Trazodone is a prescription medication that is used to treat depression and anxiety. It is also commonly prescribed off-label for insomnia, even though it is not FDA-approved for this use. Trazodone works by increasing the levels of serotonin in the brain, which can help improve mood and induce sleepiness. At lower doses, such as 50-100 mg, trazodone is more sedating and is often used for sleep. At higher doses, such as 150-600 mg per day, it acts more as an antidepressant.
Quick Answers
– Yes, it is possible to take 200 mg of trazodone for sleep, but this is considered a high dose.
– The maximum recommended dose for insomnia is usually 100 mg per night. Doses over 100 mg are associated with increased side effects.
– Taking 200 mg of trazodone can help with sleep onset and maintenance, but may cause residual daytime sleepiness.
– It is best to start with a lower dose such as 25-50 mg and increase slowly as needed and as tolerated.
– Your doctor may prescribe up to 200 mg for sleep if lower doses are not effective and the benefits outweigh the risks.
How much trazodone can you take for sleep?
The recommended dosage of trazodone for insomnia is between 25-100 mg taken 30 minutes before bedtime. Lower doses, such as 25-50 mg, are usually tried first. The maximum FDA-approved dose for depression is 400 mg per day, but doses above 100 mg are not typically used for insomnia. Taking more than 100 mg of trazodone for sleep is considered off-label use.
Some doctors do increase the dose to 200 mg per night for sleep if lower doses are not effective. However, doses higher than 100 mg are more likely to cause side effects like residual daytime drowsiness, dizziness, dry mouth, and headache. There is also an increased risk of priapism, or persistent and painful erections, in males when taking over 200 mg of trazodone per day.
Therefore, it is best to take the lowest effective dose possible for insomnia symptoms. Your doctor may cautiously increase your dose above 100 mg if needed, but do not exceed 200 mg per dose unless directed by your doctor. Always follow your doctor’s specific dosage recommendations for trazodone.
Maximum recommended dose for insomnia:
– Initial dose: 25-50 mg per night
– Maximum dose: 100 mg per night
– Doses above 100 mg are considered off-label use
Is 200 mg of trazodone safe for sleep?
While 200 mg of trazodone may help induce and maintain sleep, this higher dose is associated with an increased risk of certain adverse effects:
Potential side effects of 200 mg trazodone:
– Excessive sedation and drowsiness the next day
– Increased risk of falls, especially in the elderly
– Headache, dizziness, lightheadedness
– Dry mouth, blurred vision, nasal congestion
– Nausea, vomiting, diarrhea, constipation
– Difficulty concentrating and confusion
– Irregular heart rhythms
– Priapism (painful, long-lasting erections) in men
Lower doses around 50 mg are less likely to cause as many bothersome side effects compared to higher doses. Therefore, it is considered safer to first try lower doses of trazodone for insomnia.
200 mg may be considered if lower doses are not effective and if the benefits outweigh the potential risks. Your doctor will monitor you for any adverse reactions at this higher dosage.
What are the benefits of a 200 mg dose of trazodone for sleep?
There are some benefits associated with taking a higher 200 mg dose of trazodone for treating insomnia:
Potential benefits of 200 mg trazodone for sleep:
– Faster onset of sleep
– Increased total sleep time
– Improved sleep quality and depth of sleep
– More time spent in slow wave and REM sleep
– Increased sedation and drowsiness to fall asleep faster
– May help sleep stay asleep better through the night
– Less time spent awake at night after falling asleep
Compared to lower doses around 50 mg, a dose of 200 mg can provide greater improvements in sleep maintenance throughout the night. The higher dose provides more powerful sedation to counteract middle of the night or early morning awakenings.
This higher dosage also helps fall asleep faster than lower doses, which only start to work after 30-45 minutes. The 200 mg dose exerts its sedating effects more quickly.
For those with severe or treatment-resistant insomnia, 200 mg may provide better sleep benefits than lower doses. However, the risks and side effects need to be carefully considered before using such a high dose.
How long does 200 mg of trazodone last for sleep?
When taken by mouth, a 200 mg dose of trazodone reaches peak concentrations in the blood anywhere from 1-6 hours. Effects are usually felt within 30-45 minutes.
The half-life of trazodone ranges from about 5-9 hours on average. This is the time it takes for the concentration in the blood to decrease by half.
Most people fall asleep within 30-90 minutes after taking trazodone and can stay asleep for 6-8 hours with a 200 mg controlled-release tablet. However, some of the sedating effects may still linger into the next day.
Expect trazodone to help you fall and stay asleep for about 7-9 hours at a dose of 200 mg. The sleep-inducing effects will taper off towards the early morning hours.
Trazodone also has an active metabolite called m-chlorophenylpiperazine with a half-life up to 12-24 hours. This can further extend the duration of action.
Plan on taking trazodone 30 minutes before bedtime and expect it to help you sleep for most of the night. The next day you may still feel some residual drowsiness or sleepiness from this medication.
Is it better to take 200 mg of trazodone at once or split the dose?
With a higher dose of 200 mg trazodone for insomnia, it is usually recommended to take it all at once about 30 minutes before bedtime.
Taking the full 200 mg dose at one time provides faster onset of sleepiness compared to splitting it into two 100 mg doses. By taking the whole dose at night, trazodone levels reach higher concentrations faster to help induce sleep.
