Trazodone is an antidepressant drug that works as a serotonin antagonist and reuptake inhibitor (SARI). Although it is primarily utilized to treat major depression, Trazodone is also used to treat conditions like anxiety disorder and insomnia due to its anxiolytic and hypnotic properties. Various off-label uses for the drug include: fibromyalgia, nightmares, pain syndromes, panic disorder, diabetic neuropathy, OCD, alcohol withdrawal, and eating disorders.
Data collected from double-blind studies indicate that the effectiveness of Trazodone is similar to that of other drugs including: Amitriptyline, Doxepin, and Mianserin. Although the efficacy of this drug is relatively comparable to other medications, an unfavorable side effect of this drug is sudden drops in blood pressure (orthostatic hypotension) when standing up. Other unfavorable less common side effects include: impaired vigilance, cardiac arrhythmia, and priapism.
From a medical standpoint, this drug can be ideal for those who have anxiety and/or insomnia in addition to depression. Although some people have found Trazodone very helpful at treating their symptoms, others find it ineffective and/or cannot tolerate the side effects. Additionally some people try it, but find that the antidepressant effect wears off. After taking Trazodone for awhile, many people end up making the decision to discontinue and face the inevitable withdrawal symptoms.
Factors that influence Trazodone withdrawal
When withdrawing from antidepressant medications, there are always going to be various factors that influence the duration of withdrawal and the intensity of symptoms that you experience. These factors include things such as: the time span over which you took Trazodone, the dosage you have been taking, how quickly you taper, as well as your individual physiology.
1. Time Span
How long have you been taking Trazodone? It is thought that the longer you take an antidepressant medication, the greater the likelihood that you have become dependent on it. Those who have been taking this drug for an extended period of time (e.g. years) are likely going to experience significantly more severe withdrawal symptoms compared to someone who has been taking it for a few months.
In many cases, the greater the time span over which you take this drug, the more difficult it will be to withdraw from. Individuals who have been taking this drug for years will have a much tougher time readjusting to sober functioning than those who were on it for less than a year.
2. Dosage (50 mg to 400 mg)
Most people start at a dose of 150 mg, but doctors may have you titrate upwards in dosage if the starting dose is ineffective. The maximum recommended daily dosage is 400 mg, but in the event of very severe depression, some individuals are prescribed up to 600 mg per day in divided doses. In cases of individuals being treated for conditions other than depression, a lower dose such as 50 mg may be prescribed.
In general, the greater the dose of this drug that you have been taking, the more difficult it will be to withdraw from. When you titrate up to a relatively high dose, your body becomes dependent on that particular dosage for functioning. Discontinuing from a higher dose (e.g. 400 mg) usually results in a longer withdrawal duration and more intense symptoms than someone quitting from a lower dose (e.g. 50 mg).
3. Cold Turkey vs. Tapering
When coming off of Trazodone, it is never recommended to quit “cold turkey” as this can result in more severe and longer-lasting withdrawal symptoms. If you were on this medication for an extended period of time, it is always recommended to follow a gradual tapering protocol. To be on the safe side most experts recommend to taper at a rate of 10% of your current dose every 4 weeks.
So if you were taking 300 mg per day, start by reducing your dose to 270 mg then after another month passes, drop to roughly 243 mg. The tapering process can take an extended period of time, but this allows your nervous system to gradually adjust to the drops in dosage. If you quit cold turkey, you may shock your nervous system, leaving it in a state of disarray and end up coping with very severe withdrawal effects.
4. Individual Factors
There are many individual factors that play a huge role in influencing what you experience during withdrawal. There are some people who quit Trazodone “cold turkey” and/or with very quick tapering periods who experience zero withdrawal symptoms. There are other people who quit cold turkey and experience such severe discontinuation effects that they end up in the hospital for a few days.
In any regard, it is important to understand that what you experience during your withdrawal will be unique and influenced by individual factors. Some people naturally are less sensitive to withdrawals than others and therefore may not have as much difficulty readjusting to sober functioning. Individual habits such as: whether you take other psychiatric drugs, amount of exercise, diet, social support, etc. can also have an effect on the withdrawal process.
Trazodone Withdrawal Symptoms: List of Possibilities
Below are a list of possible symptoms that you may experience when coming off of Trazodone. Keep in mind that you may not experience every last symptom listed here and that the severity of symptoms is subject to individual variation.
- Anger: When you withdraw from a medication that helped you keep your cool while you took it, you may feel the exact opposite during your withdrawal. Trazodone tends influence serotonin activity in the brain by acting as an antagonist and reuptake inhibitor. Your brain no longer has influence from the medication, which can cause some people to lose their cool during withdrawal.
- Anxiety: Discontinuation of this medication can lead people to experience significant increases in anxiety. This drug has anxiolytic properties, meaning it provides relief from anxiety. When you stop taking it, your anxiety levels may be higher than ever before. This is due to the fact that your neurotransmitters are essentially not recovered to the level of functioning prior to taking the drug.
- Chest tightness: Some individuals report feeling a tightness feeling in their chest. Chest tightness can be a result of anxiety, but in many cases its due to the fact that the nervous system is attempting to regain drug-free functioning. It may take some time for this feeling of tightness to subside.
- Crying spells: Many people feel increasingly depressed and moody when they withdraw from an antidepressant. These feelings of depression and hopelessness during withdrawal can lead to crying spells or crying for seemingly no reason.
