Trazodone Addiction, Abuse, and Symptoms
In 2016, trazodone was the 24th most prescribed medication in the United States, with over 25 million prescriptions. According to the 2018 National Survey on Drug Use and Health, approximately 243,000 individuals ages 12 and older reported that they were current misusers of prescription sedatives like trazodone. Misuse of trazodone and other sedatives has increased in recent years, especially among adolescents and young adults.
This guide explains the effects, trends, and dangers of trazodone use, as well as an unbiased analysis of the medicinal and behavioral treatment methods for trazodone addiction based on current research and publicly available statistics. In some cases, usage statistics are derived from general prescription sedative use, which includes lorazepam, hydroxyzine, and phenobarbital, or overall prescription antidepressant use, which includes selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and monoamine oxidase inhibitors (MAOIs).
I. The Basics
II. Signs of Abuse
III. Trazodone Usage
Trazodone is usually prescribed as a treatment for major depressive disorder. Low-dose trazodone also has off-label use as a sleep aid. Some individuals with insomnia take trazodone to make it easier to fall asleep or stay asleep.
Non-medical users typically take trazodone to relax and experience the calming effects of the sedative. Trazodone is also taken to enhance the effects of alcohol and other substances. Although trazodone helps people relax and is useful for treating major depressive disorder and insomnia, it does have risks.
According to the Merck Manual, long-term use of sedatives like trazodone can cause memory loss, sudden emotional changes, involuntary eye movements, difficulty thinking clearly, and difficulty understanding other people when they speak. Long-term use of sedatives may also cause an individual to speak slowly.
Primary Trazodone Dangers
Addictiveness: In 2007, Nutt et al. published a study on the potential for addiction associated with substances such as cannabis, amphetamines, barbiturates, and benzodiazepines. Although trazodone was not included in the study, the effects of benzodiazepines are similar to the effects produced by trazodone. Based on their mean scores for physical harm, social harm, and the risk of dependence, benzodiazepines ranked seventh on the list of 20 substances studied by Nutt and his colleagues. In fact, Nutt et al. determined that benzodiazepines have a greater risk of misuse than amphetamine, tobacco, cannabis, ecstasy, LSD, and eight other substances.
Risk of overdose: In 2017, more than 5,000 U.S. deaths involved an antidepressant, according to the National Institute on Drug Abuse. Some of these deaths involved antidepressants combined with opioids or antidepressants combined with synthetic narcotics.
Unintended side effects: Trazodone use can lead to muscle aches, headaches, nausea and vomiting, dizziness, dry eyes, dry mouth, balance problems, tingling, diarrhea, constipation, confusion, sweating, fatigue, weakness, or blurry vision.
Legal risks: Although trazodone is not a controlled substance and does not have a DEA schedule number, it is still illegal to possess it without a prescription. Possession of trazodone without a valid prescription is usually charged as a misdemeanor, and the potential penalties include fines, community service, and required participation in a court-ordered treatment program.
Trazodone Background Information
Derived From Triazolopyridine
Ways Used Ingestion of immediate-release tablets, crushing the tablets and snorting the powder, adding the powder to alcoholic beverages, smoking the powder with marijuana or another substance
Scientific Name Trazodone hydrochloride
Slang/Street Names for Trazodone Trazo, trazzy, traz, trazzer, sleepeasy
How Long in Bodily System Half-life: 10 to 12 hours
Elimination in approximately two days depending on the individual's health status and metabolic function
Punitive Legal Measures: Using/Possession Trazodone is not a controlled substance, but it is still available by prescription only. Possessing trazodone without a prescription from a licensed medical professional is a criminal offense. The laws vary from state to state, but a first-time offense is usually charged as a misdemeanor. Potential penalties include fines, jail time, court-ordered community service, and mandatory participation in a treatment program.
Punitive Legal Measures: Selling/Distributing Selling or attempting to sell trazodone may be charged as a misdemeanor or felony, depending on the amount of trazodone confiscated and the individual's criminal record. The penalties are usually more severe if the defendant sold or attempted to sell trazodone in a school zone or near a public facility.
DEA Drug Rating N/A
Behavioral Symptoms of Trazodone Usage and Abuse
How trazodone affects the brain
Trazodone increases the amount of serotonin in the brain, relieving some of the symptoms of major depressive disorder. Serotonin is a hormone that helps the nerves send messages to each other. In people with depression, an imbalance of serotonin and other chemicals produces symptoms such as loss of appetite, reduced self-esteem, and persistent feelings of sadness.
