Trazodone Withdrawal: Symptoms, Timeline, & Treatment

What is Trazodone Withdrawal?

Trazodone is a medication commonly used for the treatment of depression.¹ Trazodone withdrawal, also known as antidepressant discontinuation syndrome, occurs when individuals abruptly stop taking trazodone. When taking trazodone or other antidepressants, the body and brain adjust to taking this medication. The sudden absence of the medication leads to chemical imbalances in the body, leading to a range of symptoms.

The majority of withdrawal symptoms typically peak within the first week of stopping the medication. After 2 to 6 weeks, these symptoms will typically resolve.² However, some withdrawal symptoms may last several months.

Factors That Influence Trazodone Withdrawal

Trazodone withdrawal symptoms can vary based on several factors, making it difficult to predict what each individual will experience. Some individuals may experience minimal to no symptoms, while others may experience more severe symptoms. Understanding the factors contributing to withdrawal symptoms can help individuals manage expectations and plan supportive therapies.

Factors that influence trazodone withdrawal include:

• Length of time taken: The duration of trazodone use correlates to the likelihood of experiencing withdrawal symptoms. The longer the medication has been taken, the higher the risk.
• Dosage: Higher doses of trazodone increase the risk of experiencing withdrawal symptoms.
• Abrupt discontinuation: Abruptly stopping trazodone can increase the risk of withdrawal symptoms. Because of this, it is important to taper off the medication gradually.
• Social support: Stopping an antidepressant can lead to a recurrence of depression symptoms. Individuals with a strong social support system will be better equipped to handle these symptoms.
• Individual metabolism: Variations in individual metabolisms with impact trazodone removal from the body, contributing to the variations of risk among individuals.

Causes of Trazodone Withdrawal

Trazodone withdrawal is impacted by several factors, including missing doses, suddenly stopping the medication, or transitioning to a different antidepressant. The chance of withdrawal symptoms occurring is generally low with a single missed dose of the medication. However, the risk increases with each subsequent missed dose. Suddenly stopping trazodone also elevates the risk of withdrawal symptoms. Switching to a different antidepressant can also cause withdrawal symptoms due to the different ways each medication affects the brain.

Several reasons may be involved when individuals choose to stop trazodone. Some individuals may not like how antidepressants make them feel, while others may experience significant or persistent side effects. Others may not see any benefit from taking trazodone and choose to stop the medication. It’s important to work with your healthcare provider to develop a plan to slowly stop, or taper, off trazodone in order to avoid withdrawal symptoms.

Trazodone Withdrawal Symptoms

The risk of developing withdrawal symptoms varies widely among individuals and can be difficult to predict. The most common withdrawal symptoms are mild and resolve within a few weeks. Rarely, however, individuals may experience severe symptoms requiring immediate medical attention.

Common Trazodone Withdrawal Symptoms

Common trazodone withdrawal symptoms are typically mild and do not require immediate medical attention. These symptoms commonly appear within a few days of stopping the medication, and symptoms peak within 1 to 2 weeks. While most symptoms will resolve within two weeks, some can last a month or longer.³ Withdrawal symptoms may encompass physical and psychological symptoms. Physical symptoms are those the body feels, while psychological symptoms involve moods and thought patterns.

Common trazodone withdrawal symptoms include:^{1, 2}

• Dizziness
• Drowsiness
• Fatigue
• Headache
• Nausea
• Abdominal pain
• Vomiting
• Sweating
• Insomnia
• Irritability
• Impaired balance

*All medications, including trazodone, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Serious Trazodone Withdrawal Symptoms

While the majority of trazodone withdrawal symptoms are mild, there is a risk that symptoms may be serious and require immediate medical attention. The likelihood of experiencing serious withdrawal symptoms depends on different factors, including the abruptness of discontinuation, the dosage of the medication, and the duration of its use. The risk of trazodone withdrawal leading to death is exceedingly low.

Severe trazodone withdrawal symptoms include:^{1, 2}

• Confusion
• Hypomania
• Seizures
• Hallucinations
• Amnesia
• Panic attacks
• Increased suicidal thoughts

*All medications, including trazodone, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Treatment & Management of Trazodone Withdrawal

The treatment and management of withdrawal symptoms depend on the specific symptoms experienced. Typically, the approach to treatment revolves around managing the symptoms until they naturally subside. The goal is to provide supportive measures to alleviate discomfort during the withdrawal period.

Tapering Off Trazodone

The first goal for managing withdrawal symptoms involves prevention. The best way to prevent Trazodone withdrawal symptoms is to have a gradual tapering of the medication. Tapering consists of reducing the trazodone dosage over a designated period, allowing the body to adjust to the gradually lowered dose.

Common tapering schedules often entail decreasing the dosage by 10 to 25% every 1 or 2 weeks until discontinuation.² This schedule can be adjusted based on individual needs, and tapering should always be conducted under the guidance of a medical provider.

