Does trazodone help with narcolepsy? (5+ tips)

In this article, we will discuss whether trazodone helps with narcolepsy. Furthermore, we will talk about the research findings, dosage recommendations, approved treatment options for narcolepsy, and what to do if trazodone does not help your narcolepsy. 

Does trazodone help with narcolepsy?

Trazodone may help with narcolepsy. Narcolepsy is a sleep disorder in which patients may experience sleepiness during the daytime that can not be resisted. Patients may also have irregular muscle movements in this condition which is known as cataplexy. 

Trazodone is an antidepressant that is approved by the FDA to treat major depressive disorder. However, it may also be used for other conditions such as anxiety, fibromyalgia, insomnia, and post-traumatic stress disorder (PTSD) (1).

Trazodone may start working to improve the symptoms of insomnia in the early phase of trazodone treatment, however, depression symptoms may take some time as it can not be treated overnight. 

Trazodone works by inhibiting the reuptake of serotonin and also blocks histamine and adrenergic receptors. Trazodone increases serotonin levels in the synaptic regions of the brain, and serotonin regulates mood, emotions, sleep, behaviours, sleep, and the body’s stress response (1,2).

What does research suggest about trazodone and narcolepsy?

According to a research study, a 25-year-old patient was using methylphenidate for narcolepsy and cataplexy. He was experiencing extreme sleepiness and sometimes his muscle control was also lost. His symptoms of narcolepsy got better, but he felt irritated and aggressive while using methylphenidate.

Researchers then tried giving trazodone to this patient, and his symptoms of narcolepsy and cataplexy improved a lot within two days of trazodone treatment (3). Another research study suggested that when trazodone was compared to trimipramine, another medicine for inducing sleep, trazodone gave better results.

It was observed that deep sleep was induced by trazodone only. The mechanism behind this effect is that trazodone affects certain receptors in the brain and hence patients may experience a profound sleep (4). 

What are the dosage recommendations of trazodone for narcolepsy?

The dosage recommendations of trazodone are 100 to 400mg per day either given at night or thrice a day in divided doses. However, the dose of trazodone may vary from person to person according to personalized needs. Your doctor will determine the dosage of trazodone suitable for you according to your symptoms, family or medical history. 

When trazodone is taken at night, people may experience a deep sleep and may get fresh the next morning as they will have a quality sleep. However, patients taking trazodone during the daytime may experience some of the side effects, such as dry mouth, headaches and feeling lethargic (5). 

What treatments are approved for narcolepsy?

The approved treatments of narcolepsy may include pharmacological and nonpharmacological treatments such as: 

Pharmacological treatment

The pharmacological approach to treating narcolepsy may include: 

  • Modafinil and armodafinil help to stay awake. 
  • Sodium oxybate and venlafaxine to reduce cataplexy attacks along with narcolepsy. 
  • Sodium oxybate may also be used for sleep-related disorders such as paralysis or hallucinations. 
  • Pitolisant and solriamfetol are newly emerged treatments for treating narcolepsy.
  • Methylphenidate and amphetamines can also be used as the third line of therapy (6,7). 

Non-pharmacological treatment

The non-pharmacological approach to narcolepsy treatment may include: 

  • Ensure to get enough sleep of 8 to 9 hours. 
  • Maintain a proper bedtime routine to promote quality sleep. 
  • Follow a good hygiene routine, and use a clean and comfortable nightwear. 
  • Incorporate some kind of physical activity in your daily routine, such as walking, yoga, or meditation. 
  • Avoid using gadgets near bedtime. 
  • Reduce caffeine and alcohol consumption (8). 

What to do if trazodone does not help with narcolepsy?

If trazodone does not help your symptoms of narcolepsy, please reach out to your healthcare provider. They may evaluate your current condition, family or medical history, and response to the treatment. Your doctor may try to increase the dose and check the response afterwards. 

However, if you do not respond well to the increased dose of trazodone, your doctor may recommend you take other treatment options available for narcolepsy such as modafinil, armodafinil, sodium oxybate, venlafaxine, methylphenidate or amphetamines. 

From my perspective, trazodone may help with the symptoms of narcolepsy. Trazodone may prevent narcolepsy even when used for extended periods. However, it is not necessary that trazodone may help everyone using it for narcolepsy as some patients may not respond well. Therefore, in such cases, your doctor may advise you to take other treatment options. 

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