Can Trazodone Cause Increased Thirst?
Trazodone does not typically cause increased thirst as a primary side effect, and dry mouth—not thirst—is the anticholinergic effect most commonly reported with this medication. 1, 2
Common Side Effects of Trazodone
The most frequently reported adverse effects of trazodone include 2, 3:
- Somnolence/sedation (most common)
- Dry mouth (not increased thirst)
- Headache
- Dizziness
- Nausea and vomiting
Approximately 63% of patients receiving second-generation antidepressants experience at least one adverse effect, with dry mouth being among the commonly reported symptoms rather than increased thirst 1.
Anticholinergic Profile
Trazodone has minimal anticholinergic activity compared to tricyclic antidepressants, which makes it potentially better tolerated, especially in elderly patients 2, 4. The anticholinergic effects that do occur typically manifest as dry mouth rather than polydipsia (increased thirst) 5, 3.
Important Cardiovascular and Other Considerations
While thirst is not a characteristic side effect, clinicians should monitor for 2, 3:
- Orthostatic hypotension (particularly in elderly patients or those with heart disease)
- QT interval prolongation (rare but serious)
- Cardiac arrhythmias
- Priapism (rare but requires immediate attention)
Clinical Context
If a patient on trazodone reports increased thirst, consider alternative explanations 3, 6:
- Dry mouth being misinterpreted as thirst
- Concurrent medications that may cause polydipsia
- Underlying medical conditions (diabetes, hypercalcemia)
- Dose-related effects at higher therapeutic doses (150-400 mg daily for depression)
The adverse effect profile of trazodone is generally favorable compared to older tricyclic antidepressants, with significantly fewer anticholinergic effects overall 5, 7.