Is Trazodone safe to use a single time?

January 24, 2016 5:13 PM

I am being offered a single dose of this drug by a nurse friend, because of an upcoming very sleepless night. I wiki'd the drug and am rethinking it - am I going be wandering the halls of the hospital and not remember it next morning, am I going to die, have nightmares, have an erection lasting more than 4 hours? What can I expect (a really good night's sleep?), and do you think I should do it?
posted by jbickers to Health & Fitness (36 answers total)

I didn't do well on trazodone-- it made me too groggy to function the next day, and I had some nasty headaches. But I didn't think it was usually prescribed in single doses-- more of a long term safe insomnia treatment?
posted by frumiousb at 5:17 PM on January 24, 2016

Funny, I used it for the first time last night (waiting for prescription refill on my usual sleep medicine, very difficult first part of the night). No crazy side effects, except that I felt tired in the morning but not tired enough to sleep. I do think that I got more sleep with it than I would have without it, but there may also have been a placebo effect.
posted by sorrygottago at 5:25 PM on January 24, 2016

I used it a few times and it helped me sleep. No ill effects. But I don't think you should be getting prescription medicine from friends! Go to the doctor! How do you know the dose is right for you? Have you tried something more benign but potentially equally effective (Advil PM)?
posted by three_red_balloons at 5:27 PM on January 24, 2016 [2 favorites]

There are effective over-the-counter sleep aids that have far fewer potential side effects than Trazodone. Have you tried any of those?

Also, this nurse is kind of disturbed that someone with an RN license is passing along a prescription drug to someone who's never taken it before and doesn't know what kind of effect it might have.
posted by jesourie at 5:28 PM on January 24, 2016 [20 favorites]

I've had mixed results with trazodone for insomnia. Sometimes it works, more often it doesn't. Every time I take it people comment the next day how tired I look, even though I feel fine. No side effects other than that. I've taken many different things for insomnia and so it's nice to have in the arsenal. My doctor told me it's an off-label rx for insomnia and told me to use as needed. I don't believe you have to take long term to build it up, but one might if rxed for depression.
posted by dta at 5:29 PM on January 24, 2016

I took half of one one night when I was really desperate some years ago, and I was unimpressed.

I swear by my beloved doxylamine succinate, half a dose, available OTC everywhere. It's the version of Unisom (or [Drugstorename]som) that is NOT dyphenhydramine/Benadryl.
posted by Lyn Never at 5:30 PM on January 24, 2016 [1 favorite]

Response by poster: To be clear, it would be given to me by a nurse, on the direction of her doctor. I still have a fear of sleepwalking if I take it.
posted by jbickers at 5:30 PM on January 24, 2016

Her doctor is telling her to give you this drug without ever having met you or examined you personally? As a nurse she should know way better than to think that's a good plan.
posted by jesourie at 5:34 PM on January 24, 2016 [5 favorites]

So it would be prescribed for you? That's better. I agree 1000% with jesourie above that no one should be taking meds that someone is just handing out willy-nilly.

That said ... if your "upcoming very sleepless night" will be in the hospital, no drug is going to guarantee you a good night's sleep. The hospital is a HORRIBLE place to try to sleep.
posted by shiny blue object at 5:35 PM on January 24, 2016

Response by poster: It's a doctor who is treating me this very week.
posted by jbickers at 5:37 PM on January 24, 2016

This is almost impossible to answer. Why are you expecting the upcoming sleepless night? Do you normally have problems falling asleep? What else have you tried? Have you had any drugs in the same family? What other drugs are you on, if any? Are you allergic to anything? Etc etc.

The potential side effects that you've already read are spelled out per FDA regulations. Anything we tell you is just going to be more noise - you can see wildly varying responses already.

I see your update that it's a doctor prescribing it to you - then why do you trust us over them, or the nurse? I know this is a non-answer but I think you should get a legal formal prescription for something - your GP should be able to give you something as a one-off sleep aid.
posted by desjardins at 5:40 PM on January 24, 2016 [2 favorites]

When I was prescribed trazadone, my dr advised me of the "trazadone window " that you get for about the first 30 minutes or so after taking it. Be ready to fall asleep in that window or else you'll have a hard time. He also had me take a melatonin with it. He said the melatonin helped you get into a deeper, longer stage of sleep. It did make me feel tired in the mornings sometime but I never walked around or did anything crazy.
posted by pearlybob at 6:05 PM on January 24, 2016

If it's just one night, is there any reason you can't just down a bunch of benadryl?
posted by gloriouslyincandescent at 6:13 PM on January 24, 2016

