Desyrel: Restoring Restful Sleep and Emotional Balance
Desyrel
| Product dosage: 100mg | |||
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Synonyms | |||
Desyrel (trazodone hydrochloride) is a prescription medication belonging to the class of serotonin antagonist and reuptake inhibitors (SARIs). Primarily indicated for the treatment of major depressive disorder (MDD), its potent sedative properties have made it a cornerstone in off-label management of insomnia, particularly where sleep initiation and maintenance are problematic. It works by modulating serotonin levels in the brain, which contributes to its antidepressant and sleep-promoting effects. This agent is valued for its favorable side effect profile relative to many traditional antidepressants and is available in various strengths to allow for precise dosing titration.
Features
- Active ingredient: Trazodone hydrochloride
- Available in 50 mg, 100 mg, 150 mg, and 300 mg oral tablets
- Classified as a serotonin antagonist and reuptake inhibitor (SARI)
- FDA-approved for the treatment of major depressive disorder (MDD)
- Commonly used off-label for the management of insomnia
- Requires a prescription from a licensed healthcare provider
- Typically administered orally, once or twice daily
Benefits
- Effectively alleviates symptoms of major depressive disorder, improving mood and emotional well-being.
- Promotes restful sleep by reducing sleep latency and decreasing nighttime awakenings.
- Exhibits a lower incidence of anticholinergic side effects compared to many tricyclic antidepressants.
- Lacks significant potential for abuse or dependence, making it a suitable long-term option for many patients.
- Can be used in a wide range of adult populations, including the elderly, with appropriate dose adjustments.
- Often improves anxiety symptoms that frequently co-occur with depression and sleep disturbances.
Common use
Desyrel is most frequently prescribed for the management of major depressive disorder in adults. Its efficacy in improving mood, interest levels, and overall energy makes it a first-line option for many clinicians. Beyond its approved indication, it is extensively utilized off-label for treating insomnia, especially in cases where sleep onset is delayed or sleep maintenance is poor. It is also sometimes employed in low doses to counteract insomnia caused by other antidepressants, such as SSRIs. Additionally, it may be used in certain anxiety disorders and for the management of agitation in patients with dementia, under careful supervision.
Dosage and direction
The dosage of Desyrel must be individualized based on the patient’s condition, response to therapy, and any concomitant medications. For depression, the initial dose is typically 150 mg per day in divided doses, which may be increased by 50 mg per day every three to four days. The maximum dose for outpatients usually should not exceed 400 mg per day in divided doses, and for inpatients, up to 600 mg per day. When used for insomnia, much lower doses are common, often starting at 25–50 mg taken 30 minutes before bedtime. It should be taken shortly after a meal or light snack to reduce the likelihood of dizziness or lightheadedness. Tablets should be swallowed whole and not crushed, chewed, or broken.
Precautions
Patients should be advised that Desyrel may cause drowsiness, dizziness, or impaired judgment; therefore, activities requiring mental alertness, such as driving or operating machinery, should be avoided until the individual’s response is known. Orthostatic hypotension, with associated dizziness, tachycardia, and syncope, may occur, especially during initial titration or dose increases. Priapism, a prolonged and painful erection, is a rare but serious adverse reaction requiring immediate medical attention to avoid permanent impairment. Caution is advised in patients with a history of cardiac disease, as arrhythmias have been reported. Regular monitoring of liver function and complete blood counts may be prudent during prolonged therapy.
Contraindications
Desyrel is contraindicated in patients with known hypersensitivity to trazodone hydrochloride or any component of the formulation. It must not be used concomitantly with, or within 14 days of discontinuing, monoamine oxidase inhibitors (MAOIs) due to the risk of serotonin syndrome. Its use is also contraindicated in individuals with a history of priapism.
Possible side effect
Common side effects may include drowsiness, dizziness, lightheadedness, dry mouth, blurred vision, headache, nausea, and fatigue. Less frequently, constipation, weight changes, nasal congestion, and muscle pain may occur. Serious side effects, though rare, can include priapism, serotonin syndrome (agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, diarrhea), suicidal thoughts, irregular heartbeat, and orthostatic hypotension. Any unusual or severe symptoms should be reported to a healthcare provider immediately.
Drug interaction
Desyrel has the potential to interact with several medications. Concomitant use with MAOIs is contraindicated. It may enhance the sedative effects of alcohol, barbiturates, and other CNS depressants. Caution is advised when co-administering with other serotonergic drugs (e.g., SSRIs, SNRIs, triptans, tramadol) due to increased risk of serotonin syndrome. It may potentiate the effects of antihypertensive agents and increase the risk of hypotension. Trazodone is a substrate of CYP3A4; strong inhibitors (e.g., ketoconazole, ritonavir) may increase its plasma concentration, while inducers (e.g., carbamazepine, rifampin) may decrease its efficacy.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Doubling the dose to make up for a missed one is not recommended.
Overdose
Overdose of Desyrel can be serious and potentially fatal. Symptoms may include excessive drowsiness, vomiting, priapism, respiratory depression, seizures, and cardiac arrhythmias. In case of suspected overdose, immediate medical attention should be sought. Treatment is supportive and symptomatic; there is no specific antidote. Activated charcoal may be administered if ingestion was recent. ECG monitoring is advised due to the risk of arrhythmias.
Storage
Store Desyrel tablets at room temperature, between 20°C to 25°C (68°F to 77°F), in a tightly closed container. Keep away from excess moisture, light, and heat. Keep out of reach of children and pets.
Disclaimer
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Do not disregard professional medical advice or delay in seeking it because of something you have read here.
Reviews
Clinical studies and patient reports generally reflect satisfaction with Desyrel’s efficacy in improving sleep quality and alleviating depressive symptoms, particularly noting its usefulness when other sleep aids are not appropriate. Many users appreciate the lack of a “hangover” effect the next day at lower doses. However, experiences with side effects like morning drowsiness or dry mouth vary. It is consistently emphasized that individual responses can differ significantly, and success with this medication depends on proper medical supervision and adherence to prescribed dosing.