From the Guidelines
Trazodone can be effective for treating anxiety, though it's not FDA-approved specifically for anxiety disorders. It's primarily prescribed as an antidepressant but is often used off-label for anxiety at doses ranging from 25-100 mg daily, typically taken at bedtime due to its sedating effects. For anxiety treatment, doctors usually start at a low dose (25-50 mg) and may gradually increase as needed, with full therapeutic effects potentially taking 2-4 weeks to develop. Trazodone works by increasing serotonin levels in the brain and blocking certain serotonin receptors, which helps regulate mood and anxiety. Its sedating properties make it particularly useful for patients who experience anxiety with insomnia.
Key Points
- Trazodone is often used off-label for anxiety due to its sedating effects
- Typical dosing ranges from 25-100 mg daily, taken at bedtime
- Common side effects include drowsiness, dizziness, dry mouth, and occasionally headaches
- Treatment should always be supervised by a healthcare provider to monitor response and adjust dosing as needed According to a study published in the Journal of Clinical Sleep Medicine 1, trazodone was found to be effective in reducing nightmare frequency in patients with PTSD, with a mean effective dose of 212 mg/day. However, it's essential to weigh the benefits against the potential risks and side effects, as noted in other studies 1.
From the Research
Trazodone and Anxiety Treatment
- Trazodone is an antidepressant that has been used to treat various conditions, including anxiety disorders, despite not being primarily approved for this purpose 2.
- The medication has been found to have anxiolytic properties, making it a potential treatment option for anxiety 3.
- Studies have shown that trazodone can be effective in reducing anxiety symptoms, particularly in patients with major depressive disorder (MDD) who experience anxiety as a comorbidity 4.
Off-Label Use of Trazodone for Anxiety
- Trazodone is often prescribed off-label for the treatment of anxiety disorders, including generalized anxiety disorder, panic disorder, and post-traumatic stress disorder (PTSD) 2.
- The use of trazodone for anxiety treatment is supported by its pharmacodynamic properties, which allow it to avoid the side effects of insomnia, anxiety, and sexual dysfunction often associated with selective serotonin reuptake inhibitor (SSRI) antidepressants 5, 4.
Efficacy of Trazodone in Treating Anxiety
- Research suggests that trazodone can be effective in alleviating anxiety symptoms, particularly in patients who do not respond to other treatments or experience significant side effects from other medications 3, 6.
- However, the efficacy of trazodone in treating anxiety may vary depending on the individual patient and the specific anxiety disorder being treated 6.
- Further studies are needed to fully understand the efficacy and safety of trazodone as a treatment for anxiety disorders 2, 4.