Splitting a 200 mg dose into two 100 mg doses taken a few hours apart may decrease side effects like next day drowsiness. However, this may also decrease effectiveness for sleep through the second half of the night.
There are also extended-release trazodone tablets that are designed to be taken as a single dose at bedtime. These slowly release the medication over several hours.
In summary for a 200 mg dosage:
– Take the full dose 30 minutes before bed for fastest effects
– Taking 100 mg twice per day is less optimal for sleep
– Extended-release tablets give one single dose for the full night
Always follow your doctor’s specific recommendations on how to split higher doses of trazodone if needed. Taking the full 200 mg dose at once is usually preferred.
How long can you safely take 200 mg of trazodone for sleep?
Trazodone is considered safe for short-term and long-term use at prescribed doses. There is no strict limit set for how long someone can take a higher dose of 200 mg trazodone for insomnia.
However, it is meant for short-term use for insomnia lasting from days to a few weeks. Trazodone is not intended for months or years of uninterrupted use at 200 mg, especially off-label at higher doses.
It is recommended that after taking a 200 mg dose continuously for several weeks, you consult your doctor to re-evaluate if it is still needed. It is not advised to take any sleeping pill for an indefinite period of time.
Your doctor will also monitor you for adverse effects and may recommend drug holidays from trazodone or slowly tapering the dose down if used regularly long-term. Developing tolerance is also possible with prolonged use where it becomes less effective over time.
To minimize risks like dependence, it is recommended to take trazodone for sleep intermittently if needing to use 200 mg long-term. Your doctor can guide you on the safest duration of use.
In general, 200 mg can be used safely nightly for a few weeks up to several months if instructed by your doctor. But it is best for short-term treatment of acute insomnia symptoms.
What are the risks and precautions with 200 mg of trazodone for sleep?
Before taking 200 mg of trazodone for sleep, it is important to discuss the potential risks and side effects with your doctor:
Risks and precautions with 200 mg trazodone:
– Increased risk of next-day drowsiness, accidents, and falls
– May cause impairments with alertness while driving
– Greater risk of cardiac side effects like arrhythmias
– Higher chance of priapism (prolonged erections) in men
– Potential worsening of sleep apnea symptoms
– Higher rates of headache, dizziness, lightheadedness
– Increased sedation and cognitive impairment
– Greater drug interactions with other medications
– Risk of dependence and withdrawal with prolonged use
– Not recommended in pregnant or breastfeeding women
Due to these risks, doctors will screen patients for pre-existing health conditions that may be worsened by trazodone. Your doctor will also monitor you closely for side effects if prescribing this higher dose.
To minimize risks, take the lowest effective dose for the shortest duration needed. Do not stop trazodone suddenly if used long-term. Also avoid alcohol and other sedatives when using trazodone.
Who should not take 200 mg of trazodone?
Certain individuals are advised not to take 200 mg doses of trazodone due to increased risks:
– People over the age of 65 (risk of falls/fractures)
– Those with heart conditions or arrhythmias
– People with sleep apnea or respiratory disorders
– Individuals with bipolar disorder or suicidal thoughts
– Those taking MAOIs, SSRIs, or other antidepressants
– People with liver or kidney disease
– Men at risk for priapism (prolonged erections)
– Pregnant or breastfeeding women
Elderly patients above 65 years old are at higher risk of side effects like excessive sedation, confusion, and balance issues that may increase falls. Lower doses less than 100 mg are recommended.
Those with pre-existing heart conditions also have a greater risk of irregular heart rhythms from higher doses. And men are at increased risk of the serious side effect of priapism when taking over 200 mg per day.
Your doctor will evaluate your medical history and other medications before prescribing trazodone at 200 mg. Inform your doctor of any pre-existing conditions or other drugs you are taking.
Does trazodone still work after years of use?
With regular, long-term use over months to years, trazodone may become less effective for sleep due to tolerance developing. This means your body adapts to the effects of the medication over time.
After taking trazodone regularly for years, its sleep-promoting benefits may decrease – a phenomenon known as tachyphylaxis. Higher doses may be needed to get the same results as initially experienced.
One study found that after 12 months of continued trazodone use for insomnia, its efficacy declined by 50-60%. Just over half of patients still reported trazodone as effective after 1 year of use.
In another study looking at long-term efficacy after 5 years, only 15% of patients said trazodone was still working well for their insomnia. About half felt it had minimal benefits after several years of continuous use.
To help prevent tolerance, it is recommended to take periodic drug holidays from trazodone for 1-2 weeks. Allowing your body to reset can help restore its sensitivity to the medication. Switching to alternative sleep aids can also help.
Under your doctor’s guidance, trazodone may still provide sleep benefits after long-term use, but tolerance does occur in some chronic users leading to decreased effects. Periodic breaks can help.
Conclusion
In summary, trazodone at 200 mg is an off-label and higher-end dosage for treating insomnia. While this higher amount may induce sleep more powerfully, there are more risks of side effects like pronounced sedation, dizziness, and cardiac issues. It is best to start with lower doses like 25-50 mg taken 30 minutes before bedtime.
Your doctor may cautiously increase your trazodone dosage above 100 mg if needed for stubborn insomnia symptoms. However, do not exceed 200 mg per dose unless directed and monitored closely by your doctor. Taking the lowest effective dose for the shortest time can help minimize risks when using trazodone for sleep issues.
