From the FDA Drug Label
2.6 Discontinuation of Treatment with Trazodone Hydrochloride Tablets Adverse reactions may occur upon discontinuation of Trazodone Hydrochloride Tablets [See WARNINGS AND PRECAUTIONS (5.8)]. Gradually reduce the dosage rather than stopping Trazodone Hydrochloride Tablets abruptly whenever possible.
To create a weaning schedule for trazodone 50 mg daily, it is recommended to gradually reduce the dosage.
- A possible weaning schedule could be:
- Reduce the dose by 25 mg every 3 to 4 days,
- Alternatively, reduce the dose by 12.5 mg every 1 to 2 days for a more gradual taper.
- Monitor the patient's response and adjust the weaning schedule as needed to minimize adverse reactions. 1
From the Research
A recommended weaning schedule for trazodone 50 mg daily would involve gradually reducing the dose over 2-4 weeks, as this approach helps minimize withdrawal symptoms and allows brain chemistry to adjust gradually, as suggested by the most recent and highest quality study available 2.
Weaning Schedule
To wean off trazodone 50 mg daily, consider the following steps:
- Start by taking 50 mg every other day for one week
- Reduce to 25 mg daily for one week
- Followed by 25 mg every other day for one week, before stopping completely This gradual tapering is crucial in minimizing withdrawal symptoms such as anxiety, irritability, insomnia, headaches, or dizziness that can occur when abruptly discontinuing trazodone.
Rationale
The slow reduction allows your brain chemistry to adjust gradually as serotonin levels normalize. Trazodone affects serotonin receptors, and sudden discontinuation can disrupt this balance. If you experience significant withdrawal symptoms during the taper, it is advisable to slow down the schedule further. Always consult with your healthcare provider before changing your medication regimen, as individual factors may require a personalized approach. Some patients may need an even more gradual taper depending on how long they've been taking the medication and their sensitivity to medication changes, as noted in studies comparing different antidepressants 3, 4.
Considerations
It's essential to consider the pharmacological properties of trazodone and its use in clinical practice, as outlined in recent reviews 5, 2. Trazodone is an antidepressant with a mechanism of action that remains innovative and has a favorable profile for the treatment of depression, including symptoms like insomnia. However, the primary focus should always be on minimizing morbidity, mortality, and improving quality of life, which a gradual weaning schedule aims to achieve.