What Is Trazodone?
Trazodone is an antidepressant that has been approved by the United States Food and Drug Administration (FDA) to treat adult patients with major depressive disorder [1]. The exact mechanism of action of trazodone is classified as a serotonin receptor antagonist and reuptake inhibitor (SARI), although in simpler terms it works by manipulating serotonin within the brain. Serotonin regulates many functions within the brain, including mood, sleep, and emotional responses. While the primary indication for trazodone is for depression, physicians may also prescribe it “off label” for insomnia or other sleep issues. This occurs because drowsiness is one of the most common side effects of trazodone. “Off label” means that a physician is prescribing a medication in a manner that is not specifically indicated by the FDA label, however, the physician believes it is appropriate for the patient based upon their clinical judgment.
Other common side effects of trazodone can include drowsiness, dizziness, dry mouth, constipation, blurry vision, and lightheadedness. Less common side effects of trazodone can occur in rare cases and may include irregular heartbeat, low blood pressure when standing up, serotonin syndrome, and priapism (prolonged erection) that requires immediate medical evaluation.
Is It Safe to Drink Alcohol With Trazodone?
Unless you have discussed it with your doctor and they have advised it as acceptable for your specific case, you should not consume alcoholic beverages while taking trazodone.
Trazodone product labels warn users that consuming alcohol while taking trazodone may potentiate (increase) the sedative effects of the drug [2]. Therefore, the sedative effect of trazodone can be enhanced by consuming alcohol and vice versa.
You may react differently to a moderate amount of alcohol while taking trazodone compared to when you are not taking trazodone. Additionally, someone who typically experiences no negative effects after one drink may feel excessively sleepy or unsteady while on trazodone.
This matters if you plan to operate a motor vehicle, climb stairs, care for young children, ride public transportation, or take another prescription medication.
What Are the Possible Side Effects of Combining Trazodone and Alcohol?
Combining trazodone with alcohol can impair function. Most concerning is that both substances can cause decreased alertness and coordination.
Some possible combinations of trazodone and alcohol side effects include:
- Increased drowsiness
- Lightheadedness or dizziness
- Decreased reaction time
- Impaired coordination
- Disorientation
- Blackout episodes or memory lapses
- Nausea
- Headaches
- Low blood pressure
- Falling or experiencing injuries
- Exacerbated depression or mood swings
- Making riskier decisions while under the influence
Additionally, chronic consumption of alcohol may eventually lead to decreased sleep quality. Even if alcohol initially induces sleepiness, it can create disruptions later in the evening and subsequently contribute to decreased overall sleep quality. Decreasing overall sleep quality can potentially counteract why a patient is taking trazodone (i.e., treating insomnia or depression-related sleep disturbances).
Will Consuming Alcohol Interfere With How Well Trazodone Works?
Consuming alcohol can negatively affect the efficacy of a number of treatments, including trazodone. Specifically regarding trazodone, studies have shown that even low levels of drinking may decrease the likelihood of responding positively to antidepressants, decrease adherence to prescribed antidepressant regimens, and promote greater impulsivity [3].
Alcohol may also exacerbate mood symptoms in certain individuals, especially when heavy drinking or binge drinking occur frequently.
Since trazodone is often prescribed when someone is attempting to regulate mood or sleep patterns, this represents an added challenge. Drinking can further compromise these efforts by disrupting sleep, contributing to next-day anxiety, amplifying depressive symptomology, and creating inconsistent adherence to medication schedules.
If you are unsure if trazodone is working effectively, examine your consumption of alcohol. Your medication regimen may not be the only limiting factor impacting your mood or sleep.
Is One Glass of Wine Okay?
Regardless of the type of drink consumed, ethanol remains the primary concern when assessing interactions between alcoholic drinks and medications like trazodone.
One glass of wine may induce greater sedation or disorienting effects than anticipated when taking trazodone. Some individuals may experience these effects minimally, whereas others (such as older adults and/or those taking additional medications) may experience greater consequences.
To determine whether drinking while on trazodone poses a risk for you personally, consult with your prescribing physician or pharmacist. This assessment is particularly relevant for individuals who initiated trazodone recently, have recently altered their dosing schedule, take trazodone at bedtime, or have experienced previous incidents involving falls, fainting, lowered blood pressure, liver disease, cardiac arrhythmias, and/or alcohol or substance dependence.
Waiting Period Between Drinking and Taking Trazodone
There exists no universally accepted waiting period between drinking and taking trazodone.
