How Long Does Trazodone Last in Your System?

What Is Trazodone & How Is it Used?

Trazodone is a medication classified as an antidepressant, belonging to the drug class of serotonin antagonists and reuptake inhibitors (SARIs). It works by balancing neurotransmitters in the brain, particularly targeting serotonin, which plays a key role in mood regulation. This action may help alleviate symptoms of depression and improve mood for some people.

Trazodone is FDA-approved to treat disorders such as:²

• Major depressive disorder (MDD)

Trazodone can also have off-label (non-FDA-approved) uses for treating:³

• Primary or secondary insomnia
• Generalized anxiety disorder
• Panic disorder
• Post-traumatic stress disorder (PTSD)
• Obsessive-compulsive disorder (OCD)
• Bulimia nervosa
• Benzodiazepine and/or alcohol dependence or abuse
• Fibromyalgia
• Degenerative diseases of the central nervous system, such as dementia and other organic disorders
• Schizophrenia
• Chronic pain
• Diabetic neuropathy

“Off-label” refers to the use of a medication for purposes not formally approved by the FDA. Although it may benefit some illnesses, more research is still needed to determine if trazodone is safe and effective for these off-label uses.

For How Many Hours Does Trazodone Work?

After being taken orally, peak absorption levels are typically reached within one hour when it is taken an empty stomach or two hours when taken with food. ² This suggests that individuals may begin to feel some effects or side effects within this timeframe. However, it’s important to note that the onset of actual antidepressant effects, as opposed to mere presence in the bloodstream, can be more gradual. Some patients may notice symptomatic relief during the first week of treatment, with the most effective symptom relief evident within two weeks.

For some individuals, particularly those who respond to the medication, a significant therapeutic response may be observed as early as the end of the first week of treatment. The differences in time to feel the effects of trazodone can be significant for managing symptoms, especially in conditions where rapid relief is desirable.

For instance, in cases of severe depression or anxiety, a quicker onset of action may be beneficial. Conversely, for long-term management of depression, the gradual onset and sustained release of trazodone’s effects can be advantageous, providing steady symptom control.

How Long Does Trazodone Stay in Your Body?

Trazodone typically remains in your system for approximately 42 hours after the last dose, with its effects lasting for about 5 to 9 hours. Trazodone is metabolized (broken down chemically) primarily by the liver into end products called metabolites.

Its main metabolite, m-chlorophenylpiperazine (mCPP), plays a role in trazodone’s effects on the body. Accumulation of trazodone and its metabolites in the body can impact drug testing, with different detection windows in urine, blood, saliva, and hair tests.²

• Urine: Trazodone can be detected in urine for 2-4 days after the last dose. This time frame may vary depending on individual metabolic differences and the frequency of use.
• Blood: In blood tests, trazodone can typically be detected for up to 24 hours post-administration. Blood tests are more likely to detect trazodone shortly after its use.
• Saliva: Saliva tests can detect trazodone for approximately 1-2 days following the last dose. This testing method is less common but can be effective soon after ingestion.
• Hair: Hair tests have the longest detection window, potentially identifying trazodone for up to 90 days or more after use. Hair testing is not typically used for routine screening but can provide a longer history of drug use.

Factors Affecting How Long Trazodone Stays in the Body

Several factors can influence how long trazodone stays in your body. These factors affect the metabolism, absorption, and excretion. All of these impact how long trazodone and its metabolites remain detectable in different individuals. Understanding these factors influence how effective trazodone is and side effects a person may experience.

Factors affecting how long trazodone stays in your body include:²

• Dosage and frequency of use: Higher doses of trazodone may take longer to be metabolized and excreted from the body. Additionally, frequent use can lead to the drug accumulating in the system, potentially prolonging its presence.
• The presence of other substances: Using other medications while also taking trazodone can affect its breakdown and elimination. Substances metabolized by the same liver enzymes as trazodone may have a larger impact. Substances like alcohol and certain foods can also interact with trazodone metabolism.
• Age: Metabolic rates vary with age. Older adults may metabolize trazodone more slowly, leading to a longer duration in the body.
• Liver function: The liver plays a key role in metabolizing trazodone. Impaired liver function can slow this process, leading to prolonged retention of the drug.
• Kidney function: Since trazodone and its metabolites are excreted through the kidneys, impaired kidney function can delay its elimination from the body.
• Body composition and metabolism: Individual differences in body fat, metabolic rate, and overall health can influence how quickly trazodone is processed and eliminated.
• Genetics: Genetic variations can affect how an individual’s body metabolizes trazodone, leading to differences in how long the drug stays in their system.
• Hydration and diet: Hydration levels and dietary habits can indirectly influence trazodone’s metabolism and excretion.
• Frequency of exercise: Regular exercise can influence metabolic rate and, in turn, may affect the rate at which trazodone is metabolized.
• Co-existing medical conditions: Certain medical conditions, particularly those affecting the liver or kidneys, can significantly alter the duration trazodone stays in the body.

