Learn whether trazodone is a controlled substance, how it’s prescribed, potential risks, and safe alternatives for managing depression.
Jennifer Berger LCSW MSW
Clinical Editorial Team
Learn whether trazodone is a controlled substance, how it’s prescribed, potential risks, and safe alternatives for managing depression.
Trazodone is a prescription medication whose primary FDA-approved use is for major depressive disorder. However, its off-label use for insomnia now exceeds its primary use. It is also used for a number of other conditions. It is not a controlled substance. Read on to learn more about what it is, how it works, and what it’s used for.
Trazodone is in a class of medications called serotonin modulators. Specifically, it is a serotonin antagonist and reuptake inhibitor (SARI). It inhibits serotonin reuptake and antagonizes the serotonin receptors. This increases serotonin activity in the brain and thereby helps improve mood and symptoms of depression and anxiety. As well, it inhibits other receptors, which result in its sedative and low blood pressure effects.
Primarily developed (and FDA-approved) to treat Major Depressive Disorder (MDD), the use of trazodone off-label for insomnia now exceeds that of MDD. Other main off-label uses include \[1\]:
Other off-label uses include:
Yes, trazodone is generally safe when taken as prescribed. Your doctor will be aware of interactions with other drugs you may be taking (there are many possible interactions). Currently, trazodone is a last-line measure for MDD, compared to alternative available drugs. Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.
There is increased probability of problems, such as suicidal thinking and behavior in children, adolescents, and young adults (under 24 years of age) taking antidepressants to treat major depressive disorders and other psychiatric diseases and conditions.
Common side effects include the following. Other, more severe side effects should be referred to your doctor \[2\]:
Fatigue
Drowsiness
Somnolence
Nausea
Vomiting
Diarrhea
Constipation
Changes in appetite/weight
Weakness or tiredness
Nervousness
Dizziness/light headedness
Nightmares
Muscle pain
Dry mouth
Rash/Red or itchy eyes
Sexual problems
Uncontrollable shaking
Stuffy nose
Trazodone therapy requires careful consideration for patients treated with monoamine oxidase inhibitors (MAOIs), including linezolid or intravenous methylene blue. Do not take trazodone if you are currently using monoamine oxidase inhibitors (MAOIs), or have used them in the past 14 days, due to the risk of dangerous interactions and serotonin syndrome.
You should not take trazodone if you have any of the following conditions. Discuss these with your doctor \[3\] \[4\]:
There is a wide variety of alternatives for MDD and sleep issues. Consult with your doctor.
Do not take alternatives to trazodone, including some herbal supplements like St. John’s wort, or they may cause serious problems with serotonin syndrome and heart problems.
Always tell your healthcare provider about your full medical history and any new supplements you may be taking before starting trazodone. Never start or stop trazodone without consulting your doctor.
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MedCentral. 2024. Trazodone Oral.
MedLinePlus. 2022. Trazodone.
Shin JJ, Saadabadi A. Trazodone. . In: StatPearls . Treasure Island (FL): StatPearls Publishing
Rath, K. 2024. Trazodone oral tablet interactions: Alcohol, medications, and other factors. MedicalNewsToday.
About the Author
Clinical Director, Clinical Supervisor, EMDR Provider I am a Licensed Clinical Social Worker and graduated with a degree from the USC School of Social Work in 2015 with an emphasis in mental health. I began my career working with the Orange County Welfare to Work Program providing mental health services to reduce barriers to employment. I have spent the last 5 years working various levels in behavioral health, providing direct service to those struggling with co-occurring disorders. Using an eclectic and integrative approach, I incorporate the AIP model with EMDR, Person-in-Environment (PIE), Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), family systems, interpersonal and solution-focused therapy along with Rogerian positive regard into my practice.
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