Trazonil (trazodone) is an antidepressant that belongs to the serotonin antagonist and reuptake inhibitor (SARI) class of drugs. Like most antidepressants it is believed to work by inhibiting the reuptake of the neurotransmitter serotonin, and to a lesser degree other neurotransmitters.

In the majority of cases Trazonil is used to treat:

• Depression
• Anxiety
• Insomnia

Less commonly it may be used, with or without other medications, to help manage:

• Some types of pain
• Alcohol withdrawal
• Obsessive compulsive disorder
• Other psychiatric conditions

Interestingly Trazonil is sometimes used to help treat erectile dysfunction. While most antidepressants can cause erectile dysfunction, Trazonil carries risk of the opposite---priapism (a painful or prolonged erection) is a concern with Trazonil. This side effect usually develops in the first month of treatment, and if it does happen treatment with Trazonil will most likely end.

Another concern with Trazonil is its sedative effect, which is quite powerful in some patients. Individuals who suffer from moderate to severe fatigue, low energy, or psychomotor retardation are poor candidates for this treatment. On the other hand it is a good choice for high-energy, hyperactive patients.

Managing Depression & Anxiety

Trazonil is most often prescribed for depression and/or anxiety. It begins producing significant benefit 2 to 4 weeks after treatment begins. Treatment typically continues for 6 to 9 months, though variation is not unusual.

In otherwise healthy adults treating depression:

• Start with 150 mg per day.
• Every 3 to 7 days dosage may be increased in 50 mg increments, if needed, up to 300 mg per day.
• Rarely (usually in an inpatient setting) dosage may be increased to 600 mg per day.

Otherwise healthy adults treating anxiety:

• Start with 75 mg per day.
• If needed, dosage may be increased to 150 or 300 mg per day.
• Do not exceed 300 mg per day without explicit doctor approval.

Other personal variables---age, weight, other medical conditions, etc---can influence dosage. Elderly patients (over age 65) are often given lower doses, as they're more prone to serious side effects. Patients under age 18 should not use Trazonil without explicit doctor approval, as effects are unknown.

Other medications are sometimes given along with Trazonil to further manage the condition. This is not unusual, but attention should be paid to interactions. Be sure the prescribing doctor is made aware of all other medications being taken.

When the time comes for treatment with Trazonil to end, dosage should be gradually tapered down over several weeks to avoid withdrawal effects. A doctor can help develop a discontinuation plan.

Trazonil for Insomnia

For insomnia, treatment is typically at lower doses than for other conditions. Patient response can be quite variable as well; some find the medication puts them to sleep in about 30 minutes, while others find it does little to nothing. Most patients are somewhere in the middle.

Variable response can also happen to the same individual; a patient may fall asleep right away one day, yet not even be made drowsy the next. While this does happen to some, it is unusual.

Treatment typically consists of:

• Start with 25 mg per day one or two hours before bed.
• If needed, dosage may be increased to 50 or 75 mg per day.

Duration of treatment is also variable for insomnia. Some use it daily, others as-needed. In general, if needed, treatment at low doses of 25 mg per day can continue for longer than the 6 to 9 months associated with depression or anxiety treatment.

Some individuals also seem to develop some degree of tolerance to the drug, needing larger doses over time to produce the same effect. Others do not notice this at all. If higher doses are needed, or if the medication consistently fails to induce sleepiness, speak with a doctor about alternative options.

Most patients report falling asleep easier, staying asleep, and feeling refreshed the next day.

There is no concern for withdrawal effects if taking only 25 mg per day.

Other Uses

Other off-label uses are quite varied and to some extent still experimental. Off-label use is legal provided a doctor prescribed the medication; patients are advised to speak with a doctor about a particular use. Doctor instructions regarding dosing and duration of treatment should be followed.