Does trazodone deplete magnesium? (3+ side effects)

In this article, we will discuss whether trazodone depletes magnesium. We will also discuss the symptoms of low magnesium levels, other drugs that affect magnesium levels, and other side effects of trazodone and share evidence from literature about the effect of trazodone on different electrolytes. 

Does trazodone deplete magnesium? 

No, trazodone does not deplete magnesium. A decrease in magnesium levels is not an officially documented side effect of trazodone. Changes in magnesium levels are not reported in the patients taking trazodone. 

Trazodone is a serotonin antagonist and reuptake inhibitor (SARI) and an antidepressant. It is an FDA-approved drug for the treatment of major depressive disorder (MDD) (1). 

Different drugs can affect the levels of electrolytes in the body. Magnesium is also an electrolyte required for various physiological processes in the body. Normal serum magnesium levels in the body are 1.46-2.68 mg/dL (2).

A serum magnesium level below 1.46mg/dL indicates a depletion known as hypomagnesemia (2). Hypomagnesemia is not a reported or documented side effect of trazodone. 

What are the symptoms of depleted magnesium?

If you are concerned that trazodone is affecting your magnesium levels, you must look out for the following symptoms (2): 

• nausea
• vomiting
• fatigue
• weakness
• muscular weakness
• loss of appetite
• delirium
• agitation 
• tremors
• seizures

It is important to note that the occurrence of the above-mentioned symptoms does not necessarily indicate hypomagnesemia. If you experience these symptoms you must contact your healthcare provider. 

What does research suggest?

Evidence regarding the impact of trazodone on magnesium levels is scarce. There are no case reports that mention that trazodone results in magnesium depletion. A decrease in magnesium is not even associated with trazodone overdose (3). 

In one case study, a patient presented with different symptoms secondary to intentional trazodone overdose. Her lab reports revealed that her magnesium levels were normal (3)

Thus, trazodone does not affect magnesium levels even at high doses. Individual responses to medications may vary and you must contact your healthcare provider if you are experiencing some unusual symptoms. 

How does trazodone affect other electrolytes?

Although trazodone does not affect magnesium levels in the body, it influences other electrolytes like potassium and sodium. Trazodone does not interfere with potassium levels at therapeutic doses. 

Incidences of low potassium known as hypokalemia have been reported with trazodone overdose (3). Thus, trazodone can deplete potassium levels at doses exceeding the maximum therapeutic dose. 

Trazodone also interacts with hERG potassium channels in the heart which causes the risk of QT prolongation and arrhythmia (1). Due to this risk, trazodone should not be taken by patients with hypokalemia and hypomagnesemia (4). 

The officially documented side effect of trazodone is hyponatremia. Trazodone can deplete sodium levels in your body through the syndrome of inappropriate antidiuretic hormone (SIADH). It causes excessive ADH secretion (4). 

SIADH makes the kidneys retain more water which dilutes the sodium levels in your body. Symptoms of hyponatremia include headache, confusion, weakness, memory impairment, and difficulty in concentration (4). 

What factors can deplete magnesium while you are taking trazodone? 

Different factors can be associated with hypomagnesemia while you are taking trazodone. They include (2):

Decreased intake:

A reduced dietary intake of magnesium is one of the causes of hypomagnesemia. A reduced intake can be due to starvation, conditions like anorexia nervosa, terminal cancer, or patients on IV nutrition due to critical illness (2).  

To avoid hypomagnesemia while taking trazodone you must take a diet based on different food groups. Foods rich in magnesium include whole grains, avocados, nuts, seeds, and leafy green vegetables. 

Medications:

Different medications can cause hypomagnesemia. Some of these medications might not be advised to be taken with trazodone together. You must inform your healthcare provider about all the medications you are using. 

Medications associated with hypomagnesemia include (2):

• loop and thiazide diuretics
• proton pump inhibitors
• digitalis
• pentamidine 

What to do if trazodone is affecting your magnesium levels?

If you are concerned that trazodone might affect your magnesium levels, you should contact your healthcare provider. Your healthcare provider will monitor your electrolyte levels through blood tests. 

If clinically significant results are obtained, your healthcare provider may consider a dose reduction or switch to another medication. This is however less likely to happen because trazodone does not affect magnesium levels. 

To maintain a healthy level of vitamins and minerals in your body, your healthcare provider may suggest supplements. Supplements ensure that you receive enough essential nutrients. 

You should also ensure that you consume magnesium through food sources. Foods rich in magnesium include (2):

• almonds
• oatmeal
• cashews
• potatoes
• peanuts
• cereal
• spinach
• brown rice
• yoghurt

What are the common side effects of trazodone?

Trazodone can result in some side effects that do not indicate hypomagnesemia. These side effects include (1,4):

• fatigue
• headache
• somnolence
• dizziness
• blurred vision
• dry mouth
• constipation
• orthostatic hypotension
• confusion
• nervousness
• acid reflux
• priapism 

In my perspective, trazodone does not deplete magnesium levels. It is not a documented or reported side effect. Trazodone does not deplete magnesium even if it is overdosed. 

Trazodone may affect other electrolytes in the body. It can cause hypokalemia when overdosed. A documented side effect of trazodone is hyponatremia. Thus, it can affect potassium and sodium levels. 

Hypomagnesemia can be caused by different conditions and other medications. You must communicate your complete health history and current medications with your healthcare provider before taking trazodone. 

References