Trazodone and Alcohol (A comprehensive guide)

Trazodone and Alcohol

In this blog, we will discuss the interaction between Trazodone and Alcohol, the most common uses of Trazodone, side effects, precautions, potential interactions with other drugs and substances. 

Trazodone and Alcohol: How do they interact?

Mixing Trazodone and Alcohol can become a fatal interaction. It is advised to avoid or limit alcohol consumption while being treated with Trazodone.

Alcohol intake while using Trazodone can increase the side effects such as dizziness, drowsiness, and difficulty concentrating.

Why are Trazodone and Alcohol fatal?

According to the American Addiction center, if Trazodone and Alcohol are used long-term it can result in developing physical dependence and withdrawal symptoms.

This can result in symptoms such as anxiety, agitation, and sleeping problems.

Additionally, they indicate that “acute alcohol withdrawal syndrome can be quite serious and can include symptoms such as insomnia, anxiety, increased body temperature, sweating, rapid pulse, nausea, and vomiting, as well as more severe complications such as agitation, hallucinations, delirium, and seizures. Left unmanaged, alcohol withdrawal can even be fatal due to the potential for grand mal seizures”. 

How do Trazodone and Alcohol interact?

It is known that alcohol is a central nervous depressant, acting by targetting several neurotransmitter systems by decreasing the effect of excitatory neurotransmitters in the brain and increasing the effect of inhibitory neurotransmitters (American Addiction Centers).

This is achieved due to excitatory neurotransmitters stimulating the brain and inhibitory neurotransmitters having the opposite, calming or sedative effect. 

What is Trazodone?

Trazodone is considered an antidepressant drug that belongs to the group of Serotonin Reuptake Inhibitors or SSRIs.

It is used frequently as a treatment for depression. 

This drug was developed in Italy in the 1960s as antidepressant medication. Initially, due to the side effects, this antidepressant wasn’t widely accepted in the medical community, however, it became recognized by many internists and clinicians because of the potential benefits of the drug, especially when administered at low doses.

Under the name trazodone (generic) in 1981, it was approved by the U.S Food and Drug Administration (FDA) under the brand name Desyrel.

Today, it is prescribed under the brand name Olepro to treat sleep disorders such as insomnia as well as anxiety disorder and unibipolar depression.

Trazodone and Alcohol (A comprehensive guide)

Does trazodone cause sleepiness?

For many people, this drug has a sedative effect that causes a relaxing effect and can make you feel very sleepy.

In prescribing the drug for sleep disorders, physicians typically recommend taking a low dose at bedtime in order to limit the effects of drowsiness.

Still, some people report lingering effects, including sluggishness and feeling drained or low energy, particularly upon waking.

How does Trazodone work?

Trazodone is meant to restore the depleted chemicals in the brain (neurotransmitters).

One of the most important neurotransmitters is serotonin which when balanced, improves your mood, appetite, memory, sexual function and desire, energy levels, decreases anxiety and insomnia related to depression.

Researchers have found that depression is caused by an imbalance among the neurotransmitters acetylcholine, norepinephrine, dopamine, and serotonin.

It is believed that trazodone affects the brain’s neurotransmitters by inhibiting the uptake of serotonin by nerves and consequently, the increase of this neurotransmitter end up stimulating other nerves.

How quickly does it work?

Some people who use this drug for sleep disorders have indicated that they get to experience the sedative effect within 30 mins after the intake, but remember that every person can react differently to the drug.

People who take it as an antidepressant may start noticing benefits after 1 or 2 weeks of consistently taking the medicine, and it may even take up to 4 weeks to experience the full benefits and desired results. 

Trazodone and Alcohol (A comprehensive guide)

How should I take it?

The initial dose is usually reported as 150 mg orally per day in divided doses.

This may be increased by 50 mg orally per day every 3 – 4 days.

The maximum dose reported for inpatients is 600 mg a day and for outpatients is 400 mg a day.

Administration

Trazodone’s strengths are as follows:

– 50 mg

– 100 mg

– 150 mg

– 300 mg

The tablets can be swallowed whole or taking it as a half tablet by breaking it along the scoreline. The tablets should not be chewed or crushed. 

When will I see results?

It can take up to 2 weeks before you start seeing improvement.

If your symptoms are not improving, do not stop the medication and talk to your doctor about it because you could have some unpleasant withdrawal symptoms. 

Trazodone and Alcohol (A comprehensive guide)

What happens if I miss a dose?

If you miss a dose, take the missing dose as soon as you remember.

