You should not stop using this medicine suddenly, or you could have unpleasant symptoms (such as dizziness, vomiting, agitation, sweating, confusion, numbness, tingling, or electric shock feelings). Trazodone is not approved for use in treating bipolar depression. Available as trazodone hydrochloride; dosage is expressed in terms of the salt. If drowsiness occurs, administer a major portion of the daily dosage at bedtime or reduce dosage. Some people may have a higher risk of having suicidal thoughts or actions. These include people who have or have a family history of bipolar illness (also called manic-depressive illness) or suicidal thoughts or actions.
For healthcare professionals
Report any unusual thoughts or behaviors that trouble you, especially if they are new or get worse quickly. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared.
- Check with your doctor before taking any of the above while you are using this medicine.
- Get medical help right away, if you have any of the symptoms listed above.
- Inpatients (i.e., more severely depressed patients) may be given up to but not in excess of 600 mg/day in divided doses.
- Advise patients regarding the importance of following dosage titration instructions see Dosage and Administration (2).
- Report any unusual thoughts or behaviors that trouble you, especially if they are new or get worse quickly.
- In patients with symptomatic hyponatremia, discontinue trazodone and institute appropriate medical intervention.
Anxiety States
Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs and SNRIs see Use in Specific Populations (8.5) . There were suicides in the adult studies, but the number was not sufficient to reach any conclusion about antidepressant drug effect on suicide. 100 mg Tablets, white to off white, round, biconvex, uncoated tablets debossed with «13» bisect «31» on one side and plain on other side.
Let the doctor know if you or anyone in your family have bipolar disorder (manic-depressive disorder) or have tried to commit suicide. Tell your doctor if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson’s disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with trazodone could cause a serious condition called serotonin syndrome. Anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, and/or mania may be precursors to emerging suicidality. If decision is made to discontinue therapy, taper trazodone dosage as rapidly as is feasible but consider risks of abrupt discontinuance. Concomitant administration of drugs may increase the risk of cardiac arrhythmia see Drug Interactions (7.1).
Has been used for the short-term management of depressive episodes in patients with schizophrenia† off-label. Some mixtures of medications can lead to serious and even fatal consequences. If you trazodone withdrawal: symptoms, timeline, treatment think there has been an overdose, call your poison control center or get medical care right away.
Usual Adult Dose for Depression
Activation of mania/hypomania has been reported in a small proportion of patients with major affective disorder who were treated with antidepressants. Prior to initiating treatment with trazodone, screen patients for any personal or family history of bipolar disorder, mania, or hypomania see Dosage and Administration (2.3) . Medicines that interact with trazodone may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with trazodone. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed. Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies with major depressive disorder (MDD) and other psychiatric disorders.
Does Trazodone interact with my other drugs?
Do not start taking trazodone during the 2 weeks after you stop a MAO inhibitor and wait 2 weeks after stopping trazodone before you start taking a MAO inhibitor. If you take them together or do not wait 2 weeks, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, a sudden high body temperature, an extremely high blood pressure, or severe convulsions. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use trazodone only for the indication prescribed. Some require a prescription, while others are available over the counter.
- Trazodone hydrochloride tablets are a prescription medicine used in adults to treat major depressive disorder (MDD).
- The maximum dose for outpatients usually should not exceed 400 mg/day in divided doses.
- The dosage should be initiated at a low-dose and increased gradually, noting the clinical response and any evidence of intolerance.
- Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors see Warnings and Precautions (5.1).
traZODone Dosage and Administration
It takes on average 5.5 elimination half lives for a drug to be eliminated from your system. Metabolism, age, health, weight and the amount and frequency of the drug taken, are all factors that can affect the rate at which the body can clear the drug from your system. Trazodone has an average rating of 6.3 out of 10 from a total of 1,444 reviews on Drugs.com. 53% of reviewers reported a positive experience, while 31% reported a negative experience. Extensively metabolized in the liver via hydroxylation, oxidation, N-oxidation, and splitting of the pyridine ring. In vitro studies indicate metabolism by CYP3A4 to an active metabolite, m-chlorophenylpiperazine; other metabolic pathways not well characterized.
Antidepressant effects evident within 1 week; optimal antidepressant effects usually attained after 2–4 weeks. Rapidly and almost completely absorbed from the GI tract; peak plasma concentration usually attained within 1–2 hours. Not known whether trazodone is distributed into milk; caution advised. Discontinue several days prior to surgery requiring general anesthesia whenever possible. Prescribe in smallest quantity consistent with good patient management to reduce risk of overdosage. Has been used as adjunctive therapy for the management of alcohol dependence† off-label.
Trazodone has not been studied in patients with renal impairment. Consider increasing trazodone dose based on therapeutic response when trazodone is coadministered with a strong CYP3A4 inducer see Drug Interactions (7.1). Consider reducing trazodone dose based on tolerability when trazodone is coadministered with a strong CYP3A4 inhibitor see Drug Interactions (7.1).
What happens if I miss a dose?
These may be symptoms of serious conditions called serotonin syndrome and neuroleptic malignant syndrome-like reactions. Your risk may be higher if you also take certain other medicines that affect serotonin levels in your body. For some teenagers and young adults, this medicine can increase thoughts of suicide. Tell your doctor right away if you start to feel more depressed or have thoughts about hurting yourself or others.
Drugs Affecting Hepatic Microsomal Enzymes
A prospective, longitudinal study followed 201 pregnant women with a history of major depressive disorder who were euthymic and taking antidepressants at the beginning of pregnancy. The women who discontinued antidepressants during pregnancy were more likely to experience a relapse of major depression that women who continued antidepressants. Consider the risk of untreated depression when discontinuing or changing treatment with antidepressant medication during pregnancy and postpartum. It is unknown whether the risk of suicidal thoughts and behaviors in pediatric and young adult patients extends to longer-term use, i.e., beyond four months. However, there is substantial evidence from placebo-controlled maintenance trials in adults with MDD that antidepressants delay the recurrence of depression. Adverse reactions may occur upon discontinuation of trazodone hydrochloride tablets See Warnings and Precautions (5.8).
Trazodone hydrochloride tablets should be taken shortly after a meal or light snack. Trazodone hydrochloride tablets can be swallowed whole or administered as a half tablet by breaking the tablet along the score line. This medicine may cause some people to become drowsy or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert.
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