What Is Trazodone Used For? Depression, Sleep and How It Works
Trazodone is an antidepressant approved in the US for depression, but it is also widely prescribed in low doses for sleep, an off-label use.
By withClaro Editorial · 2026-11-02 · 4 min read
Clinical section reviewed by Dr. Jason Tan, Consultant Psychiatrist, on October 27, 2026.
More about Trazodone
Key takeaways
- Trazodone is approved in the US for major depressive disorder in adults.
- It is widely prescribed in low doses for sleep, which is an off-label use.
- The American Academy of Sleep Medicine suggests not using it for chronic insomnia; that is a weak recommendation, meaning low certainty, not proof it doesn't work.
- Its label warns about priapism: an erection lasting more than 4 hours, painful or not, means stopping it and getting emergency care.
What is trazodone used for? It is approved for depression in adults. It is also prescribed, often at low doses, to help with sleep; MedlinePlus lists insomnia among its uses outside the label. In ClinCalc's estimates for 2024, trazodone was prescribed about 26.2 million times in the US, a figure that counts depression and sleep together. Desyrel was its old brand name and is no longer sold in the US.
What is trazodone used for?
MedlinePlus places trazodone in a class called serotonin modulators. The label says its safety and effectiveness in children haven't been established. Beyond depression, MedlinePlus lists off-label uses for insomnia, schizophrenia, anxiety, abnormal movements caused by other medicines, and alcohol dependence.
| Use | Approved? | Usual dose |
|---|
| Depression in adults | yes | 150 mg a day to start, up to 400 mg for outpatients |
| Sleep | no, off-label | low doses, no labeled dose |
| Anxiety | no, off-label | no labeled dose |
Is trazodone a sleeping pill?
No, it isn't approved as one, but it is often prescribed for sleep because sleepiness is one of its most common side effects. Does it help? A 2018 Cochrane review pooled three trials with 370 people: people rated their sleep somewhat better than on placebo, but in two studies with sleep measured in a lab there was almost no difference, the evidence was low quality, and morning grogginess, dry mouth and thirst were more common. The American Academy of Sleep Medicine suggests that clinicians not use trazodone for chronic insomnia; that is a weak recommendation, which the authors say shouldn't be read as proof it doesn't work, and the guideline says the same about melatonin and diphenhydramine. If you were prescribed it for sleep, ask what the plan is, how long to take it and what you would try instead. More in trazodone for sleep.
How does trazodone work?
Medically reviewed by Dr. Jason Tan on October 27, 2026, this section only.
The label says its antidepressant action is not fully understood. It describes trazodone as both a serotonin reuptake inhibitor and a 5-HT2 receptor blocker; it blocks alpha-1 receptors too, which can lower blood pressure on standing. The label doesn't say which of these causes the sleepiness. The clinical view:
Antidepressants change how the brain uses chemical messengers, but how this lifts mood is not fully understood.
The chemical change starts within hours, yet the full effect on mood takes weeks. Current thinking points to early changes in how the brain processes emotion, then slower changes in receptors, in brain circuits that handle emotion, and in how the brain forms new connections. ## What doses does trazodone come in?
Tablets come in 50 mg, 100 mg and 150 mg, scored so they can be broken; the 150 mg tablet has three sections of 50 mg each. For depression, the label starts at 150 mg a day in divided doses and allows up to 400 mg for outpatients. There is no labeled dose for sleep. More in trazodone dosage.
What side effects does trazodone cause?
In the label's outpatient trials, sleepiness affected 41% against 20% on placebo, and dry mouth 34% against 20%. The label also warns about serotonin syndrome: agitation, a fast heartbeat, tremor, stiff muscles, fever, sweating or nausea need urgent care, and it is the reason trazodone must never be combined with an MAOI. The label also warns about priapism: men with an erection lasting more than 4 hours, painful or not, should stop it and get emergency care, because it can cause lasting damage. It lengthens the QT interval, which matters for anyone with heart rhythm risks or taking other drugs that do the same, and it can lower blood pressure on standing. Like every US antidepressant, it carries an FDA boxed warning about suicidal thoughts in people 24 and younger. If you're having thoughts of harming yourself, contact emergency services or a crisis line straight away. In the US, call or text 988. In the UK, call Samaritans on 116 123. Elsewhere, find a crisis line near you.
What should you tell your prescriber before starting trazodone?
Some conditions and medications change whether trazodone is a good fit, so name them at the first appointment. Before you start, tell your prescriber about:
- heart disease or heart rhythm problems
- conditions that raise the risk of priapism, such as sickle cell anemia, multiple myeloma or leukemia
- any MAOI, including linezolid or IV methylene blue, now or in the last 14 days; trazodone must not be taken with them, and an MAOI must not be started within 14 days of stopping trazodone
- other antidepressants, migraine medicines, buspirone or sleep aids
- aspirin, anti-inflammatory pain relievers or blood thinners
- bipolar disorder, mania or hypomania in you or your family
- how much alcohol you drink, since trazodone may strengthen alcohol's effects, and overdose deaths have happened when the two were taken together
- pregnancy, plans for pregnancy or breastfeeding
Download on the App Store Trazodone can change sleep within days and mood over weeks. The withClaro app lets you log sleep, mood, energy and side effects each day, linked to your dose, and turns it into a report for your prescriber.
Related articles
Sources
- TRAZODONE HYDROCHLORIDE tablets prescribing information, US Food and Drug Administration via DailyMed
- MedlinePlus: Trazodone
- ClinCalc DrugStats: The Top 300 Drugs of 2024
- Everitt H, et al. Antidepressants for insomnia in adults. Cochrane Database of Systematic Reviews, 2018
- Sateia MJ, et al. Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults. Journal of Clinical Sleep Medicine, 2017
Claro articles are for self-monitoring and educational purposes only. They are not a medical device, therapist, or diagnostic tool, and do not replace care from your prescribing clinician. If you are in crisis, contact your care team, emergency services, the Samaritans (UK: 116 123), or the Crisis Text Line (US: text HOME to 741741).