Can trazodone be used as a muscle relaxer? (3+ risks)

In this article, we will discuss whether trazodone can be used as a muscle relaxer or not. Furthermore, we’ll explore the link between trazodone and muscle relaxation, what research suggests on this, the potential benefits and risks of using this medication for muscle relaxation and considerations or precautions when using trazodone for muscle relaxation. 

Can trazodone be used as a muscle relaxer?

No, trazodone is not typically prescribed as a muscle relaxer. However, some individuals can experience a reduction in their muscle tone and activity as an overall inhibitory effect of this medication on the central nervous system. (1)

Trazodone is generally approved by the FDA for treating patients with major depressive disorders. It may also be used as a sedative to promote sleep quality in insomniac individuals. Trazodone is classified as a SARI (serotonin antagonist and reuptake inhibitor). It exerts its action by increasing the levels of serotonin in the brain, an important neurotransmitter to regulate mood and also involved in sleep and muscle activity among other physiological functions. (1)

Muscle relaxers are medications intended solely to relieve muscle tension, stiffness or spasms by reducing overall muscle contraction. This can be beneficial for a variety of conditions including chronic pain, anxiety and certain sleep disorders. (3)

It’s important to remember that while trazodone may have indirect effects on muscle relaxation, it is not approved by the FDA to be prescribed as a muscle relaxant as it comes up with other inhibitory effects too. So, if you’re primarily concerned about muscle relaxation related to trazodone use, it’s best to discuss it with your healthcare provider. 

How does trazodone affect muscles?

The exact mechanism between trazodone and muscle activity is not well understood, however, it is believed that trazodone affects the levels of serotonin in the brain and the effects of this neurotransmitter might play an indirect role in the regulation of muscle tone. (3)

Trazodone is an antidepressant which also serves sedative properties. This sedation may cause muscle relaxation as a side effect. Serotonin is involved in the regulation of mood to alleviate the symptoms of depression, thereby producing a calming effect on the body. (1)

Trazodone also blocks the activity of a neurotransmitter in the brain called histamine which is involved in the regulation of alertness and wakefulness. By blocking histamine, trazodone promotes sedation and drowsiness in a person and indirectly leads to muscle relaxation. (5)

Trazodone is also found to have inhibitory effects on alpha-adrenergic receptors. In doing so, it slows down the fight and flight response of the body which may contribute to a calming effect and muscle relaxation. (5)

Therefore, the overall effect of trazodone on the central nervous system contributes to a general depressive effect and this CNS depression slows down brain activity leading to sedation and relaxation, including effects on muscle tone. 

What does research suggest?

According to a research study, scientists conducted a clinical study to determine the effects of trazodone which is an antidepressant and hypnotic medication, on fibromyalgia patients. Fibromyalgia is a condition of muscles in which a person experiences extreme tenderness and pain often along with sleep disturbances and fatigue. (2)

They administered trazodone to 66 fibromyalgia patients with doses ranging from 50-300mg per day for 12 weeks. They found out that trazodone given in higher doses that are typically prescribed for hypnotic purposes can be beneficial in relieving muscle tension to a great extent as its muscle relaxant property surpasses the hypnotic property in fibromyalgia patients significantly. (2)

However, they concluded that while giving trazodone in higher doses as a muscle relaxer, it’s crucial to monitor the heart closely as their 14 patients (21,2%) experience tachycardia. (2)

This case study shows that trazodone does have muscle relaxant effects but it must be given under the proper supervision of a healthcare provider for this purpose as dose adjustment and risk of other side effects is crucial. 

What are the potential benefits of trazodone as a muscle relaxer? 

The potential benefits of taking trazodone as a muscle relaxant may include: (2,5)

• Reduced muscle tension: The sedative properties of trazodone and its impact on certain neurotransmitters like serotonin and histamine in the brain can contribute to a reduction in muscle tension. This can be beneficial for people suffering from muscle spasms or stiffness. 

• Improved sleep quality: Trazodone is often used to treat insomnia because of its sleep quality-enhancing properties and improved sleep can indirectly help muscles relax and relieve tension. 

• Calming effects: Trazodone’s impact on histamine and serotonin neurotransmitters produces calming effects on the central nervous system. This calming influence might extend to muscle tissues, promoting muscle relaxation. 

• Pain management: In conditions where muscle tension and stiffness contribute to pain, such as certain types of chronic pain or fibromyalgia, the muscle relaxant effects of trazodone may help alleviate discomfort. 

• Comprehensive treatment for mood disorders: For individuals with mood disorders like depression or anxiety and also going through muscle-related symptoms, in such cases, trazodone’s dual action as an antidepressant and muscle relaxant may offer a comprehensive treatment approach. 

It’s important to keep in mind that muscle relaxant properties of trazodone are more likely considered as a side effect of the drug. Individual’s responses to trazodone may vary and its potential benefits should be weighed against its possible side effects to ensure the safety and efficacy of the intended therapeutic outcome. 

What are the risks of using trazodone as a muscle relaxer?

Here are some potential risks and considerations related to trazodone use as a muscle relaxant that one must keep in mind: (1,3,4)

Non-FDA-approved as a muscle relaxer:

Trazodone is not specifically approved by the FDA to be used as a muscle relaxant. Its use for muscle relaxation is considered off-label and there is limited clinical evidence that supports its safety and effectiveness for this purpose. 

Side effects:

Trazodone like any medication can have side effects. Common side effects include dizziness, drowsiness, dry mouth, blurred vision, constipation etc. These effects are exacerbated when given in higher doses for muscle relaxation purposes.

Cardiovascular effects: 

Trazodone use has been associated with some cardiovascular effects such as changes in heart rate and blood pressure. Tachycardia (fast heartbeat) has also been reported by many individuals as a side effect, especially with high doses. 

Interactions with other medications:

If you combine trazodone with other medications, specifically those affecting serotonin levels such as SSRI antidepressants (citalopram, Luvox etc) this can lead to excessive accumulation of serotonin in the body and cause serotonin syndrome. 

Dependence and withdrawal: 

Prolonged use of trazodone may lead to dependence and if you stop its use suddenly then you may suffer the withdrawal side effects too. Tapering off the medication, especially if you were taking high doses for muscle relaxant properties, is recommended under the guidance of your doctor. 

How to safely take trazodone?

It’s important to recognize that you must always follow your healthcare provider’s instructions regarding the appropriate dose regimen and timing of your medication. Trazodone can be taken with or without food but taking it with meal may reduce the chances of upset stomach.

Do not change the dose or stop taking it abruptly without your doctor’s approval. Be cautious with the concurrent use of other medications as trazodone can interact with them. Inform your doctor about your medication history and if you have had any specific health conditions or allergies. Avoid overconsumption of alcohol and limit smoking as these substances can alter the effectiveness of trazodone. (1)

Inform your doctor if you’re pregnant, planning to conceive or breastfeeding as taking trazodone may be risky in these situations and your doctor will tailor the appropriate treatment plan with the right dose and choice of drug. (1,5)

As a pharmacist, in my opinion, trazodone is a safe choice when it comes to the treatment of depression or anxiety but taking it solely for muscle relaxant would not be a wise choice as higher doses of trazodone are required for muscle relaxant effects which come with a lot of side effects. If you are looking for muscle relaxants consult your doctor and ask them to prescribe anti-spasmodic. 

However, taking trazodone for the dual effects of depression and muscle tension requires proper dose adjustment and close monitoring under the supervision of your healthcare provider. 

References