IRFANA PARVEEN
By Irfana Parveen

B.Sc (Psychiatry Ward)

22 November 2021
Medically reviewed by
Sumayya Salam
Pharm D
IS MIXING TRAZODONE AND ALCOHOL DANGEROUS
Table of Contents

The FDA has approved the tetracyclic antidepressant trazodone (Oleptro, Desyrel) for the treatment of depression. Due to the introduction of drugs of a newer generation to the market, trazodone is rarely used alone to treat depression. However, it has a variety of off-label uses for treating insomnia and various possible therapeutic indications for several diseases frequently linked to depression.

When trazodone and alcohol are combined, levels of intoxication might rise, causing profound sleepiness and raising the possibility of overdose and mortality when either substance is drunk in excess. Both substances can cause physical dependence and withdrawal after prolonged use.

So, let us explore the effects of mixing Trazodone and alcohol in detail.

What Is Trazodone (Desyrel)?

Trazodone is a medication used to treat depression. It may help improve mood swings, appetite, and energy levels and decrease anxiety and depression. Trazodone helps restore serotonin the natural chemical balance in the brain.

Brand Names Of Trazodone are TrazalonTrazonil, Trittico, Depryl 25, Tazodac, Trazaril, Traze, Trazodep, Trazolite, Zopotol 

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How Does Trazodone Works?

Trazodone is in a class of medication called serotonin modulators. It helps in increasing the amount of serotonin, a natural chemical substance in the brain that helps maintain mental balance. you can buy Trazodone online but it is always recommended to get advice from your doctor. 

Before understanding ‘what are withdrawal symptoms to the mixture of alcohol and trazodone,’ we should first understand Trazadone in detail.

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Who Can Take Trazodone?

Trazodone can be taken by adults over the age of 18 for depression and anxiety or both. It is advisable to take the doctor’s advice before starting Trazodone. The reason being having

  • any allergic reaction to trazodone or any other medicine of its class.Have suicidal tendencies or self-harming.
  • Have heart-related problems or kidney or liver problems.
  • Taking sleeping pills.
  • Have epilepsy or electroconvulsive treatment
  • Are pregnant or trying to become pregnant or breastfeeding?
  • Have rare diseases like porphyria or phaeochromocytoma.

In case you have diabetes, trazodone can increase your blood sugar level. Monitor your blood sugar level more frequently for the first few weeks of treatment with trazodone and adjust your diabetes treatment accordingly. Consult your doctor if your blood sugar level is a concern.   

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How And When To Take Trazodone?

A doctor may prescribe a single dose of trazodone in a day. It is generally prescribed to take after food and at bedtime. Trazodone can make you feel sleepy taking it at bedtime may help you sleep. Your doctor may prescribe splitting the dosage if you have a larger dosage. It is advisable to take trazodone after your meal to avoid feeling sick.

Dosage (Tablets)

50 mg
100 mg
150 mg
300 mg

Dosage Consideration

  • Initially, 150 mg/day orally divided in 8/12 hours
  • Increase by 50 mg/day every 3-7 days

What Are The Effects Of Taking Alcohol?

Alcohol is a depressant of the central nervous system. It affects numerous neurotransmitter systems and a variety of brain targets. It produces its intoxicating effects by elevating the activity of inhibitory neurotransmitters while decreasing the activity of excitatory neurotransmitters in the brain. Inhibitory neurotransmitters have a soothing or sedative effect, whereas excitatory neurotransmitters stimulate or excite the brain. 

Alcohol's effects on the brain and body include

  • Diminished reaction time.
  • Blurred vision.
  • Poor coordination.
  • Decreased alertness.
  • Impaired judgment.
For several reasons, you shouldn't take Trazodone and alcohol together. Alcohol is a central nervous system depressant that affects several brain processes and neurotransmitters, most notably GABA.
Store Trazodone at room temperature. Keep it between 68°F and 77°F (20°C and 25°C). Keep it away from light.
The half-life of Trazodone is 5–9 hours, so it will take 25–45 hours for the drug to leave the body.

Can You Take Trazodone And Alcohol Together?

It can be hazardous to consume alcohol when taking trazodone. Therefore, avoid the combined use of Trazodone and alcohol. Trazodone may intensify alcohol's effects, causing potentially fatal overdoses and severe degrees of intoxication.

It can cause extreme drowsiness that might potentially result in accidents and falls. Alcohol can also make anxiety and depression worse.

Study of Trazodone And Alcohol Relapse

Trazodone is one of the most commonly prescribed medications in patients with sleep disturbances in alcoholic addiction. A recent study concluded that treating insomnia with trazodone in patients with alcohol dependence might delay improvements in alcohol consumption and also lead to increased drinking when trazodone is stopped.

Until further studies have established benefits and safety, routine initiation of trazodone for sleep disturbance cannot be recommended with confidence during the period after detoxification from alcoholism.

Hence, mixing trazodone with alcohol can increase levels of intoxication, resulting in extreme drowsiness and increasing the risk of overdose and death when either is taken in an excessive amount. Long-term use of both substances can lead to physical dependence and withdrawal. 

Effects Of Mixing Trazodone And Alcohol

Physical dependence and withdrawal symptoms can also develop with long-term trazodone and alcohol use. Anxiety, irritability, and sleep issues are possible Trazadone withdrawal symptoms. People using the medicine should gradually wean themselves off under a doctor's supervision rather than discontinuing abruptly.

Acute alcohol withdrawal syndrome can cause dangers. The side effects include agitation, hallucinations, delirium, seizures, insomnia, anxiety, raised body temperature, perspiration, rapid heartbeat, nausea, and vomiting.

