Can I stop taking 100mg of trazodone (antidepressant) for insomnia?

Stopping Trazodone 100mg for Sleep

Trazodone is not recommended for chronic insomnia and should be discontinued under healthcare provider supervision to prevent withdrawal symptoms. 1

Why Trazodone Is Not Recommended for Insomnia

The American Academy of Sleep Medicine specifically includes a weak recommendation against using trazodone for chronic insomnia 1. Despite its widespread off-label use for sleep disorders, the evidence supporting trazodone's efficacy for primary insomnia is limited, with most studies being small and conducted primarily in depressed populations 2.

How to Discontinue Trazodone

When stopping trazodone, consider the following approach:

1. Do not stop abruptly: The FDA label explicitly states, "Do not stop taking Trazodone Hydrochloride Tablets without talking to your healthcare provider" 3

2. Gradual tapering is necessary: A gradual taper is recommended to minimize withdrawal symptoms and rebound insomnia 1

3. Potential withdrawal symptoms: Discontinuing trazodone can cause withdrawal symptoms including anxiety, agitation, and sleep problems 3

4. Monitoring during discontinuation: Follow up with your healthcare provider within 7-10 days of initiating the tapering process 1

Recommended Alternatives for Insomnia

The American Academy of Sleep Medicine strongly recommends:

1. Cognitive Behavioral Therapy for Insomnia (CBT-I) as first-line therapy for chronic insomnia 1

   • CBT-I produces equivalent results to medication with no side effects and fewer relapses
   • Key components include sleep consolidation, stimulus control, cognitive restructuring, sleep hygiene, and relaxation techniques

2. If medication is necessary, consider FDA-approved options matched to your specific insomnia type 1:

   • For sleep onset difficulty: Ramelteon (8mg) or Zolpidem (5-10mg)
   • For sleep maintenance difficulty: Low-dose doxepin (3-6mg) or Suvorexant (10-20mg)

Common Pitfalls When Stopping Trazodone

• Rebound insomnia: Studies show significant rebound insomnia can occur on the second night after discontinuation 4
• Withdrawal effects: Anxiety and agitation may occur if stopped abruptly 3
• Replacing with another inappropriate agent: Avoid replacing trazodone with other non-recommended agents like diphenhydramine, melatonin, or valerian, which are also not recommended for chronic insomnia 1

Special Considerations

• If you've been taking trazodone for depression rather than just insomnia, consult with your healthcare provider before discontinuing, as this could affect your depression management
• Consider implementing good sleep hygiene practices during the discontinuation process
• If you experience severe withdrawal symptoms, contact your healthcare provider immediately

Remember that while trazodone has been widely used off-label for insomnia, current guidelines do not support its use for this purpose, and proper discontinuation under medical supervision is important to minimize adverse effects.