How Long Does Trazodone Work for Sleep?

Trazodone may be prescribed off-label for sleep disorders due to its sedative effects. The duration of its effectiveness for inducing and maintaining sleep can vary, but it generally helps patients stay asleep for the entire night. The best time to take trazodone for sleep is shortly before bedtime, ideally after a meal or light snack to enhance absorption.

The medication’s peak levels occur about one hour after dosing on an empty stomach or two hours post-dosing when taken with food. It’s important to be aware of the risk of drowsiness and coordination problems, which can affect activities requiring alertness. Patients should be aware of the potential risks associated with antidepressants, including the emergence of suicidal thoughts and behavior, particularly in young adults.¹

Does Trazodone Make You Sleepy the Next Day?

Trazodone can cause residual drowsiness the next day in some individuals. This ‘hangover’ effect might manifest as continued sleepiness, dizziness, unwellness, or feeling less alert than usual. The likelihood and intensity of next-day drowsiness depend on various factors, including the dosage of trazodone, the individua metabolism, and their overall sensitivity to the medication.

Patients should monitor how they respond to the drug and discuss any persistent next-day sleepiness with their healthcare provider. This may be a reason for adjusting dosage or timing on taking the medication. Patients taking trazodone need to be cautious when driving or operating machinery the day after taking trazodone, especially when they are still evaluating their response to the medication.¹

Short-term Vs. Long-term Trazodone Use

The duration for which trazodone stays in the system can vary depending on whether it is used in the short or long term. With short-term use, trazodone is absorbed well, with peak levels occurring approximately one hour after being taken on an empty stomach or two hours after being taken when taken with food.² However, in some patients, trazodone may accumulate in the bloodstream, which could be more pronounced during long-term use.

Over a long-term period, trazodone is broken down chemically in the liver, primarily by the cytochrome P450 3A4 (CYP3A4) enzyme. Its active metabolite, m-chlorophenylpiperazine (mCPP), could accumulate over time, potentially altering the drug’s effects and duration in the system.²

Additionally, long-term use might lead to changes in the body’s ability to process and eliminate the drug, possibly resulting in accumulating effects over time. Patients on long-term trazodone therapy need to be monitored regularly for any changes in efficacy or the emergence of adverse effects, and dose adjustments may be necessary based on therapeutic response and tolerance.

When to Speak to a Professional

Misuse of trazodone can lead to adverse effects, including the risk of dependency and withdrawal symptoms. It’s important to remember that adjusting, discontinuing, or misusing psychiatric medication without medical guidance can have serious health implications. Contact your prescriber if you believe you may be misusing trazodone or developing a dependency.

There are numerous online psychiatry services offering access to licensed psychiatrists. This may be especially helpful for those who may not have local access to healthcare providers.

These services can provide initial consultations, ongoing medication management, and therapy sessions. Additionally, finding a therapist, either in-person or online, can complement the treatment with trazodone. A therapist can help address underlying issues and provide coping strategies, offering a more holistic approach to mental health care.

Questions to Ask Your Healthcare Provider About How Long Trazodone Stays in Your System

When discussing trazodone with your healthcare provider, it’s important to have a clear understanding of how it interacts with your overall health and other medications.

Questions to ask your care team about trazodone alternatives include:

1. Is it safe to take antidepressants with my other medications?
2. Am I at risk for side effects from antidepressants or supplements if I am already taking other medications, such as anxiety medications?
3. What antidepressants should I consider for fewer side effects?
4. Will my depression symptoms get better without medication?
5. Are there any foods, drinks, or activities I should avoid while taking trazodone?
6. Can I drive or operate heavy machinery while taking trazodone?
7. How will trazodone interact with my other medications?
8. Are there any over-the-counter medications or supplements I should avoid while taking trazodone?
9. How long will it take for trazodone to start working?
10. What is the recommended dosage for trazodone?
11. What should I do if I miss a dose of trazodone?
12. Are there any long-term effects of taking trazodone?
13. What should I do if I experience any side effects while taking trazodone?
14. Can trazodone be addictive?
15. How often will I need to have follow-up appointments while taking trazodone?