A typical starting dose of trazodone for treating major depressive disorder (MDD) is 150 mg daily divided into 2 to 3 separate doses. Every 3 or 4 days, your prescriber can increase your dose by 50mg, depending on individual response. The maximum dose of trazodone used for outpatients is 400 mg daily. However, inpatients (treated in a hospital) experiencing more serious MDD may be given up to 600 mg daily.1
What Is Trazodone & How Is It Used?
Trazodone is FDA-approved for adults for the treatment of major depressive disorder (MDD). Trazodone is a selective serotonin reuptake inhibitor (SSRI) and a 5HT2 receptor antagonist. Serotonin is a chemical in the brain essential for mood and happiness. SSRIs prevent the reabsorption of serotonin by cells in the brain, which makes it more available for your brain to use, leading to a better mood. Trazodone is only for adults as there is an increased risk of suicidal thoughts or behaviors found during clinical trials in children, adolescents, and young adults.1,2
Trazodone also has off-label uses. An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone. Trazodone can be used off-label for manic episodes associated with bipolar disorder (BD). When it is used in the treatment of BD, Trazodone is not meant to be used alone- it must be used with other medications.1
Other off-label uses for trazodone include:2,3,4
- Use as an add-on medication for the treatment of psychomotor activation (PA) (e.g. tapping, fidgeting, pacing), Preventing recurrence of depression after manic episodes in a patient with obsessive compulsive disorder (OCD)
- Insomnia (inability to sleep)
- Anxiety
- Alzheimer’s disease
- Substance abuse
- Bulimia
- Fibromyalgia
- Post-traumatic stress disorder (PTSD)
Online Psychiatry and Medication Management Covered by Insurance
Talkiatry can match you with a real psychiatrist who takes your insurance and is seeing new patients. They’re in-network with major insurers and offer medication management. Get started with a short online assessment
Trazodone Forms & Strengths
Trazodone is only sold in oral tablet form. These tablets are immediate-release and range from 50 mg to 300 mg in strength. Patients typically start at a lower dosage strength (75 to 150 mg). Your prescriber may increase your dose of trazodone based on your response. The dosage strength is not determined by the severity of symptoms but rather by patient factors like individual response to the medication, age, and reason for use. It is important to take trazodone as your doctor has prescribed. If there are questions about your trazodone dosage, reach out to your prescriber or pharmacist.1,2
Trazodone is available in the United States in the following forms and strengths:
- 50 milligrams (mg) oral tablet
- 100 milligrams (mg) oral tablet
- 150 milligrams (mg) oral tablet
- 300 milligrams (mg) oral tablet
How to Take a Trazodone Dose
Trazodone should be taken with food or a light snack. It is important that you do not break, crush, or chew this medication other than breaking across a scoring line (break-line that is featured on the tablet) if indicated by your prescriber. It may be recommended to take trazodone before bed due to a common side effect of drowsiness and tiredness. It is important to avoid driving or operating heavy machinery until you know how trazodone affects you. Alcohol and medications that can cause dizziness should also be avoided due to increased drowsiness or dizziness levels when combined with trazodone.1
Trazodone should be stored at a controlled room temperature in an air-tight and light-resistant container (typical prescription bottles are light-resistant). Do not suddenly stop taking trazodone. Gradually decreasing the dose as recommended by your prescriber or pharmacist is recommended to prevent trazodone withdrawal symptoms.1 Talk with your prescriber or pharmacist if you wish to discontinue your trazodone prescription.
