Does Trazodone Interact With Fluoxetine? (3 Tips)

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 interacts with Fluoxetine. We will also discuss some research studies and how to ensure the safe use of this combination.

Does Trazodone interact with Fluoxetine?

Yes, Trazodone interacts with Fluoxetine when taken together. Trazodone and Fluoxetine are both commonly prescribed medications that serve distinct purposes.

Both of these medications are antidepressants which work differently to balance the amount of excitatory chemicals in the brain to help manage symptoms associated with depression and anxiety (1,2).

Although taking both these medications together can offer some potential benefits, it is not the right treatment choice for every individual. While each of them has unique characteristics, both of them affect serotonin levels in the brain, increasing the possibility of interactions.

It is advisable never to take them together without consultation from your healthcare provider.

What does research suggest?

Only a few research studies assessing the safety and efficacy of the combination of Trazodone and Fluoxetine have been published. These studies have different views on the usage of both medications in combination.

One study indicated that when Trazodone and Fluoxetine are taken together, the levels of a substance called mCPP in the blood increase. This increase along with the higher concentration of Trazodone seems to help the combination of these medications work better in treating depression (4).

This improvement in their effectiveness might be because mCPP and Fluoxetine together reduce the activity of a certain type of serotonin receptor (5-HT2C), which could contribute to their antidepressant effects.

Another study indicated that the researchers found problems when using small amounts of Trazodone to manage sleep issues linked to Fluoxetine. 16 patients had positive results using Trazodone to help them sleep, but five had to quit taking it because it made them too sleepy (5).

What are the potential interactions of Trazodone and Fluoxetine?

Fluoxetine, a selective serotonin reuptake inhibitor, and Trazodone, a serotonin antagonist and reuptake inhibitor, affect serotonin levels in the brain. This shared mechanism of action raises concerns about the potential interactions.

In theory, combining two medications that influence serotonin could lead to a condition known as serotonin syndrome, a rare but serious condition characterized by a wide range of symptoms, including:

Agitation
High body temperature
Increased heart rate
Muscle rigidity
Confusion
Dilated pupils
Excessive sweating (3)

Increased sedation

In some individuals, Fluoxetine may cause sedation. Trazodone is an antidepressant which is also approved for treating insomnia. When taken together, they may cause additive side effects such as increased sedation among individuals (1,2).

Although the risk of serotonin syndrome and increased bleeding with the combination of Trazodone and Fluoxetine is relatively low. It is essential to be aware of potential side effects when taking these medications together.

What are the benefits of the combination of Fluoxetine and Trazodone?

The combination therapy of Trazodone and Fluoxetine is beneficial for patients who have severe depression that cannot be treated with monotherapy with either medication.

Effect on sleep

It is given to patients who report insomnia as a side effect when on Fluoxetine therapy. The combination of medications affects the patient’s sleep quality and structure. Trazodone can reduce the number of awakenings and may improve sleep quality at night hence counteracting Fluoxetine-induced insomnia.

Effect on cognitive function

Trazodone has a risk of causing memory issues. It can cause short-term memory dysfunctions. Fluoxetine is found to improve cognitive functioning and increase the concentration and recall abilities of individuals receiving therapy.

Fluoxetine also helps in preventing stress-induced cognitive impairment through its memory-protective characteristics on the hippocampus.

Effect on stress or mood-regulating hormones

Both medications are known to improve serotonin levels in the brain. Serotonin is considered a neurotransmitter and a hormone. It is needed for the regulation of mood, emotions and motor skills.

How to ensure the safe use of Trazodone and Fluoxetine together?

To ensure the safe use of the Trazodone and Fluoxetine combination, consider the following recommendations:

Medical supervision: Consult with a healthcare professional before starting, stopping or combining any medication. Adverse effects may occur if you take Trazodone and Fluoxetine unnecessarily. Your doctor can evaluate your specific condition and medical history to determine if this combination is appropriate for you.

Dosage adjustment: In some cases, your doctor may adjust the dosage of Fluoxetine or Trazodone to minimise the risk of potential side effects and interactions. This is particularly true if you take either medication before considering the other.

Always remember not to discontinue or make any changes to your treatment plan without medical supervision as it can lead to withdrawal symptoms further worsening your condition (6).

Open communication: Be sure to inform your doctor of any side effects or changes in your condition. Open and honest communication with your healthcare provider is essential for maintaining your well-being.

Regular follow-up appointments with your healthcare provider are crucial when taking Fluoxetine and Trazodone together. Close monitoring allows for early detection of any adverse effects and adjustments to your treatment plan as needed.

In my view and the knowledge available, it is evident that there is a potential for interaction between Trazodone and Fluoxetine. In most cases, these medications can be used safely together. However, each individual’s response may vary, so consult a healthcare professional before combining these medications.