Trazodone is a prescription medication often used to treat major depressive disorder, though it is commonly prescribed off-label at lower doses to help with insomnia. As a member of the Serotonin Antagonist and Reuptake Inhibitor (SARI) class of antidepressants, it works by adjusting serotonin levels in the brain. People who take this medication often wonder if its presence will be detected during a standard drug screening, especially since it is not classified as a controlled substance. While Trazodone is generally not the target of routine drug tests, its use can inadvertently lead to complications during the screening process.
Trazodone’s Status in Standard Drug Screening Panels
Standard drug screening procedures are primarily designed to detect substances commonly associated with abuse, such as cocaine, amphetamines, opiates, and marijuana. These common tests, including the 5-panel and 10-panel screens used for employment or probation, do not typically include Trazodone in their target list. The focus of these panels is on drugs with high addiction or abuse liability, a category Trazodone does not fall into. Since Trazodone is a legally prescribed medication, it is not flagged or sought after in the vast majority of routine drug screenings.
However, drug testing is not uniform across all settings, and some specialized or expanded panels do exist. An extended drug test, sometimes referred to as a prescription drug panel, may be ordered in specific clinical or forensic situations. These comprehensive tests can be customized to look for a wider array of pharmaceuticals, which might include Trazodone. Unless the testing entity has a specific reason to monitor for the drug and requests a specialized screen, Trazodone will not be detected.
Understanding False Positives and Cross-Reactivity
The major complication for individuals taking Trazodone is the potential for a false positive result on an initial drug screen. The first step in most drug testing, especially for workplace screenings, uses a rapid method called an immunoassay. This test relies on antibodies to bind to the chemical structure of target drugs or their metabolites.
Trazodone is metabolized in the body into a compound known as meta-chlorophenylpiperazine, or m-CPP. This metabolite has a chemical structure that is similar enough to certain illicit substances to cause interference with the immunoassay. The structural similarity can trick the test’s antibodies into binding to the m-CPP, incorrectly suggesting the presence of a controlled substance. This phenomenon is known as cross-reactivity and is a well-documented issue with Trazodone use. Specifically, Trazodone’s metabolite m-CPP has been strongly associated with false positive results for amphetamines and methamphetamines on urine drug screens.
Specialized Testing and Drug Detection Windows
Confirmation Testing
When an initial immunoassay yields a positive result, the sample is typically sent for confirmation testing to determine if the result is truly positive or a false positive caused by a medication like Trazodone. These confirmation methods are highly accurate and utilize advanced laboratory techniques. Techniques such as Gas Chromatography/Mass Spectrometry (GC/MS) or Liquid Chromatography/Mass Spectrometry (LC/MS) are used to separate and identify the exact molecular structure of every compound in the sample. If a false positive for amphetamines occurs, the confirmation test will be able to distinguish the chemical signature of the Trazodone metabolite (m-CPP) from that of an actual amphetamine. This process resolves the ambiguity, correcting the initial screening error and validating the individual’s prescription use. Confirmation testing can also definitively detect Trazodone itself if the test was specifically ordered to look for it.
Drug Detection Windows
The duration Trazodone remains detectable, known as the drug detection window, varies significantly depending on the sample type and individual metabolism. In urine, the most common sample for drug screening, Trazodone metabolites are generally detectable for an estimated two to four days after the last dose. Blood tests offer a much shorter window, usually less than 24 hours, and are typically used to confirm very recent use. Hair follicle testing provides the longest detection window, potentially showing evidence of Trazodone use for up to 90 days.