Trazodone Dosage for Adults With Manic Episodes
In limited instances, trazodone has been used to treat patients with manic episodes associated with bipolar disorder (BD). This is marked by things like an increase in energy, inflated self-esteem, extreme happiness, impulsive behavior, and psychomotor activation (PA).5 PA is a term describing the hyperactivity, distractibility, and restlessness that is commonly associated with hypomanic or manic episodes (e.g. fidgeting). There has been recent research to study the benefits of an injectable trazodone as well as an extended-release trazodone in mood disorders.3,4
Here is Trazodone dosage information for adults with manic episodes associated with bipolar disorder:3,4
- Typical starting dosage: 25-250 mg based on patient-specific factors and responses
- Dosage increases: 25-250 mg based on patient-specific factors and responses
- Maximum dosage: 250 mg based on patient-specific factors and responses
Trazodone Dosage Restrictions
Several factors go into determining the correct dose of trazodone for a patient. Individual patient response will allow the prescriber to decide how to adjust from the initial dose. The use of trazodone with kidney or liver impairment should be used with caution.1 Use in older populations is limited in research, but antidepressants have been associated with low blood sodium levels in elderly patients.1,2 For this reason, lower doses are recommended in elderly patients. Off-label uses of trazodone may call for different dosages. Your prescriber will decide the proper dose.2
If a patient experiences bothersome side effects with trazodone, it is common for the prescriber to decrease the dosage strength to make the medicine more tolerable for a patient. Trazodone dosage may need to be altered when taken alongside central nervous system depressants (e.g. sedatives, hypnotics), cytochrome P450 3A4 inhibitors (e.g. diltiazem, ketoconazole), digoxin, phenytoin, serotonergic drugs, or drugs affecting coagulation or bleeding.1 Make sure your prescriber or pharmacist has a complete medication list and medical history when considering if trazodone is the correct medication for you.
What if I Miss a Trazodone Dose?
If you miss a dose of trazodone, it is important that you do not double up doses to make up for your missed dose. If you miss a dose, you can take it as soon as you remember. However, if it is close to your next dose time, take the next dose as you regularly would and skip the missed dose altogether.6 You may notice withdrawal effects like anxiety, agitation, and sleep disturbances if you miss your dose.1
Patients may want to discontinue this medication during the initial stages if they experience side effects. It may take time for the body to adjust to this medication. Gradual dose increases are recommended to help the patient adjust. Patients may be tempted to discontinue trazodone once they feel symptom relief. However, providers may keep patients on this medication for extended periods of time after symptoms resolve to avoid symptom recurrence.
When discontinuing the medication, a gradual reduction of the medication should be planned with your doctor or pharmacist. This lowers the withdrawal symptoms associated with discontinuing trazodone.1,6
You should never suddenly stop taking your medication. Talk with your healthcare provider if you would like to stop taking your medication. They will help you create a plan to taper (slowly reduce) the medication.
Popular Choices for Online Psychiatry
Talkiatry – Safe, virtual mental health care from doctors who take insurance. Most psychiatry visits cost patients $30 or less* Take a short assessment.
Hims / Hers – Connect with a healthcare provider in 12 to 48 hours.** Free Assessment
*Includes copayment, deductible, coinsurance, and $0 Visits. Excludes no shows. **On average. Actual appointment times vary by state and individual patient.
Can You Overdose on Trazodone?
Yes, you can overdose on trazodone. The actual amount of trazodone to overdose varies for each individual. This is why it is important to closely follow your prescriber and pharmacist’s instructions and never double up on a dose. Overdose of trazodone can be life-threatening, and you should seek immediate medical help if an overdose is suspected.1,7
Signs of an overdose on trazodone include:1,6,7
- Strong sedation
- Intense dizziness or fainting
- Confusion
- Nausea and vomiting
- Difficulty breathing
- Inconsistent heartbeats
- Sustained, painful erection
- Seizures
What Should You Do If You Take Too Much Trazodone?
If someone is suspected of trazodone overdose, medical attention should be sought immediately. You should call your prescriber or pharmacist or the poison control center (800-222-1222) or seek emergency medical help (911). Make a note of the medication(s) taken, dosages, and the time they were taken. Stay with the patient while you wait for help, and keep a close eye on their symptoms. A 911 operator or poison control worker may give you other directions to follow while waiting for emergency help.1,7
Questions to Ask Your Healthcare Provider About Trazodone Dosage
If you think that trazodone could be beneficial to you, consider consulting with your doctor, therapist, psychiatrist, or pharmacist to discuss potential benefits, risks, and side effects associated with trazodone. You should provide a clear medical history and current medication list to help your doctor or pharmacist give you their best recommendation.1,6,7
If you need to change providers for any reason, considering an online psychiatry service might be a good option for you. These services are easily accessible and convenient for patients. They can prevent delays in your mental health services and bring services you may need right to you.