- Depersonalization: If you feel unlike your normal self or like a zombie, this may be what is referred to as depersonalization. Many times people quit taking a drug and it leaves them feeling as if they are in some sort of alternate reality. In reality, it’s a combination of brain activity changes along with neurotransmitter levels that can make a person feel depersonalized.
- Depression: People who were depressed prior to taking this medication are likely going to experience increases in depression while withdrawing. The depression people experience during withdrawal can be very severe due to the fact that quitting the drug left the brain chemically imbalanced. For more information read: Do antidepressants cause a chemical imbalance?
- Disorientation: Many have reported feeling disoriented while withdrawing from Trazodone. The disorientation can be extreme at times, especially if you didn’t follow a gradual tapering protocol. If you are feeling especially “out of it” (i.e. spacey, dizzy, etc.) you may want to taper at a slower rate.
- Dizziness: One of the most common discontinuation symptoms for any antidepressant is that of dizziness. You may feel very dizzy, especially in the early days of withdrawal. The dizzy feelings and/or potentially vertigo should gradually lessen the longer you are off of this drug.
- Faintness: Do you feel especially faint after quitting Trazodone? Many individuals report feeling a general sense of faintness and as if they need to lie down. This is usually a result of dizziness, vertigo, and/or lightheadedness.
- Fatigue: Feelings of excessive tiredness and lethargy are common, especially during the early stages of withdrawal. You may have a tough time getting up in the morning and/or mustering up the energy to be productive.
- Headaches: During withdrawal, it is very common to experience headaches. These headaches may range in severity from being mild to full blown migraines. Additionally anxiety during withdrawal can contribute to making these more intense. Expect these to be most intense during the first few weeks of withdrawal.
- Insomnia: This medication is used to help treat insomnia as it has hypnotic (sleep-inducing) properties. When you stop taking it, you may experience a rebound of insomnia as a result of low serotonin levels and spikes in anxiety.
- Irritability: You may notice that other people or that “little things” are starting to irritate you. You may become very angry and have a short-fuse when going through withdrawal. Although this feeling is usually a result of neurotransmitter imbalances, the irritability should improve over time.
- Itching: Some people quit Trazodone and notice within a few days that they have become excessively itchy. The itchiness can feel like an allergic reaction or hives. It is thought that this is a relatively severe reaction by your nervous system after removing a stimulus (Tradozone) that has influenced its functioning. The itching will likely eventually subside as time passes, but some people have reported it for months following their last dose. It is thought that a gradual taper may also help reduce itching and facilitate a quicker recovery if you do experience this symptom.
- Mood swings: Your moods may swing from feeling depressed and hopeless to feeling anxious and irritable to angry. Many people will end up dealing with negative moods that can be caused or influenced by low serotonin levels. As your nervous system resets itself, your mood will likely stabilize.
- Muscle weakness: Some people have reported that they notice feeling muscle weakness and/or joint pain when they come off of Trazodone. This weakness is generally a result of nervous system sensitivity and your body having not yet fully restored homeostatic functioning.
- Nausea: Do you feel nauseous now that you stopped taking this drug? Nausea is a very common thing to experience upon discontinuation. In extreme cases it can lead to vomiting, but if you taper off of this drug slowly, this can be significantly reduced and/or avoided.
- Sleep problems: It is common to have sleep difficulties when going through antidepressant withdrawal. You may find it difficult to fall asleep at a normal time due to insomnia. Additionally you may notice that you feel sleepy during the day. As a month or two passes, your sleep pattern will likely start to normalize.
- Suicidal thoughts: During withdrawal, you may feel more suicidal than you did prior to taking this medication. These thoughts can be a result of low serotonin levels and altered functioning as a result of taking this drug. Your brain functioning will eventually reset, but in the meantime you may feel suicidal. Just keep in mind that you will make a full recovery as time passes, but if these thoughts are severe, seek help from a psychotherapist.
- Sweats: Another way many people’s nervous systems react to quitting this drug is via sweating. You may notice that you now have heavy night sweats and/or are sweating profusely throughout the day. This is considered one way that your body detoxifies itself.
Trazodone Withdrawal Duration: How long does it last?
There is no specific duration for withdrawal from Trazodone as everyone will have a different experience. It is documented that its half-life falls within the range of 5 to 9 hours; with an average of 7.3 hours. This means that Trazodone stays in your system for approximately 1.67 days after your final dose. Therefore the drug shouldn’t be in your body for more than 48 hours after you’ve discontinued.
However, just because the drug is out of your system does not mean that withdrawal is done. Many people fall victim to the misconception that once the drug is fully out of your system, you should feel completely fine. Based on many reports of Trazodone withdrawals, most people end up experiencing withdrawal symptoms that persist for weeks after their last dose.
Those who have used the drug over a long-term have reported protracted withdrawals that last for months beyond their last dose. For people who have used Trazodone for many years, full recovery and functioning readjustment could take up to a complete year after discontinuation. During your withdrawal, the important thing to keep in mind is that you will eventually get better.
It may take a few weeks, months, or even a full year to feel better, but just know that you will eventually experience healing. If you are having a tough time dealing with symptoms, focus on taking things one day at a time. Consider getting yourself into a psychotherapist for additional emotional support and guidance during your withdrawal.
Take the time to eat healthy, stay productive, and get some light exercise as all of these things will aid in your recovery. Have you experienced withdrawal from Trazodone? If so, feel free to share your experience and/or insight in the comments section below. By sharing your experience, you may help someone who is going through the challenge of withdrawal that you have already overcome.