Trazodone and Alcohol Don’t Mix: Here’s Why

Trazodone and Alcohol: Can I Take Them Together?

Trazodone and alcohol don’t mix. If you’re taking Trazodone for depression, you should avoid drinking alcohol. Mixing these two substances can strengthen the effects of each and lead to adverse impacts such as accidents, injuries, health complications, and overdose.

What Is Trazodone?

Trazodone is a member of a class of drugs known as serotonin receptor antagonists. It’s FDA-approved to treat major depressive disorder, and it works by balancing the amount of serotonin in the brain. Trazodone is more commonly prescribed off-label to treat sleep disorders like insomnia or other sleep problems. [1]

Trazodone Dosages and Instructions

Trazdone is FDA-approved to treat major depressive disorder. If you’re prescribed this medication for depression, your healthcare provider will likely start you on an initial dose of 150 mg per day. [2] This dose will be divided so you can take it throughout the day.

It’s advised to take Trazodone after a snack or light meal. If you don’t respond to the initial dose, your doctor may recommend increasing it by 50 milligrams every three or four days until the drug begins to work. Never increase your dose on your own; only under the direction of a medical professional. It may take up to two weeks for Trazodone to begin addressing symptoms of depression.

The maximum dosage of Trazodone is 400 milligrams per day for outpatient use and 600 milligrams per day for inpatient use. If you begin responding to treatment and are doing well on the medication, your healthcare provider may gradually reduce the dose to maintain your condition. It’s generally recommended to take the lowest dose of Trazodone possible while still maintaining its benefits.

What to Know About Taking Trazodone

Serious Side Effects of Trazodone

When taking Trazodone, there are some things you need to know about this antidepressant medication, including some of the side effects to look out for. While common side effects might include fatigue, a stuffy nose, and constipation, there are other, more serious side effects associated with this drug. Side effects that warrant a call to the doctor include: [3]

• Hives or signs of an allergic reaction
• New or worsening symptoms of depression
• An erection that lasts six hours or more, or is painful
• Easy bruising
• Unusual bleeding
• Atypical thoughts or behaviors
• Shortness of breath
• Pounding heart
• Dizziness
• Faintness
• Confusion
• Severe weakness
• Slurred speech
• Suicidal thoughts

Risk of Serotonin Syndrome

Since Trazodone interacts with the brain chemical serotonin, it poses a risk of serotonin syndrome. This syndrome is a result of too much serotonin in the brain and can be life-threatening. Signs and symptoms of serotonin syndrome include: [4]

• Rapid heart rate
• Agitation
• Hallucinations
• Muscle stiffness
• Muscle twitching
• Sweating
• Shivering
• Loss of coordination
• Vomiting
• Diarrhea
• Fever
• Nausea

Trazodone Withdrawal Symptoms

If you’ve decided to stop taking Trazodone, tell your doctor. They may want to taper your dose to prevent uncomfortable or dangerous withdrawal symptoms, including: [5]

• Headache
• Nausea
• Flu-like symptoms
• Dizziness
• Insomnia
• Confusion
• Anxiety
• Mood disturbances

Trazodone Drug Interactions

Alcohol isn’t the only substance that should be avoided while taking Trazodone. Other medications may cause dangerous drug interactions, including: [6]

• Any other antidepressant
• St. John’s Wort
• Tramadol
• Diuretics
• Blood thinners
• Phenytoin
• Anxiety medications
• Medications for schizophrenia
• Migraine medications such as Maxalt, Treximet, and Imitrex

Trazodone Disease Interactions

Always tell your doctor about any other medical conditions you have before taking a new prescription. Trazodone might not be safe to take if you have certain health concerns or conditions, such as: [7]

• Liver disease
• Kidney disease
• Bipolar disorder (formerly, manic depression)
• Substance use disorder, including alcohol use disorder
• Heart disease
• Recent heart attack
• Epilepsy or seizures
• Narrow-angle glaucoma
• Long QT syndrome
• A bleeding or blood-clotting disorder
• Suicidal thoughts

Dangers of Mixing Trazodone with Alcohol

There is no safe use of alcohol while taking Trazodone. Even one or two drinks can cause serious adverse effects. [8]

Risk of Injuries from Falls

Studies show people who take Trazodone are at an increased risk of falls, especially senior citizens. [9] Using alcohol while taking this antidepressant medication may increase this risk. Falls are responsible for many life-threatening injuries, especially among the elderly.

