trazodone

Adjunctive therapy • Brands: DESYREL, OLEPTRO

Last reviewed: 2026-02-22

General information

Class: Adjunctive therapy
Common US brands: DESYREL, OLEPTRO
Typical dose range: Insomnia (off label): start 25–50 mg at bedtime; typical 50–150 mg nightly based on tolerability; reassess frequently and avoid open-ended dose escalation.
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2026-02-22

Dosing & forms

Forms/strengths: Immediate-release tablets: 50 mg, 100 mg, 150 mg, 300 mg.; Extended-release tablets (Oleptro): 150 mg, 300 mg.
Frequency: Insomnia (off label): start 25–50 mg at bedtime; typical 50–150 mg nightly based on tolerability; reassess frequently and avoid open-ended dose escalation.
Typical range: Insomnia (off label): start 25–50 mg at bedtime; typical 50–150 mg nightly based on tolerability; reassess frequently and avoid open-ended dose escalation.

Mechanism (brief)

Serotonin antagonist and reuptake inhibitor (SARI); 5-HT2 antagonism with weak SERT inhibition plus H1/α1 effects.

Metabolism & Half‑life

Metabolism: CYP3A4
Half‑life: Single-dose mean 7 h; Single-dose range 5–13 h

Therapeutic Drug Monitoring (TDM)

Recommended: No

View labelExact

Monitoring highlights

Monitor orthostatic symptoms and falls risk during initiation and after dose increases, especially in older adults or those on antihypertensives.
Reassess mood and suicidality during antidepressant initiation and titration; ensure the dose matches the target (sleep vs depression).
Review QT-risk co-medications and consider ECG/electrolytes when risk factors stack.
If used primarily for insomnia, document a stop plan and reassess regularly rather than continuing indefinitely.

Sources

Trazodone hydrochloride prescribing information — DailyMed (2025)
Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline — Journal of Clinical Sleep Medicine (2017)
The efficacy and safety of trazodone for sleep problems in depressive patients — Psychopharmacology (2025)
Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder — The Lancet (2018)

General information

Class: Adjunctive therapy

Common US brands: DESYREL, OLEPTRO

Typical dose range: Insomnia (off label): start 25–50 mg at bedtime; typical 50–150 mg nightly based on tolerability; reassess frequently and avoid open-ended dose escalation.

Therapeutic drug monitoring not routinely recommended.

Last reviewed: 2026-02-22

Dosing & forms

Forms/strengths: Immediate-release tablets: 50 mg, 100 mg, 150 mg, 300 mg.; Extended-release tablets (Oleptro): 150 mg, 300 mg.

Frequency: Insomnia (off label): start 25–50 mg at bedtime; typical 50–150 mg nightly based on tolerability; reassess frequently and avoid open-ended dose escalation.

Typical range: Insomnia (off label): start 25–50 mg at bedtime; typical 50–150 mg nightly based on tolerability; reassess frequently and avoid open-ended dose escalation.

Monitoring highlights

Monitor orthostatic symptoms and falls risk during initiation and after dose increases, especially in older adults or those on antihypertensives.

Reassess mood and suicidality during antidepressant initiation and titration; ensure the dose matches the target (sleep vs depression).

Review QT-risk co-medications and consider ECG/electrolytes when risk factors stack.

If used primarily for insomnia, document a stop plan and reassess regularly rather than continuing indefinitely.