I say take it. It is prescribed to you. If it does not work, you are no worse off than not taking it and being sleepless. I am not a doctor. I am someone who trusts his doctor. I am also someone willing to try a prescribed medicine at least once. YMMV.
posted by AugustWest at 6:19 PM on January 24, 2016

Can you ask for Lunesta instead?
posted by myselfasme at 6:33 PM on January 24, 2016

I've taken it on and off without issue - just some dry mouth in the morning. But there absolutely is a 30-ish minute window after taking it that you have to try to fall asleep during otherwise it won't work (in my experience and per the doc that prescribed it). Have you asked about Xanax or something similar? I'm not sure trazodone would be helpful in an uncomfortable sleeping situation (vs insomnia at home in your own bed and bedroom optimized for good sleep).
posted by melissasaurus at 6:39 PM on January 24, 2016

Response by poster: If it does not work, you are no worse off than not taking it and being sleepless.

... Or sleepwalking the halls the hospital I'm in and maybe getting arrested for doing something stupid?
posted by jbickers at 6:40 PM on January 24, 2016

My mother use to take it, and would occasionally give me one if I was having trouble sleeping. I had no history of sleep walking before, or during the times I took it. If you don't have a predisposition to sleep walking, I'd try it - since it's under your doctors orders. He's a smart dude, he knows what he's doing.
posted by INFJ at 6:42 PM on January 24, 2016

I have a prescription for trazodone for anxiety and depression, both of which were keeping me from sleeping, so the sleep-aide was a happy side effect. The only real side effects I've had are dry mouth and being groggy in the mornings when I first started taking it.
posted by raw sugar at 6:48 PM on January 24, 2016

Don't be just taking something not prescribed to you because your friend is a nurse. Come on.
posted by discopolo at 6:48 PM on January 24, 2016 [1 favorite]

If something did go wrong, I would think the hospital would be a safer place to be than at home, because nurses are always around. That said, if you sleep fine most of the time, one sleepless night shouldn't really be that rough on you. I can imagine if you took it your anxiety about the pill might contribute to more insomnia anyway. I would just go into it assuming you may not sleep for one night, and skip the pill. I agree that in a loud environment like a hospital it may not help that much.
posted by three_red_balloons at 6:49 PM on January 24, 2016

At this point I'm wondering if it'll have any effect on your sleep at all because you're so anxious about taking it.
posted by desjardins at 6:53 PM on January 24, 2016 [9 favorites]

If you're going to be in a hospital, can you call the doctor who is admitting you to the hospital and get a prescription for something mild that might help you relax?

I guess I'm questioning why trazodone specifically, as opposed to a milder, more common medication. Your doctor can recommend something.
posted by decathecting at 7:10 PM on January 24, 2016 [1 favorite]

Dude, if you're in the hospital, you're not going to get arrested for having a bad reaction to a prescribed medication.

OK, that sounded harsh. But you seem to be freaking out a bit about the possibility of sleepwalking, and I think that's out of proportion to any actual risk.
posted by shiny blue object at 7:10 PM on January 24, 2016 [10 favorites]

I've probably tried more sleeping pills available in North America than everybody I know, over a long period of time -- everything from chloral hydrate to OTC junk to everything prescribed off-label to every benzo and Z-drug -- and this NOT A DOCTOR hardcore insomniac thinks you are far, far too excited over a drug that some people take daily for depression. The odds of it doing anything particularly exciting are astronomical. Erowid reports are pretty unremarkable (note that the bad experiences tend to involve large doses taken deliberately to see if fun would result -- no -- or people with other issues, like mental health problems or polydrug use).

It makes me feel a little bit stupid, not in a pleasant way, and does not put me to sleep, though it can help another soporific drug work better if taken in conjunction. If your body works like mine, the worst possible outcome is that you: do not fall asleep, and only barely notice that you have taken something, and feel like you have taken a quarter toke of some poor-quality weed and are a little dopey until it wears off.

I have a couple of friends who think it is terrific stuff for occasional sleepless nights. I suspect, but would not be so unkind as to tell them, that a placebo effect is helping them out a little bit there; I just don't think it works well enough as a sleeping pill to really do the job unless one's insomnia is very modest.

"If I were you, I'd try a smallish dose on a night when the stakes aren't high, and see how it affects you. I doubt it would harm you in any real way, but you may experience frustration and discomfort" is quite sound advice here. If you can stand taking most sedating sorts of cough/cold medicines without too much psychological bother I don't think trazodone will upset you.

