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February 23, 2019

Trazodone Detox Guide

Trazodone is a popular prescription medication primarily used to treat depression, insomnia, and sleep disorders. Unlike standard antidepressants—commonly known as serotonin reuptake inhibitors (SSRIs)—trazodone is classified as a serotonin antagonist reuptake inhibitor (SARI) and works through a different mechanism of action. Trazodone appears in the marketplace under brand names such as Desyrel, Trialodine, and Oleptro and works by blocking serotonin receptors located in the brain and central nervous system (CNS). This, in turn, prevents serotonin reabsorption and produces a mood-elevating effect.

Although trazodone is not considered a controlled substance subject to the same Drug Enforcement Administration (DEA) regulations as other addictive drugs, its addictive potential remains high.  According to the National Institute of Mental Health (NIMH), approximately 16 million Americans suffered from a major depressive episode within the past year, and approximately 60 million Americans suffered from insomnia. Together, these pervasive mental health conditions form a collective equation that virtually guarantees diversion and abuse.

TRAZODONE WITHDRAWAL SYMPTOMS

Although not typically known for extreme withdrawal symptoms, trazodone is capable of producing a wide range of psychological and physiological effects. If not medically managed, these effects can rapidly accelerate and intensify, a process known as “precipitated withdrawal.” Long-term trazodone abuse—especially accompanied by polysubstance abuse— requires treatment at an inpatient facility to ensure optimal outcomes. Numerous factors including length of addiction, frequency of use, method of ingestion, and intensity of dosage all combine to determine the severity and extent of withdrawal symptoms.

Upon admission into a medically supervised detox program, clients are evaluated using a variety of clinical tools and measurements which help establish optimal medication-assisted treatment (MAT) timelines and appropriate therapies. Trazodone addiction may produce the following withdrawal symptoms, the most severe of which occur after abrupt cessation of use—otherwise known as quitting cold turkey:

  • Dizziness
  • Nausea
  • Perspiration
  • Disorientation
  • Blurred vision
  • Headaches
  • Anxiety
  • Depression
  • Erratic mood swings
  • Tinnitus—ringing in the ears
  • Hypomania
  • Extreme fatigue
  • Seizures
  • Insomnia

TRAZODONE WITHDRAWAL TIMELINE

Establishing an exact withdrawal timeline from antidepressants is difficult due to individual variables. As with withdrawal symptoms, timelines differ depending upon the duration of use, method of ingestion, and intensity of dosage. For example, a client who has habitually snorted trazodone for years may experience a significantly longer and more intense withdrawal process than a client who took the medication occasionally and as prescribed.  Age, overall health, height, weight, and gender also help determine the presentation and length of withdrawal symptoms. Generally speaking, trazodone withdrawal timelines mirror those of other antidepressants affecting serotonin levels in the brain and CNS. The following provides a basic guideline:

  • Stage One—withdrawal symptoms appear within the first two days of cessation—at variable intensity.
  • Stage Two—symptoms reach peak intensity within one week—a period known as acute withdrawal. Following this spike, symptoms gradually diminish in the majority of clients.
  • Stage Three—symptoms continue diminishing in intensity, subsiding after approximately one month.
  • Stage Four—depending upon a combination of factors, clients may experience a milder, protracted phase of withdrawal known as post-acute withdrawal syndrome (PAWS). PAWS typically involves milder psychological, mood-based symptoms that may linger for months or years following cessation. Frequently, polysubstance abuse is a major precipitating factor.

INPATIENT TREATMENT FOR TRAZODONE

Trazodone addiction requires professional intervention. Inpatient treatment is an evidence-based detox method that consists of clients living at a designated residential facility for the duration of treatment. This short-term protocol—which lasts between 30 and 90 days—features numerous benefits and services that are highly beneficial to clients recovering from trazodone and polysubstance addiction. The following are examples of the comprehensive services many inpatient treatment facilities provide:

  • Round-the-clock client monitoring
  • Highly experienced staff physicians
  • Licensed clinical teams
  • A wide range of evidence-based psychotherapies
  • On-site aftercare planning
  • Ancillary benefits and services.

MEDICATION-ASSISTED TREATMENT

Medication-assisted treatment (MAT) represents a critical component of trazodone detox. MAT is a preferred treatment method that combines various pharmacological interventions with behavioral and psychotherapy providing the foundation for successful treatment. In addition to evidence-based therapies including dialectical behavioral therapy (DBT) and cognitive behavioral therapy (CBT), the following modalities may be included in the treatment regimen:

  • Trauma-Informed Therapy
  • Family Therapy
  • Motivational Interviewing (MI)
  • Narrative Therapy
  • Creative and Expressive Therapy

DUAL DIAGNOSIS TREATMENT

Trazodone addiction—and addiction in general—may be caused or exacerbated by underlying mental health issues. Co-occurring disorders such and anxiety and depression, post-traumatic stress disorder (PTSD), antisocial personality disorder (APD), and many others are examples of conditions that increase the likelihood of trazodone addiction. Successful treatment of these precipitating factors may require additional medical and clinical management beyond the primary MAT routine. 