If it is almost time to take the next scheduled dose, discard the missing dose and keep taking it as usual.

Do not take an extra or doubled dose to compensate. 

What happens if I overdose?

If you overdose with Trazodone, seek immediate medical attention.

An overdose can be fatal if it is combined with alcohol, barbiturates such as phenobarbital, or sedatives such as diazepam (Valium).

Overdose symptoms may include:

  • Extreme drowsiness
  • Vomiting
  • Prolonged and painful erection
  • Faster heartbeats
  • Seizures 
  • Breathing that is slow or stops

Symptoms of an allergic reaction

Trazodone allergic reactions need medical assistance.

If you are experiencing the following symptoms while taking Trazodone, it is very likely that you are allergic to it:

  • Hives
  • Difficulty breathing
  • Swelling of your face, lips, tongue or throat

Side effects

Report to your doctor any sudden changes related to your mood or behavior, as being impulsive, aggressive, restless, feeling irritable, increased anxiety, panic attacks, trouble sleeping or if you are feeling agitated, hyperactive, even more depressed than before or if you are having suicidal thoughts or wanting to hurt yourself. 

Moreover, if you have shortness of breath, faster or slower heartbeats, sudden dizziness, easy bruising or unusual bleeding; low levels of sodium in your body that will manifest in headaches, confusion, slurred speech, feeling fatigued, vomiting, loss of coordination or feeling unsteady. 

Serotonin syndrome

Serotonin syndrome (SS) happens when certain drugs (antidepressants), being taken 2 or more at a time, that have the purpose of affecting the neurochemistry of the brain (synaptic serotonin levels) cause a severe and toxic interaction. Symptoms may include:

  • Hallucinations
  • Fever
  • Sweating
  • Overactive reflexes
  • Fainting
  • Shivering
  • Faster heart rate
  • Muscle stiffness
  • Twitching
  • Loss of coordination
  • Nausea
  • Vomiting
  • Diarrhea

Common side effects

The common side effects of Trazodone intake may include:

  • Drowsiness
  • Dizziness
  • Tiredness
  • Swelling
  • Weight loss
  • Blurred Vision
  • Diarrhea
  • Constipation
  • Stuffy nose
  • Headaches
  • Nausea
  • Vomiting
  • Dry mouth

Other side effects

  • Temporary loss of consciousness
  • Swelling 
  • Loss of control of your movements
  • Confusion
  • Diarrhea
  • Hypotension
  • Insomnia
  • Sedated state
  • Faster heart beating

Less common side effects 

  • Burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
  • Confusion about identity, place, and time
  • Decreased concentration
  • Fainting
  • A general feeling of discomfort or illness
  • Headache
  • Lack of coordination
  • Muscle tremors
  • Nervousness
  • Pounding in the ears
  • Shortness of breath
  • Slow or fast heartbeat
  • Swelling

Trazodone Drug interaction

There are many drugs that can interact with Trazodone, especially:

  • Any other antidepressant
  • Anagrelide
  • Droperidol
  • Methadone
  • Ondansetron
  • Antibiotics such as azithromycin, clarithromycin, erythromycin, levofloxacin, moxifloxacin, pentamidine
  • Cancer medicine such as arsenic trioxide, vandetanib
  • Anti-malaria medication such as chloroquine, halofantrine
  • Heart rhythm medicine such as amiodarone, disopyramide, dofetilide, dronedarone, flecainide,  ibutilide, quinidine, sotalol
  • Medicine to treat a psychiatric disorder such as chlorpromazine, haloperidol, pimozide, thioridazine.
  • Phenytoin
  • St John’s wort
  • Tramadol
  • Diuretic or “water pill”
  • Anti-anxiety medication
  • Other drugs to treat mood disorders or other mental illnesses such as schizophrenia
  • Blood thinners such as warfarin, coumadin, and jantoven
  • Migraine headache medicine such as sumatriptan, imitrex, maxalt, treximet, among others

This is not a complete list of the drugs that can interact with Trazodone for more information about additional drugs that may interact ask your doctor. 

Trazodone and Alcohol (A comprehensive guide)

Is it safe to take trazodone for insomnia?

Trazodone is widely prescribed as a nighttime sleep aid for people with acute insomnia, even though it was originally designed to treat depression and anxiety disorders. 

Is trazodone different from other “sleeping pill” drugs?