If you have somebody willing to provide a prescription drug to help you fall asleep, I'd ask for a "Z-drug." Also, I am skittish about unfamiliar drugs because a bad sleeping pill can give me anxiety, but in a hospital? In that setting I would cheerfully snort elephant tranquilizers if a physician gave me the go-ahead. I take it the hospital staff will know you are taking this? "I feel like I am having a bad reaction to the trazodone" will presumably bring help. AFAIK there would not be a problem with a doctor giving you a Valium or similar on top of the trazodone to send you off to bed and not wandering the halls (which I really, really do not think will happen).

Man, I wish this was not an area of pseudo-expertise for me. Also, I assume anecdata rather than medical advice was what was wanted here.
posted by kmennie at 7:40 PM on January 24, 2016 [12 favorites]

Or sleepwalking the halls the hospital I'm in and maybe getting arrested for doing something stupid?

The vast majority of people taking this medication do not start sleepwalking. It is, of course, possible that you'll have a bad reaction. At which unlikely point you'll be in the hospital with the nurses who gave you the medication, and they'll take appropriate action to get you back to bed.

You seem to be overthinking this a lot. If a drug to help you sleep is going to cause this much anxiety, perhaps it's not worth it?
posted by zachlipton at 9:15 PM on January 24, 2016 [2 favorites]

Sleepwalking isn't listed even among one of the rarer side effects of Trazodone, but priapism or 4+ hour erections (less than 1% incidence) is. And there isn't any evidence that Trazodone treats insomnia better than placebo.

I'm with the others in recommending trying either OTC or just some other prescription sleep medication rather than trying Trazodone, especially since the idea of taking it seems to be causing you a lot of anxiety and if you're gonna take something, might as well take one that makes you feel more at ease about the whole thing.
posted by maykasahara at 11:48 PM on January 24, 2016

Answering just your subject line, for the vast majority of people the answer is yes. Trazodone is generally recognized as one of the safest prescription medications for insomnia.
posted by treehorn+bunny at 12:54 AM on January 25, 2016 [3 favorites]

I've used it with no side effects apart from grogginess the next morning. And that was only when I first took it.
posted by persona au gratin at 2:02 AM on January 25, 2016

Grogginess, weird dreams. Melatonin works better for me.
posted by holgate at 3:42 AM on January 25, 2016

I take Trazadone every night. Well, half a one actually. I know lots of us out there take it and it's a very mellow, safe and effective drug when taken as prescribed.

If your doctor is prescribing it, take it.
posted by Ruthless Bunny at 5:27 AM on January 25, 2016

I take 50mg every night an hour before bed. Never had any side effects. I have been taking it for 10+ years. Others have reported to me that it gives them nightmares but that is the worst I have heard.
posted by futz at 11:06 AM on January 25, 2016

I took 50mg every night for three months and it made me really groggy all the time. More so at the beginning, but it persisted to a lesser but still significant degree the entire time I took it. It also gave me very vivid dreams and I never felt like I was fully rested. Now I take 0.5mg-1mg of klonopin every night before bed and it's perfect. It's just enough to get me to sleep, stay asleep all night, and wake up enough to get out of bed on time (most of the time--I'm not much of a morning person).
posted by E3 at 12:43 PM on January 25, 2016 [1 favorite]

Overnight psych nurse here. At my hospital, we'd just make sure you stayed in my bed.

Most of my patients get trazodone for sleep while they're admitted. The only one I've seen sleepwalk got Ambien, not trazodone.

Standard disclaimer: I am not your nurse; only take what a doctor has prescribed for you, etc.
posted by RainyJay at 1:34 PM on January 25, 2016

I used Trazadone for about 9 months. It made me a bit sleepy, but not too groggy. Your mileage will vary.

Give yourself a good 8 hours after you take it to sleep and you should be fine.
posted by tacodave at 3:11 PM on January 25, 2016

I think you're confusing Trazedone with Ambienand Lunesta. Ambien is the sleep med with all of the weird publicity about "I just bought $10,000 worth of Amazon products in the middle of the night, drove halfway to the next state, and ended up in jail" side effects. Trazedone is an old SSRI (like Prozac) that was a bad anti-depressant because it made patients sleepy. So presto, now they sell it as a sleep drug.

I took Trazedone for months, maybe even a couple of years, and never sleepwalked once. I did get progressively groggier and it got worse at helping my insomnia, so I stopped taking it. Now (after consulting with my doc), I take benedryl, which works far better, and leaves me much less groggy in the morning.

Maybe your doctor would prescribe you a single Xanax. It seems like you're feeling really anxious (understandable), and Xanax always seems to knock me out when I take it. And also makes me less anxious, of course.
posted by instamatic at 7:24 PM on January 25, 2016