{"id":627921,"date":"2024-05-16T09:30:00","date_gmt":"2024-05-16T13:30:00","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=627921"},"modified":"2025-05-02T11:25:21","modified_gmt":"2025-05-02T15:25:21","slug":"trazodone-side-effects-in-elderly","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/trazodone-side-effects-in-elderly\/","title":{"rendered":"What are the side effects of trazodone for older adults?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Trazodone is a type of antidepressant known as a serotonin antagonist and reuptake inhibitor (SARI). Also known by the brand name Desyrel, trazodone is FDA-approved to <\/span><span style=\"font-weight: 400;\">treat symptoms of major depressive disorders<\/span><span style=\"font-weight: 400;\">. It\u2019s also frequently prescribed off-label to alleviate symptoms of anxiety, insomnia, obstructive sleep apnea, and fibromyalgia. Like many other mental health medications, trazodone works by balancing the levels of serotonin in your brain.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">While trazodone is generally safe, it has several possible <\/span><span style=\"font-weight: 400;\">short- and long-term side effects<\/span><span style=\"font-weight: 400;\">. It\u2019s important to know what to look for before you start taking this prescription.<\/span><\/p>\n<h2 id=\"common-side-effects-of-trazodone-for-older-adults\"><span style=\"font-weight: 400;\">Common side effects of trazodone for older adults<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">According to <\/span><span style=\"font-weight: 400;\">clinical trials<\/span><span style=\"font-weight: 400;\">, the most common side effect is drowsiness or sedation, followed by lightheadedness, nausea, and dry mouth. Older adults may also experience dizziness, confusion, constipation, blurred vision, and headache, says <\/span><span style=\"font-weight: 400;\">Arpit Aggarwal<\/span><span style=\"font-weight: 400;\">, MD, a psychiatrist with University of Missouri Health Care.<\/span><\/p>\n<h2 id=\"serious-side-effects-of-trazodone-for-older-adults\"><span style=\"font-weight: 400;\">Serious side effects of trazodone for older adults<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Some of the serious side effects of trazodone are particularly dangerous for older adults, while others are potentially dangerous for anyone taking this medication. In general, serious side effects of trazodone include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Priapism, or <\/span><a href=\"https:\/\/medlineplus.gov\/druginfo\/meds\/a681038.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">prolonged erection in males, lasting more than six hours<\/span><\/a><span style=\"font-weight: 400;\">. This is a medical emergency requiring immediate attention to prevent permanent damage, says Dr. Aggarwal.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/link.springer.com\/article\/10.1007\/s40266-020-00796-5\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Orthostatic hypotension<\/span><\/a><span style=\"font-weight: 400;\">, or low blood pressure when moving into a standing position, which can result in fainting.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Increased risk of suicidal thoughts, especially in children and young adults.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Increased risk of <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/serotonin-syndrome-symptoms\/\"><span style=\"font-weight: 400;\">serotonin syndrome<\/span><\/a><span style=\"font-weight: 400;\">, a drug reaction that results in too much serotonin being produced by the brain.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Abnormal heart rhythm or cardiac arrhythmias, specifically something called <\/span><a href=\"https:\/\/www.nhlbi.nih.gov\/health\/long-qt-syndrome\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">QT prolongation<\/span><\/a><span style=\"font-weight: 400;\">, an issue with the electrical activity regulating your heartbeat.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weight gain or weight loss. In <\/span><a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/018207s032lbl.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">clinical trials<\/span><\/a><span style=\"font-weight: 400;\"> of outpatients taking trazodone, 5% of participants reported weight gain, and 7% reported weight loss.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">For the elderly population specifically, certain side effects of trazodone can become serious or cause further complications, notes <a href=\"https:\/\/www.muhealth.org\/doctors\/arpit-aggarwal-md\">Dr. Aggarwal<\/a>, such as:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dizziness, which can be exacerbated by other medications and increases the risk of falls and injuries.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Blurred vision, which also presents a fall risk and interferes with safe driving.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Cognitive impairment and confusion symptoms can be made worse if you already have an existing cognitive disorder like <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/alzheimers-dementia-medication-management\/\"><span style=\"font-weight: 400;\">dementia or Alzheimer&#8217;s disease<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hyponatremia, or low sodium levels, which may be exacerbated by drugs such as <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/thiazide-diuretics\"><span style=\"font-weight: 400;\">diuretics<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/li>\n<\/ul>\n<h2 id=\"how-soon-do-trazodone-side-effects-start-for-older-adults\"><span style=\"font-weight: 400;\">How soon do trazodone side effects start for older adults?