From the Guidelines
The initial dosage of trazodone should be 25 mg per day, with a maximum of 200 to 400 mg per day in divided doses, as recommended for the treatment of behavior and mood disorders 1.
Key Considerations
- The dosage may need to be adjusted based on the patient's response and tolerance to the medication.
- It is essential to use trazodone with caution in patients with premature ventricular contractions, as noted in the guidelines 1.
- The medication should be taken after meals to reduce the risk of dizziness and lightheadedness.
Potential Side Effects
- Common side effects of trazodone include drowsiness, dizziness, dry mouth, and blurred vision.
- Starting with a lower dose and gradually increasing as needed and tolerated can help minimize these side effects.
Special Populations
- Elderly patients may require lower starting doses due to increased sensitivity to side effects.
- The dosage for elderly patients is not explicitly stated in the provided guidelines, but it is generally recommended to start with a lower dose, such as 25-50 mg at bedtime, and adjust as needed.
From the Research
Trazodone Dosage
The ideal dosage of trazodone to start with is a topic of discussion in several studies.
- A study published in 1990 2 suggests that trazodone is best dosed at 150 mg given predominantly at bedtime and increased as needed to 200 to 300 mg for full antidepressant efficacy.
- Another study from 1999 3 found that trazodone at a dosage of 50-100 mg/day improved sleep disorders, particularly at the 100 mg/day dosage, when administered in a single dose before bedtime with no concomitant hypnotics.
- However, other studies do not provide direct evidence for the ideal starting dosage of trazodone, such as a 2018 study 4 that focused on combining mirtazapine with SSRIs or SNRIs for treatment-resistant depression, a 2019 study 5 that assessed adverse effects of pharmacologic treatments of major depression in older adults, and a 2009 study 6 that discussed clinically relevant drug interactions with new generation antidepressants and antipsychotics.
Considerations for Dosage
When considering the dosage of trazodone, it is essential to take into account the individual patient's needs and response to the medication.
- The 1990 study 2 highlights the importance of weighing the dose at bedtime to minimize daytime drowsiness.
- The 1999 study 3 demonstrates the effectiveness of a single dose before bedtime in improving sleep disorders.
- It is crucial to monitor the patient's response to the medication and adjust the dosage as needed to achieve the desired therapeutic effect while minimizing adverse effects.