Trazodone (also known as Desyrel, Oleptro, and a number of other brand names) is a serotonin antagonist and serotonin reuptake inhibitor. 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.
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.
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:
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 that may indicate that an individual is abusing trazodone include:
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: