Discontinuing Trazodone from 100 mg
Trazodone should be tapered gradually over 10-14 days when discontinuing from 100 mg to minimize withdrawal symptoms. 1
Recommended Tapering Schedule
The most direct guideline evidence states that discontinuing antidepressants, including trazodone, over 10-14 days limits withdrawal symptoms. 1 This represents the standard approach for antidepressant discontinuation at therapeutic doses.
Practical Tapering Approach
Reduce the dose by 25 mg every 3-4 days over approximately 2 weeks 1
- Day 1-3: 75 mg daily
- Day 4-7: 50 mg daily
- Day 8-10: 25 mg daily
- Day 11-14: Discontinue
For patients with prior withdrawal sensitivity, extend the taper to 3-4 weeks with smaller decremental reductions 2
Important Clinical Considerations
Withdrawal Symptoms to Monitor
Trazodone withdrawal can produce noradrenergic rebound symptoms due to its effects on the serotonergic system and its relatively short half-life. 2 Watch for:
- Dizziness and light-headedness 3
- Nausea and gastrointestinal symptoms 3
- Anxiety, agitation, or irritability 3
- Sleep disturbances 3
- Flu-like symptoms (fatigue, myalgia, chills) 3
Management of Withdrawal Symptoms
If withdrawal symptoms emerge during tapering, slow the taper rate or temporarily reinstitute the previous dose. 3 The research evidence specifically notes that trazodone should be tapered at a "very slow rate" in patients who develop withdrawal symptoms. 2
- Reassure patients that symptoms are typically transient and self-limiting 3
- For moderate-to-severe symptoms, return to the last tolerated dose and slow the taper further 3
- Avoid misdiagnosing withdrawal as depression relapse or new medical illness 3
Critical Pitfalls to Avoid
Do not abruptly discontinue trazodone, even at 100 mg. 2 Case reports document withdrawal symptoms developing despite gradual discontinuation when the taper was too rapid. 2
The 10-14 day guideline represents a minimum duration—some patients require longer tapers based on individual tolerance. 1, 2 Factors suggesting need for slower taper include: