Trazodone Overdose: Signs, Symptoms, & What to Do

Is Trazodone a Controlled Substance?

No, trazodone is not a controlled substance.¹ Controlled substances are drugs regulated by the government due to their potential for abuse or addiction. Trazodone is not subject to these regulations and is not considered an addictive substance when used as prescribed. Physicians have flexibility in prescribing it, and it’s often covered by insurance.

Is Trazodone a Narcotic?

No, trazodone is not a narcotic. It’s an antidepressant medication used to treat conditions like depression and is not considered addictive. While it’s generally safe for long-term use, some individuals may develop physical dependence. Trazodone withdrawal symptoms may develop if they abruptly stop taking it. It’s essential to follow a healthcare provider’s guidance when discontinuing trazodone.

Can You Overdose on Trazodone?

Yes, it is possible to overdose on trazodone, just as with any medication.¹ While the occurrence of trazodone overdose is relatively rare when used as prescribed, it can happen, especially in cases of intentional misuse or when combined with other substances like alcohol. In such instances, overdose can have serious and potentially fatal consequences.

Symptoms of a trazodone overdose may include priapism (a painful, prolonged erection), respiratory difficulties, seizures, and abnormal heart rhythms, including QT prolongation.¹ The severity of overdose effects can vary, so it’s crucial to seek immediate medical attention if there is any suspicion of an overdose.

What is the Maximum Amount of Trazodone You Can Take?

The maximum amount of trazodone you can take depends on various factors, including the individual’s specific medical condition and their healthcare provider’s recommendation. Trazodone is available in different strengths, including 50 mg, 100 mg, 150 mg, and 300 mg tablets.¹

For some patients, higher doses might be prescribed when necessary, based on the severity of their depression and their response to the medication. However, the exact dosage should always be determined by a qualified healthcare professional, as taking too much trazodone can lead to adverse effects and even overdose.

What Is a Toxic Level of Trazodone?

A toxic level of trazodone is typically considered to be anything above 600 mg within a 24-hour period. In cases of overdose, individuals have ingested significantly higher amounts, often around 2000 mg, which is much greater than the recommended maximum daily dose of 300 mg.²

The risk of toxicity can be influenced by various factors, including an individual’s overall health, tolerance, and whether other substances are ingested concurrently. Trazodone overdoses can result in symptoms like central nervous system depression, serotonin syndrome, and cardiac dysrhythmias. Medical attention is crucial in cases of trazodone overdose to manage these serious complications.

Symptoms of a Trazodone Overdose

Early signs may include extreme drowsiness, dizziness, nausea, and vomiting. As the overdose progresses, symptoms can become severe, including prolonged, painful erections, seizures, breathing problems, and heart rhythm issues.

Common symptoms of a trazodone overdose can include:¹

• Extreme drowsiness
• Dizziness
• Nausea
• Vomiting
• Confusion
• Rapid heartbeat
• Weight loss
• Blurred vision
• Swelling

Serious symptoms of a trazodone overdose include:¹

• Prolonged, painful erections (priapism)
• Seizures
• Irregular heart rhythms (cardiac arrhythmias)
• Increased risk of bleeding

What Can Cause a Trazodone Overdose?

A trazodone overdose can occur when an individual takes a dosage of the medication that is harmful to the body. This can happen in two ways: by accidentally taking too much trazodone at once or by intentionally misusing the medication in an attempt to achieve a high or harm oneself.

Accidental overdose can result from miscalculation or forgetting a prior dose, while intentional misuse may involve taking trazodone in excessive amounts, often in combination with other substances like alcohol, to produce a desired effect or due to self-destructive tendencies. In either case, the consequences of a trazodone overdose can be severe and require immediate medical attention.

Taking More Than the Prescribed Dosage

Taking more trazodone than prescribed can happen for various reasons. Accidental overdose may occur due to misinterpretation of dosing instructions, forgetfulness, or confusion regarding the correct amount to take. On the other hand, intentional misuse can result from an individual seeking to amplify the medication’s effects, whether for recreational purposes or as a form of self-harm.

