Maois
Contraindicated
Database
Serotonin syndrome/hypertensive crisis
Avoid within 14 days of MAOI
Source: Kimi deep-research + Cla
Drug reference
Trazodone
Serotonin antagonist/reuptake inhibitor (SARI) · Anxiolytic/Sedative
Also known as Trazodone Hydrochloride, Desyrel, Oleptro, Trittico
START
Depression 150 mg/day (divided/nocte), titrate; insomnia 25–100 mg nocte (off-label)
TYPICAL MAX
600 mg/day inpatient (400 mg/day outpatient)
STOP IF
Priapism (urgent), serotonin syndrome, significant QT/arrhythmia, suicidality
WATCH
Orthostatic BP, priapism counselling, QT if cardiac risk/other QT drugs, mood (esp. <25), sodium
CDSCO approvedSchedule HATC N06AX05
KDIGO 2024 + manufacturer label
- ONSET
- 1h · sedative onset
- PEAK
- 1.5h · Cmax
- t½
- 7h · terminal t½
- DURATION
- 7h · sedation duration
EXCRETION
Hepatic CYP3A4; ~70% renal metabolites
route + CYP
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
Use only if benefit outweighs risk — limited data; neonatal effects if used near term
FDA category + note
Top interactionssee all 12 →
- MaoisContraindicatedDatabaseKimi deep-research + Cla
- AlmotriptanSevereDatabaseDDInter
- AmiodaroneSevereDatabaseDDInter
- AmisulprideSevereDatabaseDDInter
Available in India
34 branded formulations. Look up specific brands in the Drugs workspace.
Mechanism
5-HT2A receptor antagonism, weak serotonin reuptake inhibition, plus H1 and alpha-1 blockade; antidepressant at higher doses, sedative-hypnotic at low doses (off-label insomnia).
Indications
Major depressive disorderInsomnia (low-dose, off-label but very common)Anxiety (adjunct, off-label)
Dosing
- Adult
- Depression: 150 mg/day in divided doses or at night, titrate to 300–400 mg/day (max 600 mg/day inpatient). Insomnia (off-label): 25–100 mg at bedtime.
- Pediatric
- Not established.
- Renal adjustment
- Caution in severe renal impairment; no fixed reduction.
- Hepatic adjustment
- Caution; reduce dose in hepatic impairment.
- Geriatric
- Lower dose; orthostasis/sedation/fall risk.
- Max dose
- 600 mg/day (inpatient); 400 mg/day outpatient
Pharmacokinetics
Onset
Hypnotic ~30–60 min; antidepressant 2–4 weeks
Peak effect
1–2 h (food delays)
Duration
Sedation ~6–8 h
Half-life
Biphasic ~3–6 h then ~5–9 h
Bioavailability
~65%
Protein binding
~89–95%
Metabolism
Hepatic CYP3A4 → active mCPP
Excretion
Renal (~70–75% metabolites); faecal
Contraindications
- Concomitant or recent (14 days) MAOI
- Recovery phase of myocardial infarction (relative)
- Hypersensitivity to trazodone
- Caution: significant QT prolongation/cardiac disease
Side effects
Common
Sedation/drowsinessOrthostatic hypotension, dizzinessDry mouth, blurred visionHeadache, nausea
Serious
- Priapism (urological emergency)
- QT prolongation/torsades
- Serotonin syndrome (with serotonergics)
- Suicidality (boxed — young patients)
- Cardiac arrhythmia; severe hyponatraemia (SIADH)
Pregnancy & lactation
Pregnancy
Use only if benefit outweighs risk — limited data; neonatal effects if used near term
Lactation
Small amounts in milk; low-dose short-term considered acceptable with infant monitoring
Drug interactions
Almotriptan
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amiodarone
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Amisulpride
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amitriptyline
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Amoxapine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Anagrelide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Arsenic Trioxide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Bedaquiline
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Bepridil
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Bupropion
Severe
Database
Drug interaction classified as: metabolism.
Source: DDInter
Buspirone
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Related guidelines
Generalised anxiety disorder and panic disorder
NICE · Psychiatry · 2020
Alcohol use disorder
MOHFW · Psychiatry · 2021
Empirical antimicrobial use in common syndromes
ICMR · Infectious Diseases · 2019
Hypertensive disorders of pregnancy
FOGSI · Obstetrics & Gynaecology · 2019
Substance use disorders
NIMHANS · Psychiatry · 2022
Ask House about Trazodone
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e, Harrison 22e, Katzung, BNF·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19