Does trazodone affect heart rate? (3+ factors)

In this article, we will discuss whether trazodone affects heart rate, how trazodone affects heart rate, what research suggests, what are the risks associated with this effect, what factors can contribute to this effect, and what to do if trazodone affects your heart rate.

Does trazodone affect heart rate?

Yes, trazodone may affect the heart rate of individuals using it to treat their mental health conditions. Trazodone primarily targets neurotransmitters in the brain, but it can also affect other systems in the body, including the cardiovascular system.

Trazodone is an antidepressant and belongs to the class of serotonin antagonists and reuptake inhibitors. It is an FDA-approved drug for the treatment of major depressive disorder, but it is also prescribed off-label to treat various conditions like insomnia, anxiety, and chronic pain. (1)

Trazodone can increase or decrease heart rate. However, individual responses to trazodone may differ, and not everyone’s heart rate is affected by the use of trazodone. (2)

How does trazodone affect the heart rate?

Trazodone reduces heart rate through its impact on serotonin receptors. Serotonin can induce changes in the autonomic nervous system and decrease heart rate. (3) Trazodone interacts with hERG potassium channels and increases the risks associated with changes in heart rate. (1)

What does research suggest?

Research findings on the specific effect of trazodone on heart rate are inconsistent. Some studies suggest that trazodone may cause a mild increase in heart rate, while others report a decrease in heart rate.

A case of experiencing bradycardia after taking a single dose of trazodone was reported in the Asian Journal of Psychiatry. The patient was prescribed 50mg of trazodone for the treatment of major depressive disorder, and after taking the first dose, the patient experienced a decrease in heart rate, which was resolved, and trazodone was discontinued. (4)

A study investigated the cardiac side effects of trazodone in rats. The rats were given repeated doses of trazodone, and it was observed that trazodone lowers the heart rate, and trazodone-related cardiotoxicity is dose-dependent. (5)

Another study compared the cardiac adverse effects of trazodone, amitriptyline, and iprindole in rats and observed that trazodone use is associated with hypotension and bradycardia. (6)

One case of trazodone-induced tachycardia was reported in the Journal of Chest. A 79-year-old woman experienced ventricular tachycardia during exercise stress while taking trazodone. (7)

Individual differences may influence the variability in research outcomes in response to the medication and the presence of pre-existing cardiovascular conditions.

What are the risks associated with trazodone’s effect on heart rate??

Trazodone is generally considered safe for most individuals, but there are risks associated with changes in heart rate. Individuals with underlying heart conditions are more susceptible to the harm caused by fluctuations in heart rate. An irregular heartbeat can increase the risk of many life-threatening conditions, such as:

  • Decreased heart rhythms can increase the risk of stroke and pulmonary embolism.
  • Increased heart rhythms can cause ischemia, heart failure, and cardiomyopathy.

It is essential for healthcare providers to consider these factors when prescribing trazodone and monitor patients accordingly.

What factors can contribute to trazodone’s effect on heart rate?

Several factors can contribute to the variability in how trazodone affects heart rate:

  • Dosage: Higher doses of trazodone may be more likely to affect heart rate than lower doses. However, studies suggest that low-dose trazodone can also cause fluctuations in heart rate.


  • Individual Variability: People respond differently to trazodone, and factors such as age, overall health, individual pharmacodynamics, and genetic factors can influence this response.


  • Concurrent Medications: The interaction between trazodone and medications that are inhibitors of the CYP3A4 enzyme can precipitate qt prolongation, as trazodone also causes qt prolongations. These drugs include itraconazole, clarithromycin, quinidine, sotalol, etc., and should be avoided while taking trazodone. (2)


  • Underlying health conditions: Individuals with pre-existing heart conditions are more susceptible to the risks associated with trazodone-induced changes in heart rate. (1)

What to do if trazodone affects your heart rate?

If you experience changes in your heart rate while taking trazodone, it is crucial to consult with your healthcare provider immediately. Your healthcare provider will take the necessary actions according to your condition.

  • Adjust the dosage: Your healthcare provider may lower your dose if you are experiencing changes in heart rate due to a higher dosage.


  • Alternative medication: If the symptoms are concerning and lowering the dose does not help your condition, your healthcare provider may consider switching to an antidepressant that has a different side effect profile.


  • Monitoring: Your doctor might do additional monitoring by doing ECG and blood tests to investigate symptoms caused by the trazodone-induced change in heart rate.


  • Lifestyle modifications: Your healthcare provider may suggest incorporating exercise into your daily routine and modifying your diet to promote heart health.

Do not stop taking trazodone without consulting your healthcare provider, as sudden discontinuation of the medication can cause withdrawal effects.


From my perspective, trazodone is an effective medication for managing various mental health conditions. However, its potential effect on heart rate should not be overlooked, especially if you already have cardiac issues.

Talking to your healthcare providers plays a crucial role in making informed decisions to ensure your overall well-being.

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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:


DESYREL (trazodone hydrochloride), a prescribing guide by The U.S. Food and Drug Administration. Available from:


Pe´rgola, P. E., & Alper, R. H. (1992). Effects of central serotonin on autonomic control of heart rate in intact and baroreceptor deficient rats. Brain Research, 582(2), 215-220. 


Li, T., Chiu, H., Ho, K., & Tzeng, D. (2011). Bradycardia following a single low dose of trazodone. Asian Journal of Psychiatry, 4(1), 77-79.


Atli, O., Kilic, V., Baysal, M., Kilic, G., Gormus, G., Ucarcan, S., Korkut, B., & Ilgin, S. (2018). Assessment of trazodone-induced cardiotoxicity after repeated doses in rats. Human & Experimental Toxicology.


Richardson JS, Chiu EK. The acute effects of amitriptyline, iprindole and trazodone on blood pressure and heart rate in rats. Pharmacol Biochem Behav. 1982 Dec;17(6):1221-3. doi: 10.1016/0091-3057(82)90124-1. PMID: 7163353.


Vitullo, R. N., Wharton, J. M., Allen, N. B., & Pritchett, E. L. (1990). Trazodone-Related Exercise-Induced Nonsustained Ventricular Tachycardia. Chest, 98(1), 247-248.

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