OUTPATIENT TREATMENT

Outpatient treatment is a convenient option for clients with demanding personal and/or professional schedules. Although outpatient facilities feature many of the same benefits and services as inpatient treatment, outpatient treatment is offered on a non-residential basis only. For many clients, outpatient treatment represents a natural progression in continuing care following successful completion of detox and a residential program.  Although outpatient treatment is cheaper than inpatient services, it is generally considered less effective. In addition to the less intensive level of total care, outpatient facilities lack 24/7 clinical supervision and may be inappropriate for those suffering from trazodone or polysubstance addiction.

CAN TRAZODONE DETOX BE DONE AT HOME

Successfully treating trazodone addiction requires the expertise of trained medical and clinical professionals and should never be attempted at home!  The physiological and psychological changes that accompany long-term use may produce a myriad of withdrawal symptoms— all of which are potentially dangerous, and none of which can be effectively managed alone. Even in mild cases, self-guided detox leads to less than favorable treatment outcomes and a higher probability of future relapse.

TAPERED VS COLD TURKEY

Addiction treatment professionals prefer a controlled, tapered approach to trazodone detox. Tapering involves a physician administering trazodone in diminishing doses over a predetermined period of time known as a “tapering schedule.” Quitting trazodone cold turkey is dangerous once physical dependence has been established. For this reason, tapering is considered the safest, most reliable detox method.    

CONSIDERATIONS/HOW TO DECIDE WHAT IS RIGHT FOR YOU

The decision to seek professional treatment for trazodone addiction deserves serious and careful consideration. For the majority of clients, this decision is based largely upon affordability, insurance coverage, and program location. Although choosing a location close to home may be a critical factor for certain clients, many industry renowned treatment centers require out-of-state travel.

Reputable facilities have trained admissions staff available to help answer questions regarding insurance coverage and address cost-related concerns for those seeking treatment. Many programs are also willing to assist those of limited financial means. Private scholarships, federal grants, flexible payment plans, or other alternative arrangements are all examples of options that may be discussed on a need basis. When it comes to the quality of your future and recovery, cost alone should never be the only factor when considering where to seek treatment. The following considerations should also be factored into an educated, well-informed decision:

  • Program reputation—locally and nationally
  • Addition of amenities, aftercare services, and other on-site benefits
  • Use of state-of-the-art technology and evidence-based treatment options
  • Proximity to major recreational attractions (ocean, mountains, etc.)
  • Accessibility from major airports and other convenient means of transportation

RECOVERY SUCCESS AND AFTERCARE SERVICES FOR TRAZODONE

Many clients enter detox intimidated by statistics such as the 40-60 percent relapse rate following treatment—a relatively high percentage. Despite this daunting statistic, long-term recovery is entirely possible. In fact, studies clearly show that after just five years of abstinence, clients enjoy an 85 percent success rate. One of the greatest barriers to long-term abstinence is overconfidence early in the process. Certain clients, confident over their successful completion of initial detox and subsequent treatment, prematurely feel secure in their sobriety and succumb to internal and/or external triggers. Achieving optimal recovery outcomes requires strictly following a comprehensive, evidence-based relapse prevention plan that includes:

  • NA, AA, or other 12-step recovery group involvement
  • Actively working with a sponsor
  • Taking physician-prescribed medications exactly as required
  • Developing a strong sober support network
  • Making healthy dietary and lifestyle decisions
  • Practicing abstinence and avoiding social and environmental triggers
  • Seeking community involvement or volunteer opportunities
  • Continuing individual and/or group therapy
  • Developing a strong sense of spirituality or faith-based outlook

WHO NEEDS TRAZODONE DETOX

Addiction is not a disease affecting only those with known substance use disorders (SUDs) or genetic susceptibility. Anyone, at any time, regardless of race, gender, socioeconomic status, age, or religion can find themselves addicted to trazodone and in need of professional treatment. If you or someone you love are addicted to trazodone and in need of treatment, call a substance abuse professional today. A brighter future begins with the decisions you make today!

For more about trazodone and recovery, check out these related articles:

Sources:

  • Innovations in Clinical Neuroscience. Trazodone for Insomnia: A Systematic Review. July, 2017.
  • CNS Drugs. Rediscovering Trazodone for the Treatment of Major Depressive Disorder. Dec, 2012.
  • The Journal of Neuropsychiatry. Low-Dose Trazodone-Related Drug Eruption. July, 2010.
  • PLOS ONE. The Sedating Antidepressant Trazodone Impairs Sleep-Dependent Cortical Plasticity. July, 2009.
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