Key takeaways
Trazodone, an older antidepressant used for depression and insomnia, most commonly causes drowsiness and can also cause weight gain, sexual dysfunction, and urinary incontinence.
Serious side effects, including suicidal thoughts, serotonin syndrome, and heart problems, are rare.
Some side effects, like sexual dysfunction and weight changes, can develop over time, but many resolve after stopping the drug.
To manage side effects, follow your provider’s instructions, avoid certain medications and alcohol, eat a healthy diet, and report serious or persistent issues to your provider.
People can be prescribed trazodone hydrochloride to treat major depressive disorder. It has been used to help with anxiety as well, but most commonly is used off-label to take advantage of its tendency to cause sedation and help with insomnia. It belongs to a group of antidepressants called serotonin modulators or atypical antidepressants. These drugs alter brain chemistry by inhibiting serotonin reuptake and blocking certain serotonin receptors, thereby permitting greater control over mood.
Though not as well-known as typical selective serotonin reuptake inhibitors (SSRIs), such as Paxil (paroxetine) and Prozac (fluoxetine), serotonin modulators affect the body similarly, so side effects are similar but not exactly the same. Trazodone is only available as a generic but was previously sold under the brand names Desyrel and Oleptro. Brand-name alternative serotonin modulators include Trintellix (vortioxetine) and Viibryd (vilazodone).
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What are the side effects of trazodone?
The most commonly experienced side effect of trazodone is drowsiness, affecting almost one in four people taking the drug. About one in five people, according to the drug’s label, has reported dizziness or high blood pressure. Other common side effects listed on the label include:
- Dry mouth
- Nervousness
- Tiredness
- Nausea or vomiting
- Headache
- Constipation
- Diarrhea
- Low blood pressure
- Aches and pains
- Problems with coordination
- Abdominal pain
- Blurred vision
- Confusion
- Problems with concentration
- Tremors
- Red and itchy eyes
- Nasal or sinus congestion
- Edema
- Skin reactions
- Disorientation
- Feeling bad
- Fainting
- Sexual dysfunction
- Weight changes
Serious side effects of trazodone
The most serious adverse effects of trazodone are relatively rare and include:
- Suicidal thoughts and behaviors
- Worsening of depression
- Serotonin syndrome
- High blood pressure
- Orthostatic hypotension
- Heart attack
- Arrhythmias (heart rhythm problems)
- Angle-closure glaucoma
- Hyponatremia (dangerously low sodium levels)
- Seizures
- Persistent and painful erections (priapism)
- Bleeding
- Withdrawal
- Severe allergic reactions
Specific trazodone side effects
Weight gain
Weight changes are possible with trazodone. Some people gain weight, while others may lose it. Clinical data shows:
- About 5% report weight gain
- Up to 6% report weight loss
If you notice unexpected weight changes, consider speaking with a healthcare provider or dietitian.
Trazodone side effects sexually
Sexual side effects are common with antidepressants. With trazodone:
- Reduced sensitivity may occur
- Decreased libido affects a small percentage
- Erectile dysfunction is rare (less than 2%)
The good news: These effects often improve after stopping the medication. If trazodone and erectile dysfunction or other sexual concerns arise, talk to your provider about options.
Urinary incontinence
Urinary incontinence is rare, affecting up to 1% of people. If it happens, your provider can help determine whether trazodone or another factor is the cause.
Trazodone side effects for females
There isn’t enough evidence to confirm whether women experience more side effects from antidepressants like trazodone than men, but gender differences in antidepressant response have been explored. Responses vary from person to person, so monitoring symptoms is key.
Trazodone side effects timeline
How soon do trazodone side effects start?
Some trazodone side effects can begin within 30 minutes of taking a dose. Early side effects may include:
- Drowsiness
- Lightheadedness or dizziness
- Dry mouth
- Nausea
Other effects, like weight changes or sexual dysfunction, may develop over time.
How long do trazodone side effects last?
Most side effects improve as your body adjusts. After stopping trazodone, many symptoms resolve, though some—like weight changes—may take longer.
Long-term side effects
Rarely, long-term issues can occur, including:
- Persistent sexual dysfunction with serotonergic antidepressants
- Heart-related complications with serotonergic antidepressants
Always report ongoing symptoms to your healthcare provider.
Trazodone contraindications
Because of certain medical conditions, some people cannot safely take trazodone. These include anyone allergic to the drug or who has recently experienced a heart attack.
The FDA has approved trazodone only for use in adults. Safety and efficacy have not been established in patients under 18 years of age. However, some healthcare professionals may prescribe it off-label to children and adolescents. If so, they will need to be closely monitored for worsening depression and suicidality. Trazodone is used with caution in seniors due to heightened concern regarding side effects.
There is no evidence that trazodone is unsafe for women who are pregnant or breastfeeding. Although trazodone does show up in breast milk, there is no evidence that it will harm a nursing baby. Major depressive episodes can be a risk during pregnancy, and the use of trazodone or any antidepressant must consider the benefits to the health of the mother against the unknown risk to the baby.
Trazodone warnings
Like many antidepressants, trazodone carries important warnings.
Suicidality
Antidepressants in general carry a known risk of increased suicidal thoughts, especially in younger people. Close monitoring is essential at the start of treatment.
