If taking trazodone for insomnia, it will begin working about 30 to 60 minutes after taking a dose.
If you are taking trazodone for the treatment of depression, it generally takes at least 4 to 6 weeks to realize the full effects of the drug. This is true for the vast majority of antidepressant medications.
According to the prescribing information for trazodone, food can significantly affect absorption and how fast it begins to work.
If taken on an empty stomach, peak concentrations occur 1 hour after taking a dose by mouth. However, when taken with or shortly after food, peak concentrations are delayed to 2 hours after dosing.
Answer SummaryIf taking trazodone for the sedative effects, it works quickly, within 30 to 60 minutes. If it is being used as a treatment for depression, it can take 4 to 6 weeks to begin noticing effects.
Trazodone has a complex mechanism of action, but the antidepressant effects appear to be due to its blocking of serotonin re-uptake. It also antagonizes certain serotonin receptors. Studies have found it to have a comparable antidepressant activity to SSRIs (selective serotonin reuptake inhibitors), like Zoloft.
As trazodone has fairly significant sedative effects, it generally is only recommended as a second or third line anti-depressant medication.
According to The Guidelines for the Treatment of Major Depressive Disorder:
Although trazodone is an effective antidepressant, relative to placebo, in contemporary practice it is much more likely to be used in lower doses as a sedative-hypnotic than as an antidepressant.
As stated above, it generally takes at least 4 to 6 weeks of consistent dosing for trazodone to begin working for the treatment of depression.
While trazodone can be used for the treatment of depression, as the guidelines above state, it is more commonly used to treat insomnia.
The sedative effects of trazodone are thought to be due to two mechanisms:
- Alpha-adrenergic blocking
- Histamine blockade (i.e. an antihistamine)
The alpha-adrenergic blocking effects of trazodone is why it can cause low blood pressure, lightheadedness, and dizziness. In fact, alpha-adrenergic blockers (also known as alpha-blockers) are a commonly used class of blood pressure medication (which includes drugs like terazosin and prazosin).
The American Academy of Sleep Medicine guidelines recommend the use of low-dose trazodone as a:
- Second-line treatment option for secondary insomnia (treating concurrent depression or anxiety).
- Third-line treatment in cases of other recommended treatment failures (e.g., melatonin-receptor agonists, Ambien, etc...) for primary insomnia.
Nevertheless, it is sometimes used as a first option for many due to its lower risk of dependence and less severe withdrawal symptoms when compared to other drugs, like benzodiazepines.
The sedative effects of trazodone are generally seen with the very first dose. Peak concentrations happen about 1 hour after dosing, so you will feel the effects quickly.
Trazodone is classified as an oral antidepressant, structurally unrelated to others. It does, however, have similarities in the mechanism of action to other antidepressant drugs.
In addition to its use as an antidepressant, it also possesses anti-anxiety and significant sedative effects. It is therefore commonly prescribed off-label for the treatment of insomnia and anxiety disorder.
Trazodone can cause you to be dizzy or drowsy, especially when quickly going from a lying/sitting position to standing. This is known as 'orthostatic hypotension'. Be sure to stand or sit up slowly.
Other common side effects include dry mouth, dry eyes, and blurred vision.
Trazodone is available as immediate-release tablets and extended-release tablets (Oleptro).