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">It depends on the individual side effect, says Dr. Aggarwal. You might experience side effects as soon as your first dose, or it may take several weeks. Typically, milder symptoms such as sleepiness, headache, and dry mouth are more likely to occur right away, or within the first few hours after taking the drug. Side effects like weight loss, weight gain, and <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7586935\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">cardiac arrhythmia are more likely after prolonged use of trazodone<\/span><\/a><span style=\"font-weight: 400;\">. These side effects are dose-dependent, with higher doses causing increased side effects.<\/span><\/p>\n<h2 id=\"how-long-do-trazodone-side-effects-last-for-older-adults\"><span style=\"font-weight: 400;\">How long do trazodone side effects last for older adults?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5842888\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">most common side effects of trazodone<\/span><\/a><span style=\"font-weight: 400;\">, like dizziness, dry mouth, and headache, often go away after one to two weeks. Some of the more serious side effects, like cognitive impairment, may last longer. Your provider may start you on a lower daily dose initially and gradually increase to a higher dose as these early, mild symptoms resolve.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">However, some people never fully tolerate the side effects, says <\/span><a href=\"https:\/\/valleyoaksmed.com\/about-us\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Upinder Singh<\/span><\/a><span style=\"font-weight: 400;\">, MD, internist, geriatric specialist, and chief medical officer of Valley Oaks Medical Center. Talk to your provider if you are still having side effects after two to three weeks of taking the medication.<\/span><\/p>\n<h2 id=\"what-are-the-long-term-side-effects-of-trazodone-for-older-adults\"><span style=\"font-weight: 400;\">What are the long-term side effects of trazodone for older adults?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Unfortunately, there are no systematic studies on the side effects of long-term trazodone use. There is no data on how many people are affected or what other risk factors\u2014like co-existing medical conditions or interactions with other medications that increase the chances of side effects, says Dr. Singh. Furthermore,\u00a0 it can be difficult to determine whether long-term side effects are <\/span><i><span style=\"font-weight: 400;\">actually <\/span><\/i><span style=\"font-weight: 400;\">caused by trazodone since many older adults are taking other medications that may interact with trazodone and also lead to serious issues.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">However, heart palpitations, diarrhea, and blurred vision are the side effects most commonly associated with long-term use of the drug, Dr. Singh notes. These risks are increased with higher doses of trazodone. According to a <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4513583\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">case report<\/span><\/a><span style=\"font-weight: 400;\">, prolonged use of 150 to 200\u2005milligrams of trazodone per day is more likely to cause side effects than low doses or short-term doses. In some cases, <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3127346\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">sexual side effects such as lower libido<\/span><\/a><span style=\"font-weight: 400;\"> may also occur.<\/span><\/p>\n<h2 id=\"trazodone-warnings-for-older-adults\"><span style=\"font-weight: 400;\">Trazodone warnings for older adults<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Trazodone is an antidepressant that may increase suicidal thoughts, so it has been issued a <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/black-box-warning\/\"><span style=\"font-weight: 400;\">black box warning<\/span><\/a><span style=\"font-weight: 400;\"> by the FDA. It should be used with caution in patients with mental health conditions and other health conditions. For example, Dr. Aggarwal says people with compromised liver or renal function should be careful taking trazodone.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There is a long list of medications that could potentially interact with trazodone. Some of the more common drugs include triptans for migraine, other antidepressants, NSAIDs (such as Advil), and warfarin, which is used as a blood thinning agent.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">While many people can safely take trazodone when they have other medical conditions or are taking other prescription drugs, some people should not take trazodone at all. This typically includes people with angle-closure glaucoma (increased pressure in the eye), cardiac arrhythmias (especially QT prolongation), or a history of priapism, says Dr. Singh. The manufacturer of trazodone also advises that people taking monoamine oxidase inhibitors (MAOIs) not use the drug.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">All that said, trazodone is still considered a fairly safe drug. In fact, it\u2019s safer than many other sleep medications, including <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/ambien\"><span style=\"font-weight: 400;\">Ambien<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/diphenhydramine-hcl\"><span style=\"font-weight: 400;\">diphenhydramine<\/span><\/a><span style=\"font-weight: 400;\">, and benzodiazepines such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/ativan\"><span style=\"font-weight: 400;\">Ativan<\/span><\/a><span style=\"font-weight: 400;\"> and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/xanax\"><span style=\"font-weight: 400;\">Xanax<\/span><\/a><span style=\"font-weight: 400;\">, says <\/span><a href=\"https:\/\/siliconpsych.com\/team\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Alex Dimitriu, MD<\/span><\/a><span style=\"font-weight: 400;\">, psychiatrist, sleep medicine specialist, and founder of Menlo Park Psychiatry &amp; Sleep Medicine.