What to do about a skin reaction on the back and itchy throat after stopping trazodone (antidepressant)?

Management of Skin Reaction After Stopping Trazodone

For a skin reaction on the back with throat itching after stopping trazodone, apply a mild-strength topical corticosteroid (hydrocortisone 1% cream) to affected areas once daily and take an oral antihistamine such as cetirizine 10mg or fexofenadine 180mg for symptom relief. 1

Understanding the Reaction

This appears to be a diffuse drug rash with pruritus (itching) that has developed after discontinuation of trazodone. Drug reactions can occur not only while taking a medication but also after stopping it, as the body adjusts to the absence of the drug.

Treatment Approach

Immediate Management

1. Topical treatment:

   • Apply hydrocortisone 1% cream to affected areas on the back once daily 1
   • If the rash is moderate to severe, consider using a moderate-strength topical corticosteroid such as clobetasone butyrate 0.05% 1

2. Oral antihistamines for itch relief:

   • Non-sedating options: cetirizine 10mg daily or fexofenadine 180mg daily 1
   • If itching disrupts sleep, consider diphenhydramine 25-50mg at bedtime 2

3. Throat itching management:

   • The throat itching suggests a possible systemic reaction
   • Take oral antihistamines as mentioned above
   • Monitor for any signs of difficulty breathing, swelling of the face/lips/tongue, or other signs of anaphylaxis which would require emergency care 1

Skin Care

• Use gentle, soap-free shower gels 1
• Apply alcohol-free moisturizers containing 5-10% urea at least twice daily 1
• Avoid hot showers, which can worsen itching 1
• Avoid skin irritants and fragranced products 1

When to Seek Further Medical Care

Seek immediate medical attention if you experience:

• Difficulty breathing
• Swelling of the face, lips, tongue or throat
• Widespread rash covering more than 30% of body surface area
• Blistering or skin sloughing
• Fever or other systemic symptoms 1

Follow-up

• If symptoms don't improve within 1 week or worsen at any point, consult a healthcare provider 1
• A dermatology referral may be necessary if the rash persists beyond 2 weeks despite treatment 1

Prevention of Future Reactions

• Document this reaction to trazodone in your medical records 1
• Consider wearing a medical alert bracelet if the reaction was severe
• Inform all healthcare providers about this reaction before receiving any new medications

Special Considerations

• If the rash covers more than 10% of your body surface area or if throat symptoms worsen, consult a healthcare provider promptly as you may need systemic corticosteroids 1
• For persistent itching that doesn't respond to antihistamines, medications such as gabapentin (100-300mg three times daily) might be considered under medical supervision 2

Remember that while trazodone is primarily used as an antidepressant, it can cause various adverse effects including skin reactions that may appear even after discontinuation 3. Proper management of these reactions is important to prevent progression and provide symptom relief.