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Trazodone is an antidepressant medication that is also sometimes used off-label for the treatment of insomnia and as an adjunctive treatment for schizophrenia. The drug was formerly available as Oleptro and Desyrel, but both brands are now discontinued.

Trazodone acts acts to inhibit the reuptake of the neurotransmitter serotonin, effectively increasing the amount of serotonin in the brain. Serotonin is one of the brain’s chemical messengers that helps to regulate mood. High levels of serotonin can make a person feel happy and relaxed, as well as sleepy.

While trazodone is relatively safe and is not typically thought of as a drug of abuse, some people may take toxic amounts of trazodone either accidentally or purposefully. Trazodone overdose can result in serious and sometimes life-threatening symptoms. An overload of trazodone on the brain and body can interfere with normal bodily and autonomic functions. Heart rate, blood pressure, and respiration can all be negatively affected.

Misuse of a medication like trazodone can lead to a potentially fatal overdose and have a wide range of short-term and long-term effects.

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Characteristics of a Trazodone Overdose

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There have been reports of suicide attempts involving very high doses of trazodone. Fortunately, trazodone alone is relatively safe in overdose; when medical help is received, death or permanent harm is unlikely.

Mixing trazodone with alcohol, benzodiazepines, or other central nervous system depressants, however, can increase the odds for suffering from an overdose. In the case of fatal overdoses, another substance of abuse is also typically involved.

Overdose is also more likely when the drug is misused in ways like taking it via alternate methods, such as crushing up the drug and snorting it. Tampering with the drug in this way alters the drug’s normal metabolism and delivers the drug to the brain more rapidly, intensifying the effects and increasing the risk of overdose.

The drug should only be taken as prescribed and under the supervision of a trained medical professional. This is especially important for the younger population of trazodone users. The US National Library of Medicine (NLM) warns that taking trazodone may actually increase suicidal thoughts and tendencies in some people, especially in children, adolescents, and young adults under the age of 25, and it can have unpredictable effects on a person’s mental health status. Increased risk of suicidal ideation also occurs any time the dose is increased, so those who are misusing the drug may be in greater danger. Always report any suicidal thoughts to your physician, and seek emergency help if you have immediate thoughts of attempting suicide.

The FDA lists the following potential effects of a trazodone overdose:

  • Nausea and vomiting
  • Priapism (erection that is prolonged and usually without sexual arousal)
  • Heart rhythm irregularities
  • Seizures
  • Respiratory arrest

When used as directed under medical supervision and direction, trazodone can be a relatively safe therapeutic medication; however, there are several troublesome side effects that my be intensified in overdose, including the following:

  • Orthostatic hypotension (low blood pressure that can lead to a person fainting when they stand up quickly from laying or sitting down)
  • Hypertension
  • Piapism that may require medical intervention
  • Drowsiness
  • Diarrhea
  • Incoordination
  • Tremors
  • Confusion
  • Disorientation

Trazodone can also cause hyponatremia (low sodium in the blood that can lead to difficulty walking/feeling unsteady, headache, confusion, troubles concentrating, weakness, and memory issues), as well as a very dangerous condition called serotonin syndrome, which is characterized by significantly severe symptoms such as hallucinations, agitation, rapid heartbeat, changes in mental status, coordination problems, dizziness, gastrointestinal distress, rapid heart rate, delirium, and seizures.

A trazodone overdose can be complicated by the presence of other drugs or alcohol as well as by medical or mental health conditions. Biological and genetic factors, such as metabolism, family or personal history of mental illness and/or substance abuse and addiction, can also play a role in the severity of a trazodone overdose.

There is no specific medication to reverse a trazodone overdose; however, medical intervention is necessary to manage and minimize the possible effects of an overdose.

Tolerance and Dependence

A trazodone overdose can be complicated by the presence of other drugs or alcohol as well as by medical or mental health conditions

Someone taking trazodone may develop a tolerance to it and need to adjust their dose to experience the sought-after effects. With increasing dose adjustments, they may risk overdose, especially if they increase their dose without consulting a doctor first.

With regular and prolonged use of trazodone, a person can develop a physical dependence on the medication that makes it difficult to stop taking it, as withdrawal symptoms can crop up when the drug processes out of the body.

Withdrawal symptoms can include anxiety, agitation, and insomnia. A slow reduction in dose is recommended to keep withdrawal symptoms at bay.

Medical detox can help a person manage trazodone withdrawal with minimal symptoms.

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When to Seek Help for Trazodone Abuse

The National Institute on Drug Abuse (NIDA) reports that prescription medications and over-the-counter drugs are the most regularly abused substances in the United States by those ages 14 and older after marijuana and alcohol. Any time a person uses a drug without medical direction or need, it is abuse.

NIDA estimates that over 50 million adults in the United States have abused a prescription medication for non-medical purposes at some point in their lives. Prescription drug abuse is a public health concern that impacts nearly one-quarter of the American adult population.

Trazodone, and other prescription drug abuse, is risky, and the odds of an overdose are greatly raised by medication misuse, especially when multiple substances are involved. Addiction treatment, or rehab, can reduce the risk of overdose by managing medication misuse and physical dependence. If someone is misusing trazodone, rehab can help to uncover potential triggers, or stressors, that may be encouraging drug abuse and manage any potential co-occurring medical and/or mental health disorders. At the same time, rehab can address the physical and emotional impact and root causes of medication misuse.

Overdose is a real risk factor for trazodone abuse. Rehab can help to circumvent this potentially fatal outcome while fostering a healthy recovery.