Can trazodone increase dopamine? (risks vs benefits)

This article will explore the topic of trazodone’s effect on dopamine levels. It will also discuss the research conducted on trazodone’s impact on dopamine. Furthermore, the article will mention the potential benefits and possible side effects of trazodone-induced increased dopamine. 

Finally, it will provide recommendations on what to do if trazodone is affecting dopamine levels and causing dopaminergic side effects.

Can trazodone increase dopamine?

Yes, trazodone can increase dopamine levels in the body. However, it is important to understand that trazodone does not directly increase dopamine levels, and its primary action is not related to dopamine. 

Trazodone directly acts on various other neurotransmitters in the brain, primarily serotonin. However, direct changes in the levels of certain neurotransmitters can indirectly affect the levels of other neurotransmitters through mechanisms like positive or negative feedback, or shared receptors.

Thus, the indirect increase in dopamine that is caused by trazodone is not consistent across all people who administer it. Moreover, it will not lead to noticeable effects in most people, as the impact it may have on dopamine levels is minimal.

People who concurrently take medications that increase dopamine, have diseases that involve high dopamine levels, or have a family history of high dopamine-related disorders are more likely to experience a significant increase in dopamine levels while taking trazodone.

If you experience any side effects that you suspect are caused by trazodone-induced increased dopamine, you should discuss this with your doctor. They will evaluate your symptoms and risk factors and suggest a solution that is appropriate for your condition.

How does trazodone affect dopamine and other neurotransmitters?

Trazodone is a serotonin antagonist and reuptake inhibitor (SARI) that inhibits both the serotonin transporter and serotonin type 2 receptors. Thus, it prevents the reuptake of serotonin, leading to its antidepressant effects. Trazodone also blocks histamine and alpha-1-adrenergic receptors [1].

As for trazodone’s impact on dopamine, it was found that its specific inhibition of serotonin type 2C receptors increases extracellular dopamine. To illustrate, trazodone was shown to restore the inhibited firing rate of dopamine neurons by blocking these receptors in the ventral tegmental area [2].

Other antidepressants that may also indirectly affect dopamine levels include Prozac, Effexor, and fluvoxamine.

What does research suggest?

There aren’t enough studies investigating trazodone’s effects on dopamine in humans. However, researchers have conducted studies to examine the effects of short-term administration of trazodone on dopamine activity in rats [2].

After the course of a 2-day and 14-day administration of trazodone, there was no significant increase observed in dopaminergic activity when compared to the control group. This activity was measured through electrophysiological recording of dopamine neurons in the brain [2].

However, the rats were then injected with a drug that reduces dopamine activity and subsequently treated with trazodone for 2 days. After taking trazodone, the inhibition of dopamine was reversed, and its activity was restored [2].

This increase in dopamine was observed after only 2 days of trazodone administration. Thus, it can be suggested that a longer duration of trazodone use may increase dopamine.

What are the benefits of trazodone’s effect on dopamine?

Trazodone-induced increased dopamine levels can benefit its antidepressant effects in multiple ways. Some of the benefits of increased dopamine for treating depression are mentioned below [3]:

• Increased dopamine can enhance trazodone’s effectiveness in enhancing mood, as it is directly linked to motivation and the brain’s reward system. Thus, trazodone-related increased dopamine could increase motivation, which can help in decreasing depressive symptoms. 

• Dopamine plays a major role in enhancing and maintaining cognitive functions like concentration, learning, memory, and decision-making. Thus, this is beneficial for depressed people who suffer from impaired cognitive function as a result of their depression.

• Furthermore, for people suffering from both Parkinson’s disease and depression, trazodone’s serotonin-mediated action will alleviate depression, while its induced increased dopamine may aid in reducing Parkinsonism-related symptoms.

However, trazodone’s impact on dopamine should not be relied upon for Parkinson’s disease management.

What are the side effects of trazodone’s effect on dopamine?

While trazodone’s impact on dopamine levels is very minimal and is unlikely to cause significant side effects, some people may be at risk of experiencing dopamine-related side effects while taking trazodone.

For instance, people who already have disorders that lead to high dopamine levels or who are concurrently taking medications that increase dopamine may experience increased dopamine-related side effects while taking trazodone. Some of these side effects are mentioned below: 

• Increased dopamine levels, particularly in the prefrontal cortex, can lead to a risk of psychotic symptoms such as paranoia or schizophrenia. This is especially likely to occur in people with severe depression or those with a personal or family history of schizophrenia [3].

• Increasing dopamine activity through trazodone may increase the risk of developing dependence on the drug and its dopamine-mediated increased motivation. Dopamine-induced dependence on trazodone, however, is more likely to occur in people with high sensitivity to medications.

• Increased dopamine may lead to dopamine dysregulation syndrome, which involves impulsive actions like compulsive shopping, eating, or even gambling. This side effect is unlikely to be caused by trazodone alone, as it does not significantly increase dopamine levels to that extent.

What to do if trazodone is affecting your dopamine levels?

If you suspect that trazodone is causing dopaminergic side effects, you should discuss this with your doctor. Depending on the severity of your symptoms, they may reduce your trazodone dosage, and monitor your condition, or discontinue the drug after tapering down the dose gradually.

You should also inform your doctor about all your comorbidities and concurrent medications. It is also recommended that you inform them about your family history. This will help assess whether trazodone is causing your symptoms or whether another drug or medical condition is causing them.

What treatment options can help with trazodone-induced dopaminergic side effects?

The doctor will adjust your treatment plan accordingly. If they find that your condition requires dopamine-lowering medications, they may prescribe antipsychotics like aripiprazole. Furthermore, they may switch you to another antidepressant that is safer for people with increased dopamine, like Celexa.

They may also recommend cognitive behavioral therapy or psychobehavioral therapy for people suffering from impulsive behavioral disorders due to dopamine dysregulation syndrome.

Based on my research, I found that trazodone can increase dopamine levels in the body indirectly, although its primary action is not related to dopamine.

From my perspective, individuals who take medications that increase dopamine or have high dopamine-related disorders may be more likely to experience a significant increase in dopamine levels while taking trazodone.

Furthermore, while trazodone-induced increased dopamine levels can have potential benefits for treating depression, such as enhancing mood and cognitive function, I believe that there is also a risk of side effects related to increased dopamine activity, such as impulsive decisions and dependence.

If you suspect that trazodone is affecting your dopamine levels, I recommend discussing this with your doctor. They will evaluate your case to recommend an appropriate treatment plan, which may include adjusting your dosage, switching to a different drug, or exploring other therapeutic interventions.

References