As previously stated, the risks associated with combining alcohol and trazodone depend on several factors including:
- Amount of trazodone dosing schedule (time of day)
- Amount of alcohol consumed
- Age
- Any additional medical conditions being experienced
- Additional prescription or over-the-counter drugs being taken
Trazodone may remain active in the body beyond the point where you take it, i.e., if you feel sleepy or dizzy in the morning after taking trazodone last night.
If your prescriber instructed you not to drink while taking trazodone (or other CNS depressants), please adhere to that instruction. If you have consumed alcohol prior to taking trazodone (or other CNS depressants), contact your prescriber or pharmacist for guidance rather than risking a guess. Please avoid taking additional doses, missing doses consistently, or discontinuing your medication regimen abruptly without consulting your prescriber first.
When Does the Risk Increase?
While the risk posed by combining moderate amounts of alcohol with trazodone can be considerable enough on its own, the risk increases exponentially when combining other sedating substances into the mix.
High-risk combinations include:
- Trazodone, alcohol, and opioids
- Trazodone, alcohol, and benzodiazepines
- Trazodone, alcohol, and sleep medications
- Trazodone, alcohol, and muscle relaxers
- Trazodone, alcohol, and other antidepressants
- Combination of sedating prescriptions or over-the-counter substances
Fatal overdoses have occurred among individuals who took trazodone with other CNS depressant medications including alcohol [4].
This does not imply that every individual who combines trazodone and alcohol will overdose. Rather, caution should be exercised, especially when mixing multiple sedating agents.
Seek immediate medical help if you observe any of the following symptoms among individuals who have combined trazodone and alcohol:
- Severe drowsiness
- Extreme disorientation
- Passage into unconsciousness
- Slowed or shallow breathing
- Chest pain
- Abnormal heart rhythms
- Dizziness to excessive levels
- Loss of consciousness
- Vomiting persistently
- Difficulty staying awake
- Symptoms indicative of an overdose or poisoning from either substance
If you experience any of these symptoms after combining trazodone and alcohol, call 911 immediately.
If the individual cannot be awakened or has blue or gray lips (cyanosis), is having a seizure, or may have also consumed opioids, benzodiazepines, or sleep medications, call 911 immediately as well.
What Should I Do if I Accidentally Drink While on Trazodone?
If you accidentally drank while taking trazodone (or other CNS depressants), don’t panic.
Your actions will now depend on how much you drank, how you feel, and whether you were taking any other substances.
Some safer approaches include:
- Do not operate vehicles around pedestrians
- Do not perform activities that require coordination
- Avoid using additional sedating agents unless directed by a clinician
- Do not drink additional alcoholic beverages
- Ensure someone you trust is present if you feel extremely impaired
- Consult with a pharmacist, prescriber, or poison control center for guidance
- Seek emergency care if symptoms become severe
Depending on your symptoms, your healthcare provider may simply advise monitoring and avoidance of future alcoholic consumption. Conversely, if you are feeling severely sedated, dizzy, faint, or short of breath, seek urgent medical attention.
Sometimes the bigger concern isn’t just the potential dangers of mixing trazodone and alcohol. Sometimes it’s the fact that you really struggle to avoid alcohol altogether, especially since using it might harm the effectiveness of your mental health treatments.
You may want to consider seeking professional help if:
- You continue to consume alcohol despite warnings from your doctor.
- You use alcohol to fall asleep or use it as an aid to help regulate your moods.
- Your use of alcohol interferes with treating your depression, anxiety, or mood swings.
- You experience withdrawal symptoms each time you try to decrease or eliminate alcohol.
- You keep your use of alcohol from a family member or friend.
- You consume more alcohol than you intend to.
- You cannot stop consuming alcohol once you’ve started.
- You mix alcohol with prescribed medications knowing they have side effects due to this action.
- You believe that alcohol makes your depression or sleep issues worse.
Mood disorders and alcohol use disorders commonly occur together. A dual diagnosis treatment program can provide the necessary support to treat these conditions simultaneously and enable individuals to better control their cravings, manage their withdrawal symptoms, and focus on managing their depression, sleep disturbances, and overall recovery without feeling overwhelmed.
Alcohol and Mental Health Treatment at Alpas NOVA
At Alpas Wellness Northern Virginia, we provide compassionate, individualized treatment for people struggling with alcohol use, other substance use, and co-occurring mental health concerns. For people experiencing alcohol or other substance use alongside anxiety, depression, or another mental health condition, we address substance use and co-occurring disorders together through a personalized treatment plan.
If alcohol use, difficulty managing trazodone safely, cravings, withdrawal symptoms, or related mental health concerns have become difficult to manage, you can contact our admissions team for an initial assessment and help determine an appropriate next step in care.
