Does trazodone cause falls? (5+ factors)

In this article, we will discuss whether trazodone causes falls, how trazodone causes falls, what research suggests, what factors can contribute to trazodone-induced falls, what to do if you experience this side effect, and what are the precautions to avoid trazodone-induced falls.

Does trazodone cause falls?

Yes, trazodone can cause falls in individuals using it for the treatment of major depressive disorders, anxiety, and insomnia. This side effect is common among older adults, but individual responses can vary, and not everyone will experience trazodone-induced falls. (1,2)

Trazodone is an antidepressant drug that belongs to the class of serotonin-antagonist reuptake inhibitors (SARI). It’s FDA-approved for the treatment of major depressive disorders, while its non-FDA-approved uses include the treatment of insomnia, fibromyalgia, and certain types of chronic pain. (1)

However, it is important to be cautious, avoid situations where falls may happen, and report any unwanted symptoms to your healthcare provider.

How does trazodone cause falls?

The exact mechanism by which trazodone may contribute to falls is not fully understood. However, several factors may play a role. Trazodone is a SARI and exerts its effect by inhibiting the reuptake of serotonin as well as histamine and alpha-1-adrenergic receptors. This alteration in serotonin levels can affect various systems in our body. (1)

Trazodone has sedative properties, and its side effects can include dizziness, drowsiness, hyponatremia, and orthostatic hypotension. These effects can impair balance and coordination, making individuals more susceptible to falls. (2)

What does research suggest?

Research on the connection between trazodone and falls is not entirely conclusive, and findings may vary across studies. Some research suggests an increased risk of falls among older adults using trazodone for the treatment of insomnia.

A research study on 1,699,913 Medicare beneficiaries concluded that older adults who are being treated for insomnia with trazodone and benzodiazepines experienced twice as many falls as the control group. (3)

A study published in the Canadian Medical Association Journal concluded that trazodone is responsible for as many falls and osteoporotic fractures as atypical antipsychotics. However, the rate of mortality is much lower in trazodone-dispensed patients. (4)

It’s crucial to note that individual responses to trazodone can vary, and not everyone prescribed trazodone will experience fall-related injuries.

What factors can contribute to trazodone-induced falls?

Several factors may contribute to an increased risk of falls in individuals taking trazodone for the treatment of major depressive disorders and insomnia:

• Age: Older adults may be more susceptible to CNS-related side effects like drowsiness and dizziness from trazodone, potentially increasing the risk of falls. (7)

• Dosage and duration: High doses can increase the drowsiness and dizziness caused by trazodone and contribute to the fall risk associated with trazodone use. Long-term use of trazodone can also contribute to the fall risk associated with trazodone.

• Polypharmacy: Taking multiple medications, like antipsychotics, antidepressants, anxiolytics, benzodiazepines, drugs that cause sedation like antihistamines, etc., can amplify the risk of trazodone-induced falls. (5)

• Alcohol and other CNS depressants: Consumption of alcohol and other CNS depressants, along with trazodone, can also contribute to fall-related injuries. (6)

• Underlying medical conditions: Individuals with pre-existing conditions affecting balance can be more susceptible to falls when taking trazodone. (7)

• Individual variation: Individual responses to medication can differ, and not everyone will experience the same side effects while using trazodone. Individual pharmacodynamics can also play a role.

What to do if you have experienced a fall from trazodone?

If you experience dizziness, lightheadedness, or an increased risk of falling while taking trazodone, it is crucial to communicate with your healthcare provider immediately. Your doctor might consider the following strategies to manage this side effect:

• Adjust the dosage: Sometimes high doses can increase effects like drowsiness, which can cause falls. Your doctor may consider lowering the dose to mitigate these effects. (9)

• Discontinuation: If lowering the dose does not help, your doctor will gradually taper the prescribed trazodone dose and discontinue it. (8)

• Recommend a different medication: If lowering the dose does not help, your healthcare provider might consider a different antidepressant with a lower risk of falls.

• Explore alternative treatments: Your doctor will assess your specific health situation and might advise you on cognitive-behavioral therapy for your mental health.

What precautions can you take to avoid trazodone-induced falls?

• Monitoring side effects: Pay attention to how your body responds to trazodone. Report any dizziness, lightheadedness, or unsteadiness to your healthcare provider immediately.

• Medication review: Regularly review your medications with your healthcare provider to ensure there are no potential interactions that could increase the risk of falls. (10)

• Be cautious: If you are taking trazodone, exercise caution while driving or even walking or climbing stairs. Remove any tripping hazards that could make you fall.

• Fall prevention strategies: Maintaining a well-lit living environment and using handrails can help reduce the risk of falls.

• Stay hydrated: Dehydration can also cause dizziness and low BP, so drink plenty of water to reduce the risk of falling.

• Physical activity: Regular physical activity can help improve your balance and reduce fall risk. Tai chi is a martial art that has many musculoskeletal benefits. It is beneficial for older adults to avoid falls. (10)

• Vitamin D: Vitamin D supplementation is important for muscle strength and balance and helps reduce fall risk. (10)

From my perspective, the link between trazodone and falls is prevalent in elderly patients, so it is essential for individuals taking trazodone to be aware of the potential risks and communicate openly with their healthcare providers.

By understanding the factors that may contribute to trazodone-induced falls and taking the necessary precautions, patients can minimize the risk and safely manage their mental health conditions.

References