Is Trazodone a Controlled Substance? Understanding This Sleep and Depression Medication

If you're struggling with insomnia or depression, you may have heard of trazodone. One of the most common questions patients ask is whether it's a controlled substance—and for good reason. Understanding a medication's potential for dependence is important when making treatment decisions.

At Next Step Psychiatry in Lilburn, GA, we help patients understand their medication options so they can make informed choices about their care.

Is Trazodone a Controlled Substance?

No, trazodone is not a controlled substance. This means the risk for dependence and misuse is low compared to controlled medications like benzodiazepines (Xanax, Ativan) or sleep aids like Ambien.

This is one reason trazodone has become a popular option for treating insomnia—especially for patients concerned about becoming dependent on sleep medication.

What Is Trazodone Used For?

Trazodone was originally FDA-approved to treat major depressive disorder. However, due to its sedating effects, it's now more commonly prescribed off-label for:

• Insomnia (the most common use today)
• Anxiety

"Off-label" doesn't mean unsafe—it means the medication is being used for purposes beyond its original FDA approval, based on scientific research supporting its effectiveness.

How Does Trazodone Work?

Trazodone is classified as a serotonin antagonist and reuptake inhibitor (SARI). It affects serotonin levels in the brain, which influences mood regulation. Its sedating effects come primarily from its antihistamine properties—not its effects on serotonin.

For sleep, trazodone is typically prescribed at lower doses (50-200mg) compared to the doses used for depression (150-600mg).

Trazodone vs. Other Sleep Medications

Compared to controlled sleep medications, trazodone offers some advantages:

• Lower addiction risk: Unlike benzodiazepines or Z-drugs (Ambien), trazodone isn't habit-forming
• Can be used long-term: Many controlled sleep aids are only recommended for short-term use
• No scheduled drug concerns: Easier to refill prescriptions without additional restrictions

However, trazodone may not be right for everyone, and more research is needed on its effectiveness for chronic insomnia.

Is Trazodone Like Xanax?

No. Trazodone and Xanax are different medications with distinct purposes:

• Trazodone: Antidepressant primarily used for insomnia; not a controlled substance
• Xanax: Benzodiazepine primarily used for anxiety and panic disorder; is a controlled substance with higher addiction potential

While both can cause drowsiness, Xanax has a much higher risk of dependence and abuse.

Potential Side Effects

Common Side Effects

• Drowsiness
• Dizziness
• Dry mouth
• Nausea
• Headache

These usually don't require medical attention unless they're bothersome or persistent.

Serious Side Effects (Contact Your Doctor)

• Signs of allergic reaction (rash, swelling, difficulty breathing)
• Unusual bruising or bleeding
• Fast or irregular heartbeat
• Prolonged or painful erection (priapism)—seek immediate medical attention
• Signs of serotonin syndrome (confusion, rapid heart rate, muscle rigidity)
• Worsening depression or suicidal thoughts

What to Tell Your Doctor Before Taking Trazodone

Make sure your psychiatrist knows if you have:

• Heart disease or irregular heartbeat
• History of suicide attempts or suicidal thoughts
• Bipolar disorder
• Bleeding problems
• Kidney or liver disease
• Glaucoma
• Low sodium levels

Also share your complete medication list, as trazodone can interact with many drugs including MAOIs, certain antifungals, and pain medications.

Other Depression and Insomnia Treatments

If trazodone isn't right for you, other options include:

For Depression

• SSRIs: Prozac, Zoloft, Lexapro, Celexa
• SNRIs: Effexor, Cymbalta, Pristiq
• Atypical antidepressants: Wellbutrin, mirtazapine

For Insomnia

• Sleep hygiene improvements
• Cognitive behavioral therapy for insomnia (CBT-I)
• Other non-controlled medications
• Short-term use of other sleep aids when appropriate

FAQs

Does trazodone make you gain weight?

Some people experience weight changes on trazodone, but it's not a universal side effect. Discuss any concerns with your psychiatrist.

Is trazodone used for anxiety?

Trazodone can help with anxiety due to its sedating effects, though it's not a first-line treatment. SSRIs are more commonly prescribed for anxiety disorders.

How quickly does trazodone work for sleep?

Trazodone's sedating effects typically begin within 30-60 minutes, which is why it's usually taken at bedtime.