Can disulfiram be taken with trazodone? (+3 risks)
In this article, we will discuss whether disulfiram and alcohol can be taken together or not. We will discuss the potential risk factors of taking disulfiram and trazodone in combination. Furthermore, we will look at the preventive measures to avoid the potential adversities of taking trazodone and disulfiram together.
Can disulfiram be taken with trazodone?
Disulfiram can be taken with trazodone if your doctor has prescribed it. These two medications may interact with each other and cause adversities. Therefore, it is better to take disulfiram and trazodone only under your doctor’s supervision.
Trazodone is an antidepressant medication that modulates the serotonin level in the brain. It works by serotonin antagonism and by inhibiting serotonin reuptake in the pre-synaptic cleft resulting in increased serotonin levels and activity in the brain (1).
Trazodone is an FDA-approved medication for the treatment of major depressive disorder. It is also used off-label for the treatment of anxiety, insomnia, fibromyalgia, bulimia, and substance abuse (1).
Disulfiram, on the other hand, is an FDA-approved medication to treat alcohol dependence. When alcohol is ingested, disulfiram works by inhibiting the enzyme called alcohol dehydrogenase, which results in the accumulation of toxic acetaldehyde which causes unpleasant effects (2).
For safety concerns, disulfiram and trazodone should not be taken together without consulting your healthcare provider.
How do disulfiram and trazodone interact?
Disulfiram and trazodone may interact based on their mechanism of action. However, there is not very extensive research available about the interactions between disulfiram and trazodone.
Both these medications affect the central nervous system and some neurotransmitters in the brain therefore, the interaction involves additive or synergistic effects on the neurotransmitter levels and activities.
It is important to note that the exact mechanism of interaction between trazodone and disulfiram may vary depending upon individual factors such as health condition, dosage, frequency, and pharmacokinetics.
What are the potential risks of taking disulfiram and trazodone?
The following potential risks can occur if you take disulfiram while on trazodone therapy (3,4):
- Increased sedation- Both disulfiram and trazodone together may cause increased sedation and drowsiness. Taking these medications together may cause additive sedation leading to sleepiness and impaired cognition.
- CNS depression- Trazodone and disulfiram both affect the central nervous system (CNS). Therefore, taking these medications together may cause symptoms such as dizziness, confusion, and mood disorders.
- Liver function- Disulfiram may affect the liver metabolism and function. Trazodone is also metabolized by the liver therefore, combining these drugs may have an impact on liver metabolism and functioning.
However, it is important to note that individual patient variation is important to consider. Every patient may experience these risk factors with varying severity based on their individuality and response to medications.
Who should not take disulfiram and trazodone together?
Trazodone and disulfiram must be avoided in the patients with following conditions:
- Liver dysfunction- Patients with severe liver dysfunction or any disease must not take disulfiram and trazodone in combination due to the potential for worsening effects.
- Alcohol use- Chronic alcohol consumption along with taking trazodone and disulfiram may cause additional adverse effects such as excessive sedation and drowsiness which could be harmful to the patient.
- Drug interactions- Taking such medications that may alter serotonin levels or cause CNS effects leads to worsening effects and adversities.
- Medical interactions- Patients with pre-existing health conditions, must be carefully monitored before taking trazodone and disulfiram to avoid potential adversities.
- Pregnancy or breastfeeding- Pregnant or breastfeeding women must be given medications carefully that do not affect their condition. Therefore, trazodone and disulfiram combination must be given to pregnant and breastfeeding women under your doctor’s guidance.
Always communicate openly with your healthcare provider about your medical history and medications to get the most appropriate personalized treatment for your condition without potential adversities.
What to do if you have taken disulfiram and trazodone together?
If you suffer from severe side effects after taking trazodone and disulfiram, consult your doctor and discuss your side effects and dosage of the medication openly to get the most appropriate treatment.
You must need regular follow-ups and monitoring if your doctor suggests based on your condition and response to the medications. Your doctor must observe and monitor you closely for any potential adversities.
Trazodone is generally a safe medication that does not mess you up. However, if taking it with disulfiram is causing additional side effects such as gastrointestinal distress, CNS effects, or sedation, then it must be tapered or replaced under your doctor’s guidance.
Additionally, patient education is important regarding the dosage and potential side effects of taking this drug combination.
In the end, I would recommend you always have an open and transparent discussion with your doctor about ingesting any substance while on medication such as alcohol or caffeine which may exacerbate the side effects.
If you have ingested alcohol along with trazodone or disulfiram, seek medical help and openly talk about the amount and side effects observed. In this way, doctors can provide the most appropriate and timely therapy to get rid of severe side effects.
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Shin JJ, Saadabadi A. Trazodone. [Updated 2022 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470560/
Center for Substance Abuse Treatment. Incorporating Alcohol Pharmacotherapies Into Medical Practice. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2009. (Treatment Improvement Protocol (TIP) Series, No. 49.) Chapter 3—Disulfiram. Available from: https://www.ncbi.nlm.nih.gov/books/NBK64036/
AHFS Patient Medication Information [Internet]. Bethesda (MD): American Society of Health-System Pharmacists, Inc.; c2019. Trazodone; [updated 2020 Jun 24; reviewed 2018 Jul 5; cited 2020 Jul 1]; [about 5 p.]. Available from: https://medlineplus.gov/druginfo/meds/a681038.html
AHFS Patient Medication Information [Internet]. Bethesda (MD): American Society of Health-System Pharmacists, Inc.; c2019. Disulfiram; [updated 2020 Jun 24; reviewed 2018 Jul 5; cited 2020 Jul 1]; [about 5 p.]. Available from: https://medlineplus.gov/druginfo/meds/a682602.html