Trazodone side effects sexually:
Common side effects of trazodone | Serious side effects | Weight gain | Sexual dysfunction | Urinary incontinence | Side effects timeline | Contraindications | Warnings | Interactions | How to avoid side effects | How to treat side effects
People with depression or anxiety are given trazodone hydrochloride to help them feel better. Trazodone is an older antidepressant that is approved for the treatment of major depression.
It has also been used to help with anxiety, but most of the time it is used off-label to help people sleep because it makes them feel sleepy. It is in a class of drugs called serotonin antagonists and reuptake inhibitors. These drugs change the way the brain works so that mood can be controlled better. Trazodone has the same effects on the body as better-known drugs like Paxil (paroxetine) and Prozac, so it has the same side effects as fluoxetine. Desyrel and Oleptro used to be brand names for trazodone, but now it’s only sold as a generic.
Common trazodone side effects
Drowsiness is the most common side effect of trazodone. It happens to almost one in four people who take the drug. One in every five people has reported feeling dizzy or having high blood pressure. These are some other common side effects:
- Dry mouth
- Nausea or vomiting
- Low blood pressure
- Aches and pains
- Problems with coordination
- Abdominal pain
- Blurred vision
- Problems with concentration
- Red and itchy eyes
- Nasal or sinus congestion
- Skin reactions
- Feeling bad
- Muscle pain
- Trouble sleeping
- Sexual dysfunction
- Weight changes
Serious side effects of trazodone
The most serious adverse effects of trazodone are relatively rare and include:
- Suicidal thoughts and behaviors
- Worsening of depression
- Serotonin syndrome
- High blood pressure
- Orthostatic hypotension
- Heart attack
- Heart rhythm problems
- Angle-closure glaucoma
- Dangerously low sodium levels
- Painful erections (priapism)
- Severe allergic reactions
In clinical trials, about 1 out of every 100 people who took trazodone gained weight. Later research suggests that the number could be as high as 5%, but research also shows that up to 6% of people who take trazodone lose weight. No matter what, though, you should always talk to a doctor if you take a drug and your weight goes up or down by accident. You might need the help of a nutritionist.
Problems with sexuality
Almost everyone who takes an SSRI will feel less sensitive in the genital area. As a result, SSRIs are frequently used outside of their approved indications to treat men who ejaculate too early. Impotence is a rare problem for people who take trazodone. In the first clinical trials, it happened to less than 2% of the people who took the drug. Research shows that less than 1% of people will have trouble having orgasms because of genital numbing. About 1.5% of people will have less sexual desire. When most people stop taking trazodone, their genital sensitivity, sexual desire, and sexual function all comeback. If you are having trouble with sexual function, you should talk to a doctor.
Problems with urination
People who take trazodone rarely have problems with not being able to hold their urine. It has been said to be a side effect, but the number of people who have it varies from 0% to 1%, depending on the study. If you have trouble holding your urine, keep in mind that trazodone may not be the only cause. Talk to a doctor or nurse about how to move forward.
Effects of Trazodone on Women
Are the side effects of trazodone more likely to happen to women than to men? No one has replied to this question. The best thing that can be said about trazodone is that it affects different people in different ways. Any bad effects of a drug have to be weighed against its good effects. SSRIs seem to help women more than men, but we don’t know why.
How soon do the side effects of trazodone show up?
The serotonin effects of trazodone happen within half an hour of taking a dose, so side effects like drowsiness, dry mouth, dizziness, trouble sleeping, nausea, urinary incontinence, blurred vision, genital numbing, and other similar side effects can happen early or even after the first dose. Other side effects, like sexual problems or changes in weight, may appear and get worse over time. Heart problems, especially changes in the rhythm of the heart, can happen quickly and without warning. Suicidal thoughts and worsening depression may not appear right away, but they should be monitored as soon as therapy begins.
How long do the side effects of taking trazodone last?
