From the Guidelines
Trazodone should not be used as a treatment for sleep onset or sleep maintenance insomnia in adults, according to the American Academy of Sleep Medicine clinical practice guideline 1.
Reasons for this recommendation
- The guideline suggests that the benefits of trazodone for insomnia do not outweigh its risks, including adverse effects such as morning drowsiness, dizziness, and dry mouth.
- The evidence supporting the efficacy of trazodone for insomnia is low-quality and limited, with most studies having short durations of therapy and follow-up periods 1.
- Other treatments, such as cognitive behavioral therapy for insomnia (CBT-I) and certain medications like eszopiclone and zolpidem, have stronger evidence supporting their effectiveness for insomnia 1.
Important considerations
- If trazodone is prescribed for insomnia, it is essential to start with a low dose (25-50 mg) and gradually increase as needed, under medical supervision.
- Patients should be aware of the potential risks and benefits of trazodone and monitor for adverse effects, such as daytime impairment, dizziness, and dry mouth.
- Alternative treatments, such as CBT-I and other medications, should be considered before initiating trazodone for insomnia.
From the Research
Trazodone Dosage for Sleeping
- The dosage of trazodone for sleeping varies, but studies have used doses ranging from 50mg to 100mg per day 2, 3.
- A study published in 2011 used a dose of 50mg of trazodone 30 minutes before bedtime for 7 days and found it to be effective in improving sleep maintenance difficulties 2.
- Another study published in 2008 used a dose of 100mg of trazodone per day for 8 weeks and found it to be effective in improving sleep latency, sleep efficiency, and total sleep time 3.
- A systematic review published in 2017 found that low-dose trazodone (≤100mg/d) is effective and safe for the treatment of insomnia, with the most common side effect being drowsiness 4.
- More recent studies have also used trazodone to treat insomnia, with doses ranging from 50mg to 100mg per day, and have found it to be effective in improving sleep duration and reducing symptoms of insomnia 5, 6.
Comparison of Trazodone Dosage
- The optimal dosage of trazodone for sleeping is not well established, but studies suggest that lower doses (50mg-100mg per day) may be effective and safer than higher doses 2, 4, 3.
- The dosage of trazodone may need to be adjusted based on individual patient response and tolerance, as well as the presence of any underlying medical conditions or concomitant medications 4.
- Further research is needed to determine the optimal dosage of trazodone for sleeping and to compare its efficacy and safety with other treatments for insomnia 5, 6.