Trazodone Efficacy and Safety for Sleep Disorders

Efficacy for Sleep

• The American Academy of Sleep Medicine suggests that a dose of 212 mg/day of trazodone is effective for treating insomnia and nightmares 1
• Trazodone at a dose of 100 mg reduces the time in stage 1 sleep and increases the duration of slow-wave sleep (stages 3+4) 1
• The American Academy of Sleep Medicine recommends that trazodone may be useful when insomnia is associated with depression 6

Safety and Adverse Effects

• The American Academy of Sleep Medicine and the American College of Physicians note that a dose of 100 mg of trazodone is associated with a higher incidence of adverse effects, including daytime sedation and dizziness, compared to 25 mg 1, 2
• Common adverse effects of trazodone include sedation, dizziness, dry mouth, and in rare cases, priapism, with higher doses increasing the risk of these effects 1, 2, 3

Clinical Considerations

• The American Academy of Sleep Medicine and the American College of Physicians recommend that trazodone is not a first-line treatment for chronic insomnia, with non-benzodiazepine hypnotics like zolpidem and eszopiclone generally preferred when pharmacological therapy is necessary 2, 4, 5, 6
• Trazodone shows a reduction of only 10 minutes in sleep latency and 8 minutes in wake time after sleep onset compared to placebo 4