Trazodone Addiction: Signs and Side Effects of Trazodone Abuse

Trazodone is a prescription antidepressant that’s sometimes used off-label to treat insomnia. Due to its status as a prescription medication, many people underestimate the risk of dependence when using trazodone. Oleptro and Desyrel are two of the most common brand names, but brand availability can change over time, so your medication may have a different name on the label.

For most people, trazodone doesn’t produce that classic “high” feeling, but it can still be misused, especially if you have persistent sleep problems. As a result, this medication can quickly become a crutch for relieving anxiety, numbing negative emotions or addressing insomnia.

This guide explores trazodone misuse, including why it can become addictive, warning signs and common withdrawal symptoms. Because it’s dedicated to signs and health effects of trazodone misuse, it doesn’t include information about treatment options or rehab centers.

Trazodone is an atypical antidepressant that regulates serotonin levels in the brain. Because of how it affects the nervous system, it can have sedating and calming effects. This may reinforce repeated use for anyone chasing sleep or seeking emotional relief.

Once you begin using it to cope with insomnia, stress or mood swings, it’s difficult to stop. As a result, trazodone use can lead to tolerance, which is when you need to take higher doses to get the same effects.

Rebound insomnia and physical discomfort after stopping trazodone can also push continued use, especially if you’re afraid of not being able to sleep. Rebound insomnia is a return of sleep difficulties after abruptly stopping a medication like trazodone. Additionally, mixing trazodone with alcohol or other depressants can increase impairment and decision-making, leading to an even greater loss of control.

Although many people use the terms “abuse” and “addiction,” clinicians are now using the terms “misuse” and “substance use disorder” to reflect the outdated belief that substance use is a choice. Trazodone abuse refers to the use of this medication outside medical guidance.

Examples include:

• Taking extra doses
• Using someone else’s prescription
• Mixing it with other substances to intensify its sedative effects
• Using trazodone for sleep without consulting a healthcare provider

In contrast, trazodone addiction is the compulsive use of trazodone with loss of control, intense cravings and an inability to stop using even when it harms you. Misuse sometimes begins with taking trazodone “just to sleep” and then shifts into relying on trazodone to function, cope with strong emotions or avoid nighttime anxiety.

Trazodone use may cause you to:

• Run out of pills early
• Hide your use from loved ones
• Take it early in the day to blunt your emotions
• Continue to use trazodone despite falls, blackouts or dangerous mixing

Trazodone is a serotonin antagonist and reuptake inhibitor (SARI), so it increases the amount of serotonin in your brain. Serotonin is a neurotransmitter that affects mood, sleep and digestion. Neurotransmitters are chemicals that help your nerve cells communicate.

Over time, your body gets used to the effects of trazodone. If you try to stop taking or cut back on trazodone, you may experience uncomfortable discontinuation symptoms. This indicates that you have a physical dependence on trazodone.

Psychological dependence is when you feel unable to sleep, cope or calm down without trazodone. The risk of dependence increases with higher doses, long-term use and using it nightly as your only method of getting some sleep.

Trazodone dependence isn’t the same as trazodone addiction. However, it may indicate that your use patterns are escalating.

Trazodone is a habit-forming medication, so it can affect your mood, behavior and ability to function. Common mood and mental signs include irritability, anxiety related to sleep or feeling like you can’t relax unless you use trazodone. You may also experience cravings.

These are some of the most common behavioral signs of trazodone addiction:

• Taking more trazodone than intended
• Repeated failed attempts to cut back or stop using trazodone
• Planning sleep around your medication use
• Spending significant time thinking about your next dose

Trazodone addiction also affects your behavior around medication use. You may take it earlier than recommended, stack during the night or engage in “doctor shopping.” Doctor shopping involves obtaining prescriptions from multiple prescribers.

Because trazodone works on your nervous system, it can make it difficult to function. Some people experience morning grogginess that interferes with work, school or parenting. You may also miss important events or drive before the sedative effects of trazodone wear off.

You should also be aware of the safety red flags associated with trazodone misuse. Mixing it with alcohol, opioids or benzodiazepines increases the risk of harm. Frequent falls or fainting episodes also indicate that your trazodone misuse has progressed to addiction.

Trazodone withdrawal isn’t as severe as the withdrawal process associated with opioids or benzodiazepines. However, you can still experience discontinuation symptoms when you stop using the medication. This is known as antidepressant discontinuation syndrome.

