Does Trazodone Cause Prolonged QTc? (+3 Factors)

By Ivan Kahwa

Page last updated: 02/02/2024 | Next review date: 02/02/2026

Author bio

Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.

Mr Ivan Kahwa’s Highlights:

Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.

Professional Experience:

Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.

With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.

With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.

Education:

2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.

2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.

2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.

Publications:

▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7

▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60

▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.

https://ethnobotanyjournal.org/index.php/era/article/view/4683

▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.

https://doi.org/10.53388/TMRIM202307004

▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.

https://doi.org/10.1186/s43094-021-00296-2

▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.

https://doi.org/10.5799/jmid.951600

Published book Chapter

▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.

https://doi.org/10.1016/B978-0-323-91942-5.00012-4

Submitted manuscripts Under Review:

▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience

▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine

▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology

Submitted book chapters under review

1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.

2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press

You can view my works on the following professional sites:

Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa

Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en

ORCID: https://orcid.org/0000-0002-6440-3437

Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159

Ivan Kahwa

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In this article, we will discuss whether Trazodone causes prolonged QT interval. We will share the factors that can contribute to prolonged QT interval while using Trazodone. Moreover, this article will also mention the safest antidepressants for cardiovascular patients.

Does Trazodone cause prolonged QTc?

Trazodone can cause prolonged QTc. However, it is not a common side effect of Trazodone. Although cardiac side effects are not common in standard doses of Trazodone, it could still affect some people.

The QT interval is the measure of the heart’s electrical cycle. Prolongation of the QT interval can potentially lead to a serious, life-threatening heart rhythm disorder known as Torsade de Pointes (1).

Trazodone is normally not considered an ideal antidepressant to be used in people who have active cardiac diseases, this is because it is more cardiotoxic than other antidepressants.

If we talk about a healthy individual with this medication, he/she may not experience cardiac side effects. Prolonged QT interval could also be an early side effect in someone who’s new to Trazodone or antidepressants in general.

In such cases, heart issues go away on their own, as your body adjusts to the medication. On the other hand, if this issue persists reach out to your healthcare provider immediately.

How does Trazodone cause prolonged QTc?

The exact mechanism behind the prolongation of QT interval due to Trazodone is not fully known. However, there are some possibilities regarding this phenomenon.

Trazodone is an antidepressant which when administered at higher doses can exert a more pronounced adrenergic effect, potentially leading to elevated heart rate and blood pressure (2).

Trazodone increases the level of certain neurotransmitters, including serotonin, in the brain. These neurotransmitters play a role in the cardiovascular system and can influence the QT interval. They can interact with ion channels in the heart, affecting the electrical conduction system (3).

However, the specific interactions with the ion channels that may contribute to QT interval prolongation are not fully elucidated. It is important to note that the risk of Trazodone affecting heart rhythm is generally considered to be low at lower doses.

However, individuals taking Trazodone, especially at higher doses, must be closely monitored for QT interval prolongation and heart pounding.

What factors contribute to prolonged QT interval while using Trazodone?

Several factors can contribute to the prolonged QT interval associated with Trazodone. These include (4):

The incidence of prolonged QT interval is dose-dependent. Higher doses of Trazodone are more likely to cause QT interval prolongation.
Some individuals are more susceptible to QT interval prolongation, regardless of medication use.
Certain medications such as other antidepressants, and antipsychotics can interact with Trazodone and increase the risk of QT interval prolongation.
Individuals with a history of heart rhythm disorders, congenital long QT syndrome and hyperthyroidism are at higher risk of experiencing QT interval prolongation.
Elderly females are more likely to experience QT interval prolongation and other cardiovascular events.
Alcohol can interact with Trazodone and increase the risk of QT interval prolongation.
Low levels of potassium, magnesium and calcium can significantly lead to changes in the heart rhythm.

What to do if Trazodone causes prolonged QT interval?

If you suspect that Trazodone is causing QT interval prolongation or is affecting your heart functioning, it is important to reach out to your healthcare provider.

Your healthcare provider will likely conduct a thorough medical evaluation including ECG to assess your heart’s electrical activity and determine the suitable interventions.

If your healthcare provider suspects that Trazodone is the main culprit, they may consider dose reduction. If dose adjustment does not work, your healthcare provider may gradually discontinue your medication to mitigate the risk of QT interval prolongation.

Do not discontinue the antidepressant on your own as it can cause horrible withdrawal symptoms further worsening your condition (5).

Your doctor may recommend regular exercise, a balanced diet, and stress management to protect your heart.

Regular monitoring is essential to track your heart rhythm and QT interval. This can ensure your heart is functioning properly.

What are alternatives if Trazodone causes QTc prolongation?

Some antidepressants are considered safer for individuals with cardiovascular conditions. However, individual responses to antidepressants vary widely.

SSRIs are often considered among the safer options for cardiovascular patients. These include

Sertraline (Zoloft)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Citalopram (Celexa)

Based on my research, it is evident that Trazodone can cause QT interval prolongation. Although it is generally considered safe at lower doses, close monitoring is required.

I recommend you talk to your doctor about your symptoms or concerns regarding prolonged QT interval. Always follow your healthcare provider’s recommendations and attend regular check-ups to monitor your health while on antidepressant therapy.