptoms and reduce the risk of withdrawal.

Get a refill of Trazodone prescription for anxiety and depression. Our online doctors are happy to help you.

When should I see a doctor?

You should visit a doctor if you notice an increase in anxiety and depressive symptoms while taking Trazodone for more than 2 weeks. If bothersome or severe side effects, like persistent drowsiness or mood changes, occur or if you are having suicidal thoughts, seek medical attention immediately. Moreover, if you notice unusual physical symptoms, such as changes in heart rate or persistent headaches, inform your doctor. You should also consider seeing a doctor if you are pregnant or are planning to be while taking Trazodone.

Other FAQs about Trazodone

What happens if you take too much Trazodone for depression? Can it cause serotonin syndrome?

Taking too much Trazodone can lead to an overdose, potentially causing symptoms like drowsiness, vomiting, and even serotonin syndrome in severe cases.

Can you become addicted to Trazodone for anxiety?

Though Trazodone is not usually addictive, it is possible to become dependent on it if you are using it for a long time. Follow your doctor’s orders when taking this medication, and talk to them if you have any questions or concerns.

Is Trazodone a first-line treatment for anxiety?

No, when dealing with anxiety, Trazodone is not the first-line treatment. When other drugs have failed to alleviate symptoms or have caused undesirable side effects, Trazodone is recommended.

Can Trazodone be combined with other anxiety medications?

No, you should be cautious about combining Trazodone with other medications. Do not take Trazodone and Xanax at the same time. A healthcare provider should be consulted before combining Trazodone with any other anxiety medications.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

  • Gruen, M. E., & Sherman, B. L. (2008). Use of trazodone as an adjunctive agent in the treatment of canine anxiety disorders: 56 cases (1995–2007). Journal of the American Veterinary Medical Association233(12), 1902-1907.
  • https://www.nhs.uk/medicines/trazodone/pregnancy-breastfeeding-and-fertility-while-taking-trazodone/
  • Bossini, L., Casolaro, I., Koukouna, D., Cecchini, F., & Fagiolini, A. (2012). Off-label uses of trazodone: a review. Expert opinion on pharmacotherapy13(12), 1707-1717.
  • Stahl, S. M. (2009). Mechanism of action of trazodone: a multifunctional drug. CNS spectrums14(10), 536-546.

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