So Tired. Can’t Sleep. Is trazodone a safe sleeping pill?

Dear Wren,

I can’t sleep. I can’t sleep. I can’t sleep. I’ve tried all the regular stuff like Tylenol pm and benedryl. I used to take melatonin, but it stopped working. I have used weed and booze, too. Nothing works for long. My friend is taking trazodone and offered to give me one. Is is safe? Will it put me to sleep?

Zombie Fried

Dear Zombie,

Kudos for stopping to ask whether the medicine is safe during a bout with insomnia. There have been times when the Wren might have tried drinking drain cleaner if it was certain to ensure blissful dreaming. There’s nothing like lying wide-eyed in the wee hours to make you think alcoholism might not be such a bad thing if it helped you get some shut-eye.

The answer to your questions about trazodone is, well…yes and no. Yes, it’s relatively safe. No, it’s not a sleeping pill. Trazodone, also known as Desyrel, is actually an antidepressant. It’s part of a class of drugs called Serotonin Antagonist and Reuptake Inhibitors (SARIs). They are believe to work by increasing the availability to the neurotransmitter serotonin to neurons in the brain. Although trazodone is an effective antidepressant, it is very sedating and is no longer generally prescribed for that purpose, as most patients disliked the extreme drowsiness and stopped taking it.

Now, trazodone is primarily prescribed off-label for sleep problems. In fact, it is often used to offset the sleep problems caused by other medications. Research suggests that it is relatively safe and few patients had difficulty with side effects. One of the reasons it remains so popular is that it is not habit-forming and causes far fewer serious side effects than any of the hypnotics, so-called sleeping pills. However, no drug is entirely safe. Even something as innocuous as Tylenol can cause serious liver damage in susceptible people. The most common side effects are extreme drowsiness (but we like that one), dizziness, headaches, and blurred vision. In a small, but significant, portion of the population, it has also been known to cause priapism, the famed “erection lasting more than four hours.”

Overall, trazodone might be just what you need to help you get away from those sheep and into dreamland. But if you’re thinking about taking your friend’s trazodone, remember what you learned in elementary school about prescription drugs. No sharing. Talk to your doctor. She’ll help you get some sleep.


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