The most commonly prescribed drugs as sleeping aids are Ambien, Sonata or Lunesta, but Trazodone differs from them in a few ways such as:

  • Ambien and Lunesta have the potential for misuse and abuse (dependence or addiction) so they are classified as controlled substances.
  • Trazodone is not considered to be an addictive substance, hence it is not a controlled substance so physicians aren’t limited in how many pills they can prescribe
  • Compared to other drugs it is an inexpensive generic drug covered by most insurance companies
  • Trazodone is not recommended to be taken by pregnant women or women who are breastfeeding. 

Are there risks while taking trazodone as an antidepressant?

For someone under the age of 24, there are heightened risks in regards to mental health.

According to MedlinePlus, the following side effects and symptoms can occur among patients under age 24: “new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement.” 

It is important to be aware that the manifestations of any of these symptoms or side effects should be discussed with your doctor immediately. 

When treated with Trazodone, it is important to be aware of avoiding taking other medicines classed as SSRIs, SNRIs or other antidepressants.

Additionally, if you have a cold, an allergy or you are having trouble sleeping, before you take over-the-counter medication to treat the symptoms consult with your doctor.

Trazodone and Alcohol (A comprehensive guide)

Is it safe to use trazodone with alcohol or other drugs?

It is recommended to avoid or limit the consumption of alcohol while using Trazodone since both substances affect the central nervous system, and the consequences have been described as fatal.

Additionally, missing this medicine with drugs of abuse can cause serotonin syndrome, potentially fatal as well.

While trazodone is not considered addictive, any amount over 600 mg in 24 hours is an overdose.

Can you become addicted to trazodone?

Trazodone is a non-controlled substance and it is considered non-addictive and non-habit-forming, however, it should only be taken as prescribed and under a physician’s care in order to avoid misuse, especially if you have a history of substance abuse or other drug addiction.

Some of the warning signs of drug misuse can be using the medication without a prescription, using it at higher doses than recommended/prescribed or snorting or crushing the tablets to speed up the intended effects.

Why is this blog about Trazodone and alcohol important?

If you are considering taking Trazodone for depression, sleeping disorders or anxiety, it is important to be aware of any side effects and warning signs of a major medical complication that can be manifested. 

Hence, when considering mixing Trazodone and Alcohol it is also important to understand that this could have a fatal outcome.

This is why it is advised to avoid at all costs mixing Trazodone and Alcohol while using this medicine.

If you have additional questions about the interaction of Trade and Alcohol we advise to consult it with your doctor

Although we consider this “Trazodone and Alcohol” guide compiled accurately and up to date information from trustworthy medical sources, it is not intended as a strict how-to guide, it is only informative.

Additional questions or concerns should be answered by your doctor.

Please feel free to comment on the content of “Trazodone and Alcohol” in the comments section below. 

Frequently Asked Questions (FQAs) about Trazodone and Alcohol

Can you take trazodone after drinking a glass of wine?

After drinking a glass of wine it is not advised to take trazodone since trazodone can heighten the effects of alcohol leading to you feeling dizzy, drowsy, or having difficulty concentrating. 

Can trazodone cause weight gain or loss?

Weight gain is one of the possible side effects of Trazodone.

Additionally, it can also potentially lead to weight loss.

How long does it take for trazodone to kick in?

It has been reported that Trazodone can take 1 to 2 weeks to start working, and 4 to 6 weeks before you feel the full benefit.

Additionally, some people may feel worse during the first week of the treatment and then they begin to feel better. 

Is trazodone used for bipolar disorder?

Yes, in some cases Trazodone is used for Bipolar Disorder. 

Is trazodone bad for the liver?

Trazodone can cause enzyme levels to be altered when taking normal doses but the elevation is usually modest and does not require dose modification or for the treatment to stop.

Although, the mechanism by which trazodone causes liver damage are still unknown.

Recommended reading

  1. Trazodone Hydrochloride; Third Edition
  2. Trazodone 627 Questions to Ask that Matter to You 
  3. Trazodone: Webster’s Timeline History, 1973 – 2007
  4. Trazodone: New Clinical Applications and Safety Considerations for a Third Generation Antidepressant 4th World Congress of Biological Psychiatry, … Antidepressant – Symposium Proceedings
  5. Trazodone – A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

References

Drugs.com

Cigna

Hazelden Betty Ford Foundation

Medline Plus

American Addiction Centers: Are there Dangers of mixing Trazodone with Alcohol?

Trazodone and Alcohol (A comprehensive guide)

Juanita Agboola

Juanita Agboola is the editor in chief of HFNE and an expert in mental health online. She has been writing about online behavior, mental health and psychology issues since 2012. All Guides are reviewed by our editorial team which constitutes various clinical psychologists, PhD and PsyD colleagues.