Does trazodone help with anxiety? (+5 options)

This article will explore the use of trazodone for anxiety. It will explain the mechanism by which trazodone can help with anxiety and discuss the research findings regarding its effectiveness in managing anxiety.

The article will also mention the potential side effects associated with its use. Furthermore, alternative drugs for anxiety treatment will be examined.

Does trazodone help with anxiety?

Yes, trazodone can help with anxiety, especially in patients who are suffering from both anxiety and depression. However, trazodone is not FDA-approved for this condition.

The mechanism of action of trazodone involves targeting imbalances in certain neurotransmitters in the brain. To illustrate, by impacting the serotonin and adrenergic systems, trazodone has the potential to alleviate anxiety symptoms in some individuals.

Trazodone is also helpful in managing anxiety due to its sedating and calming effects. For instance, people who can’t get enough quality sleep due to anxiety-induced restlessness may benefit from taking trazodone, as it is known for being effective in treating sleep disturbances.

However, trazodone should never be taken for anxiety unless it is prescribed by a doctor. Moreover, people’s responses to medications can vary, and trazodone may not improve anxiety symptoms for everyone. 

It is important to consult with a doctor before considering taking trazodone for anxiety. They will assess your medical history and prescribe the most appropriate medication for your anxiety accordingly.

How can trazodone help with anxiety?

In people with depression and anxiety, there is a significant reduction in serotonergic activity, while noradrenergic activity is increased and overactive. To effectively alleviate anxiety symptoms, it is important to regulate the levels of these neurotransmitters [1].

Trazodone is a serotonin antagonist and reuptake inhibitor (SARI). Its mechanism of action involves inhibiting both the serotonin transporter and serotonin type 2 receptors. Consequently, it prevents the reuptake of serotonin, increasing its levels. Trazodone also blocks alpha-1-adrenergic receptors [2].

Given that anxiety involves a decrease in serotonin and an increase in norepinephrine, trazodone can effectively address these effects by elevating serotonin levels and inhibiting the adrenergic receptors. As a result, it can be an effective management option for anxiety symptoms.

What does research suggest?

Two controlled studies were conducted to evaluate the effectiveness of trazodone in managing anxiety in depressed patients in comparison to a placebo. Additionally, three controlled trials compared the efficacy of trazodone in managing anxiety symptoms in depressed patients to that of amitriptyline [3].

According to a review article analyzing the findings and conclusions of these studies, a daily dose of 75 mg of trazodone was found to be significantly more effective than a placebo in managing anxiety, while a higher daily dose of 151 mg was shown to be more efficacious than amitriptyline for anxiety [3].

In these studies, the effectiveness of trazodone in treating anxiety was assessed based on its ability to enhance feelings of guilt and obsessive-compulsive symptoms [3].

The review article also highlighted the findings of an open trial, which found that 90% of depressed and anxious hospitalized patients experienced improvement in their depression and anxiety symptoms after taking trazodone. Among these patients, 50% of those with anxiety showed significant improvement [3].

Furthermore, other open trials conducted among outpatients indicated that 70% of depressed patients with co-occurring anxiety experienced improvements in both anxiety and depression symptoms as a result of taking trazodone [3].

What are the side effects of using trazodone for anxiety?

Before considering using trazodone for anxiety, it is important to be aware of its potential risks and side effects. Side effects of trazodone include [4]:

What other drugs can help with anxiety?

Various alternatives to trazodone can be used in managing anxiety disorders. To illustrate, selective serotonin reuptake inhibitors, such as escitalopram, sertraline, paroxetine, fluoxetine, and fluvoxamine, are all among the most recommended drugs for different types of anxiety disorders [5].

Moreover, the serotonin-norepinephrine reuptake inhibitor, venlafaxine, is approved for the treatment of generalized anxiety disorder. Duloxetine was also found to be effective in treating anxiety. Buspirone is also effective in helping with anxiety [5].

Additionally, benzodiazepines, such as diazepam, alprazolam, and lorazepam, are approved for enhancing anxiety and managing panic attacks. Barbiturates (phenobarbital) can also be used to help with anxiety [5].

 

Based on my research, I have found that trazodone is effective in helping with anxiety, particularly in individuals who are dealing with both anxiety and depression. However, it is important to note that trazodone is not FDA-approved specifically for anxiety.

It is important to be aware of potential side effects associated with trazodone use, such as nightmares, muscle pain, dizziness, dry mouth, and QT prolongation. I recommend discussing these risks with a doctor to understand the benefits and drawbacks of using trazodone for anxiety.

Based on my knowledge, there are also other drug alternatives available for managing anxiety, such as selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, buspirone, and benzodiazepines. It is worth exploring these options with a healthcare professional to find the most suitable treatment for your case.

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References

1.-

Ressler KJ, Nemeroff CB. Role of serotonergic and noradrenergic systems in the pathophysiology of depression and anxiety disorders. Depress Anxiety. 2000;12 Suppl 1:2-19. https://pubmed.ncbi.nlm.nih.gov/11098410/

2.-

Stahl SM. Mechanism of Action of Trazodone: a Multifunctional Drug. CNS Spectrums. 2009;14(10):536-546. doi:10.1017/S1092852900024020 https://www.cambridge.org/core/journals/cns-spectrums/article/abs/mechanism-of-action-of-trazodone-a-multifunctional-drug/336DB6B060471BA6C675337CC8AA637C

3.-

Brogden RN, Heel RC, Speight TM, Avery GS. Trazodone: a review of its pharmacological properties and therapeutic use in depression and anxiety. Drugs. 1981 Jun;21(6):401-29. doi: 10.2165/00003495-198121060-00001. PMID: 7018873. https://pubmed.ncbi.nlm.nih.gov/7018873/

4.-

Shin JJ, Saadabadi A. Trazodone. [Updated 2022 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470560/#:~:text=Trazodone%20is%20a%20medication%20used,reuptake%2Dinhibitor%20class%20of%20medications.

5.-

Garakani A, Murrough JW, Freire RC, Thom RP, Larkin K, Buono FD, Iosifescu DV. Pharmacotherapy of Anxiety Disorders: Current and Emerging Treatment Options. Front Psychiatry. 2020 Dec 23;11:595584. doi: 10.3389/fpsyt.2020.595584. PMID: 33424664; PMCID: PMC7786299. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7786299/

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