Risk of Trazodone Overdose

Trazodone has sedative effects and can cause CNS depression, especially at higher doses or when combined with other CNS depressants like alcohol, but it is not classified as a primary CNS depressant. Taking them both together increases the risk of Trazodone overdose. If you or a loved one is taking Trazodone, it’s essential to be aware of the signs of a potentially fatal overdose: [10]

• Extreme drowsiness
• Vomiting
• Prolonged or painful erection
• Rapid or pounding heartbeat
• Seizures
• Slowed breathing
• Coma

Other substances besides alcohol can also increase the risk of a fatal Trazodone overdose, including barbiturates and sedatives.

Worsening Depression

Both Trazodone and alcohol pose a risk of worsening depression, so taking them both together increases this risk. To make matters worse, Trazodone can cause suicidal thoughts in specific populations, such as teens and young adults. It’s critical to notify a healthcare professional right away if you experience any of the following mood changes: [11]

• Hostility
• Aggressive behavior
• Increased restlessness
• Increased anxiety
• Panic attacks
• Hyperactivity
• Feeling more depressed
• Irritability or agitation
• Thoughts of self-harm
• Thoughts of suicide

Liver Damage

Both Trazodone and alcohol can cause liver damage, so consuming both at once can pose an even greater threat to the liver. Liver toxicity with Trazodone is rare but has been reported in isolated cases, usually associated with preexisting liver dysfunction or overdose. Liver disease or damage doesn’t always cause symptoms, but when it does, there may be signs such as: [12]

• Swelling in the legs/ankles
• Yellowing of the skin or eyes
• Easy bruising
• Constant fatigue
• Dark urine
• Pale stool
• Loss of appetite
• Pain or swelling in the abdomen
• Itchiness
• Nausea
• Vomiting

Other Medications to Avoid With Alcohol

Drinking alcohol not only interacts with Trazodone. It can worsen the side effects and adverse risks of many other medications, including: [13]

• Selective serotonin reuptake inhibitors
• Serotonin and norepinephrine inhibitors
• Buspirone
• Hydroxyzine
• Tricyclic antidepressants
• Benzodiazepines
• Melatonin
• Diphenhydramine
• Doxepin
• Ambien
• Ramelteon

Signs of Alcohol Addiction

If you’re thinking about taking Trazodone and you’re having a hard time abstaining from alcohol, this could be a sign of substance abuse or addiction. Other signs of alcohol use disorder may include: [14]

• Increasing alcohol consumption to get the same level of intoxication (i.e., building tolerance)
• Intense cravings for alcohol
• Giving up other activities you enjoy because of drinking
• Using alcohol in risky situations (e.g., drinking and driving)
• Spending a lot of time acquiring alcohol, drinking alcohol, or recovering from alcohol consumption
• Failing to meet deadlines or other responsibilities due to alcohol use
• Unsuccessful attempts to reduce the amount you drink or to stop drinking.
• Continuing to use alcohol even though it’s causing problems in your life

If you’re trying to quit drinking, it’s best to seek assistance from a substance use and rehabilitation counselor. Quitting on your own could lead to potentially life-threatening withdrawal symptoms. A treatment center can provide a medically-assisted detox so that you can quit safely and comfortably. Medical detox typically includes around-the-clock supervision by a staff of medical professionals.

Alternatives to Trazodone

If you do drink alcohol or have a history of alcohol use disorder, tell your doctor. There may be safer alternatives to treat depression or insomnia. Both conditions often respond well to healthy lifestyle changes, particularly increased exercise and improved sleep hygiene. A healthy diet including lean proteins, leafy greens, and whole grains may also have a positive effect on mood and sleep quality. Avoiding both alcohol and caffeine could also assist with recovery. Be sure to talk to your doctor before starting a new diet or exercise program.