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Trazodone is generally not habit-forming, though it\u2019s better to taper off the dose slowly rather than stop abruptly, says Dr. Singh. If trazodone is suddenly stopped when you\u2019re on higher doses, it may cause irritability, sleep problems, and excessive sweating. These are considered mild withdrawal symptoms, but they can be easily avoided with guidance from a healthcare provider. While it\u2019s possible to overdose on trazodone, it\u2019s not common with <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6699354\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">appropriate use<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h2 id=\"managing-trazodone-side-effects-in-the-elderly\"><span style=\"font-weight: 400;\">Managing trazodone side effects in the elderly<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Although trazodone can cause several short- and long-term side effects, some of these effects can be managed with easy-to-implement strategies. Dr. Dimitriu shares the following advice for managing trazodone side effects in elderly patients:<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Take it at night.<\/b><span style=\"font-weight: 400;\"> Even if you\u2019re not using it for insomnia, trazodone can be sedating. Remember to be cautious when getting up at night to use the bathroom. Sit up in bed and then stand slowly, using supports if needed, to avoid falls.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Start with a low dose.<\/b><span style=\"font-weight: 400;\"> Ask your provider about starting on a low dose at first and then increasing the amount slowly until you find the lowest effective dose for you.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Practice good sleep hygiene.<\/b><span style=\"font-weight: 400;\"> Though it\u2019s an antidepressant, <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/trazodone-for-sleep\/\"><span style=\"font-weight: 400;\">trazodone is commonly used for insomnia<\/span><\/a><span style=\"font-weight: 400;\">. A good <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/how-to-sleep-better\/\"><span style=\"font-weight: 400;\">sleep hygiene routine<\/span><\/a><span style=\"font-weight: 400;\"> can also help manage insomnia symptoms. Exercise daily; set regular bedtimes and wake times; limit technology use after 10 p.m.; and create a cool, comfortable sleep environment.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Take on an empty stomach.<\/b><span style=\"font-weight: 400;\"> Though taking trazodone with food can mitigate any nausea the drug causes, taking it on an empty stomach\u2014if you can tolerate it\u2014will help it work more effectively.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Prioritize rest.<\/b><span style=\"font-weight: 400;\"> Adults naturally sleep a little less as they age, but <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/why-is-sleep-important\/\"><span style=\"font-weight: 400;\">getting enough sleep is important for overall health<\/span><\/a><span style=\"font-weight: 400;\"> and can improve memory, focus, attention, and emotional regulation. If you\u2019re not sleeping well at night, talk to your healthcare provider.<\/span><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">Though trazodone is generally a safe and effective treatment for health conditions such as depression and insomnia, it\u2019s not without risks and drug interactions. It\u2019s important always to inform your prescribing healthcare provider of existing health conditions and all the medications you take\u2014including supplements and over-the-counter treatments.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you are taking trazodone and experience any of the following, contact your healthcare provider immediately or seek urgent medical care:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Confusion<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Loss of balance<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Muscle weakness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Irregular heart rate or breathing<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Erection lasting longer than four hours<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Excessive drowsiness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vomiting<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Seizures<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">New or worsening symptoms of depression<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Suicidal thoughts<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">These can be signs of a serious adverse reaction and require immediate medical attention.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Trazodone is a type of antidepressant known as a serotonin antagonist and reuptake inhibitor (SARI). Also known by the brand name Desyrel, trazodone is FDA-approved to treat symptoms of major depressive disorders. It\u2019s also frequently prescribed off-label to alleviate symptoms of anxiety, insomnia, obstructive sleep apnea, and fibromyalgia. Like many other mental health medications, trazodone [&hellip;]<\/p>\n","protected":false},"author":135,"featured_media":627467,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[451,788,450,11278],"coauthors":[8860],"class_list":["post-627921","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-depression","tag-drug-safety","tag-mental-health","tag-singlecare-for-seniors","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Trazodone side effects in the elderly<\/title>\n<meta name=\"description\" content=\"Trazodone, FDA approved for depression, is also used off-label to treat insomnia in the elderly. 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