What to Expect When Starting Trazodone

Trazodone is a serotonin modulator prescribed for depression and, very commonly, for insomnia. While it was originally developed as an antidepressant, its pronounced sedating properties have made it one of the most widely prescribed medications for sleep problems, often at lower doses than used for depression.

For insomnia, trazodone is often preferred over traditional sleep medications because it is not habit-forming and does not carry the same dependency risks as benzodiazepines or Z-drugs like zolpidem. For depression, higher doses are used and it works similarly to other antidepressants by modulating serotonin activity.

The dose your doctor prescribes will depend on whether you are taking it for sleep (typically 25-100 mg at bedtime) or depression (150-400 mg daily, often in divided doses). This guide will help you understand what to expect for both uses.

Take trazodone at bedtime, with a light snack or small meal. Food helps slow absorption and reduces the risk of dizziness, while also improving the medication's effectiveness. Allow 7-8 hours for sleep before you need to be alert.

Rise slowly when getting up at night or in the morning. Trazodone can cause orthostatic hypotension — a drop in blood pressure when you stand up — leading to dizziness or lightheadedness. Sitting on the edge of the bed for a moment before standing can help.

For male patients: be aware of the rare but serious risk of priapism (prolonged erection). While very uncommon, this is a medical emergency requiring immediate treatment to prevent permanent damage. Seek emergency care if an erection lasts more than 4 hours. Avoid alcohol, which increases sedation and dizziness. Do not combine trazodone with MAO inhibitors or other serotonergic medications without medical supervision.