Does trazodone cause a lack of appetite? (3+ tips)

In this article, we will talk about trazodone-induced lack of appetite. We will also discuss some research findings linked with trazodone and the factors contributing to lack of appetite. 

Does trazodone cause a lack of appetite? 

Yes, trazodone can cause a lack of appetite. Side effects caused by trazodone vary among individuals in severity and occurrence; not all individuals consuming trazodone experience this side effect. Trazodone is an antidepressant which helps treat symptoms of depression, insomnia and other sleep-related disorders. (1)

Reduced appetite can be associated with depression, hypothyroidism, gastrointestinal disorders, etc. If you are experiencing a lack of appetite, consult your physician for proper management and avoid abrupt discontinuation of the drug, as it can cause withdrawal symptoms and worsen your condition.

What does the research suggest? 

A study compared amitriptyline, trazodone and placebo to analyse the effect of these drugs on weight. They found that the group treated with amitriptyline had weight gain, whereas the group treated with trazodone had slight weight loss, which can be linked to reduced food intake and loss of appetite. (2)

Some antidepressants, such as fluoxetine, duloxetine, desvenlafaxine, etc., are associated with loss of appetite. The effect of the drug varies among individuals and can subside as your body gets used to the drug. 

How does trazodone cause a lack of appetite? 

Trazodone belongs to the class of serotonin-antagonist and reuptake inhibitors. It acts on serotonin transporters as well as serotonin type 2 receptors and increases serotonin levels. 

Serotonin is a neurotransmitter that plays an important role in regulating mood, attention, concentration, behaviour, and other cognitive functions. 95% of serotonin is found in the gastrointestinal tract, and an increase in serotonin can lead to diarrhoea, constipation, nausea, vomiting, loss of appetite, etc. (3)

The release of serotonin into the postsynaptic receptors is associated with a decrease in appetite. A study conducted by G. Curzon found that serotonin can influence appetite disorders. (4) 

Serotonin stimulates proopiomelanocortin (POMC) neurons and inhibits agouti-related peptide (AgRP) neurons in the hypothalamus, which regulates appetite. A study conducted on rats revealed that those with low serotonin levels had increased appetite. (5)

What factors contribute to a lack of appetite while taking trazodone? 

There are many factors which can contribute to reduced appetite while taking trazodone, such as:

• Acute infections like the common cold can cause loss of appetite. 
• Chronic medical conditions such as thyroid disorders, kidney disorders, and gastrointestinal problems can contribute to a lack of appetite. 
• Mental illnesses such as depression, anxiety, etc can affect appetite. 
• Treatment with chemotherapy drugs, antidepressants, antibiotics, antipsychotics, etc., can have an impact on appetite. 
• GI problems such as gastroesophageal reflux disease (GERD), peptic ulcers, and irritable bowel syndrome (IBD) can contribute to loss of appetite. 
• Older adults may experience reduced appetite compared to adults due to changes in their physiology. 
• Acute stress can cause a temporary loss of appetite in some individuals, whereas, in some individuals, it can lead to binge eating. 
• An unhealthy lifestyle, poor diet, and lack of physical activities can have a negative impact on your health, leading to decreased appetite. 
• Hormonal fluctuations during menstruation and menopause can have an impact on appetite. 

What to do if trazodone causes a lack of appetite? 

In some individuals, side effects such as lack of appetite can subside as the body gets used to the drug. If you are experiencing a lack of appetite for a prolonged period and if you notice weight loss, consult your healthcare professional for proper management.

Abrupt discontinuation of trazodone can cause withdrawal symptoms. It is important to taper the dosage of trazodone before completely stopping its use. Do not alter the course of your treatment without the guidance of a qualified physician.

If you are consuming trazodone to treat your depression or anxiety disorder and do not notice any change in your symptoms, that indicates the drug is not working for you. Alternatives to trazodone are as follows: 

• Selective serotonin reuptake inhibitors (SSRIs): citalopram, escitalopram, paroxetine, and sertraline. 
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): venlafaxine. milnacipran, desvenlafaxine, levomilnacipran. 
• Tricyclic antidepressants: amitriptyline, amoxapine, nortriptyline, imipramine. 
• Atypical antidepressants: bupropion, mirtazapine. 
• Monoamine oxidase inhibitors (MAOIs): isocarboxazid, selegiline. 

What are the measures to improve appetite while taking trazodone? 

You can follow a few measures to avoid weight loss due to a lack of appetite while consuming trazodone.

• Timing of the drug: Taking the drug in the evening may minimise its impact on appetite during the day.
• Take small and frequent meals: Eat smaller meals more frequently instead of a large meal. It is easy to consume the right amount of calories this way. 
• Nutrition-rich food: Eat foods which are rich in vitamins, minerals and proteins. Add a variety of fruits, vegetables, and whole grains to your meals and avoid junk foods.
• Hydration: Stay hydrated throughout the day. Drink at least 2-3 litres of water in a day. 
• Choose liquid calories: Consider taking liquid calories if you have difficulty in consuming solid foods such as protein shakes and fruit juice. 
• Vitamin supplements: If nutritional needs are not met with food intake. Consider taking multivitamin supplements, which will provide you with the required amount of vitamins and nutrients.
• Regular exercise: Performing physical activity can stimulate appetite. Avoid intense workouts close to bedtime. 
• Limit stimulants: Limit the use of stimulants such as caffeine, which can reduce appetite. 
• Flavour enhancement: Try experimenting with herbs and spices, which make the food more appealing and can stimulate your appetite.  

If you are experiencing any unwanted effects after consuming trazodone, make sure you consult your physician for a proper evaluation. Do not stop taking the drug before consulting your physician. Trazodone is associated with the risk of suicidal thoughts. Look for any negative behavioural changes while taking trazodone. 

In my experience as a pharmacist, trazodone can cause a lack of appetite. However, the side effects vary among individuals. If you are experiencing reduced appetite and weight loss for a prolonged period, make sure you consult your physician for a proper evaluation and management. 

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