Abuse and dependence
The U.S. Food and Drug Administration (FDA) does not consider trazodone to be a drug with the potential for abuse or physical dependence.
Overdose
An overdose of trazodone will require emergency medical care. Depending on the dose, it can cause severe problems that could be life-threatening, particularly when taken with alcohol or sedatives. The most common symptoms of a trazodone overdose are drowsiness or vomiting.
Withdrawal
The sudden discontinuation of trazodone or any other SSRI can cause withdrawal symptoms such as excessive sweating, nausea, irritability, anxiety, agitation, dizziness, confusion, headache, mood swings, ringing in the ears, and even seizures. When trazodone therapy needs to stop, the doses will gradually decrease over a period of weeks.
Trazodone interactions
Certain medications can increase the risk of trazodone side effects or serious complications.
Among the possible drug interactions, avoid or use caution with:
- MAO inhibitors (MAOIs)
- Other antidepressants
- Opioids
- Blood thinners
- NSAIDs
- Sedatives
Combining these drugs may increase the risk of serotonin syndrome, bleeding, or dangerous levels of sedation.
How to avoid trazodone side effects
Most people taking trazodone will experience transient side effects. Not all are avoidable, but there are a few ways to minimize problems.
1. Take trazodone as directed
Follow the instructions given by the prescribing healthcare provider. Most people will initially take a 25-50 mg dose one or two times daily with food. If taken multiple times daily, it’s easy to miss a dose or take an extra dose of trazodone, so it helps to use an alarm or app to make sure doses are taken correctly. If a dose is missed, take it as soon as it’s remembered. If it’s nearly time to take the next dose, skip the missed dose and take the next dose as scheduled.
2. Inform the prescriber about all medical conditions
The first and best way to avoid problems taking trazodone is to make sure the prescribing healthcare provider has a complete medical history before the first pill is taken. Don’t leave anything out, but make sure that the prescriber knows about:
- Suicidal thoughts
- Heart disease
- Heart rhythm problems, particularly a problem called QT prolongation
- A history of bleeding or blood-clotting problems
- A history of seizures
- Dehydration
- Low sodium
- Glaucoma
- Narrow angles in the eye
- Mania or bipolar disorder
- Liver problems
- Pregnancy or pregnancy plans
- Breastfeeding or breastfeeding plans
3. Tell the doctor about all medications being taken
Drug interactions are another source of side effects when taking trazodone, so tell the prescribing healthcare professional about all prescription drugs, over-the-counter medications, and supplements being taken, especially:
- MAO inhibitors
- Antidepressant medications, including other SSRIs, SNRIs, and tricyclic antidepressants
- Medicines that treat anxiety, schizophrenia, or other mental health conditions
- Seizure medications
- Migraine medications called triptans
- Opioids
- Amphetamines or ADHD medications
- Heart rate medications
- Blood thinners such as warfarin
- NSAIDs
- Over-the-counter supplements such as St. John’s wort or tryptophan
4. Do not quit taking trazodone
If you have concerns, talk to a healthcare professional before quitting trazodone. Sudden discontinuation—particularly after months of treatment—could lead to unpleasant withdrawal symptoms.
5. Avoid alcohol
Alcohol will worsen many of the sedative effects of trazodone, such as sleepiness, fatigue, and dizziness.
6. Be careful about driving and other risky activities
Speaking of sedative effects, trazodone could make driving and other risky activities more dangerous. Healthcare professionals may advise that these activities be put on hold for a few days when first taking trazodone. This allows people to determine whether they can drive or engage in other activities safely.
7. Avoid NSAIDs
To avoid abdominal problems and possible bleeding events, avoid NSAID pain relievers such as aspirin or ibuprofen. If possible, use acetaminophen instead.
8. Eat a healthy diet
To avoid or minimize weight changes, eat a healthy diet. If weight goes up or down unintentionally, talk to a dietitian or nutritionist, as well as the prescribing healthcare professional.
How to treat the side effects of trazodone
Most trazodone side effects are manageable with small adjustments while seeking input from your healthcare provider.
- Drowsiness or dizziness: Move slowly and avoid fall risks
- Weight changes: Adjust diet or consult a dietitian
- Mood changes: Contact your healthcare provider immediately
- Heart symptoms: Seek urgent medical care
- Serotonin syndrome symptoms: Get emergency help
If side effects interfere with your daily life, your provider may adjust your dose or suggest alternatives.
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Expert takeaway
“We prescribe trazodone more for its sedating side effect, which is useful in the treatment of insomnia and dementia-related agitation, rather than for its antidepressant effect,” explains Chad Shaffer, MD, a member of the SingleCare Medical Board, “but monitoring for residual daytime drowsiness is a must.”
- Trazodone drug label, NIH Daily Med (2026)
- Post-SSRI sexual dysfunction & other enduring sexual dysfunctions, Epidemiology and Psychiatric Sciences (2019)
- Trazodone hydrochloride drug summary, Prescriber’s Digital Reference (2024)
- Gender difference in antidepressant drug response, International Review of Psychiatry (2010)
- Women and depression: Does gender matter?, U.S. Pharmacist (2013)
- Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors, and isotretinoin: 300 cases, The International Journal of Risk & Safety in Medicine (2018)
- Risk of stress cardiomyopathy associated with selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors: a real-world pharmacovigilance analysis, Scientific Reports (2024)
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