What is the normal dosage of trazodone (an antidepressant medication)?

From the Guidelines

The normal dosage of trazodone for adults with insomnia is typically in the range of 25-100 mg at bedtime, with elderly patients starting at 25-50 mg at bedtime and gradual increases as necessary 1.

Key Considerations

• Trazodone works by increasing serotonin levels in the brain, which helps regulate mood and sleep, and has a sedating effect, making it useful when taken before bedtime.
• Patients should be aware that trazodone may cause drowsiness, dizziness, and dry mouth, and should avoid alcohol while taking this medication.
• The evidence supporting the efficacy of trazodone for insomnia is low-quality and outweighed by its adverse effect profile, as reported in a systematic review 1.
• A clinical practice guideline suggests that clinicians not use trazodone as a treatment for sleep onset or sleep maintenance insomnia in adults, based on trials of 50 mg doses of trazodone 1.

Dosage and Administration

• Treatment usually begins with a low dose, often taken at bedtime, with gradual increases if necessary.
• The dose may be adjusted based on individual response and tolerance.
• It is essential to monitor patients for adverse effects and adjust the dosage or discontinue treatment as needed.

Important Safety Information

• Trazodone may cause serious side effects, including increased risk of suicidal thoughts and behaviors, serotonin syndrome, and cardiac arrhythmias.
• Patients should be closely monitored for signs of adverse effects, and the medication should be used with caution in patients with a history of seizures, bipolar disorder, or liver disease.

From the FDA Drug Label

1. Dosage and Administration 2. 1 Dose Selection An initial dose of 150 mg/day in divided doses is suggested. The dosage should be initiated at a low-dose and increased gradually, noting the clinical response and any evidence of intolerance. The maximum dose for outpatients usually should not exceed 400 mg/day in divided doses. Inpatients (i.e., more severely depressed patients) may be given up to but not in excess of 600 mg/day in divided doses.

The normal trazodone dosage is:

• Initial dose: 150 mg/day in divided doses
• Maximum dose for outpatients: 400 mg/day in divided doses
• Maximum dose for inpatients: 600 mg/day in divided doses 2

From the Research

Normal Trazodone Dosage

• The normal dosage of trazodone is between 150 mg to 300 mg per day, with the dose often weighted at bedtime due to its 3- to 9-hour half-life and pharmacokinetics 3.
• Studies have shown that single nighttime dosing is more productive of sleep with less daytime drowsiness, especially at the onset of treatment 3.
• Trazodone can be dosed at 150 mg given predominantly at bedtime and increased as needed to 200 to 300 mg for full antidepressant efficacy 3, 4.
• The dosage may vary depending on the patient's response and tolerance, with geriatric patients responding similarly to the standard dosage 3.
• A once-daily formulation of trazodone has been introduced, which maintains effective blood trazodone levels for 24 hours while avoiding concentration peaks associated with side effects 4.
• The most common adverse effects of trazodone are somnolence, headache, dizziness, and xerostomia, with minimal anticholinergic activity but potential for orthostatic hypotension, QT interval prolongation, and cardiac arrhythmias 4, 5.