In any given year, nearly one-third of North Americans have trouble with insomnia, and between 4 and 7 percent have prolonged difficulty sleeping (LeBlanc et al, Sleep, Aug. 2009). It isn’t any wonder, then, that so many people are eager to find a great sleeping pill? Unfortunately, that is easier said than done. Many of the medications people use to get to sleep have distressing side effects. What can you do to get a good night’s sleep?
Is Trazodone a Great Sleeping Pill?
Q. What is your take on trazodone for insomnia? My doctor thinks it is a great sleeping pill.
A. Trazodone is an old-fashioned antidepressant that is highly sedating. No doubt that is why doctors prescribe it to treat insomnia. A thorough review of the research by the Cochrane Collaboration concluded that short-term use of trazodone may improve sleep quality (Cochrane Database of Systematic Reviews, May 14, 2018).
The FDA never approved trazodone for insomnia, however, and the drug has a number of unpleasant side effects. It can cause morning hangover as well as blurred vision, constipation, dry mouth and dizziness. Some people faint while taking trazodone. More serious side effects include liver injury, hypertension, abnormal heart rhythms (include QT prolongation) and glaucoma.
Trazodone affects the brain chemical serotonin and can make people more susceptible to serotonin syndrome. We worry about this, as it can be extremely serious. No one should stop trazodone suddenly, as withdrawal symptoms can be troublesome.
Other Options for Overcoming Insomnia:
Probably the first choice for overcoming insomnia is not a pill, but something called cognitive behavioral therapy for insomnia (Journal of Sleep Research, Dec. 2017). Finding a clinician skilled in this approach might be difficult. However, there are some online programs that can be effective (JAMA Psychiatry, Sep. 25, 2018).
Our Guide to Getting a Good Night’s Sleep offers many other options with fewer side effects than trazodone. (This Guide is not a pdf or a printed booklet, but is designed as an online resource.)
Updated 10/25/2018