Short-term Side Effects

The short-term effects of mixing alcohol and trazodone majorly make user

  • Dizzy
  • Sleepy.
  • Blurry vision
  • Headaches
  • Fatigue
  • Constipation
  • Nausea

Long-term Side Effects

Mixing trazodone with alcohol has a drastic effect on one’s health. It’s better to stay
away from the mixture as long as possible.

  • Damage to the nervous systems
  • Upset stomach 
  • Short-term memory dysfunction
  • Coma
  • Seizure
  • Hypotension

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Side Effects Of Trazodone

Trazodone side effects are unwanted effects that occur after taking the drug. These can be common or severe or rare effects. Inform your doctor if any such side effects 

Common

Serious

Headache

Abnormal heartbeats

Feeling sleepy or tired

Suicidal thoughts

Feeling sick

Worsening depression

Constipation 

Serotonin syndrome

Dry mouth

Seizure

Diarrhea

A long-lasting and painful erection that lasts for more than 4 hours, even though you are not having sex

Blurred vision

Vision problems, unusual bleeding

Weight loss

Low blood pressure

Call Your Doctor Immediately

  • Yellow skin or whites of your eyes turn yellow
  • Suicidal tendency
  • Severe constipation or problem with peeing or stomach pain.
  • More bruising than usual
  • Sore throat or skin infection
  • In rare cases, it’s possible to have a severe allergic reaction to trazodone in rare cases.

How To Cope With Side Effects?

  • Feeling sleepy or tired: Reduce your alcohol intake when you start trazodone. This problem may reduce after a few days as your body becomes habitual to the medicine.
  • Headaches: You should increase your fluid intake. Reduce alcohol intake. Talk to your doctor if it lasts longer than a week or is severe.
  • Feeling sick: It is advisable to take trazodone after food. Avoid spicy or rich food.
  • Constipation: Eat more high-fiber foods, such as fruits, vegetables, and cereals. Try to drink several glasses of water. Some exercise may also help.
  • A dry mouth: Chew sugar-free gum or sugar-free sweets.

What Are The Precautions To Follow Before Taking Trazodone?

Precautions are necessary to prevent any undesired effects of the drug. A proper set of instructions and cautions are essential for the safe use of the drug.

Before You Take Trazodone

  • Take Trazodone as prescribed.
  • Inform your physician if you have any of the following
  • Heart conditions
  • Mania
  • Bipolar disorder 
  • Glaucoma
  • Tell your doctor about all your medications before starting Trazodone.
  • Trazodone tablets should be swallowed whole or broken in half along the score line. Do not chew or crush the tablets.
  • Without consulting your doctor, do not discontinue taking trazodone tablets.
  • Avoid driving, operating machinery, or engaging in other risky activities until you know how Trazodone affects you. Trazodone can impair your ability to think and move.
  • Until you speak with your doctor, avoid drinking alcohol or using other drugs that make you sleepy or lightheaded while taking Trazodone. 
  • Take Trazodone tablets just after a meal or a small snack.
  • If you are pregnant or intend to become pregnant, consult your doctor. Only use Trazodone if the potential benefit outweighs the potential harm to the fetus.
  • Trazodone may enter the breast milk and harm a nursing infant. If you breastfeed your child, speak with your doctor.

Interactions of Trazodone

  • There are many other drugs Trazodone interact with other than alcohol. These can be moderate or severe life-threatening interactions.
  • Avoid using MAOIs within 14 days of trazodone.
  • Trazodone can amplify the side effects of alcohol, benzodiazepines, and barbiturates, such as respiratory depression and drowsiness.
  • If you take CYP3A4 enzyme inhibitors such as clarithromycin or ketoconazole, you might need to take less trazodone.
  • Trazodone toxicity can nevertheless happen at lower-than-normal amounts.
  • More doses of trazodone may be necessary if you use  CYP3A4 inducers (such as carbamazepine). 
  • Concomitant use of Trazodone with Digoxin or phenytoin may result in elevated serum levels of these drugs.
  • Trazadone use with warfarin (Coumadin) can affect prothrombin timings, impairing blood coagulation.
  • Serotonin syndrome may result from taking anti-serotonin drugs.
  • Aspirin, anticoagulants, and non-steroidal anti-inflammatory medicines (NSAIDs) can all raise the risk of bleeding.

Bottom Line From Practical Anxiety Solutions

Trazodone is used to treat depression and insomnia, which can both get worse after drinking alcohol. Although there aren't many studies on the combined use of alcohol and Trazodone,  they can be fatal.

Trazodone can depress the central nervous system, disrupt heart rhythm, and lead to a potentially lethal illness known as serotonin syndrome when taken at exceedingly high levels. Similar to how extreme central nervous system depression brought on by alcohol poisoning might result in respiratory issues.

As a result, exercise caution while combining Trazodone with alcohol. Seek emergency medical attention if any side effects occur.

  • Nierenberg, Andrew A., et al. "Trazodone for antidepressant-associated insomnia." The American journal of psychiatry (1994). From https://doi.org/10.1176/ajp.151.7.1069 Obtained on 20-11-2022
  • Frecska E. [Trazodone--its multifunctional mechanism of action and clinical use]. Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakologiai Egyesulet Lapja = Official Journal of the Hungarian Association of Psychopharmacology. 2010 Dec;12(4):477-482. PMID: 21220793. Obtained on 20-11-2022
  • Kolla, Bhanu Prakash, et al. "Trazodone and alcohol relapse: a retrospective study following residential treatment." The American Journal on Addictions 20.6 (2011): 525-529. From https://doi.org/10.1111/j.1521-0391.2011.00172.x Obtained on  20-11-2022
  • Bossini, Letizia, et al. "Off-label uses of trazodone: a review." Expert opinion on pharmacotherapy 13.12 (2012): 1707-1717. From https://doi.org/10.1517/14656566.2012.699523 Obtained on  20-11-2022
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