Discontinuation symptoms are more likely if you’ve been using trazodone nightly. You may experience:

• Rebound insomnia
• Anxiety
• Irritability
• Restlessness
• Vivid dreams
• Nausea
• Headaches
• Dizziness

Some people also report mood swings and agitation during the early stages. Symptoms of trazodone withdrawal vary based on:

• Dose
• Duration of trazodone use
• Individual sensitivity
• Use of other substances

Like all medications, trazodone can cause short-term side effects. The most common ones include:

• Heavy drowsiness
• Dizziness
• Dry mouth
• Fuzzy thinking
• Slow reaction time

Due to the way it affects the nervous system, trazodone can also lead to some safety issues. Falls and fainting are the most common.

If you fall while taking trazodone, you may sustain an injury, such as a broken bone or a large cut. Injuries are more likely in older adults and people who develop orthostatic hypertension due to trazodone use. Orthostatic hypotension is a sudden, significant drop in blood pressure that occurs when you stand up from a sitting or lying position.

Serious side effects of trazodone misuse may include:

• Serotonin syndrome. Serotonin syndrome is a potentially life-threatening reaction that can occur when you take substances that increase serotonin levels or boost serotonin activity. If you develop serotonin syndrome, you may experience altered mental status, high blood pressure and fast heartbeat. It can also cause muscle rigidity, rapid breathing and tremors.
• QT prolongation. QT prolongation is when your heart takes too long to recharge between beats. Long pauses can cause dangerous heart rhythms, increasing the risk for seizures, fainting or sudden cardiac arrest.
• Priapism. Priapism is a persistent erection that lasts longer than 4 hours, according to Weill Cornell Medicine. Without treatment, priapism may cause long-term erectile dysfunction.

If you mix trazodone with alcohol, opioids or benzodiazepines, there’s a risk of oversedation. This side effect can cause dangerous impairment or make it difficult to wake up.

Potential long-term effects of trazodone misuse include:

• Daytime fatigue
• Worsening sleep quality
• Increased dose reliance
• Growing risk-taking around mixing it with other substances

Risk factors are any characteristics, traits or behaviors that increase the likelihood that you’ll develop a particular condition. There are several types of risk factors for trazodone addiction.

Sleep and Mental Health Patterns

The presence of sleep problems and mental health conditions may increase the risk of trazodone misuse. For example, you may self-medicate for anxiety, depression or chronic insomnia. Trazodone addiction has also been linked to using this medication to cope with stress.

Trazodone Use Patterns

How you use trazodone can also affect your risk level. You’re more likely to develop a trazodone use disorder if you use it nightly for long periods of time, take backup doses or use it without consulting a medical professional.

Substance Use Factors

Current and prior substance use patterns may increase the risk of trazodone addiction. Common examples include a history of alcohol misuse, opioid misuse and benzodiazepine misuse. Polysubstance use, or the use of multiple substances together or within a short period of time, is also a risk factor for trazodone use disorder.

Medication Factors

One of the biggest risk factors is the use of other medications that raise the risk of serotonin syndrome. You may also have an increased risk of trazodone use disorder if you take other drugs with sedative effects.

Life Factors

Because trazodone has calming effects, isolation and irregular schedules increase the risk of misuse. You may also be at risk if you have limited non-medication tools for coping with stress or sleep problems.

When diagnosing trazodone addiction, clinicians examine your patterns of use over time. Addiction is characterized by compulsive use, so a medical professional needs to look beyond one or two episodes of misuse to determine if you have a substance use disorder.

Clinicians ask questions to determine if you have cravings, risky use patterns or you’ve lost control over your trazodone use. An initial assessment also covers:

• Life impact of trazodone use
• Dose escalation
• Compulsive use for sleep
• Dangerous mixing patterns
• Continued use despite harm

This assessment may also include a mental health evaluation. Insomnia and mood symptoms can drive trazodone misuse, so it’s crucial to tell your healthcare team if you have these issues.

Finally, a clinician reviews your medications to determine if there’s a risk of dangerous actions. A medication review also helps rule out lookalike causes of symptoms.

Medication use often builds gradually, especially when you struggle to fall asleep and feel like you need something to help you rest. You may benefit from professional support if you’ve been taking higher doses, mixing trazodone with other substances or experiencing withdrawal symptoms if you try to cut back. Fainting and frequent falls are also signs you may need structured care.

If someone doesn’t wake up, has severe confusion, collapses or has trouble breathing after using trazodone, call 911 right away. Once they’re stable, use Help.org to find professional trazodone abuse support. It’s a free, confidential treatment finder that allows you to compare trazodone addiction treatment options based on your clinical needs, location and personal preferences.