Does trazodone cause dystonia? (+5 factors)

In this article, we will discuss whether trazodone can cause dystonia or not. We will further dig deep into some factors that may explain the concept regarding trazodone-induced dystonia. Furthermore, we will look at the ways to overcome this challenge caused by trazodone. 

Does trazodone cause dystonia?

Trazodone may cause dystonia. However, very rare and insignificant cases have been reported regarding trazodone-induced dystonia in patients. More research and studies are required to clearly state that dystonia can be induced by trazodone.

Trazodone is an antidepressant medication that works primarily by serotonin modulation in the brain. Trazodone belongs to the serotonin antagonist and reuptake inhibitors drug class. Trazodone is an FDA-approved medication for the treatment of major depressive disorder (1). 

Dystonia is a disorder that affects body movements. It causes a repetitive and involuntary abnormal movement of the muscles. These abnormal muscle movements or spasms can sometimes be associated with pain (2).

Dystonia is not very commonly associated with trazodone. However, individual responses to medications may vary. If you feel symptoms of dystonia or other severe side effects of trazodone, seek immediate medical help. 

What does research suggest?

According to the research studies, very rare evidence and studies are available regarding trazodone-induced dystonia in patients. 

According to a study, a 61-year-old Japanese schizophrenic patient was reported. She was a schizophrenic patient since her mid-20s and was partially responsive to the treatment (3).

This patient was then prescribed trazodone 25mg/day for delirium and insomnia along with schizophrenia. After a few weeks, she came to the [psychiatric ward with complaints of slowness and excessive fatigue (3). 

However, she was diagnosed with secondary dystonia due to trazodone. The prominent symptoms that she displayed were cervical extension and dysphagia which were improved after discontinuing trazodone (3).  

Another case of a 55-year-old patient was reported who developed oromandibular dystonia after initiating treatment with trazodone for insomnia. Therefore, it is recommended that trazodone must be administered to patients with caution (4). 

What are the symptoms of dystonia?

The following are some common symptoms of dystonia (2):

• Uncontrolled muscle cramps
• Repetitive muscle spasms
• Shaking (tremors)
• Rapid and uncontrolled blinking of the eyes
• Abnormal twisting of body parts (such as neck, feet, etc)

However, it is important to note that not all patients face these symptoms. Some may suffer from these symptoms while others may not. The severity of symptoms among patients also varies depending on their characteristics. Therefore, if you face any such symptoms while taking trazodone, consult your doctor. 

What factors may cause trazodone-induced dystonia?

The following factors may contribute to causing trazodone-induced dystonia:

• Age and gender- Younger children, usually under 18 years of age are at a greater risk of developing dystonia. Males have a higher probability of developing dystonia as compared to females (5).

• Medical history- Patients with a medical history of dystonia or other movement disorders are at a higher risk of developing dystonia due to trazodone.  

• Dosage- An increased dosage of trazodone may increase the likelihood of dystonia. You must consult your doctor for a minimum effective therapeutic dose of trazodone which may not induce dystonia. 

• Drug interactions- Concurrent use of trazodone along with other antipsychotics develops a chance of dystonia and dyskinesia in some patients due to drug-drug interaction. 

• Alcohol consumption- There is a higher risk of dystonia in patients who consume large amounts of alcohol while on trazodone. Alcohol consumption must be limited with the use of antidepressant medications to reduce potential side effects. 

What to do if trazodone causes dystonia?

If you suffer from repetitive abnormal muscle movements or spasms after taking trazodone, then you must consult your healthcare provider. 

Your doctor must assess your health and figure out the actual cause of these muscle spasms or dystonia. If it is due to trazodone administration, then your treatment plan must be changed accordingly. 

For treating an episode of dystonia, an intramuscular injection of anticholinergic (biperiden 5mg) or an antihistamine (promethazine 50mg) is usually effective within 20 minutes. Usually, 2nd and 3rd injections are administered at half-hour intervals (5). 

If your doctor suspects a higher risk of dystonia based on your symptoms and factors, they may give an anticholinergic drug (benztropine 2mg/2-3 times a day) as a prophylactic treatment (5). 

Your doctor may suggest non-pharmacological modes of therapy such as physiotherapy or occupational therapy which may be beneficial for some patients in alleviating dystonia. 

Your doctor must outweigh the benefits and risks of trazodone treatment concerning dystonia. If the risks and symptoms of dystonia are more severe than the benefits, then dosage and frequency adjustments of trazodone are required. 

However, if you suffer from severe side effects, do not abruptly stop taking trazodone as it may cause withdrawal symptoms. Consult your doctor and if appropriate they may reduce your drug dosage before discontinuing to avoid withdrawal symptoms. 

In my opinion, you must be vigilant and careful about your signs and symptoms regarding dystonia while taking trazodone based on your risk factors. Though trazodone does not possess a high chance of causing dystonia, still you need careful monitoring of your symptoms and side effects to avoid complications. 

References