Trazodone Classification and Treatment Guidelines

Classification and Efficacy

• The American College of Physicians recommends trazodone as a second-generation antidepressant, alongside SSRIs, SNRIs, and SSNRIs, with similar efficacy to first-generation antidepressants but lower toxicity in overdose 1
• Second-generation antidepressants like trazodone have similar efficacy but lower toxicity in overdose compared to first-generation antidepressants, according to the American College of Physicians 1
• The American Academy of Sleep Medicine classifies trazodone as a "sedating low-dose antidepressant" that may be considered when insomnia is accompanied by comorbid depression 3

Clinical Applications and Safety

• Trazodone is commonly prescribed off-label at lower doses for insomnia, with guidelines noting its sedating properties and little or no anticholinergic activity compared to other antidepressants 3
• The American Academy of Sleep Medicine notes that trazodone has little or no anticholinergic activity compared to other antidepressants like doxepin and amitriptyline 3