A lot of the negative effects of trazodone will get better over time. Trazodone is meant to be a short-term treatment, so most side effects, including sexual dysfunction, should go away soon after you stop taking it. But some problems, like changes in weight or serious heart problems, can take a while to get better.
What are trazodone’s long-term side effects?
People who take trazodone may have long-term problems even after they stop taking it. In rare cases, sexual dysfunction can last for a long time after an SSRI is stopped. This is called “post-SSRI sexual dysfunction,” and it is a medical condition. Some serious side effects, like a heart attack, can cause problems for the rest of your life.
Some people can’t take trazodone because they have certain health problems. People who are allergic to the drug or who have just had a heart attack are two examples.
The FDA has only given its OK for adults to use trazodone. Patients under the age of 18 have not been studied enough to know if the drug is safe and effective. However, some doctors may give it to children and teenagers despite the label’s instructions.If so, they will need to be closely watched to see if their depression or thoughts of killing themselves get worse. Seniors should be careful when taking Trazodone, but there is no evidence that they are more likely to get sick from it.
There is no proof that trazodone is dangerous for pregnant or nursing women. Even though trazodone is found in breast milk, there is no proof that it will hurt a baby who is being fed by its mother. Having a major depressive episode while pregnant is a risk, and trazodone or any other antidepressant should only be used if the benefits to the mother’s health outweigh the unknown risks to the baby.
Trazodone has risks, just like any other prescription drug. People who take this drug need to know about these and, in some cases, be watched more closely for side effects.
On the drug information sheet for trazodone, the FDA has put a “black box” warning about the risk of suicidal thoughts and actions, especially in children and young adults. These people will need to be closely watched for changes in behavior.
Abuse and dependence
The U.S. Food and Drug Administration (FDA) does not consider trazodone to be a drug with the potential for abuse or physical dependence.
An overdose of trazodone will require emergency medical care. Depending on the dose, it can cause severe problems that could be life-threatening, particularly when taken with alcohol or sedatives. The most common symptoms of a trazodone overdose are drowsiness or vomiting.
The sudden discontinuation of trazodone or any other SSRI can cause withdrawal symptoms such as excessive sweating, nausea, irritability, anxiety, agitation, dizziness, confusion, headache, mood swings, ringing in the ears, and even seizures. When trazodone therapy needs to stop, the doses will gradually decrease over a period of weeks.
Trazodone could worsen some medical conditions. People with these medical conditions can take trazodone, but they will need to be monitored more closely for problems. These include:
- Heart disease or other heart problems
- Electrolyte imbalances
- Bipolar disorder
- Bleeding problems
- Seizure disorders
- Narrow angles or a history of angle-closure glaucoma
- Liver disease
- Renal impairment
Trazodone can also cause problems when combined with other drugs. In some cases, these issues can be risky enough that healthcare professionals never prescribe trazodone with these other drugs. At the top of the prohibited list are monoamine oxidase inhibitors (MAOIs), a small family of drugs that treat depression or Parkinson’s disease. Allow for at least 14 days to lapse between stopping MAOI treatment and initiating trazodone. Trazodone is also never combined with the antipsychotic medications pimozide or thioridazine, or the HIV/AIDS drug saquinavir.
Because of the risk of serotonin syndrome, a hazardous elevation of serotonin in the brain, healthcare professionals are cautious about combining trazodone with other serotonin-increasing drugs including other antidepressant medications, migraine drugs (triptans), antipsychotics, opioids, anxiety medications, anticonvulsants, anti-nausea drugs, lithium, and some common over-the-counter supplements such as St. John’s wort or tryptophan.
When some drugs are combined with trazodone, the risk of serious adverse effects increases. Combining these drugs will require closer monitoring and vigilance. These include:
- Blood thinners
- Sedatives and other central nervous system (CNS) depressants
- Drugs that affect heart rhythm
- Drugs that speed up or slow down the body’s metabolism of trazodone.