Supportive Therapies

Therapeutic interventions, such as cognitive-behavioral therapy (CBT) and participation in support groups, can play a valuable role in alleviating withdrawal symptoms. These supportive therapies are especially effective in mitigating psychological symptoms, such as anxiety, panic attacks, depression, and mood swings.

Managing Physical Symptoms

Individuals can experience diverse physical symptoms during withdrawal, and managing them may include both prescription and over-the-counter medications. Specific medicines can address issues like nausea, headaches, and generalized discomfort. Lifestyle adjustments, such as taking time off work and refraining from operating machinery, may be necessary during this time. Discuss available options with your healthcare provider to develop a plan to manage physical symptoms associated with withdrawal.

Managing Psychological Symptoms

Addressing psychological symptoms like anxiety, depression, and panic attacks may be more challenging to treat with medications. Some medications may offer temporary relief of these symptoms but may not be helpful enough for some. Alternative approaches, including therapy, support groups, and other non-medication depression treatments, may also be effective.

Discontinuation of Trazodone After Long-Term Treatment

Long-term use of trazodone may increase the risk and severity of withdrawal symptoms. This highlights the importance of gradually tapering the medication to reduce the risk of these negative effects. Individuals who have been taking trazodone for an extended period may require a longer tapering of the medication.

Discontinuing an antidepressant such as trazodone also comes with the risk of recurring depression symptoms. In this case, it may be necessary to start back the trazodone or switch antidepressants.

Discontinuation of Trazodone While Pregnant

The risks that may come with taking antidepressants during pregnancy have not been well-studied, and it is unclear if trazodone is safe to take while pregnant. However, there have been no reported significant birth defects, miscarriages, or adverse mother or baby outcomes for pregnant women taking trazodone.¹ Regardless, the decision to continue taking trazodone during pregnancy should be made in conjunction with your healthcare provider.

Preparing for Trazodone Discontinuation

To discontinue using trazodone, start by having a discussion with your healthcare provider. It is important to be aware of the potential withdrawal symptoms and the risk of depression symptoms recurring. Your healthcare provider can assess your circumstances and develop a personalized tapering schedule. During this time, your healthcare provider may recommend frequent follow-up visits to monitor your response.

How Long Does Trazodone Withdrawal Last?

The duration and time frame of trazodone withdrawal varies from person to person and is based on several factors, including the duration you have been taking the medication, the dosage of medication, and the tapering schedule. Antidepressant discontinuation syndrome, in general, lasts approximately two weeks but may last longer for some individuals.

Trazodone Withdrawal Timeline

The beginning and resolution of trazodone withdrawal symptoms can differ significantly among individuals. While the specific timeline for mirtazapine withdrawal hasn’t been fully studied, it is likely similar to that of other antidepressants.

Factors that may influence the withdrawal timeline of trazodone include:

• Dosage
• Length of use
• Tapering schedule
• Use of other medications

Here’s what you may expect for the withdrawal timeline for trazodone:^{2, 3}

• Days 1 through 3: In the initial few days of discontinuation, the body is just starting to entirely remove trazodone. The symptoms of withdrawal may become noticeable.
• Days 4 through 7: Symptoms of withdrawal often peak around this time.
• Days 8 through 14: Withdrawal symptoms may persist, but you may notice alleviation during this timeframe.
• Weeks 2 through 4: Withdrawal symptoms may resolve during this time.

How Long Does it Take to Get Trazodone Out of Your System?

The half-life of a drug is the time it takes for half of a drug to be removed from the body. After 4 to 5 half-lives, a drug is considered to no longer affect the body. The half-life of trazodone is approximately 3 to 9 hours.⁴ It typically takes 15 to 45 hours for trazodone to be eliminated from the body.

How Do I Safely Stop Taking Trazodone?

Safely stopping trazodone involves a gradual tapering process that is guided by a healthcare professional, such as a primary care physician or psychiatrist. A sudden discontinuation of the medication can lead to more significant withdrawal symptoms. Individualized tapering over weeks to months can decrease this risk of withdrawal symptoms.

The most effective approach to managing trazodone withdrawal symptoms depends on the specific symptoms experienced. Therefore, stopping trazodone should always be done under the care of a healthcare professional who can help manage your withdrawal symptoms. If you are looking for a provider, online psychiatry services can provide a convenient way to access a healthcare professional. Additionally, finding a therapist can be helpful during this time.

When to Seek Professional Help for Trazodone Withdrawal

Discussing trazodone withdrawal symptoms with your healthcare provider is crucial to ensure your safety and to know when immediate medical attention may be necessary. While common withdrawal symptoms from trazodone are mild and short-lived, some may be more severe or persistent.

If you encounter serious withdrawal symptoms, consult with your healthcare provider for guidance. Immediate medical assistance may be necessary for serious symptoms, such as suicidal thoughts, significant agitation hallucinations, or severe mood changes.