TRAZODONE
Drugs in Pregnancy and Lactation.
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Name: TRAZODONE
Class: Antidepressant
Risk Factor: CM
Fetal Risk Summary
No published reports of the use of trazodone in human pregnancy have been located. At high doses in some animal species, trazodone is fetally toxic and teratogenic.
One manufacturer has received several anecdotal descriptions concerning the use of trazodone in pregnancy (T. Donosky, personal communication, Mead Johnson Pharmaceutical Division, 1987). Included in these was a report of an infant born with an undefined birth defect after in utero exposure to the antidepressant. Another report described a normal infant exposed throughout gestation beginning with the 5th week. No confirmatory follow-up information was available for either of these cases. A third case from the manufacturer's files involved a woman who took trazodone, 50–100 mg/day, during the first 3 weeks of pregnancy and eventually delivered a normal infant. Finally, a woman was treated with trazodone for 8 days, at which time the drug was discontinued because of a positive pregnancy test. A spontaneous abortion occurred approximately 1.5 months later. No cause-and-effect relationship can be inferred between trazodone and any of the above adverse outcomes.
In a surveillance study of Michigan Medicaid recipients involving 229,101 completed pregnancies conducted between 1985 and 1992, 100 newborns had been exposed to trazodone during the 1st trimester (F. Rosa, personal communication, FDA, 1993). One (1%) major birth defect was observed (four expected), but details are not available. No anomalies were observed in six defect categories (cardiovascular defects, oral clefts, spina bifida, polydactyly, limb-reduction defects, and hypospadias) for which specific data were available.
A prospective multicenter study evaluated the effects of lithium exposure during the 1st trimester in 148 women (1). One of the pregnancies was terminated at 16 weeks' gestation because of a fetus with the rare congenital heart defect, Ebstein's anomaly. The fetus had been exposed to lithium, trazodone, fluoxetine, and L-thyroxine during the 1st trimester. The defect was attributed to lithium exposure.
Breast Feeding Summary
Trazodone is excreted into human milk (2). In six healthy lactating women, 3–8 months postpartum, a single 50-mg oral dose of trazodone was given after an overnight fast. Simultaneous serum and milk samples were collected at various times up to 30 hours after ingestion. The infants of the mothers were not allowed to breast-feed during the first 4 hours after the dose. The mean milk:plasma ratio, based on the concentration-time curves for the two fluids, was 0.142. Based on 500 mL of milk consumed during a 12-hour interval, the infants would have received a trazodone dose of 0.005 mg/kg (2). This study was unable to include a potentially active metabolite, 1-m-chlorophenylpiperazine, in the analysis (2). Although the amount of trazodone in milk is very small, the American Academy of Pediatrics considers the potential effects of trazodone on the nursing infant to be unknown, but of possible concern (3).
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References
- Jacobson SJ, Jones K, Johnson K, Ceolin L, Kaur P, Sahn D, Donnenfeld AE, Rieder M, Santelli R, Smythe J, Pastuszak A, Einarson T, Koren G. Prospective multicentre study of pregnancy outcome after lithium exposure during first trimester. Lancet 1992;339:530–3.
- Verbeeck RK, Ross SG, McKenna EA. Excretion of trazodone in breast milk. Br J Clin Pharmacol 1986;22:367–70.
- Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:137–50.
Q&A about Trazodone
Can Trazodone (50mg) be safely ingested with alcohol?
Get you get messed up on the pill "Trazodone?"
I have a teenage daughter who has a tendency to take my pills and share them with her friends.
Would this be one I need to keep an eye on?
I've been prescribed trazodone to help with insomnia. It's a 10 mg pill and I've been instructed to take half. I have a 2 year old and I need to be able to get up with her when she wakes in the mornings. So I was wondering when I would need to take it in order to be up when she wakes up. Thanks for the help. I will try to call the pharmasist tomorrow. I guess I'm asking whether it's too late to take it tonight or not.
I read that it would be useful to reduce the level of serotonin in my GI tract. Is that true? And if so, will trazodone provide the necessary chemicals to reduce those levels?
http://en.wikipedia.org/wiki/Trazodone
It would be my first time taking it. I've been on Citalopram (Celexa) 10 mg for over a month now. I'm having a lot of trouble sleeping and my doctor prescribed me one pill of Trazodone/Desyrel at bedtime.
I take lamictal and welbutrin for bi-polar disorder. They both make sleeping difficult. My psychiatrist prescribed trazodone. I'm am taking 25 - 50 mgs and I find that I have no energy and have to take a nap every day. But without it I can't sleep at night with or without a nap.
Has anyone had a similar problem and what did you do?
I just started taking Trazodone for sleep and anxiety, but I find that after I go to sleep, I have the most stressful dreams. It's like the anxiety moves from my conscious to my sub-conscious. I don't have "scary" dreams, just VERY stressful dreams like being lost in a foreign country or my husband cheating on me. (I don't think I worry about these issues though.) Anyone else experience stressful dreams on this drug?
see if it is a side effect or call your drug store
I have insomnia and the only thing thats worked for me so far is to take 2mg of lunesta and 50mg of trazodone to fall asleep. I have tried everything and this is the only that has worked that keeps me asleep for 5 1/2 hrs and then i can get back to sleep for antother 1-2 hrs. Has anyone had bad experiences with this? My doctor says its safe to take but im not sure. I wasnt depressed before the insomnia (1 month ago) so im wondering if it will do more harm than good. I tried all the relaxation stuff and nothing works, my mind won't let me sleep! I've been taking it for 3 days now after many nights on unrestful sleep or no sleep. Just wondering what your experiences are... thanks in advance for any advice.
50mg is a low dose, so if you're doing well with that - wonderful.
It is not habit forming like the other sleeping pills, and has been around for years and years, so any big problems would have come out by now (you know, like the sleep driving on Ambien).
100mg - 200mg are the most common doses needed, so if it starts not working as well in a few months, don't be afraid to ask for a prescription for the higher strength pills.
I went to the doctor last week, and she prescribed me Trazodone to help me sleep. It wasn't until just a few days ago I started having stomach pain, like someone was stabbing me, and dark green diarrhea, 99% liquid. I looked at different websites and haven't been able to link the two, so I was wondering if anyone would know?
Color on diarrhea (or any bowel movement) can come from other things, such as food you ate. For example, when I drink grape Crystal Light, I get green BMs all the time. You could be looking at a combination of foods and some colorant from the pills.
However, if you are having diarrhea, you should contact your doctor tomorrow.
I had to take 60mg of temazapam to get to sleep and the doctor said that was too much. So she gave me 50mg of trazodone to get to sleep tonight. Will I be able to sleep? She also wrote me a script for Prozac and I took 1 today for the first time, but I do not feel any different.