Trazodone may also affect the amounts of dopamine and norepinephrine in the brain. Like serotonin, dopamine and norepinephrine are chemicals that help the nerves communicate with each other. In people with depression, trazodone can correct imbalances of these chemicals, relieving depression symptoms.
Behavioral signs of trazodone usage and abuse
The signs of trazodone misuse are not always obvious right away, but long-term use can cause several behavioral changes. It may be difficult to carry on a conversation with someone who misuses trazodone, as long-term trazodone use can interfere with the ability to speak or understand what people are saying. Individuals who use trazodone may also experience mood swings or sudden emotional changes, making it difficult to predict how they will react to certain situations.
In adolescents, misuse of trazodone or another similar substance can lead to behavioral changes such as skipping school, not putting effort into personal grooming, loss of interest in sports or other activities, and a decline in school performance. Trazodone misuse can also interfere with the relationships adolescents form with their family members and peers.
Adults who misuse trazodone may miss work frequently, lose interest in hobbies they used to enjoy, ask friends and relatives to borrow money, stop paying attention to personal hygiene, or exhibit drastic changes in their behavior. Some individuals try to hide what they are doing by being secretive about where they go, refusing to let other people enter their rooms, or refusing to introduce new acquaintances to their friends or family members.
Physical Symptoms of Trazodone Abuse
How trazodone affects the body
Trazodone increases the amounts of serotonin and norepinephrine in the brain, which has a relaxing effect on the body. As the body relaxes, the individual may start to feel sleepy. Trazodone may also cause dry mouth, dizziness, nausea and vomiting, weakness, fatigue, sweating, and blurry vision. Long-term use of trazodone may cause a loss of appetite, leading to unintended weight loss.
Early physical effects of trazodone
After taking trazodone, an individual can expect to experience several physical and psychological effects within as little as 30 minutes. Some of these side effects are undesirable, while others can be dangerous.
This table illustrates the possible short-term physical effects associated with trazodone.
Short-term Physical Symptoms
Initial (direct effects of drug, 30-60 min.) Sleepiness/drowsiness
Lack of motor coordination
Lingering (within an hour of taking the drug) Sleepiness/drowsiness
Difficulty maintaining normal balance
Inability to coordinate movements
Post-Use (several hours to days after use) Short-term memory loss
Verbal learning difficulties
Problems maintaining equilibrium
Severe and long-term physical effects of trazodone
Individuals who use trazodone for long periods often develop a tolerance to the drug. Once this tolerance develops, it takes more trazodone to produce the same effects that used to occur with smaller doses. As a result, it becomes necessary to take trazodone more frequently or increase the amount of trazodone in each dose. Increasing the amount of trazodone taken each day increases the risk for overdose, which can cause difficulty breathing, chest pain, abnormal heart rhythms, seizures, and tremors. In severe cases, trazodone overdose can cause an individual to stop breathing or slip into a coma.
Prolonged use of trazodone has also been associated with symptoms similar to the ones produced by Parkinson's disease. These symptoms include muscle spasms, altered mental status, and rigidity of the arms and legs. Parkinsonian symptoms are more likely to develop in elderly users of trazodone.
The physical effects of trazodone are more pronounced when trazodone is combined with another substance. Some individuals use trazodone to enhance the effects of alcohol or balance out the effects of stimulants, such as cocaine. Trazodone is especially dangerous when combined with alcohol, other sedatives, and barbiturates, as combining these substances affects the central nervous system, which is responsible for breathing and other critical functions.
This table illustrates the possible long-term physical effects associated with trazodone.
Long-term Physical Symptoms
Casual Confusion
Unusual tiredness
Tingling/burning sensations
Chronic (Including all of the above effects for casual use) Fainting
Lack of coordination
Inability to concentrate
Slow heartbeat
Withdrawal Muscle pain
Tightness in the chest
Both the National Institute of Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) offer in-depth information on the symptoms and treatment of prescription sedative addiction.
Trazodone usage has increased significantly over the past decade
In the United States, the number of trazodone prescriptions issued since 2006 has increased by more than 150%. As a result, trazodone went from the 48th most prescribed medication in 2006 to the 24th most prescribed medication in 2016. Based on data from 2016, an estimated 25 million trazodone prescriptions are issued each year. Misuse of trazodone has also increased, as evidenced by the number of drug-seizure cases involving sedatives. The United Nations Office on Drugs and Crime reports that the quantities of sedatives and tranquilizers seized around the world increased by 700% in 2016, indicating an increased demand for trazodone by non-medical users.
