Is Trazodone a Controlled Substance? Drug Class, Effects and Addiction

Many antidepressants can cause physical dependence. It is why healthcare professionals evaluate patients carefully before prescribing these medications, especially ones who are recovering addicts. Trazodone is an example of a prescription antidepressant—it is better known by its trade names like Desyrel, Trittico, Oleptro, Dividose, and Trazorel. Keep reading to learn more about this drug.

Is Trazodone a Controlled Substance?

In the U.S., trazodone is not considered a controlled substance. However, there is still a serious risk to taking it—patients should always follow their doctor’s prescription when taking this drug. 

Controlled substances are prescription drugs that are potentially addictive. Taking these drugs can lead to abuse—as such, the federal government regulates their use. A person who uses controlled substances without a prescription will face the consequences from law enforcement.

There are various categories of controlled substances, and the CSA or Controlled Substances Act provides categories or schedules for different drugs. Schedule V drugs are ones with the least potential for addiction or abuse. Meanwhile, Schedule I drugs are highly unsafe—they are likely to cause physical or psychological dependence. Heroin and LSD are Schedule I drugs, and cough preparations like Robitussin AC fall under Schedule V.

What is Trazodone’s Drug Class?

Trazodone is an atypical antidepressant and a serotonin modulator. It is not chemically related to SSRIs or selective serotonin reuptake inhibitors, TCAs or tricyclic antidepressants, or MAO (monoamine oxidase) inhibitors.

Instead, trazodone is chemically related to the phenylpiperazine compound nefazodone, and it acts in similar ways. Doctors describe nefazodone as a SARI or serotonin antagonist and reuptake inhibitor. Aside from binding to transporters the way SSRIs do, they could “hit” dopamine receptors in several ways, which could be the reason why nefazodone and trazodone cause dependence.

Although this drug can potentially help alleviate the symptoms of insomnia, it does not affect a person’s cognitive functions. These effects are in contrast to benzodiazepines and other sleep-inducing drugs. Note, though, that there are anecdotal reports of trazodone causing hallucinations. There are also various severe consequences to taking too much of it, and using it recreationally is dangerous.

What is Trazodone?

Doctors most frequently use trazodone to treat major depressive disorder. It is suitable for patients with or without anxiety. Trazodone can also mitigate insomnia and help treat alcohol dependence. This prescription drug causes dependence, but experts are still debating whether it causes addiction.

First developed in Italy in the 1960s, trazodone wasn’t popular in the medical community because of the various adverse side effects it causes. Taking this drug induces dizziness, fainting, irregular heartbeat, and in some cases, even priapism in men. Eventually, clinicians recognized the benefits of administering it in low doses.

Patients who take the drug for insomnia can experience its effects within 30 minutes. Meanwhile, those who take it as an antidepressant might have to wait up to four weeks to see its benefits. Whether they’re taking trazodone for sleeplessness or depression, though, a patient might experience intense side effects during treatment.

Many patients report feeling relaxed and sleepy after taking trazodone, and physicians recommend taking low doses of this drug at bedtime to limit its debilitating effects. However, some people say this drug causes them to feel sluggish and drained, especially after waking.

What Does Trazodone Do?

Trazodone restores depleted chemicals and increases neurotransmitters in the central nervous system. This drug affects serotonin, which is a chemical messenger that regulates various functions. Serotonin is responsible for regulating the body’s circadian rhythm, enabling us to have an intuitive sense of when to rest and when to wake up. It is also responsible for our mood, memory, desire, appetite, digestion, and even sexual function.

what is trazodone
Is Trazodone a Controlled Substance

According to experts, depression occurs due to imbalances in the brain’s neurotransmitters—acetylcholine, norepinephrine, dopamine, and serotonin. Doctors have yet to understand mood disorders like depression fully, but they know that trazodone inhibits serotonin uptake and stimulates other nerves.

What Are the Side Effects?

This drug causes side effects ranging from mild to severe. Below are some of the most common side effects that could occur when a patient takes trazodone. Note that this is not an exhaustive list—patients could exhibit other reactions to this drug. Speak with a pharmacist or your doctor to learn more about trazodone’s side effects or how to deal with them.

Common side effects of trazodone include sleepiness and dizziness. People who take it could also experience swelling, stuffy nose, and diarrhea. Blurred vision and weight loss are also typical. These effects could subside within days or weeks. If they do not, consult your doctor or a pharmacist.

Serious Side Effects of Taking Trazodone

If you or your loved one are experiencing any of the symptoms below, you must call your doctor immediately. If the symptoms feel life-threatening or if you think you have a medical emergency, call 911. Here are serious side effects that you could experience:

  • Worsening depression leading to suicidal thoughts
    • intrusive or persistent thoughts about suicide
    • new or worse depression and anxiety
    • feelings of agitation and restlessness
    • serious suicide attempts
    • irritability, aggression, anger, and violence
    • exhibiting poor impulse control
    • panic attacks
    • trouble sleeping
    • mania, or excessive energy
    • other deviations from typical behaviors
  • Serotonin syndrome (symptoms below)
    • agitation, trouble thinking, or confusion
    • visual or auditory hallucinations
    • elevated heart rate
    • tightness in the muscles
    • nausea, vomiting, and diarrhea
    • trouble with coordination and walking
  • Problems with vision, including:
    • eye pain, swelling, or redness
    • blurred vision
    • visual disturbances
  • Irregular or fast heartbeat
  • Low blood pressure
  • Bleeding and unusual bruising
  • Fainting or dizziness due to movement
  • Priapism, or erections that last for hours
  • Hyponatremia, or low sodium in the blood, causing:
    • headaches and confusion
    • memory problems and trouble concentrating
    • weakness and instability, especially when walking

Is It Possible to Get Addicted?

Trazodone is not inherently dangerous to take, even for months or years, because it is a long-term medication. However, it has been medically proven to result in dependence. If you need to take Trazodone to feel stable and normal or experience withdrawal symptoms when you cease taking this drug, you might become dependent on it.

Medical professionals distinguish between drug dependence and addiction, however. When a person depends on a substance, it means they need it to function normally. Meanwhile, an addict experiences cravings for the drug. Research is ongoing on whether or not antidepressants are addictive—people don’t typically crave these types of drugs, but they do experience withdrawal symptoms when they stop taking this medication.

Conclusion

Patients who no longer want to take trazodone should speak to their healthcare provider about gradually taking themselves off the substance. Since this drug causes severe withdrawal symptoms, ceasing to follow your prescription could cause a combination of the adverse effects listed above. 

If you want to stop taking this drug, your healthcare provider can put you on a plan to taper off your dosage until you can end the treatment safely. Withdrawal and relapse are common among people with addiction disorders. Although there isn’t conclusive evidence of trazodone being addictive, it causes severe dependence and can trigger the withdrawal-relapse cycle that addicts go through. Fortunately, a combination of detoxification treatments and therapy at a rehabilitation facility will help.

Sources:

https://medlineplus.gov/druginfo/meds/a681038.html

https://www.ncbi.nlm.nih.gov/books/NBK470560/