Does trazodone cause tiredness? (+5 factors)

In this article, we will discuss whether trazodone causes tiredness. We will also share the mechanism through which trazodone causes tiredness, evidence from research, factors contributing to tiredness while taking trazodone, and tips to manage trazodone-associated tiredness. 

Does trazodone cause tiredness?

Yes, trazodone causes tiredness. Tiredness is a sign of fatigue and fatigue is an officially documented and frequently reported side effect of trazodone. Trazodone is categorized as a serotonin antagonist and reuptake inhibitor (SARI) antidepressant (1). 

Trazodone is a commonly prescribed medication to treat major depressive disorder (MDD). It is also used as a hypnotic to help individuals who have trouble sleeping (1). 

Fatigue is broadly defined as a lack of energy and is characterized by physical symptoms of tiredness, difficulty in being physically active, feeling weak, heavy, slow, and sluggish, and general weakness (2). 

Fatigue commonly occurs in patients while taking trazodone and patients may experience that their motivation, attention, and concentration are reduced and they are feeling low (2). These symptoms can make a person feel tired all the time.

Feeling tired while taking trazodone is common and you should not be concerned. However, you should communicate with your healthcare provider if the tiredness significantly affects your quality of life to get help in managing this side effect.

What does research suggest?

The association of tiredness with trazodone is well-established in the literature. Research suggests that about 10% to 38% of patients taking antidepressants experience fatigue (3).

Trazodone is more likely to cause fatigue than selective serotonin reuptake inhibitors (SSRIs) (3). In one study, 396 men were treated for erectile dysfunction with trazodone and 15% of the population experienced fatigue as a side effect (4).

Another study investigated the safety, tolerability, and effectiveness of the prolonged-release formulation of trazodone and reported that fatigue was among the side effects that were frequently reported (5). 

Moreover, trazodone is often prescribed for insomnia due to its sedative properties. As a result, daytime drowsiness and sleepiness are commonly experienced. These side effects also make a person feel tired during the day (6). 

How does trazodone cause tiredness?

Trazodone can cause tiredness through different mechanisms. It blocks serotonin reuptake and increases the concentration of this neurotransmitter (1). Studies have shown that drugs that increase serotonin levels in the body cause tiredness (7). 

Serotonergic drugs like Celexa and Cymbalta result in tiredness in many individuals. This suggests the role of serotonin in causing tiredness. It is assumed that the inhibition of the dopaminergic system by serotonin may cause fatigue (7). 

Thus serotonin-induced low levels of dopamine may cause tiredness in individuals (7). Additionally, trazodone causes sedation by its antagonist effects on some serotonin, histamine (H1), and alpha-1 adrenergic receptors (1). 

This sedation and drowsiness may linger and cause the individual to feel tired throughout the day. Trazodone may also deplete sodium levels in the body which also results in tiredness (1). 

What factors contribute to tiredness while taking trazodone? 

Different factors contribute to tiredness while taking trazodone. They are as follows: 

Dosage: 

The activity of trazodone depends on the dose you are taking. At low doses, trazodone does not have an antidepressant effect and does not cause drowsiness during the day (6). Thus, higher doses of trazodone increase the tiredness. 

Fatigue as a symptom of depression: 

Tiredness is a physical sign of fatigue and fatigue is a highly and frequently reported symptom of depression. Fatigue is also a factor that can lead to depression as fatigued individuals are likely to develop depression (7). 

Research suggests that fatigue is one of the symptoms that can persist even after the individual has been adequately treated for depression. Thus, fatigue is a residual symptom that may result in relapse (2). 

Thus, if you are taking trazodone, the tiredness present as symptom of depression may be exacerbated. This side effect of trazodone may be resolved within a few weeks or persist for up to 3 months (3). 

Other medications: 

Different medications can cause sleepiness during the day and make the patient feel tired. Simultaneous use of these medications with trazodone can increase the tiredness. Medications that can cause tiredness include (7):

• antipsychotics like clozapine and olanzapine 
• antihistamines like doxylamine
• immunosuppressants
• hypnotic like zolpidem 
• anticancer drugs 
• antihypertensives

Therefore, it is important to inform your healthcare provider about all the medications you are taking before starting trazodone. Combining some medications with trazodone can be dangerous. 

Health conditions:

Different health conditions result in fatigue and taking trazodone might further exacerbate the tiredness. Health conditions that result in fatigue include (7):

• sleep apnea
• hypothyroidism
• anemia
• chronic diseases
• cardiac failure

Lifestyle factors: 

Different lifestyle factors contribute to tiredness. Having a sedentary routine can decrease the energy levels of an individual. Individuals who overwork are likely to feel burnout and more tired while taking trazodone (7). 

Individuals who do not consume appropriate nutrition or are on a diet that promotes quick weight loss are likely to feel tired while taking trazodone. Dehydration is also a common cause of tiredness (7). 

What to do if trazodone causes tiredness?

You should not be concerned if trazodone causes tiredness because it is a common side effect of this medication. You can contact your healthcare provider if it significantly affects your daytime alertness. 

Your healthcare provider may consider dose reduction to reduce the tiredness. It is advised to take the major portion of the trazodone dose at night. If you are prescribed trazodone once a day, do not take it in the morning. 

If trazodone causes extreme tiredness, your healthcare provider may switch you to a prolonged-release formulation of trazodone. This would reduce the dosing frequency and significantly decrease the side effects.  

Your healthcare provider may consider prescribing a psychostimulant to manage the fatigue. If trazodone-induced tiredness is not manageable, your healthcare provider may consider switching to other antidepressants like: 

• SSRIs like citalopram, paroxetine, sertraline
• SNRIs like venlafaxine and desvenlafaxine
• tricyclic antidepressants like amitriptyline and nortriptyline

To manage tiredness, you can include aerobic exercise in your routine. Gradually increasing the intensity of exercise helps manage fatigue in depression (7). You should also consume adequate nutrition and maintain hydration to manage tiredness 

Your healthcare provider may also recommend cognitive behavioural therapy (CBT) to manage tiredness. CBT is often used to address the fatigue resulting from different health conditions. 

In my perspective, trazodone causes tiredness. Tiredness is a sign of fatigue and fatigue is a frequently and highly reported side effect of trazodone. The reports of tiredness in patients taking trazodone are abundant in the literature. 

Trazodone may cause fatigue by affecting serotonin or due to its sedative properties. Factors like dosage, health conditions, lifestyle, and other medications also contribute to trazodone-associated tiredness. 

Tiredness caused by trazodone can be managed by dose reduction, taking the medicine at night, or switching to other drugs. Lifestyle modifications are also needed to combat trazodone-induced tiredness. 

References