Trazodone is a medication approved by the Food and Drug Administration (FDA) for depression treatment. However, it can also be utilized off-label to treat other conditions such as anxiety and insomnia. Trazodone is not a controlled substance and is probably less habit-forming than other popular anxiety treatments such as benzodiazepines (e.g., Ativan, Klonopin, Valium, and Xanax). For this reason, if effective, it may be preferable to use, particularly in the long term.
Trazodone is available as a tablet in multiple dosages. including 50 mg, 100 mg, 150 mg, and 300 mg tablets. The tablets can also be split to get a lower dose when needed. Regardless of the reason for the prescription, health providers usually start patients on the lowest effective dose, increasing it as needed.
Trazodone for Anxiety
Trazodone is not federally approved for anxiety, but it can be prescribed off-label for this purpose. However, first-line treatments for anxiety, including other antidepressants, are more likely to be tried first. Trazodone is thought to help with anxiety because it influences neurochemicals linked to excitability, such as serotonin, adrenaline, dopamine, histamine, and acetylcholine.
For the treatment of anxiety, trazodone can be administered at a dose of 50-100 mg, 2-3 times per day. The total daily dosage should not be higher than 400 mg.
Using Trazodone for Depression
Although trazodone is only federally approved for depression, it is not commonly prescribed for this purpose. Selective-serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft), paroxetine (Paxil), escitalopram (Lexapro), and citalopram (Celexa), are more common and generally considered to be the gold standards for depression treatment. Trazodone is more popular as an off-label medication for other medical conditions, such as insomnia.
When an individual starts taking a drug like trazodone for depression, it can take several weeks to experience the medication’s full effectiveness. For the treatment of depression, trazodone may begin to improve symptoms in 1-2 weeks. The maximum effects may take anywhere from 4-6 weeks to be felt. If you have been using trazodone for depression and have not seen improvement after this time, it is essential to tell your prescribing health provider.
Compared to when it’s prescribed off-label for other conditions, trazodone for depressive symptoms typically requires higher doses (usually starting at 150 mg per day). It can then be increased to a maximum amount of 600 mg daily, split across multiple doses throughout the day.
Because trazodone is often used at high doses in depression, it is critical not to attempt to quit cold turkey. Instead, your dose should be slowly tapered over two to four weeks to avoid withdrawal symptoms if you intend on discontinuing trazodone.
Is Trazodone Similar to Xanax?
Trazodone and Xanax are very different medications. Unlike trazodone, Xanax is not categorized as an antidepressant and instead is a benzo and remedy for anxiety. Xanax is a short-acting benzo that affects brain neurochemicals, namely GABA, which may be imbalanced in individuals who experience anxiety or panic disorder.
Another critical difference between the two drugs is that Xanax is a Schedule IV controlled substance and may not be an ideal option for individuals with a history of drug abuse. However, trazodone may be more prudent because it is not a controlled substance with a lower potential for habit formation.
However, the side effects of trazodone and Xanax, such as drowsiness, may be similar because both medications are central nervous system (CNS) depressants.
Using Trazodone for Sleep
When trazodone is used to treat a disorder, such as depression, the drowsiness side effect can be problematic. However, this side effect is what makes trazodone an option to be prescribed for sleep disturbances. That said, some doctors who specialize in sleep medicine do not recommend it for insomnia treatment due to a lack of solid evidence regarding its effectiveness.
Regardless, trazodone is a popular drug for sleep due to its reputation as a safer alternative to other sleep medications; unlike trazodone, many of these other medications are controlled substances.
Trazodone for Sleep vs. Ambien
When prescribed for sleep, trazodone can be used as a 50-100 mg dose before bed. If warranted, the dose can be increased to up to 200 mg to help with sleep disturbances and insomnia. Those with both depression and sleep issues may require a higher amount in some cases, perhaps up to 300 mg.
Ambien (zolpidem) is a popular prescription sleep aid. Unlike trazodone, Ambien is what is referred to as a sedative-hypnotic, and a Schedule IV controlled substance, meaning that it has a significant risk of abuse and dependence.
Although sleep medication guidelines recommend Ambien for insomnia, some individuals are hesitant to take Ambien due to its side effects. Aside from its risk of dependence, extreme side effects may include complex sleep behaviors, such as sleepwalking and sleep-driving.
Finding Professional Help
Although trazodone is not classified as a controlled substance, it is still possible to become dependent upon it. If you struggle with using too much trazodone and found that you cannot stop, Just Believe Detox and Just Believe Recovery can help.
We offer customized, comprehensive programs that include therapeutic services and activities beneficial for the recovery process, including psychotherapy, psychoeducation, counseling, group support, art and music therapy, aftercare planning, and more.