What are the side effects of Trazodone (triazolopyridine antidepressant)?

From the Guidelines

Trazodone is associated with a range of side effects, most commonly somnolence, as well as constipation, diarrhea, dizziness, headache, insomnia, nausea, and sexual adverse events. Patients may experience sedation, dry mouth, and blurred vision, particularly when starting treatment. More serious but less common side effects include priapism, orthostatic hypotension, cardiac arrhythmias, and serotonin syndrome. Some patients report weight changes, constipation, or diarrhea. Trazodone may also cause psychiatric effects like confusion, agitation, or nightmares. These side effects occur because trazodone affects multiple neurotransmitter systems, primarily serotonin receptors but also histamine and alpha-adrenergic receptors. The sedative effects, while problematic for daytime functioning, make trazodone useful for treating insomnia at lower doses (50-150mg) 1.

Common Side Effects

• Somnolence
• Constipation
• Diarrhea
• Dizziness
• Headache
• Insomnia
• Nausea
• Sexual adverse events

Serious Side Effects

• Priapism
• Orthostatic hypotension
• Cardiac arrhythmias
• Serotonin syndrome

Psychiatric Effects

• Confusion
• Agitation
• Nightmares

It is essential to note that side effects often diminish over time as the body adjusts to the medication, and taking trazodone with food can reduce gastrointestinal discomfort. Patients should report severe or persistent side effects to their healthcare provider 1. The most recent and highest quality study available indicates that trazodone has a similar adverse event profile to other second-generation antidepressants, with some differences in the incidence of specific adverse events 1.

From the FDA Drug Label

What are the possible side effects of Trazodone Hydrochloride Tablets? Trazodone Hydrochloride Tablets can cause serious side effects or death, including: Serotonin syndrome. Symptoms of serotonin syndrome include: agitation, hallucinations, and problems with coordination, fast heartbeat, tight muscles, trouble walking, sweating, fever, nausea, vomiting, and diarrhea. Irregular or fast heartbeat or faint (QT prolongation) Low blood pressure You feel dizzy or faint when you change positions (go from sitting to standing) Unusual bruising or bleeding Erection lasting for more than 6 hours (priapism) Feeling high or in a very good mood, then becoming irritable, or having too much energy, feeling like you have to keep talking or do not sleep (mania). Withdrawal symptoms Symptoms of withdrawal can include anxiety, agitation, and sleep problems. Do not stop taking Trazodone Hydrochloride Tablets without talking to your healthcare provider. • Visual problems. eye pain changes in vision swelling or redness in or around the eye Only some people are at risk for these problems You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are. Low sodium in your blood (hyponatremia). Symptoms of hyponatremia include: headache, feeling weak, feeling confused, trouble concentrating, memory problems and feeling unsteady when you walk. Get medical help right away, if you have any of the symptoms listed above The most common side effects of Trazodone Hydrochloride Tablets include: swelling blurred vision dizziness sleepiness tiredness diarrhea stuffy nose weight loss

The side effects of Trazodone include:

• Serious side effects: serotonin syndrome, irregular or fast heartbeat, low blood pressure, unusual bruising or bleeding, priapism, mania, and withdrawal symptoms.
• Common side effects: swelling, blurred vision, dizziness, sleepiness, tiredness, diarrhea, stuffy nose, and weight loss.
• Other side effects: visual problems, low sodium in the blood (hyponatremia). 2

From the Research

Trazodone Side Effects

• The most common adverse effects reported with trazodone are drowsiness (somnolence/sedation), headache, dizziness, and dry mouth 3.
• Other events reported with low incidence include orthostatic hypotension, minimal anticholinergic activity, corrected QT interval prolongation, torsade de pointes, cardiac arrhythmias, and rare occurrences of priapism and suicidal ideation 3.
• Trazodone can also precipitate serotonin syndrome, a potentially life-threatening condition, when used in combination with other medications that increase serotonin levels, such as selective serotonin reuptake inhibitors (SSRIs) 4.
• However, studies suggest that trazodone may not increase the risk of suicidal behavior, and may even reduce the risk, particularly when compared to SSRIs 5.
• Trazodone extended release has been shown to improve health status and quality of life in patients with major depressive disorder, with greater improvements in self-care, usual activities, pain/discomfort, and anxiety/depression measures compared to SSRIs 6.

Comparison with Other Antidepressants

• Selective serotonin reuptake inhibitors (SSRIs) are known to have side effects such as initial lack of response to treatment, drowsiness, nausea, and sexual dysfunction 7.
• Trazodone, on the other hand, has a unique mechanism of action as a serotonin receptor antagonist and reuptake inhibitor (SARI), which may overcome the tolerability issues associated with SSRIs 3.
• The choice of antidepressant medication, including trazodone, should be based on individual patient needs and medical history, as well as the potential risks and benefits of each medication 3, 4, 5, 6, 7.