Trazodone
Sleep & Recovery · 5-HT2A antagonist / SARI
Tier B-
Bottom line
Read Off Label grades Trazodone as B- (6.3/10) based on moderate evidence, moderate benefit magnitude, and a low-med-risk safety profile.
Workhorse off-label hypnotic; less addiction potential than Z-drugs or benzos; not FDA-approved for insomnia but widely used.
Typical use: 25-100 mg PO at bedtime (sleep); 150-600 mg divided (depression) — Rx.
What this is
Workhorse off-label hypnotic; less addiction potential than Z-drugs or benzos; not FDA-approved for insomnia but widely used. Priapism is a real counseling point especially for men. Morning grogginess common at higher doses.
Mechanism
Serotonin antagonist/reuptake inhibitor; primary sleep effect via H1 and alpha-1 antagonism at low doses; antidepressant at higher doses (150-600 mg) but sedation is dose-limiting
Dose & route
25-100 mg PO at bedtime (sleep); 150-600 mg divided (depression)
Citations
- https://pubmed.ncbi.nlm.nih.gov/28335872/
- https://pubmed.ncbi.nlm.nih.gov/8994214/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC5078692/
- https://doi.org/10.5281/zenodo.20131254
Links go to the source. If a link is dead or you want something re-checked, let me know.
Common questions
- Does Trazodone work?
- Read Off Label rates the evidence for Trazodone as Moderate and the benefit magnitude as moderate, producing an overall grade of B- (6.3/10). Workhorse off-label hypnotic; less addiction potential than Z-drugs or benzos; not FDA-approved for insomnia but widely used.
- Is Trazodone safe?
- Trazodone has a low-med risk profile in published human data. Legal status: Rx. This is not medical advice — see the disclaimer.
- What is the typical dose for Trazodone?
- 25-100 mg PO at bedtime (sleep); 150-600 mg divided (depression)
- How does Trazodone work?
- Serotonin antagonist/reuptake inhibitor; primary sleep effect via H1 and alpha-1 antagonism at low doses; antidepressant at higher doses (150-600 mg) but sedation is dose-limiting
This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.