Trazodone hydrochloride is an oral medication approved by the U.S. Food and Drug Administration (FDA) to treat depression. It’s also prescribed off-label for insomnia and other mental-health conditions, including anxiety.
If you suffer from chronic insomnia, a licensed healthcare provider can determine whether trazodone for sleep is right for you. If they recommend trazodone, you could get a prescription online in as little as 24 hours.*
Providers on Klarity Health are independent practitioners with clinical autonomy; a diagnosis, treatment, or prescription is not guaranteed.
Providers on Klarity Health are independent practitioners with clinical autonomy; a diagnosis, treatment, or prescription is not guaranteed.
Licensed medical professionals on Klarity Health work with you to create an insomnia treatment plan tailored to you, including medication prescriptions if medically appropriate, behavioral counseling or therapy, or skills training.
Valium
Use: FDA-approved for anxiety, muscle spasms, and seizures; prescribed off-label for insomnia
Key ingredient: Diazepam
Ambien
Use: FDA-approved medication for insomnia
Key ingredient: Zolpidem
Ramelteon
Use: FDA-approved medication for insomnia
Key ingredient: Ramelteon
Quviviq
Use: FDA-approved to treat insomnia
Key ingredient: Daridorexant
Xanax
Use: FDA-approved for panic and anxiety disorders; use off-label use for insomnia
Key ingredient: Alprazolam
Reviews from real patients who received treatment from healthcare providers on Klarity Health.
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Trazodone hydrochloride is an oral antidepressant medication. It was approved by the FDA in 1981 to treat major depressive disorder (MDD). It belongs to a class of antidepressants called serotonin antagonist and reuptake inhibitors (SARIs), which slow the reabsorption of serotonin (a chemical messenger) back into the brain to prolong its “feel good” effects.
Trazodone can be taken by itself or in combination with other medications to treat depression. It’s often used with selective serotonin reuptake inhibitor (SSRIs) antidepressants to prevent some of the more common side effects of those drugs: sexual dysfunction, anxiety, and insomnia.
Trazodone is also prescribed off-label (a condition it’s not FDA approved for) as a treatment for insomnia by itself, as well as several other mental-health conditions: generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, and post-traumatic stress disorder (PTSD). Trazodone is also used off-label for other health conditions, including bulimia, substance abuse, chronic pain, and dementia.
Trazodone is a generic drug. The brand name for trazodone is Raldesy. Other brands of the medication — Desyrel, Desyrel Dividose, and Oleptro — have been discontinued in the U.S.
Trazodone was shown to improve sleep problems in patients taking the drug for treatment of depression or GAD, which led to it being prescribed by providers off-label for insomnia. It works by having a sedative effect on the body and reducing certain neurotransmitters that are associated with arousal.
Trazodone also blocks histamines, which help the immune system and keep the brain alert. A histamine blocker, or antihistamine (as found in common allergy medications, like Benadryl), can have a sedative effect and make you drowsy.
A clinical placebo-controlled study found taking 50 to 100 milligrams a day of trazodone helped secondary insomnia caused by depression, with the higher dose most effective for improving sleep. The same study found 50 milligrams of trazodone was more effective than a placebo for improving sleep duration and shortening the time it took to fall asleep in patients with primary insomnia (insomnia that’s not a side effect of another health condition). Zolpidem (brand name Ambien) was found to be more effective in this study than both trazodone and a placebo though.
The FDA hasn’t approved trazodone for sleep because there’s not enough data to show it’s effective. And clinical guidance from the American Academy of Sleep Medicine doesn’t recommend trazodone as a treatment for insomnia due to the lack of quality scientific evidence to support it.
Trazodone is FDA-approved to treat depression. If your healthcare provider thinks the effects of trazodone will improve your sleep, they can prescribe it off-label.
In 2022, over 27 million prescriptions for trazodone were issued in the U.S. Research found that trazodone is more commonly prescribed as a sleep aid than as an antidepressant.
Trazodone requires a prescription from a licensed healthcare provider, such as a physician assistant/associate (PA), medical doctor (MD), or nurse practitioner (NP). If one of these healthcare professionals thinks trazodone is appropriate for you to improve sleep, they can prescribe it for you.
Find a board-certified, licensed provider to discuss trazodone or other insomnia medications on Klarity Health.
If you and your provider decide trazodone is right for you, your provider can send your prescription to an online or local pharmacy or you can drop it off or submit it yourself.
Some states require at least one in-person visit before a provider can prescribe medication. Find online prescribing regulations for your state on the Center for Connected Health Policy website.
Trazodone comes in oral tablets in 4 dosages: 50, 100, 150, or 300 milligrams. It’s taken daily. Because of its sedative effects, trazodone should be taken close to bedtime, following a snack or a light meal.