Some may believe that higher doses will lead to quicker relief from symptoms, unaware of the potential risks. Regardless of the cause, exceeding the prescribed dosage of trazodone can lead to harmful consequences and should be avoided to ensure safety and well-being.

Taking Trazodone with Other Substances

Combining trazodone with other substances, including herbal treatments, supplements, or other medications, can significantly increase the potential for overdose. Certain substances can interact with trazodone, affecting its metabolism and increasing its concentration in the bloodstream, leading to harmful side effects.

Substances that can increase the risk of a trazodone overdose when used together include:

• Alcohol: Combining trazodone and alcohol can lead to enhanced sedative effects, causing extreme drowsiness, impaired coordination, and respiratory depression, which can increase the risk of overdose.
• St. John’s Wort: Taking St. John’s wort with trazodone can lead to increased serotonin levels and a greater risk of serotonin syndrome.
• Tryptophan: The use of tryptophan supplements alongside trazodone may raise serotonin levels and increase the potential for serotonin syndrome, which can be harmful.
• Warfarin: Altered prothrombin times have been reported when taking both warfarin and trazodone, requiring careful monitoring and potential dosage adjustments.

Taking Trazodone with Other Medications

Combining trazodone with other medications can pose risks due to potential drug interactions that may increase the risk of overdose or adverse effects.

Medications that can increase the risk of a trazodone overdose when taken together include:

• MAOIs (monoamine oxidase inhibitors): Using MAOIs within 14 days of taking trazodone can lead to serotonin syndrome, a potentially life-threatening condition characterized by agitation, hallucinations, rapid heart rate, and fever.
• Central nervous system (CNS) depressants: Trazodone may potentiate the effects of other CNS depressants, such as barbiturates, increasing the risk of extreme drowsiness, sedation, and respiratory depression.
• Cytochrome P450 3A4 inhibitors: Taking trazodone with CYP3A4 inhibitors like ritonavir or ketoconazole can lead to significantly increased trazodone levels in the bloodstream, potentially causing adverse effects and a higher risk of overdose.
• Cytochrome P450 inducers: Taking carbamazepine with trazodone can reduce trazodone’s effectiveness, potentially necessitating higher trazodone doses and raising the risk of overdose.
• Digoxin and phenytoin: Combining trazodone with these drugs can alter their serum levels, necessitating close monitoring and potential dose adjustments.
• Serotonergic drugs: Using trazodone with other medications that affect serotonin can increase the risk of serotonin syndrome, a potentially life-threatening condition.
• NSAIDs, aspirin, or other drugs affecting coagulation or bleeding: Using these drugs concurrently with trazodone should be monitored due to the potential risk of gastrointestinal bleeding.

Trazodone Overdose & Serotonin Syndrome

Overdosing on trazodone can increase the risk of a dangerous condition called serotonin syndrome. This can happen when trazodone is mixed with other medications that affect serotonin levels in the body. These medications may include certain antidepressants, pain relievers, and even herbal supplements like St. John’s Wort. Serotonin syndrome can cause a range of symptoms, from confusion and rapid heart rate to tremors and seizures.¹

To avoid this, it’s important to let your healthcare provider know about all the medications and supplements you’re taking. They can then adjust your treatment plan to keep you safe. If any symptoms of serotonin syndrome arise, it’s crucial to stop taking trazodone and related medications immediately and seek medical help.

Seeking Professional Help for Trazodone Overdose

If you suspect a trazodone overdose, call emergency services at 911 immediately or contact your nearest poison control center. Provide information about the person, the amount of trazodone ingested, and any other substances taken. Quick action is vital for their well-being.

