Trazodone is a medication that is FDA-approved for depression treatment. However, it can also be prescribed off-label to treat problems like insomnia and anxiety. Trazodone has a wide dosing range, so there are many different dosages people take when they are prescribed the drug. It is only available as a generic prescription, though it was previously available under brand names like Oleptro.

Article at a Glance:

  • Trazodone is an antidepressant that is FDA-approved for depression.
  • Off-label uses for trazodone are common and include insomnia and anxiety.
  • Because trazodone is not a controlled substance, some doctors consider it safer than other alternatives for insomnia and anxiety.

Trazodone Dosage Overview

Trazodone is available as a tablet in several dosages. The lowest tablet strength is 50 mg, while higher strengths include 100 mg, 150 mg and 300 mg tablets. The tablets can be split to get a lower dose when needed; for example, someone may split a 50 mg tab to get a 25 mg dose.

Physicians usually start patients on the lowest effective dose, increasing the dose as needed.

Trazodone for Depression

Although trazodone is only FDA-approved for depression, it is rarely prescribed for that reason. Selective-serotonin reuptake inhibitors (SSRIs) like sertraline (Zoloft), escitalopram (Lexapro) and fluoxetine (Prozac) are more common and are generally considered some of the gold standards for depression treatment. Trazodone is more popular as an off-label drug for other medical issues, such as insomnia.

When someone starts taking a medication like trazodone for depression, it can take several weeks for the drug’s full effectiveness to begin. For the treatment of depression, trazodone may start to help improve symptoms in one to two weeks. The maximum effects may take anywhere from four to six weeks to show. If you have been taking trazodone for depression without improvement after this time, it is important to tell your doctor.

Dosage for Depression

Compared to when it’s used off-label for other conditions, trazodone for depression treatment typically requires higher doses. The starting dose of trazodone for depression is 150 mg daily. It can then be increased to a max dose of 600 mg daily, which may be split across multiple doses during the day.

Because trazodone is used at high doses in depression, it is important not to stop the drug cold turkey. Instead, if you are stopping trazodone, your dose should be slowly tapered over two to four weeks to avoid withdrawal symptoms.

Trazodone for Anxiety

Trazodone is not FDA-approved for anxiety, but it can be prescribed off-label for this reason. However, first-line treatments for anxiety — including other antidepressants — are more likely to be used first. Trazodone is believed to help with anxiety because it influences neurotransmitters that are linked to excitability, such as serotonin, noradrenaline, dopamine, acetylcholine and histamine.

Trazodone Dosage for Anxiety

To treat anxiety, trazodone can be taken at a dose of 50 mg to 100 mg, two to three times daily. The total daily dosage should not exceed 400 mg.

Is Trazodone Like Xanax?

Trazodone and Xanax are very different from one another. Unlike trazodone, Xanax is not classified as an antidepressant; instead, it is a benzodiazepine. Xanax is a short-acting drug that enhances brain neurotransmitters like GABA, which may be imbalanced in people with anxiety or panic disorders.

Another big difference between trazodone and Xanax is the fact that Xanax is a Schedule IV controlled substance. Xanax may not be an ideal option if a patient is prone to drug abuse, but trazodone may be appropriate because it is not a controlled substance.

Side effects of trazodone and Xanax, such as drowsiness, can be similar because both drugs are central nervous system depressants.

Using Trazodone for Sleep

When trazodone is used to treat a condition like depression, the drowsiness side effect can be problematic. However, this side effect is what causes trazodone to be prescribed for insomnia. That said, sleep medicine doctors do not recommend it for insomnia treatment due to unclear evidence of its effectiveness. Regardless, trazodone is a popular drug for sleep due to its reputation as a safer alternative to other sleep medications; unlike trazodone, many of these other medications are controlled substances.

Trazodone Dosage for Sleep

When prescribed for sleep, trazodone can be taken as a 50 mg to 100 mg dose at bedtime. If needed, the dose can be increased to up to 200 mg at bedtime to help with sleep. Those with both depression and sleep problems may need a higher dose in some cases — up to 300 mg at bedtime.

Trazodone vs. Ambien

Ambien is a brand name of zolpidem, a popular prescription sleep aid. Unlike trazodone, Ambien is a sedative-hypnotic and a Schedule IV controlled substance, meaning that it has a risk of abuse, dependence and addiction.

Although sleep medicine guidelines recommend Ambien for insomnia, some people are hesitant to take Ambien because of its side effects. Aside from its addiction risk, side effects include complex sleep behaviors like sleepwalking and sleep-driving. The FDA has even issued a Black Box Warning for these effects.

Find the Help You Need

Although trazodone is not a controlled substance, it is still possible to become addicted to it. If you struggle with taking too much trazodone and are unable to stop, The Recovery Village can help. Contact our experts today to learn more about treatment plans that can work well for your situation.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.

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