Trazodone Abuse: Side Effects, Warnings, and Treatment

The drug was originally designed to be used in the treatment of depression, but due to its sedating effects, it is more often used as a sleep aid in people with depression and to treat anxiety, fibromyalgia, and many other conditions/disorders.

Can Trazodone Be Abused?

The short answer to this question is “yes.” It appears that most any type of drug or medication can be a substance of abuse given the rather entrepreneurial nature of many who seek to abuse substances. Certain classifications of prescription medications have a higher potential for abuse than others (e.g., narcotic painkillers versus antidepressants); however, individuals who abuse prescription medications will attempt to find ways to abuse nearly any type of drug.

It has been recognized that antidepressant medications are potential drugs of abuse, although this is a relatively rare phenomenon compared to other classes of drugs, and often, antidepressant abuse occurs in conjunction with other drugs of abuse. In addition, a 1994 article in the journal Mayo Clinic Proceedings reporting two case studies concerning the abuse of Prozac also reported what is believed to be the first actual documented case of co-abuse of trazodone.

A 1999 study in the journal Psychopharmacology compared the abuse potential of three drugs used for sedation and anxiety control: trazodone, Ambien, and Halcion. The potential for abuse was rated by both objective tests and the subjective experiences of former drug abusers. The findings indicated that trazodone had a significantly less potential for abuse than the other two drugs; however, this can also be interpreted as meaning that trazodone does have some abuse potential although it is most likely not commonly a primary drug of abuse. There are numerous reports on the Internet of individuals snorting trazodone, which alone would indicate that the drug is being abused because this form of administration is not consistent with medical instructions and therefore indicates these people are taking the drug for nonmedical reasons. Snorting trazodone will most likely intensify some of its sedating the facts and enhances its onset of action, indicating a misuse of the medication for nonmedical reasons.

Finally, trazodone has a mild potential for abuse and for the development of a mild syndrome of physical dependence that is associated with other antidepressant medications and often termed antidepressant discontinuation syndrome. Trazodone overdoses are not very common, but they can occur.

Who Abuses Trazodone?

Data regarding the abuse of prescription medications as indicated by the National Institute of Drug Abuse and numerous scholarly sources regarding addiction and abuse help to define the parameters of prescription medication abuse, like trazodone abuse, such that:

• People who take prescription medications for medicinal purposes and under the supervision of a physician are far less likely to abuse these drugs.
• People who take prescription medications for nonmedical reasons are significantly more likely to develop substance use disorders and to combine them with other drugs of abuse.
• Antidepressant medication abuse more commonly occurs as a secondary drug of abuse mixed with other drugs of abuse as opposed to being a primary drug of abuse. Thus, individuals who abuse trazodone are far more likely to also have histories of abusing other drugs or addiction to other drugs of abuse.

Any person who uses antidepressant medications for a period of greater than 6-8 weeks may potentially develop a physical dependence on the drug.  Is important to note that physical dependence, while a potential symptom of a moderate to severe substance use disorder (addiction), by itself does not indicate abuse or addiction. Individuals who take these same medications strictly for medicinal purposes under the supervision of a physician may develop a physical dependence; however, they are not addicted or abusing them according to the formal clinical criteria for addiction and abuse (substance use disorders) as presented by the American Psychiatric Association. Addiction and abuse by definition entail the nonmedical use of drugs or substances that result in a number of negative consequences for the individual and lead to stress or functional impairments.

Signs of Trazodone Abuse or Addiction

Signs that may indicate that an individual is abusing trazodone include:

• The person gets trazodone without a prescription.
• A person with or without a prescription for trazodone uses the medication more often than prescribed, more frequently than prescribed, in manners not consistent with the prescribed use of the drug (e.g., snorting it), or combines it with other drugs, such as alcohol, painkillers, etc.
• A person with a prescription attempts to get more trazodone than originally prescribed by doctor shopping, buying it illegally, stealing it, etc.
• The person begins to spend more time attempting to get or using trazodone.
• The person continues to use trazodone even though its usage leads to negative consequences, such as issues at work, issues with relationships, issues at school, etc.
• The person begins to disregard major obligations as a result of trazodone abuse, such as at work, as a parent, spouse, etc.
• The person’s drug use causes health issues.
• The person uses trazodone under potentially dangerous conditions, such as combining it with other drugs.
• The person has been using trazodone for reasons other than its intended use (e.g., to get “high” or to enhance the high experiences other drugs).
• The person begins to demonstrate issues with tolerance and withdrawal symptoms when going without the drug in the addition to displaying at least one of the above issues.

Common and Severe Side Effects

Treatment Options for Trazodone Abuse

Since it is highly likely that individuals abusing trazodone are also abusing other drugs it is important to identify the context of their abuse and other drugs that may be associated with their trazodone abuse.

This will require a comprehensive assessment of the individual and the development of a treatment program that may include the following:

• Medical detox: Individuals who abuse trazodone may have developed a physical dependence on the drug. Detox can be done in either an inpatient or outpatient setting, depending on the particular circumstances involved in each individual case. Recovery from an antidepressant discontinuation syndrome typically requires physician-assisted tapering of the drug to control the withdrawal process.
• Treatment for co-occurring disorders: This includes treatment for any other addictions, substance abuse, and psychiatric/psychological disorders.
• The option for inpatient or outpatient treatment: This decision will depend on the specific details of the individual’s patterns of abuse, lifestyle, preferences, etc.
• Comprehensive therapy: This will be targeted at the initiating factors that contributed to the person’s drug abuse, the development of coping skills, a relapse prevention program, a program that addresses other potential psychological disorders/issues, and a long-term aftercare program. Therapy can be delivered in the form of individual therapy, group therapy, or both.
• A psychoeducation program: This can help clients learn about the mechanisms of addiction and how to prevent relapse.
• 12-Step meetings: These meetings can also serve as part of the individual’s long-term aftercare plan.