Trazodone is a prescription medication often used to manage certain mental health conditions. It is primarily known for its role as an antidepressant and is also frequently prescribed to help with insomnia.
Trazodone’s Intended Purpose
Trazodone is classified as a serotonin antagonist and reuptake inhibitor (SARI), an atypical antidepressant. It is primarily prescribed for the treatment of major depressive disorder, aiming to improve mood, appetite, and energy levels while reducing anxiety and insomnia associated with depression. Beyond its antidepressant effects, low doses of trazodone are commonly used off-label to aid sleep due to its sedative properties.
Trazodone works by influencing certain neurotransmitters in the brain, particularly serotonin. It inhibits serotonin reuptake, increasing its availability. Trazodone also blocks specific serotonin receptors (5-HT2A and 5-HT2C) and has antagonistic effects on histamine H1 and alpha-1 adrenergic receptors, which contribute to its calming and sedating effects.
Addressing the “High” Question
Despite recreational misuse, trazodone does not produce a euphoric “high” like illicit drugs such as stimulants or opioids. Any perceived “high” is more accurately described as intense sedation, drowsiness, or dizziness. These effects stem from the medication’s impact on histamine and adrenergic receptors, which contribute to its calming properties.
Trazodone’s mechanism of action does not involve a significant release of dopamine or other neurotransmitters associated with the rewarding and addictive properties of recreational drugs. Instead, its primary effects are related to serotonin modulation and general central nervous system depression, leading to feelings of relaxation and sleepiness.
Dangers of Misuse
Taking trazodone in ways other than prescribed carries significant risks. Misuse, such as taking higher doses than recommended, without a prescription, or combining it with other substances, can lead to dangerous side effects and potential overdose. Overdose symptoms can include severe drowsiness, low blood pressure, chest pain, tremors, seizures, difficulty breathing, and an irregular heartbeat. In extreme cases, overdose can lead to coma or be fatal.
Combining trazodone with alcohol or other central nervous system depressants, such as benzodiazepines or opioids, is particularly hazardous. This combination can intensify sedative effects, leading to extreme drowsiness, impaired coordination, slowed breathing, and an increased risk of overdose. Trazodone can also interact negatively with other medications, including those that affect serotonin levels, potentially leading to a serious condition called serotonin syndrome, characterized by symptoms like agitation, hallucinations, rapid heart rate, and muscle rigidity.
Safe Use and Seeking Assistance
To ensure safety, trazodone should only be taken exactly as prescribed by a healthcare professional. Follow all dosage instructions and never take more than the prescribed amount. The medication should never be shared with others, as it is prescribed based on an individual’s specific medical needs. If a dose is missed, it should be taken as soon as remembered, unless it is almost time for the next scheduled dose.
If you or someone you know has taken too much trazodone or is experiencing severe adverse effects, seek emergency medical attention immediately. You can call emergency services or a poison control center for guidance. For concerns about substance misuse, resources are available to provide support and treatment. The Substance Abuse and Mental Health Administration (SAMHSA) National Helpline offers confidential information and treatment referrals. Local health services, general practitioners, and support groups can also provide assistance and guidance for substance use concerns.