Key points
- Major depressive disorder in adults is the only FDA-approved use, and trazodone for sleep is off-label.
- It is sold today as a generic: MedlinePlus lists the Desyrel and Oleptro brands as no longer on the market.
- The label warns about heart rhythm problems, so a history of heart disease or arrhythmia matters.
- An erection lasting more than 4 hours is a medical emergency, according to the label.
- The label advises lowering the dose gradually rather than stopping suddenly whenever possible.
What trazodone is
Trazodone is an antidepressant that the label describes as both a selective serotonin reuptake inhibitor (SSRI) and a blocker of a serotonin receptor called 5HT2. MedlinePlus calls it a serotonin modulator. MedlinePlus lists its former brands, including Desyrel and Oleptro, as no longer on the market, so you will usually see it under its generic name.
What it is approved for, and off-label uses
The Food and Drug Administration (FDA) label lists one use: major depressive disorder in adults. It is not approved for children and teens.
Sleep is not on the label, so using trazodone for it is off-label. MedlinePlus says it is sometimes used to treat insomnia and anxiety, and the National Institute of Mental Health (NIMH) says antidepressants are in some cases prescribed for conditions such as anxiety and insomnia. Off-label means the use is outside what the FDA has approved for this medicine, so ask your prescriber about the risks and other options for your situation.
MedlinePlus also names a few other off-label uses, which are not covered on this page. Your prescriber can tell you more.
How it is thought to work
The label says trazodone's antidepressant action is not fully understood, but it is thought to be related to its effect on serotonin activity in the brain. It blocks serotonin reuptake and also blocks 5HT2 receptors, and the label says the net result of these actions is unknown.
What taking trazodone can be like
The label says tablets are taken shortly after a meal or light snack. Drowsiness and dizziness are among its common effects, and it cautions against driving or using machinery until you are reasonably sure the medicine does not affect you. MedlinePlus says alcohol can make side effects worse, and to ask your doctor about grapefruit.
Blood pressure can drop when you stand, and the label reports fainting. Tell your prescriber about dizziness or fainting, and about any blood pressure medicine you take.
MedlinePlus says it may take 2 weeks or longer to feel the full benefit for depression. NIMH notes that finding the right medicine can take several tries.
Do not stop trazodone suddenly or without talking to your prescriber. The label lists nausea, sweating, irritability, agitation, dizziness, electric shock sensations and other symptoms after stopping, particularly abruptly, and says to lower the dose gradually whenever possible.
Side effects and warnings
Boxed warning: antidepressants increased the risk of suicidal thoughts and behaviors in children, teens and young adults in short-term studies. Everyone taking an antidepressant should be watched closely for worsening and for new suicidal thoughts. The warning has no exception for sleep use, so mention any mood change. If you are in crisis, call or text 988 or call 911. Locascio Wellness does not provide emergency services, and our crisis resources page lists other options.
Dangerous combinations: the label says trazodone must not be taken with monoamine oxidase inhibitors (MAOIs), including linezolid and intravenous methylene blue, or within 14 days of stopping one, because of serotonin syndrome. It also says to avoid trazodone with certain medicines that prolong the QT interval, including some antiarrhythmics and antipsychotics, and with certain antifungals and antibiotics that slow its breakdown. Triptans, tramadol and St. John's wort also raise serotonin syndrome risk.
The most common side effects listed in the Medication Guide are swelling, blurred vision, dizziness, sleepiness, tiredness, diarrhea, stuffy nose and weight loss.
- Heart rhythm: the label says trazodone prolongs the QT interval and may cause arrhythmias in people with heart disease. It says to avoid it with known QT prolongation or a history of arrhythmias, and it is not recommended during early recovery from a heart attack.
- Priapism: an erection lasting more than 4 hours, painful or not, means stop the medicine and get emergency care, because untreated priapism can permanently damage tissue.
- Bleeding: the risk rises with aspirin, anti-inflammatory pain relievers or warfarin.
- Also on the label: mania in people with bipolar disorder, angle-closure glaucoma and low sodium.
Can trazodone be managed online in Pennsylvania and New York
The label says trazodone is not a controlled substance, and it describes no certified setting or restricted program. Heart history is the main thing to raise, since an ECG or blood tests cannot happen over video. Ask how those would be arranged if your prescriber wants them.
A licensed psychiatrist on our team, a Doctor of Osteopathic Medicine (DO), treats depression online by secure video, for people physically located in Pennsylvania or New York during each visit. Whether it is an option for you is a decision for you and your prescriber. Ask us whether our psychiatrist can help. Our overview of medications for depression gives wider background.
Our therapists do not prescribe. They see clients in Pennsylvania, West Virginia, Arizona, Colorado and Florida, not New York, so a New York reader can get psychiatry here but not therapy here. Ask us about fees and coverage.
Common questions
Is trazodone approved for sleep?
No. The FDA label lists major depressive disorder in adults as its approved use. MedlinePlus says trazodone is sometimes used to treat insomnia, which is an off-label use. The boxed warning and other label warnings still apply when it is used that way. Ask your prescriber about the risks, and about other options for sleep problems.
Is a long-lasting erection on trazodone an emergency?
Treat it as one. The label says men with an erection lasting more than 4 hours, painful or not, should stop the medicine and get emergency medical care right away, because untreated priapism can permanently damage the tissue. Call 911 or go to an emergency room. Tell your prescriber afterward, and mention beforehand any condition that makes priapism more likely.
Should I tell my prescriber if I am pregnant or breastfeeding?
Yes. Tell your prescriber if you are pregnant, planning a pregnancy or breastfeeding, and do not stop trazodone on your own because of it. Your prescriber can go over what the label says about your situation. Share every medicine and supplement you take as well, since several can interact with trazodone, including heart and migraine medicines.
Sources
Published by Locascio Wellness. Published November 5, 2026. Clinically reviewed by Kenneth M. Levy, DO, Psychiatrist (Pennsylvania license OS007464L). This page is general information, not medical advice or a diagnosis.