How to avoid trazodone side effects
Most people taking trazodone will experience transient side effects. Not all are avoidable, but there are a few ways to minimize problems.
1. Take trazodone as directed
Follow the instructions given by the prescribing healthcare provider. Most people will take a 50–100 mg dose two or three times daily with food. At this frequency, it’s easy to miss a dose or take an extra dose, so it helps to use an alarm or app to make sure doses are taken correctly. If a dose is missed, take it as soon as it’s remembered. If it’s nearly time to take the next dose, skip the missed dose and take the next dose as scheduled.
2. Inform the prescriber about all medical conditions
The first and best way to avoid problems taking trazodone is to make sure the prescribing healthcare provider has a complete medical history before the first pill is taken. Don’t leave anything out, but make sure that the prescriber knows about:
- Suicidal thoughts
- Heart disease
- Heart rhythm problems, particularly a problem called QT prolongation
- A history of bleeding or blood clotting problems
- A history of seizures
- Low sodium
- Narrow angles in the eye
- Mania or bipolar disorder
- Liver problems
- Pregnancy or pregnancy plans
- Breastfeeding or breastfeeding plans
3. Tell the doctor about all medications being taken
Drug interactions are another source of side effects when taking trazodone, so tell the prescribing healthcare professional about all prescription drugs, over-the-counter medications, and supplements being taken, especially:
- MAO inhibitors
- Antidepressant medications including other SSRIs, SNRIs, and tricyclic antidepressants
- Medicines that treat anxiety, schizophrenia, or other mental health conditions
- Seizure medications
- Migraine medications called triptans
- Amphetamines or ADHD medications
- Heart rate medications
- Blood thinners such as warfarin
- Over-the-counter supplements such as St. John’s wort or tryptophan
4. Do not quit taking trazodone
If there are problems, talk to a healthcare professional before quitting trazodone. Sudden discontinuation—particularly after months of treatment—could lead to unpleasant withdrawal symptoms.
5. Avoid alcohol
Alcohol will worsen many of the sedative effects of trazodone such as sleepiness, fatigue, and dizziness.
6. Be careful about driving and other risky activities
Speaking of sedative effects, trazodone could make driving and other risky activities more dangerous. Healthcare professionals advise that these activities be put on hold for a few days when first taking trazodone. This allows people to determine if they can drive or perform other activities safely.
7. Avoid NSAIDs
To avoid abdominal problems and possible bleeding events, avoid NSAID pain relievers such as aspirin or ibuprofen. If possible, use acetaminophen instead.
8. Eat a healthy diet
To avoid or minimize weight changes, eat a healthy diet. If weight goes up or down unintentionally, talk to a dietitian or nutritionist.
How to treat side effects of trazodone
Most people will only experience minor problems taking trazodone. The most common is sleepiness and dizziness due to the sedative effects of the drug. Many of these transient side effects get better over time as the body adapts to the drug. Some can be managed by making simple lifestyle changes. Others might require medical attention.
- Sleepiness, dizziness, lightheadedness. These side effects can’t always be avoided but can be managed by removing obstacles in the house that can cause falls, moving carefully, and modifying daily activities.
- Weight changes. If weight goes up or down, talk to a dietitian or nutritionist about the best diet to counter these weight changes.
- Worsening depression or suicidal thoughts
Immediately talk to the prescriber or another mental health professional. Trazodone may need to be stopped.
- Signs of heart problems. Immediately get medical help for any signs of heart problems such as racing heartbeats, fluttering heartbeats, slowed heart rate, shortness of breath, or fainting.
- Low sodium. Call a healthcare professional at any sign of low sodium such as confusion, headache, weakness, or coordination problems.
- Serotonin syndrome. A potentially severe side effect, serotonin syndrome does require emergency medical help. The signs are psychiatric and neurological: agitation, restlessness, hallucinations, tremors, stiff muscles, and problems with coordination. The usual treatment is to stop taking drugs like trazodone that raise serotonin.