The use of sedatives like trazodone is also increasing outside of the United States. According to the 2019 Drug Use Survey Nigeria, published by the United Nations Office on Drugs and Crime, 481,000 respondents reported that they had used sedatives or tranquilizers in 2017. Sedative use was slightly more common among Nigerian men than Nigerian women. In Palestine, the number of people using sedatives has also increased, which some people attribute to recent changes in the country's drug laws.
Baker et al. conducted a study to compare the prevalence of sedative use in several European countries with the prevalence of sedative use in the United States. The researchers issued surveys and conducted personal interviews with study participants. While the prevalence of sedative use in the United States was 12.9%, it was as high as 17.6% in Belgium. France, Switzerland, and Spain ranked second, third, and fourth with prevalence rates of 15.9%, 14.6%, and 14.2%, respectively. Although the study was published in the 1980s, the results indicate that sedative misuse is not a uniquely American problem.
Prescription Sedative Use Throughout the World
Highest Second Third
Regions with the Highest Number of Prescription Sedative Users Africa Asia and Australia Western and Central Europe
Source: United Nations Office on Drugs and Crime Global Overview of Drug Demand and Drug Supply 2017
Trazodone Usage Demographics in the U.S.
Sedative usage is on the rise in the United States, especially among adolescents and young adults
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 497,000 individuals aged 12 or older — about 0.15% of the population — misused sedatives in 2016. Approximately 73,000 of these individuals were adolescents (23,000) or young adults (50,000). This represents 0.1% of the adolescent population and 0.1% of young adults.
The National Institute on Drug Abuse published the Monitoring the Future Study to give the public information on substance use among middle-school and high-school students. Alcohol, illicit drugs, and prescription drugs were included in the study. Although the researchers did not ask participants specifically about trazodone, they did ask about the use of sedatives, barbiturates, and tranquilizers without the supervision or approval of a medical professional.
According to the 2018 data, 15.5% of 12th graders reported misusing one of these substances at some point in their lives, and 9.9% reported that they had misused a prescription drug within the past year, a statistically significant difference from the previous year. Additionally, 4.2% of 12th graders reported misusing a sedative, tranquilizer, barbiturate, or another prescription drug within the previous month.
Demographics of Prescription Usage
Past Year (2018) Lifetime
8th grade (14-15 yo) Data not collected Data not collected
10th grade (15-16 yo) Data not collected Data not collected
12th grade (17-18 yo) 9.9% 15.5%
Source: 2015-2018 Monitoring the Future Study: Trends in Prevalence
Long-term use of trazodone makes the drug less effective, causing some users to take even more trazodone to experience its calming, relaxing effects. These effects increase the potential for misuse, which may lead to dependence on trazodone and make it difficult to stop taking the drug. Even if an individual wants to stop taking trazodone, the withdrawal effects can cause severe discomfort.
Stopping trazodone suddenly increases the risk of withdrawal complications. Therefore, it is safer to undergo a supervised withdrawal process that focuses on slowly tapering off trazodone. This process also provides valuable social support and reduces the risk of relapse. To learn more about this process, read our trazodone rehabilitation guide, a comprehensive resource that explains the rehabilitation options available to trazodone users.
If you have a loved one who's struggling with addiction, staging an intervention is often the first necessary step towards sobriety, but it's important to be strategic and loving in your approach. Even the most well-meaning of interventions can have a negative effect if they aren't handled correctly.
5 Tips for Staging an Intervention
1. Don't Do It Alone. A professional interventionist is always the most qualified to guide a successful intervention. Also, rely on non-addict family and friends – especially those who have a close relationship with you or the addict.
2. Research Ahead of Time. It's best to do plenty of research ahead of time to gather insight on the addiction and how it affects the addict. Also, be prepared with local resources for getting help.
3. Write Out Your Statement. During the actual intervention, emotions will likely be running high, so it's best to have a statement of how the person's addiction has impacted you and your relationship with him or her. These statements should be honest, yet written from a place of love – no personal attacks.
4. Offer Help. It's important for everyone attending the intervention to offer tangible help and support as the person works through detox and rehabilitation.
5. Set Boundaries. If the person refuses to seek help and take the next steps outlined, it's important that they understand that everyone present will end codependence and enabling behaviors.
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