Here is information important to share when seeking treatment for a trazodone overdose:

• The current signs and symptoms being experienced, such as extreme drowsiness, vomiting, or seizures.
• The person’s regular dosage amount of trazodone.
• Any other medications or substances taken in addition to trazodone.
• The time and amount of the trazodone overdose.
• Any pre-existing medical conditions or allergies.
• If the individual has a history of depression or mental health issues.
• Any recent changes in medication or treatment plans.
• The person’s age and weight (if known).

Trazodone Overdose Treatment

Emergency treatment for a trazodone overdose involves supportive care, as there’s no specific antidote. Treatment duration varies based on severity and individual response, with more severe cases requiring extended monitoring and care. The decision depends on specific circumstances.

Emergency treatment for an overdose of trazodone might include:

• Continuous monitoring of vital signs, such as heart rate and blood pressure.
• Offering supportive care to alleviate overdose symptoms.
• Administering medications or interventions to manage specific symptoms, like seizures.
• Conducting tests to assess organ function and overall health.
• Providing intravenous fluids to maintain hydration and support organ function.
• Ensuring a safe and supportive environment to prevent further harm or complications. These actions aim to address the individual’s immediate needs and stabilize their condition.

Next Steps After a Trazodone Overdose

After a trazodone overdose, it’s essential to take specific steps. For accidental overdoses, stick to prescribed dosages and consult with a healthcare provider if needed. For intentional overdoses, seek mental health support and discuss any suicidal thoughts with a professional. Be honest with your providers about the circumstances/reason for your overdose. Strategies for preventing another overdose will depend on why you overdosed this time

To prevent future overdose, store medications securely, separate from substances like alcohol. Regularly check in with a healthcare provider to ensure treatment effectiveness. The approach differs for accidental and intentional overdoses, with the latter requiring more focus on addressing mental health concerns.

If the Overdose of Trazodone Was Unintentional

Recovering from an unintentional trazodone overdose may involve continued trazodone use under close supervision, with careful dosage adjustments and precautions. These precautions include secure storage and open communication with a healthcare provider. However, if there’s a high risk of accidental overdose, alternative treatments might be considered, such as adjusting the medication regimen or exploring non-pharmacological therapies.

The next steps to consider after an unintentional trazodone overdose include:

• Take medication as prescribed: Adhering to your prescribed dosage and schedule helps minimize the risk of accidental overdose and ensures medication effectiveness.
• Consult with your psychiatrist: Regularly discuss your medication with your psychiatrist to assess its effectiveness, potential interactions, and any necessary adjustments to prevent overdose.
• Avoid substances: Steer clear of alcohol and other substances that can interact with trazodone, increasing the risk of overdose.
• Secure medication: Store your medication securely to prevent unintentional access, especially if there are children or individuals at risk of overdose in your household.
• Seek immediate help: If you miss a dose, don’t double it; consult your healthcare provider to avoid potential complications.

If the Overdose on Trazodone Was Intentional

Recovering from an intentional trazodone overdose involves managing mental health concerns. Continuing trazodone may be an option under psychiatric supervision with necessary adjustments to minimize risk. Precautions include secure storage and open communication. When self-harm risk persists, alternative treatments like therapy or medication adjustments are explored.

The next steps to consider after an intentional trazodone overdose include:

• Seek psychotherapy: Psychotherapy can be instrumental in addressing the underlying causes of suicidal thoughts and self-harm behaviors and providing coping strategies.
• Consult your psychiatrist: Discuss with your psychiatrist whether a different medication or dosage adjustments are needed to better manage your mental health.
• Build a support network: Reach out to trusted friends and family for emotional support during your recovery journey.
• Safety planning: Work with mental health professionals to create a safety plan to manage crisis situations and minimize self-harm risk.
• Avoid substances: Steer clear of alcohol and other substances that can exacerbate mental health challenges.
• Regular check-ins: Maintain regular follow-up appointments with your healthcare provider to monitor progress and adjust treatment plans as necessary.