Questions to ask your care team about trazodone dosage include:
- How long will it take for me to adjust to taking trazodone?
- How long does trazodone take to work?
- Am I at risk for more serious side effects if I am already taking other anxiety/depression medications?
- What’s the most effective dosage of trazodone for treating anxiety?
- Is there anything I should tell my therapist if I start to take trazodone?
- Are there any long-term side effects from taking trazodone?
- How long should I take trazodone before talking to my doctor if I do not think it is working?
- Can trazodone cause weight gain and does my dosage have anything to do with it?
- What are the most common side effects of taking trazodone?
- Will taking trazodone affect my sex life?
- Are there any dietary restrictions while taking trazodone?
- Will my insurance cover trazodone?
- When should I call my healthcare provider about the side effects of taking trazodone?
- Can I drink alcohol while taking trazodone?
- Can trazodone help with sleep problems?
In My Experience
In my experience, I currently do not see trazodone prescribed alone for its use as an antidepressant as often as other newer antidepressants. I often see it prescribed at lower doses in combination with other medicines to treat sleeping problems. Although trazodone is not the typical first-line treatment for MDD today, it may be an effective option for the treatment of depression and insomnia (difficulty sleeping) in some patients. You should talk with your doctor or pharmacist to determine if trazodone could be a useful medication for you. Be sure to share your individual needs, medical history, and other medications you take to ensure there are no possible interactions.
I usually see lower doses used for insomnia and higher doses for depression. While trazodone is generally considered safe and well tolerated, the side effect my patients encounter most would be a sudden decrease in blood pressure when standing (orthostatic hypotension). This is especially prominent with elderly patients, which can be a risk factor for fall risk for this population. Other common side effects my patients mention include drowsiness, headache, nausea, and dry mouth.
Using trazodone to treat manic episodes associated with bipolar disorder shows some therapeutic potential. The mainstay treatments for manic episodes usually involve mood-stabilizing medications such as lithium or anticonvulsants like valproate or carbamazepine. More studies are required to determine if trazodone is safe and/or effective for this patient population.
Additional Resources
To help our readers take the next step in their mental health journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy is compensated for marketing by the companies included below.
Virtual Psychiatry
Talkiatry – Get help from a real doctor that takes your insurance. Talkiatry offers medication management and online visits with expert psychiatrists. Take the online assessment and have your first appointment in days. Free Assessment
Hims / Hers – If you’re living with anxiety or depression, finding the right medication match may make all the difference. Connect with a licensed healthcare provider in just 12 – 48 hours. Explore FDA-approved treatment options and get free shipping, if prescribed. No insurance required. Get Started
Free Prescription Discount Card
Optum Perks – Save up to 80% on most prescriptions. Optum Perks provides discounts at over 64,000 pharmacies nationwide. No memberships or costs to you, ever. It’s really that easy. Get your card and start saving. Get the discount card!
Talk Therapy
BetterHelp – Get support and guidance from a licensed therapist. BetterHelp has over 30,000 therapists who provide convenient and affordable online therapy. Take a Free Online Assessment and get matched with the right therapist for you. Take free assessment
Anxiety Newsletter
A free newsletter from Choosing Therapy for those impacted by anxiety. Get helpful tips and the latest information. Sign Up
Online Anxiety Test
A few questions from Talkiatry can help you understand your symptoms and give you a recommendation for what to do next.
Best Online Psychiatry Services
Online psychiatry, sometimes called telepsychiatry, platforms offer medication management by phone, video, or secure messaging for a variety of mental health conditions. In some cases, online psychiatry may be more affordable than seeing an in-person provider. Mental health treatment has expanded to include many online psychiatry and therapy services. With so many choices, it can feel overwhelming to find the one that is right for you.