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Psychiatry & Medication

Trazodone for Anxiety

 April 12, 2020

By  Natalie Kirilova

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The Bottom Line

Trazodone for anxiety is an off-label medication in the treatment for anxiety that requires around the clock supervision of doctors but may bring positive results in stabilizing one’s well-being.

What Is Trazodone?

Originated to primarily treat depressive disorders in adults, Trazodone is a prescription antidepressant proven to have anxiolytic properties. It has many indications for use, and, for example, together with therapies, it shows efficacy in affecting alcohol dependence. In 1981, it was approved for depression by the FDA, and today is also distributed in generic form. Its efficacy for anxiety is not clearly outlined, however this triazolopyridine derivative from the group of serotonin receptor antagonists and SARIs is believed to increase serotonin levels. That, in turn, is responsible for mood, sleeping processes, and emotions. The SARI property of Trazodone has shown efficacy in treating sexual disorders in men. 

Each tablet contains 50, 100, 150 or 300 mg of trazodone. The secondary group of ingredients has corn starch, dibasic calcium phosphate, hypromellose, lactose monohydrate, magnesium stearate, polyethylene glycol, povidone, sodium starch glycolate, triacetin, microcrystalline cellulose, pregelatinized starch, and stearic acid.

Nowadays, this medication is prescribed in tablets, drops, and solutions for injections. Trazodone is not a controlled substance.

Is It FDA Approved for Anxiety?

Trazodone is not FDA approved for anxiety. It was originally produced to help patients with major depressive disorder (MDD). However, Trazodone can be used as an off-label drug for treating insomnia, anxiety, and other health conditions related to mood, memory, and emotions in adults. The FDA does not approve its hydrochloride tablets in pediatric patients and for use in children. Today, it is still unknown if Trazodone dosage for anxiety is safe in children.  A doctor usually prescribes it only if no other drugs show progress.

When Should I Consider Asking My Doctor for Trazodone for Anxiety?

Doctors will choose Trazodone for anxiety only in the case you are not responding to other medications, the previously-taken remedies showed no progress, or if previous pharmaceutical treatment caused many side effects. You should always consult your doctor before taking Trazodone. 

What Research Supports Trazodone for Anxiety? 

As of now, there is limited research supporting the Trazodone and anxiety connection. 

  • Trazodone for anxiety was studied together with diazepam 15mg and chlordiazepoxide on how they function in treating concomitant anxiety in depressed patients. Its application was favorable in tremor and chronic alcoholism treatment. And, studies suggest Trazodone is less likely to develop cardiotoxicity in adults with no confirmed signs of overdosing. Elderly patients and people with anxiety symptoms found it well-tolerable without experiencing neurological side effects.

  • Trazodone showed a greater anti-anxiety effect compared to amitriptyline and desipramine. In animal studies, it illustrated anti serotonin activity with a significant therapeutic effect at optimized dosages. Trazodone 100 mg for anxiety showed fewer anticholinergic side effects in comparison with tricyclic antidepressants.

  • Also, in these studies focused on dogs, Trazodone 50mg was prescribed for anxiety together with the primary treatment. The combination involved non-steroidal drugs, antibiotics. The results showed a therapeutic effect with minimal side effects in 90% of dogs that took Trazodone for 2-3 months. They were reported to have calmness and confinement tolerance. The duration of anxiety attacks was reduced and the effect fluctuated in 30-45 minutes up to four and more hours.

However, there is no clear information on how Trazodone for anxiety works exactly.  The functionality is usually related to the enhancement of serotonergic activity in the central nervous system (CNS) which possibly can alert the brain about the onset of anxiety.

What Are the Possible Side Effects? 

The adverse reactions are usually rare or have a temporary effect only. However, here are the risks that the FDA warns against in connection with taking Trazodone for anxiety:

  • Extreme tiredness;

  • dizziness;

  • nausea;

  • suicidal thoughts in children, and adults;

  • serotonin syndrome;

  • cardiac arrhythmias;

  • glaucoma;

  • potentially high risk of motor impairment.

There is a rare risk of experiencing priapism in men which occurs in the first months of therapy with Trazodone for anxiety. Pregnant women should NOT take Trazodone as it may cause fetal harm, based on this evidence. Prior to the application, a doctor should screen patients for the history of bipolar disorder or mania. In those patients, this medication can cause manic manifestations or activation of hypomania. It may alter the physical ability to perform hazardous job duties. Patients with anxiety diagnoses should inform their doctor about such works to exclude the danger of operating hazardous equipment or machinery. The withdrawal symptoms are anxiety, agitation, and sleep disturbances.

Does Trazodone Have Interactions With Other Medications?

The following medications can alter the functionality and effect of Trazodone for anxiety, ensure you speak about taking these alongside Trazodone with your doctor. 

  • Blood thinners;

  • SSRIs;

  • Diuretics;

  • Cold drugs;

  • HIV/AID drugs;

  • Certain heart and seizure drugs;

Beware of interactions with alcohol. It affects the efficacy of Trazodone for anxiety and may alter or maximize the effects of barbiturates, or certain CNS (central nervous system) depressants.

How to Take Trazodone for Anxiety? 

The initial or starting dose is 150 mg in divided doses daily. It may be increased up to 400mg. Trazodone for anxiety should be taken after food or light snack. Swallow a tablet whole or broken in half, wash it down with a lot of water. It is prohibited to abruptly stop the intake. Adverse reactions may occur upon sudden discontinuation of Trazodone used for anxiety. A gradual decrease in dose is highly recommended under the doctor’s supervision only.

Are There Alternatives to Trazodone?

Prescription Medications as Alternatives to Trazodone

Trazodone is an off-label medication for anxiety as its primary indication is for Major Depressive Disorder (MDD). There are a variety of other prescription medications for anxiety:

  • Klonopin

  • Buspirone

  • Lexapro

  • Prozac

  • Paxil

  • Xanax

  • Valium

  • Inderal

  • Cymbalta

  • Tofranil

  • Hydroxyzine

  • Zoloft

There are various alternatives. If you’d like to learn more about whether trazodone, another medication or treatment modality is right for you, we recommend that you speak with a licensed psychiatrist. Here are the best online psychiatry platforms so you can speak with someone right away!

Therapy as an Alternative to Trazodone

Learn more about different therapy options for anxiety here

Energy & Holistic Modalities as an Alternative to Trazodone

Learn more about different energy & holistic modalities for anxiety here

Tech & Devices as Alternative Treatments to Trazodone

Learn more about tech & devices for anxiety  here

Disclaimer: This website does not provide medical advice. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on our Site. If you think you may have a medical emergency, immediately call your doctor or dial 911

Natalie Kirilova


Natalie is a writer with a focus in medical research with over 10 years of experience

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