trazodone

Taking antidepressants, like trazodone, might sometimes worsen depression and raise thoughts of suicide or self-harm. The risk is highest for people who are 24 years of age or younger, during the first few months of treatment, and whenever there's a dose change. If you or anyone around you notice that you have suicidal thoughts or unusual behavior (e.g., anxiety, panic attacks, difficulty sleeping, feeling angry or irritated, restlessness) while taking trazodone, get medical help right away.

Some people taking trazodone have developed a rare, but potentially life-threatening condition called serotonin syndrome. This condition happens where there's too much serotonin in the brain. Your risk for serotonin syndrome is higher if you use trazodone with other medications that can raise your serotonin levels, such as certain antidepressants, mental health medications, and migraine medications. Let your psychiatrist know about all the medications you take before starting trazodone. Symptoms of serotonin syndrome include fast heart rate, sweating, muscle stiffness or spasms, fever, and confusion. Get medical help right away if you have any of these symptoms.

Trazodone can affect your heart rhythm, which can be serious and life-threatening. One example includes lengthening the time period from when the heart pumps and then relaxes. This is known as QT prolongation. Your risk is higher if you have certain factors, including abnormal electrolyte levels, heart rhythm problems, or are taking other medications that cause heart rhythm problems, such as amiodarone (Pacerone) and ciprofloxacin (Cipro), among others. To lower your risk, your psychiatrist or primary care provider might periodically monitor your heart and perform electrocardiograms (EKGs) to make sure your heart rhythm is normal. If you feel your chest pounding, have shortness of breath, have chest pain, or feel faint or lightheaded while taking trazodone, call 911 right away.

Trazodone can cause extreme sleepiness and lower your ability to think, react, and focus. Your risk is higher if you're also taking other medications that can make you feel sleepy or dizzy. Make sure you know how this medication affects you before driving or doing activities that require your concentration. Talk to your psychiatrist right away if you feel too sleepy from taking trazodone.

Trazodone can cause extremely low blood pressure, including a drop in blood pressure when you stand from a sitting or lying down position. This can lead to dizziness and fainting. To avoid falling, get up slowly if you've been sitting or lying down. If dizziness or lightheadedness doesn't go away, talk to your psychiatrist.

Trazodone can raise your risk of severe bleeding or bruising, especially if you're also taking antiplatelets (e.g., aspirin, clopidogrel (Plavix)) or anticoagulants (e.g., warfarin (Coumadin), apixaban (Eliquis), or rivaroxaban (Xarelto)). Get medical help if you get bruising that doesn't improve, black-colored stools, pink or red-colored urine, coughing up or vomiting blood, or unusual bleeding from the nose or gums.

Though rare, trazodone can cause prolonged and painful erections, which sometimes require surgery to treat. If you develop a prolonged erection that lasts longer than 4 hours, stop taking trazodone and get medical attention right away.

Trazodone can lead to or worsen angle-closure glaucoma. You might need to see your optometrist regularly and get eye exams to check your eyes and make sure your vision isn't worsening. Contact your psychiatrist or optometrist if you notice changes in your vision after starting trazodone.

Trazodone might cause low sodium levels in your blood. Get medical help right away if you experience weakness, confusion, difficulty concentrating, headache, or memory problems because these could be signs of low blood sodium levels, which is a medical emergency.