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Trazodone for Insomnia is Neither Safe Nor Recommended


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I'm not sure where the best place is to post this information (feel free to move it to a better location).  I was prescribed Trazodone for improving my sleep and since then have found the official recommendations from the American Academy of Sleep Medicine to be eye opening:


Trazodone for Insomnia is Neither Safe Nor Recommended


The following excerpts are from the Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline (2017).


Due to apparent concerns regarding the potential for tolerance and dependency with BZD use, physicians increasingly prescribed sedating antidepressants “off label,” especially trazodone, despite the absence of efficacy studies for this or any other sedating antidepressants for treatment of insomnia. Survey of office-based physician prescribing practices for the period 1987–1996 revealed an over 50% decline in BZD hypnotic prescriptions accompanied by a nearly 150% increase in trazodone prescriptions. Overall prescriptions for insomnia declined by about 25% during this period.


We suggest that clinicians not use trazodone as a treatment for sleep onset or sleep maintenance insomnia (versus no treatment) in adults.


Harms outweigh benefits


Quality of sleep: No improvement in quality of sleep, compared to placebo.


HARMS: In all, 75% of trazodone subjects reported some adverse event(s), compared to 65.4% of subjects who received placebo.

Patients’ values and preferences: Based on its clinical judgement, the task force determined that, despite the absence of significant efficacy for trazodone 50 mg and the paucity of information regarding harms, the majority of patients would be likely to use trazodone compared to no treatment. This is based on the perception of trazodone as a “safer” sleep-promoting agent by many physicians and the resulting recommendations and prescribing practices of those physicians.

  • 2019-01-16 50 mg of Trazodone 2x/week
  • 01-23 up to 100 mg, various frequencies and dosages
  • 05-03 100 mg
  • 05-10 90 mg
  • 05-16 Starting tapering by 2.5 mg/day
  • 05-30 50 mg
  • 05-31 65 mg
  • 06-07 75 mg
  • 06-15 67.5 mg
  • 06-17 75 mg
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