Because trazodone isn’t FDA-approved for insomnia, there are no recommended dosing instructions for trazodone for sleep. Your healthcare provider can determine a dosage that’s best for you, likely prescribing low doses of trazodone first and increasing your dose if needed.
The most common potential side effects of trazodone are dry mouth, constipation, drowsiness, dizziness and lightheadedness, fatigue, nervousness, daytime sleepiness, nausea, vomiting, and skin conditions.
Trazodone also has potentially serious side effects. It comes with an FDA-boxed warning for increased thoughts of suicide and suicidal behavior in children, adolescents, and young adults taking the drug for MDD. Young patients should be closely monitored by their families and healthcare providers while taking it.
Trazodone is also linked to priapism (a prolonged painful erection that lasts for several hours). Medical intervention is required if patients have this side effect.
Patients with heart disease should be closely monitored by their providers because trazodone and other antidepressants have been associated with cardiac arrhythmias.
Trazodone shouldn’t be taken with other antidepressants, as it can increase the risk of a rare but serious condition called serotonin syndrome. Other antidepressants include duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), bupropion (Wellbutrin), and sertraline (Zoloft). Wait at least 14 days after taking an MAOI to use trazodone. People taking the muscle relaxant cyclobenzaprine (Flexeril) should also avoid taking trazodone to avoid serotonin syndrome.
If you take Trazodone and have any side effects, work with your provider and consider reporting negative side effects to the FDA by visiting MedWatch or calling 1-800-FDA-1088.
Trazodone is inexpensive because it’s a generic drug. A 30-day supply of 100-milligram trazodone tablets costs about $19 out of pocket. The 50-milligram tablets cost about $18, and the 150-milligram tablets cost about $21 for 30 tablets. The 300-milligram tablets cost $151 for 100 tablets. Costs are from drugs.com with its discount.
Trazodone is typically covered by insurance. So you may pay only your copay and any applicable deductible depending on your insurance plan. And, with or without insurance, you can use a prescription discount site like GoodRx, SingleCare Rx, NeedyMeds, or drugs.com to save up to 80% on your out-of-pocket cost.
More than 20 medications are FDA-approved to treat sleep disorders because they’re proven to be safe and effective treatments for insomnia in clinical trials. Trazodone isn’t FDA-approved for insomnia and is only used off-label as a sleep aid.
FDA-approved insomnia medications include zolpidem (Ambien), ramelteon (Rozerem), and daridorexant (Quviviq). Some benzodiazepines are also FDA-approved for sleep, but these are classified as Schedule IV controlled substances due to their high risk of abuse and addiction.
Zolpidem (Ambien) is FDA-approved to treat short-term insomnia. In clinical trials, it was found to be more effective than a placebo for improving sleep. Research also found Ambien doesn’t impair motor functions 8 hours or more after taking it. Ambien has an FDA-boxed warning due to its link with complex sleep behaviors that can potentially be dangerous, including sleep-walking and sleep-driving.
Ramelteon (Rozerem) is FDA-approved to treat insomnia that’s characterized by difficulty falling asleep. It may cause temporary cognitive or behavioral changes because it’s a hypnotic drug that depresses the central nervous system (CNS) to promote sleep.
Daridorexant (Quviviq) is FDA-approved to treat insomnia characterized by difficulty falling asleep and staying asleep in adults. It’s also a hypnotic. Complex sleep events, including sleep paralysis and sleep-walking, have been reported with daridorexant. Worsened depression and increased suicidal thoughts also have been reported.
The best way to find out which insomnia medication, if any, is best for you is to talk to an insomnia specialist.
*Appointments are generally available within 24 hours. Free initial consultations are available only with select providers. Prescriptions, particularly for controlled substances, may require an in-person evaluation depending on the state of residence and current federal regulations.
The information provided in this article is for educational purposes only and should not be construed as medical advice. Controlled substances may not be appropriate for all patients and any mention of these medications is for educational purposes only, not for marketing or encouraging self-diagnosis. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health. Providers on Klarity Health are independent practitioners with clinical autonomy. Nothing in this article is intended to diagnose or treat any condition, including guaranteeing prescription medication of any kind or dosage. Not all providers on Klarity Health prescribe all medications, particularly medications that are controlled substances.
If you’re having a mental health crisis or experiencing a psychiatric emergency, it’s crucial to seek immediate help from a mental healthcare professional, such as a psychiatrist, psychologist, or therapist. You can also call your local emergency services, visit your nearest emergency room, or contact a crisis hotline, such as the National Suicide Prevention Lifeline, by calling or teTrazodoneting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.